December 2011 Archives

Bilirubin is a substance found in the bile of infants.  Bile helps the body digest fats, is produced by the liver, and released into the small intestine to help with the digestion.  A small amount of bile is released into the stool and must therefore be replaced by the liver.  When the liver breaks down old red blood cells, it produces bilirubin, which is then removed from the body through the stool. Elevated bilirubin levels may be an indicator that a baby is in danger of getting certain diseases such kernicterus.  A bilirubin test will measure the amount of bilirubin in a blood sample.

If bilirubin levels rise slightly, this is usually not a problem.  In fact within the first 24 hours after birth, nearly half of all newborns have elevated bilirubin levels.  This is because newborns do not have a liver that is mature enough to break down the excess red blood cells they are born with.  However a high level of bilirubin can cause hearing loss or eye movement problems, mental retardation, and eventually if left untreated, can lead to kernicterus. 

Kernicterus is a form of brain damage that occurs by a high level of bilirubin in an infant's blood.  Elevated bilirubin levels can be caused by severe jaundice which is a yellowing of the skin and eyes of a newborn which may be detected within days of birth.  Severe jaundice can be treated with special lights, phototherapy, or a blood transfusion.

Kernicterus warning signs to pay attention to:

• The baby has an abnormally high pitched cry
• The baby is lethargic and extremely sleepy
• The baby does not respond to touching or startles from sudden movements
• The baby has poor muscle tone
• The baby suffers from seizures
• The baby has a fever

Long term disabilities resulting from kernicterus:

• Movement difficulties
• Hearing loss or deafness
• Problems moving the eyes
• Learning problems

These problems are an important reason why parents need to pay attention to elevated bilirubin levels and jaundice in their newborns.  In the case of kernicterus, prompt treatment may help prevent additional brain damage from occurring.  Treatment for kernicterus includes speech therapy, physical therapy, and special education. 

If you discover your child has kernicterus, you should consult with a birth injury attorney like Dr. Bruce Fagel.  If the kernicterus could have been prevented, you may have a case for medical malpractice. Visit Kernicterus Video for an informative video.

During gestation, the unborn infant faces a variety of threats, including umbilical and placental problems, difficult delivery, and serious illnesses with the mother.  If an infant does not receive an adequate supply of oxygen to the brain, such as from asphyxiation, this can result in a condition called hypoxic ischemic encephalopathy / HIE.  HIE causes injuries to the baby's brain from asphyxia or hypoxia. 

If the baby's brain is starved of oxygen or blood, especially over a period of hours, the infant's brain will attempt to repair the problem.  Depending on the severity of the HIE, the baby's brain may or may not be able to repair itself.  If the condition of the HIE is mild, the brain should be able to repair itself, however, if the condition is serious, the infant's brain attempting to repair the problem may actually cause even more damage.

Hypoxic ischemic encephalopathy occurring at birth may cause serious brain damage to the infant by lowering the oxygen and reducing the heart's output.  When the baby is resuscitated, there will be a sudden increase of blood flow and oxygen, which may end up causing even greater brain injuries to the baby, as the brain is trying to repair the problem.

During hypoxic ischemic encephalopathy, a procedure called brain cooling may help the infant reduce or even avoid the chances of permanent and severe brain damage, and therefore have a healthy life.  Brain cooling uses a cooling cap or water filled blanket that lowers the infant's temperature to 91 degrees Fahrenheit for 72 hours.  By lowering the temperature of the baby, the metabolic rate slows, preventing dangerous chemical reactions from taking place that could trigger additional rounds of dangerous reactions.  Once the baby is subjected to 72 hours of brain cooling, he or she will be slowly and gradually warmed up to a normal body temperature for the next 6 hours.  Studies show that properly applied, brain cooling procedures have reduced death and disabilities in infant's with HIE.

An infant with HIE should only be subjected to the brain cooling procedures if the following conditions apply:

• If the infant suffered brain damage from HIE
• The gestation period for the infant is greater than 36 weeks
• Be initiated within the first 6 hours after birth

Brain hypothermia, is induced by cooling a baby to around 33 degrees Celsius for 3 days after birth and has recently been proven to be the only medical intervention that reduces brain damage and improves a baby's chances of normal survival after birth asphyxia. Brain cooling has become widely used in neonatal units throughout America.

If you believe your child suffered serious injuries due to the negligence of a doctor, nurse, or medical staff, you may have a case for medical negligence or medical malpractice.  Contact a top medical malpractice lawyer like Dr. Bruce G. Fagel, immediately for a free consultation.  Dr. Fagel is both a leading birth injury attorney and a licensed physician, with over 10 year's emergency room experience. So he understands exactly how the birth process should happen and where medical negligence or medical malpractice occurred in a birth injury. 

Each year cancer diagnosis delays or cancer misdiagnosis, leads to enormous suffering and wrongful deaths for thousands of Americans and their families. Cancer is the uncontrollable growth of abnormal cells and can occur anywhere in the body.  These cells can either be cured or they will lead to the eventual death of the patient.  While normal cells multiply when the body has a need for them and then die when the body no longer has a need for them, cancer happens when the growth of cells in the body is uncontrollable and the cells begin to divide too quickly.  Cancer cells also do not die when the body requires them to die.

Early detection for many forms of cancer is critical to improving a patient's survival rate.  With the improvements in cancer treatment over the past couple decades, those with certain types of cancers have a dramatically improved chance of recovery if the cancers are detected and treated early.  The types of cancers that have a good chance of being treated, if treated early in the stages, include colon cancer, breast cancer, lung cancer, and non-small cell cancers.  However, some cancers have a poor chance of recovery no matter what stage the cancer is detected.  These types of cancers include small cell lung cancer, pancreatic cancer, and ovarian cancer.

Proper cancer diagnosis and early detection are critical to helping the patient live a longer and healthier life.  If a doctor fails to diagnose cancer in its early stages, confuses the cancer for another medical condition, or even fails to diagnose the cancer at all, can lead to the spreading of the cancer to other parts of the body and the eventual death of the patient.   

If a cancer misdiagnosis by a doctor for a treatable cancer leads to serious injuries to the patient or death, a medical negligence or medical malpractice lawsuit may be initiated. One critical element in a medical malpractice lawsuit involving cancer is proving that the doctor should have diagnosed the cancer at the early stage and provided proper treatment, preventing the cancer from causing severe damage to the patient.  If the cancer was a type where early treatment would not have made a significant difference, then a medical negligence or medical malpractice lawsuit would likely not be feasible.

Dr. Bruce Fagel has extensive experience dealing with cancer misdiagnosis and delay in diagnosis cases.  In addition to being a top medical malpractice lawyer, Dr. Fagel is also a licensed physician, and has over 10 years emergency room experience.  This extensive combination of experience allows Dr. Fagel to probe medical records and understand if there is a case for medical malpractice.  

A birth injury attorney should be consulted if a child was born with birth injuries resulting from medical negligence or medical malpractice.  A birth injury not only causes serious pain and suffering to a child, but to the family as well.  The child may require a lifetime of medical care, while the parents may require a lifetime of personal and financial sacrifices in order to care for the child.  When a child with serious birth injuries matures into an adult, the sacrifices from everyone involved will continue.  Therefore, if a doctor, nurse, or hospital was responsible for the birth injury, they should be responsible for covering the financial damages in order to help the family properly care for the victim.  This is where the services of a top birth injury attorney, such as Dr. Bruce Fagel should be researched.

There are two main categories of birth injuries from medical negligence that may occur, injuries from lack of oxygen to the brain and injuries from trauma.  Brain injuries that result from a lack of oxygen or blood flow to the brain may occur if a nurse or doctor isn't paying attention to the fetal monitor strip and the strip is showing signs that the baby does not have a proper heart beat for a dangerous period of time.  A trauma injury may occur if the doctor improperly uses a vacuum device or forceps, causing permanent injuries to the infant, or if a cesarean section (C-section) was necessary but not taken.

One of the most serious birth injuries that a baby may sustain during labor or delivery is cerebral palsy.  Cerebral palsy is a group of neurological disorders that may involve the brain and nervous system functions, including movement, learning, and thinking.  Cerebral palsy is caused by injuries to the brain.  The conditions of cerebral palsy can range from mild to severe and the child may require a lifetime of medical care.  Symptoms range from the child not being able to perform fine motor skills to the inability to walk.  Severe cases may include involuntary body motions, seizures, and mental retardation.   Early symptoms may include developmental delays and lack of muscle coordination.  Although cerebral palsy symptoms may not be noticed right away in an infant, they should become apparent by the time the child is three years old.

Birth injuries from trauma will usually occur during a vaginal delivery from the improper use of forceps or a vacuum device used to extract the baby during a difficult delivery.  These instruments can cause serious and permanent injuries to the baby's head and brain.  A common birth injury from trauma involves the stretching of the brachial plexus nerves, which is known as Erbs palsy.  If the baby's head is too big to fit through the birth canal, a C-section may be required.  If the C-section can't be performed or it is too late to perform the C- section, then the doctor will need to use the vacuum or forceps to help in the delivery.  In some cases involving brachial plexus injuries, the doctor may use too much force when twisting the baby's head through the birth canal, causing the brachial plexus nerves to damaged, causing paralysis to the hand or arm of the baby.

Gastric bypass surgery modifies the patient's digestive system to help them lose weight by limiting how much the patient can eat or reducing the absorption of nutrients.  Gastric bypass surgery makes the stomach smaller and allows the food to bypass part of the small intestine.  The surgery takes a loop of bowel and bypasses the major portion of the stomach, creating a small pouch instead that makes the patient eating feel full with a much smaller portion of food.  Since part of the intestine is bypassed when the food is consumed, the patient is also absorbing fewer calories. 

Since gastric bypass surgery has become one of the most common elective surgical procedures, people tend to think there aren't any dangers involved.  However, gastric bypass surgery is still a major abdominal surgery, and therefore thought must be put into the risks of this procedure before moving forward.  For example, risks include an infection occurring in the area where the incision is made, leakage from the stomach into the abdominal cavity, anesthesia complications, which can lead to brain damage and death.

Gastric bypass surgery negligence can occur from anesthesia complications.  Anesthesia errors or anesthesia mistakes can happen if the medical staff fails to properly communicate with each other, doesn't understand the medical condition of the patient, or the anesthetist is not properly trained.  Also, many gastric bypass surgeries, as well as other elective plastic surgeries are performed in non-hospital medical clinics or doctor's offices.  Since these elective surgeries are performed outside of hospitals, these facilities often do not have properly trained medical staff with the necessary resources prepared to handle emergencies.  Even in hospitals, sometimes the medical staff make serious errors during elective surgeries that lead to injuries to the patient, including brain damage or death.

If you or someone you love was a victim of gastric bypass surgery negligence or other plastic surgery negligence and suffered serious injuries, you may have a case for medical negligence or medical malpractice.  Dr. Bruce G. Fagel is a leading medical malpractice attorney specializing in surgical negligence.  In fact, Dr. Fagel is not only a top medical malpractice lawyer, he is also a licensed medical doctor and practiced emergency room medicine for over 10 years.  This strong medical background and legal experience gives Dr. Fagel and his clients the edge when dealing with negligent doctors or medical staff.  If you would like more information, including a free consultation, contact the Law Offices of Dr. Bruce G. Fagel & Associates today. There is also an informative video about gastric bypass surgery problems.

A major problem is occurring in emergency rooms throughout the country.  Hospital emergency rooms are usually overcrowded and medical staff often overworked.  When this happens, medical errors and medical mistakes are more likely to occur.  Most emergency room errors don't cause critical injuries to the patients and many may not even be noticeable; however, some medical errors result in serious injuries or even death for patients.  

Problems with overcrowded emergency rooms or overworked medical staff can crop up when patients are kept waiting too long or the medical personnel rush too quickly through examinations.  If a patient with a serious injury who needs immediate medical attention is kept waiting too long, the injury can become critical.  Another problem is misdiagnosis.  If an overworked doctor or nurse is lacking in sleep, or in a hurry, he or she may provide an incorrect diagnosis for the patient, resulting in a serious medical injury.  

Unlike patients who visit hospitals or medical centers for elective surgery, patients who visit the emergency room do not have the opportunity to interview the doctor and medical staff prior to surgery or medical care.  Patients who visit emergency rooms often need emergency medical attention immediately; therefore, they must trust that the doctors and nurses will provide the proper diagnosis and treatment, and in a timely fashion.

Dr. Bruce Fagel is both a top medical malpractice lawyer and a licensed physician.  Prior to becoming an attorney, Dr. Fagel practiced emergency medicine for over 10 years, working in emergency rooms at hospitals.  Dr. Fagel knows first-hand how emergency rooms are supposed to operate, including during peak periods or when there is a shortage of medical staff.  Dr. Fagel also understands how to detect medical negligence in an emergency room or hospital.  Bruce Fagel uses his expertise as both a medical malpractice attorney and a licensed medical doctor to examine the medical records. He also knows how to ask the right questions with a negligent medical staff during a deposition or trial. Medical personnel understand medicine very well and are often able to confuse an attorney with complicated medical terminology; however, being a licensed physician, Dr. Fagel knows how to get to the facts and find where the medical negligence occurred in a medical malpractice case.  

Medical malpractice cases are often the most complicated and expensive cases to pursue.  Proving that a doctor, nurse, or hospital was responsible for medical malpractice or medical negligence requires proving the connection between the negligent care and the patient's injury or death.  This is why it is critical for a victim of medical malpractice to find an attorney like Dr. Bruce G. Fagel who specializes in medical malpractice cases, understands the medical field, and has a strong track record of winning cases and obtaining maximum settlements for his clients.

Anesthetists and anesthesiologists are responsible for administering anesthesia to the patients and for the safety of the patients before, during, and after surgical procedures.  An anesthetist is a nurse who is board certified in anesthesia and may work under the supervision of a physician, whereas an anesthesiologist is a physician who completes an accredited residency program in anesthesiology.

Anesthesiologists are one of the most important medical professionals involved with a surgical operation.  Not only do they provide pain relief for a patient during surgery, they also monitor the patient to make sure they wake up properly after the surgery. Anesthesiologists have control over the patient's critical life functions during surgery, including the patient's breathing and heart rate.  Therefore, a patient under anesthesia is vulnerable to severe injuries or even death if medical negligence occurs.  This requires very careful monitoring by the anesthetist or anesthesiologist before, during, and after the surgery to make sure the patient doesn't have a dangerous reaction to the drug or the surgery.  Because of the dangers of administering anesthesia, anesthetists and anesthesiologists receive extensive medical training in their field.

Often, anesthesia errors can be quickly corrected during a surgery; however, sometimes the errors may result in severe and permanent brain injuries, a coma, even death.  Patients considering surgery often meet with their doctors and surgeons to discuss the surgery and any complications; however, they rarely ever meet with their anesthetists.   Most people think anesthesia is used in hospitals for major surgeries, but they often forget that anesthesia is also used for elective surgeries in medical clinics, cosmetic clinics, and the dentist office.  Someone electing for a simple plastic surgery operation, is vulnerable to an anesthesia error, just like the patient going in for a major surgery.  In fact medical clinics, cosmetic clinics, and dentist offices are often more dangerous than hospitals because if a patient runs into a serious emergency in one of these facilities, the medical facilities likely do not have quick access to a specialized nursing staff or doctors to handle the emergency.  While the medical facility scrambles to contact professional help, such as calling an ambulance, the patient will be losing precious minutes that may result in a critical brain injury or death.

Most people think once an operation is completed and the operation was successful, the danger is over.  This is an incorrect assumption.  Many patients have been critically injured post-surgery, after a successful operation, due to anesthesia negligence. 

If you or a loved one has suffered a serious injury from an anesthesia error, you may have a case for medical negligence or medical malpractice.  Contact Dr. Bruce Fagel for a free consultation.  Dr. Fagel is a leading medical malpractice attorney and a licensed physician.  In addition to 30 years practicing law, Dr. Fagel worked for over 10 years as an emergency room physician, so he understands medical negligence, including anesthesia errors.

If a victim of medical malpractice died from the negligence of a doctor, nurse, hospital, or medical center, then a wrongful death claim may be filed.  Wrongful death cases address damages the victim can recover differently than other medical malpractice claims.

Determining how much money the victim's family in a wrongful death case will receive can be very complicated.  Add to that, some states restrict how much money victim's families may recover.  California is one such state restricting the amount of non-economic damages for the plaintiff to $250,000.  However, it is important to note that the $250,000 limit is for non-economic damages; regarding economic damages, there is no set limit.  The income and age of the wrongful death victim play a large part in how much economic damages may be awarded in a wrongful death case.  California even recognizes economic value for non-monetary services a wrongful death victim may have provided to his or her family, such as child care.

Another complication with wrongful death cases involves the elderly or patients with complex underlying medical conditions.  In situations like this an autopsy often is not conducted and the cause of death is left to the opinion of the doctor. Even when an autopsy may be provided under these circumstances, it may not provide adequate evidence that negligence caused the death.

Who are the plaintiffs in a wrongful death case?

• The plaintiffs of a wrongful death case are the heirs to the descendant
• If the wrongful death involves a child, the parents are the heirs
• If the wrongful death victim was married, then the heirs are the spouse and any children
• If the patient was not married, then the heirs would be the children. 
• If the victim had no children, then the heirs would be the parents.  If the parents are not alive, then the heirs would be the victim's siblings.

The death of a family member is one of the most terrible experiences a family can go through.  The grieving family has the right to know what caused the death of their loved one and they are entitled to proper compensation for their loss.  This includes both the non-economical and economical losses they incur.  Dr. Fagel is both a leading wrongful death attorney and a licensed medical doctor. Dr. Fagel understands how to interpret the medical records and autopsy report, and how to ask the right questions from the medical staff in order to get the family members the answers they need and the compensation they are depending upon.  Visit wrongful death video for more information.

The most common medical mistake leading to medical negligence in hospitals is medication errors.  Over 1.5 million cases of medication errors are reported each year in the United States.  Take into consideration that these are just the cases that were actually detected and documented (the total number of medication errors are likely far higher.)  The problem is so large, that on average, every person who is hospitalized in the U.S. receives at least one medication error every day.  Although the majority of the time medication errors do not cause any significant or even noticeable harm to the patient, sometimes the injuries they cause are enormous and permanent.  In fact, occasionally, medical errors even lead to the death of the patient.

The Law Offices of Dr. Bruce G. Fagel & Associates has extensive experience dealing with cases involving medication errors.  For example, we have had cases where patients incorrectly were administered Heparin, a blood thinner, which can cause serious injuries to the brain if the patients can't tolerate the medication in their condition. We had cases where patients were incorrectly administered lethal doses of Demerol due to a simple miscommunication of the doctors, causing the death of the patients.

Did my doctor give me the wrong medication or an overdose of medicine?

If a doctor prescribed the wrong medication or an overdose of the correct medication, evidence of this error can usually be detected by the administration of a corrective medication.  For example, if a doctor or nurse, administered an overdose of narcotic pain medications, which could likely happen if a doctor or nurse exiting one shift failed to notify the new shift doctor or nurse that they had already given a dose of the medication, then the new shift doctor may administer Narcan to counter the effects.  Another example could be a doctor or nurse administering an overdose of Heparin.  After realizing the mistake, they may then administer Protamine to reverse the effects.

This is why retaining the services of an experienced medical malpractice attorney is critical to the success or failure of a medical negligence or medical malpractice case. Dr. Bruce Fagel is both a licensed medical doctor and a leading medical malpractice attorney.  This unique background of being both a medical malpractice lawyer and a licensed physician enables Dr. Fagel to thoroughly investigate the medical records and determine if a medical error was responsible for the serious injuries or even death to the patient.  Being a medical doctor also helps Dr. Fagel in the deposition and court room when questioning doctors, nurses, and medical staff.  Medical professionals often use complicated medical jargon to confuse attorneys; however, this does not work with an experienced medical malpractice attorney who is also a licensed medical doctor.