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Braces and Dental Malpractice

Tuesday, August 28th, 2012

There are some tooth facts that we just all know. Here’s a quick list off the top of my head: Don’t gorge yourself on Halloween candy and expect to have a good dental check; Don’t eat caramel and candy apples if you have capped front teeth; Don’t carry dentures in your back pocket.

On the other hand, sometimes you should be able to depend on your dentist for wisdom and not just caring for your wisdom teeth. (I know, I shouldn’t go down the tooth humor path).

 

 

 

 

 

 

Most of the time, I really have no interest in even discussing malpractice. In my own life, I have had such great experiences with the medical profession. However, there have been some dental cases that have simply ticked me off.

That’s how I felt when I read the UPI story about the Oregon dentist who caused someone permanent injury. Brad Chvatal provided orthodontic care to Devin Best for most of his childhood years. That included braces.

Normally, braces are to be worn for a period of 1 to 3 years. For some reason, this dentist kept him in braces for 11 years.  As a result, Best suffered injuries to his gums, mouth and teeth.

For me, I guess that I am blogging on it to send this story just a little farther on the Internet.  True dental malpractice. A kid that depended on his dentist and was hurt by it.

In the article, the President of the American Association of Orthodontists was quoted as saying that he “could not think of an instance” where someone would ever need to wear braces for 11 years. The reporter in the article attempted to get some explanation from the dentist about his conduct. All he would say was that the situation “was very complicated”.

For pic o’ day, I decided that I wasn’t going to post anything else dental. Instead, I thought I would focus on something more positive. How about that everyone should exercise!

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A Positive From a Negative

Thursday, April 12th, 2012

Tucked in the Obituary section of the Richmond Times Dispatch is the notice of the passing of 87-year-old Dr. Allan Unger. His life is a lesson in taking a “No” and turning it into a tremendous impact on a multitude of lives.

Dr Unger worked at Richmond’s Medical College of Virginia (later to become known as VCU Medical Center)  after graduating from the Medical College of Virginia School of Medicine. He had decided to become a doctor, after serving in an Army evacuation hospital during World War II.  He was looking forward to a career in medicine, as a surgeon. That career path changed when he was diagnosed with chronic Hepatitis. At that time, it was suggested that he should avoid a surgical career.

Faced with this life obstacle, he soon decided to become MCV’s first nephrologist, to work with those suffering from kidney disease and related kidney problems. Soon, he persuaded MCV to purchase an artificial kidney, as the first hospital in Virginia to now be able to perform dialysis.

From those beginnings resulting from that purchase, he was known as the founder of the dialysis program at MCV. According to his biography, the machine was described as heavy; made out of steel mesh, and requiring two “burly” men to carry it from a truck.

This machine was used to keep Oklahoman Bill Merriman alive two years later, while his 26-year-old identical twin was prepped to donate his kidney. It would be the first kidney transplant performed in the state of Virginia.

Dr Unger managed Merriman’s life threatening blood pressure until Dr David M. Hume was able to perform that kidney transplant. Today, the VCU Transplant Center is named after Dr. Hume. Probably, that advancement and even the transplant department would not have existed at that time, without the initial purchase of that rotating drum primitive dialysis machine.

After serving on the MCV faculty, Dr Unger moved to San Francisco in 1960.  There, he helped  to start the California Pacific Medical Center’s kidney transplant service and became the first chief of the hospital’s department of nephrology.

Dr Unger passed away on March 29 in San Francisco. He had retired from medical practice there in 1989. All those lives were touched because he didn’t let life’s circumstances stop him. He just went around the obstacle and kept moving forward. I never knew him, but he certainly had impact on my life because of the great Nephrology Department at VCU Medical Center.

For pic o’ day, I thought that I would look for something related to hard work. I came across the following which made me think, “Please never let me do this”!  :)

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Link of Organ Donation

Sunday, February 19th, 2012

    February 19, 2008, I was behind a curtain at the hospital; lying (always get that “laying” and “lying” confused) under a cover, with no one in sight. I was all prepped and ready to go for a kidney transplant. My wife, was my donor. A while earlier, they had brought her by just before taking her off to surgery. Now, I was just waiting. 

     All of a sudden, the curtain moved and the nurse came in quickly with a “let’s go, I have to get you down there”. I have never moved that fast in the hospital. Well, I really had nothing to do with it since I was just along for the ride. Apparently, once the doctor says that they are ready; they are ready to transplant. One of those times that they can’t start without you.

     I remember a lot of details of that morning. Well, I remember, until that moment when the doctor put the mask on me and said, “start counting backwards”. Not so much detail from that point.

     Now, I celebrate 4 years of good health because of that day. Coincidentally, I just read the NY Times story  of 60 lives and 30 kidneys that was all coordinated through the non-profit National Kidney Registry.   

     Waiting for the kidney of a deceased donor can take at least five years, and those needing a transplant have difficulty waiting. This NY Times story is about one donor who started a chain of living donation. He wanted to help a friend who was in kidney failure, but he wasn’t a match. But, by being willing to donate to a stranger through the registry, he was able to ultimately facilitate a donor for his friend.

     The link joined 30 people who were willing to donate, to create matches for another 30 in need of a kidney transplant. The momentum of one donor ended up coordinating 17 hospitals in 11 states. For some needing a kidney, it was like finding a “kidney in a haystack”. But, with this chain of selflessness, it was possible. This 6 page article is filled with the moving stories of the impact of transplant and how these 60 people are now all connected. I think you’ll enjoy it if you click to it. It has pictures of the sixty person chain.

     Donors and recipients become members of an unofficial club. Sure, we might tell each other jokes like, “did you hear the one about the man who got a kidney transplant from a dog….. he can’t stop himself from chasing the mailman”. Well, maybe we really don’t sit around telling jokes, but there is a tremendous connection. What a gift that I have been given and I am so thankful. 

     On our firm homepage, you can click for instructions to become a donor and register it on your driver’s license. You really can make a difference.  

 I thought that for pic o’ it would be appropriate to just put a bunch of smiles for celebration:

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Hospital Assignment Form

Wednesday, February 15th, 2012

When it’s time to sit down and do a blog, sometimes I am faced with ”which one to choose?”. I thought the “choice” gave me an excuse to use these coconuts. Now that I’ve attached them, I kind of find them a bit distracting.

So, let me get to the blogging.  Today, I saw correspondence from a hospital that made me shake my head. But, let me start from the beginning.      

     A few months ago, a lady was involved in a car crash that broke her arm. She was taken by ambulance to a South Carolina hospital. They initially began treating her by casting the arm and giving her pain medication.

     Then, while she was sitting there, someone from the hospital billing came with forms for her to sign. By now, the pain medication had kicked in. She doesn’t have a clear memory of all the events but she does remember signing with her left hand; since her right, dominant hand was in a cast.

     About a month later, the lady called us to represent her. After she signed a medical authorization form, we requested her medical records from the hospital.   Soon, we received those records which also included that original billing assignment form that she had signed with her left hand.

     On the form, we noticed that it authorized The Joel Bieber Firm to protect this hospital bill at the time of settlement or disbursement. Not that unusual except; At the time that the client had signed the form, I’m not sure if she had decided to hire a lawyer for her crash. I do know that she had not hired or even called us.

     When this lady had signed the form, apparently there was a blank there. After the hospital received our letter of representation, they just filled in the form with ”The Joel Bieber Firm”. Effectively, they changed the assignment form.

     Can you imagine ever thinking that you would sign a contract or form, and then having someone just add to it several days later? Apparently, this hospital does it on accident cases. Someone, I think, has some strange thinking going on in their coconuts, over at that billing department! 

     And for pic o’ day, I saw a story about singer, Shakira, almost being attacked by a Sea Lion. Thankfully her brother rescued her. Not a story for the blog; but I decided to look up pictures of Sea Lions. The first picture made me smile. OK, the second one does too. It compares to a character on “The Office”.

 

  

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Legionnaires at the Luxor

Wednesday, February 1st, 2012

    

      A few years back, I received an unusual phone call. The caller said that an injury happened at a hotel, while in a hot tub. I immediately assumed that someone had fallen.

     A husband and wife were in a hotel hot tub and had contracted Legionnaire’s disease from bacteria in the hot tub. The one was experiencing some significant symptoms including memory loss and dizziness. 

     At that time, I knew only a little bit about Legionnaires and how it attacked the immune system. I quickly googled it and was reminded that Legionnaires ‘ disease derived its name from a 1976 Philadelphia American Legion convention, where an outbreak occurred. Completely unexpected.

     After some quick research I was retained on the case. We ultimately resolved the case a couple of years ago. The injuries included of pneumonia and permanent problems of brain injury and  neurological deficits; all from a hot tub in an expensive hotel.

     Recently, the Luxor Hotel in Las Vegas, Nevada, has been in the news relating to claims that guests have been diagnosed with Legionnaires disease. The Southern Nevada Health District has reported three cases in the past year. One man has even died.

     Water samples from the Hotel/Casino found traces of the bacteria in their water. Typically, the disease takes the form of a fever/pneumonia or an upper respiratory illness. Symptoms usually become prevalent within 2 weeks of exposure, which makes it harder to figure out the source. If antibiotics are not started quickly, then the mortality rate can be as high as 30%. Even worse in a hospital, where a person’s immune system is already potentially weakened.

     Usually during treatment, doctors ask about travel history. Poorly ventilated areas around water; or showers, hot tubs or heating/air conditioning  sytems can all be high exposure areas.

     Luxor Hotel has predictably gone into defense mode by quickly outlining all the steps that have been taken since the bacteria has been discovered. I blog on this because, after handling that case, it has made me much more aware during travel, to try to pay attention to ventilation issues in the room. Plus, I never consider it “an upgrade” when a hotel front desk tries to move me to a room that includes a hot tub. No thank you. I’d rather sleep in a closet size room.

     If you click on the disease attachment above, it will give you a much better description of the disease. It just wasn’t something that I thought about before that original phone call.

     Sometimes I find it very hard to switch to pic o’ day after a serious issue. But, then I realize I need a good smile.

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Defense Medical Exam

Thursday, July 14th, 2011

     I had been practicing law in Virginia for about three months. My employer had thrown me right in,which included handling several depositions.

     I noticed that insurance companies kept hiring the same doctor to give medical opinions. The defense lawyers called these opinions an “Independent Medical Exam”.

     I soon noticed that the same doctor kept getting hired by different defense attorneys.  (for the sake of this blog, I’ll call him Dr Nappy) Sometimes, he would see our injured clients for the defense and give his opinion. I noticed the consistency of those repeated written opinions.

      Other times, he simply gave his opinion after reviewing the medical records in the case. Each time, the opinion was similar;  He would say that the client should have gotten better. He would go on to say that they needed no treatment and certainly had no permanent injury.

     In about the first month or so, I had already taken this same doctor’s deposition, multiple tims. There were different attorneys on the other side, defending these cases, but the doctor was adamant in his opinion.

      As a young lawyer, I tried to combat him with my enthusiasm but I’m not sure that I made much impact on his “independent medical opinion”. He frustrated me and I didn’t think that such opinion was fair to the clients.

     Shortly thereafter, I received a phone call from a defense lawyer.  ”Hey, did you hear what happened to Dr Nappy?” he asked. I hadn’t heard anything and I was supposed to take his deposition again in the upcoming weeks.

     The defense lawyer went on to tell me that Dr Nappy had done surgery in the emergency room. Then, he changed and left. Just as he stepped out of the hospital door, someone hit him over the head with a baseball bat.

     He was found and rushed back inside. The same team that had just been with him in surgery, was now working to save his life. He ultimately lived but had a head injury and never returned to work.

     Later, I was told that nothing was stolen. This occurred before security cameras and no one was ever charged. It was speculated that either an unhappy patient had assaulted him, or someone angry from his defense opinions,  had taken “justice/injustice”  into their own hands.

     The doctor had impacted many cases by his consistent defense testimony. I will never understand the motivation of doctors that do such a thing by always testifying for the defense. Maybe some really believe that all claimants are faking. Whatever his motivation; that certainly doesn’t mean that he deserved such a horrible injury.

     It is my belief that such doctors are not effective in testifying and I always hope that jurors see through their motivations and testimony. Many times, for testifying, these defense medical witnesses receive more money than the treating doctors, that  provided the actual medical treatment. Of course, the opinion by these hired doctors would not be used by defense lawyers, if they were not favorable to the defense.

     As referenced earlier, this doctor never testified or did reviews again. Shortly thereafter, I started seeing another doctor “on the circuit”.  I have learned that there seems to always be someone else willing to step up.  

     I’m not sure how they find these “opinion givers” that they can count on. I just rely on the jury system to overcome the testimony of these hired opinion-givers.

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A Pantry of Fears

Tuesday, June 28th, 2011

Daily Bread reminded me of the story of the mother who asked her 5-year-old to go to the pantry and get a can of chicken noodle soup. As he got close, he stopped and didn’t want to go in to get the soup.

“What’s wrong with you?” the mother asked. The little boy hung his head and said that he didn’t want to go into the pantry “because it’s dark in there”.

His mom assured him that it was okay. “Don’t be afraid, Jesus is in there.” The boy slowly opened the door and began to peer in. Then, without going in he shouted, “Jesus, can you hand me a can of chicken noodle soup?”

All of us call it “planning” when we look into the future. What are we going to do about meeting bills or retirement? Is President Obama driving us off a cliff or do we worry if he’s not re-elected? Rep. Michele Bachman has never had a bill or resolution passed and never chaired a committee or subcommittee. How can she be President?

Is the US Supreme Court so “pro-business” that it is eliminating personal rights and ignoring the concept of precedence. Is Tom Cruise and Katie Holmes expecting another baby and trying to take over the world with their beliefs of Scientology?

I just saw that the Virginia Governor and Attorney General are attending a policy seminar in Colorado, that is organized by two brothers (Koch) that have made their money, primarily in the Oil and Chemical business. Their beliefs revolve around eliminating government regulation and letting corporations be free to work.

When one of Kochs ran on the Libertarian Party Presidential ticketin 1980, the platform included the following: (from Wikipedia) “abolish Social Security, the Federal Reserve Board, welfare, minimum-wage laws, corporate taxes, all price supports and subsidies for agriculture and business, and U.S. Federal agencies including the SEC, EPA, ICC, FTC, OSHA, FBI, CIA, and DOE.[2][12] The ticket proposed legalization of prostitution, recreational drugs, and suicide.

The wealthy have the ears of our politicians and I haven’t even included worries of flying, the ego of Lebron James, or whether your cell phone plan has enough minutes and enough bars.

I’ve gone overboard to discuss worry because one of the greatest damages in many auto accident cases is mental anguish and worry and future medical expense. Many clients ask, “What is going to happen for my care. Who is going to pay for it?” These damages are sometimes the most ridiculed by the defense.

Also, such future damages of what is out there for the future, face some cap limitations in some states. Maryland caps pain and suffering and mental anguish, at 750K. Worries of what is out there for future limitations and surgery may be the greatest damage in a case.

It’s easy to be afraid of the future. Will I have my health? Will I have a job? Will I have enough for retirement? We can feel like the little boy looking into the pantry; the uncertainty brings the most fear. It is the same worry in dealing with the future of injury.

The History of “The Serenity Prayer” (also modified and adopted by some 12 step programs) tells us that the Armed Forces adopted a prayer for soldiers and army chaplains, that was attributed to a minister named Reinhold Niebuhr. It was to help as they faced the fears and difficulties of war. A familar prayer; but also, a good reminder:

“O God and Heavenly Father, Grant to us the serenity of mind to accept that which cannot be changed; courage to change that which can be changed, and wisdom to know the one from the other, through Jesus Christ our Lord, Amen”

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Bedtime for Governor McDonnell’s Veto

Monday, April 11th, 2011

     I just saw an article about a lawyer who defends railroads,  in lawsuits. She described people that get injured or killed by  trains as trespassers. The defense is that you shouldn’t get in the way of that train.  I wouldn’t have thought up that kind of defense; but, I guess, it works as a defense or they wouldn’t use it.

    When Ronald Reagan was running for President, he received a great deal of joking over his role in “Bedtime for Bonzo“. It was the story of a professor who was determined to prove his point with the help of a chimp. That choices of right and wrong are effected by your environment and other influences.

     I’m not sure that I ever was able to really watch the movie in its entirety, but I do remember that it didn’t stop him from being elected President; though I suspect that he personally disagreed with the premise of the movie.

     There were some great quotes in the movie.  One man was discussing a shady character. “When he  was buried,  there wasn’t a dry eye in the cell block”.  

     In this last Virginia General Assembly, one bill sailed through the house and Senate. It’s purpose was to increase the  dollar cap on a possible recovery in  malpractice lawsuits.

     It passed the House of Delegates by a margin of 89-8. The Senate then passed it on a 40-0 vote and sent it to the Governor for signature and into law. It had been passed by both governing bodies because it was a compromise between the Medical Society of Virginia, the Virginia Hospital and Healthcare Association, and the Virginia Trial Lawyers Association. Basically, all sides agreed to this bill.

     The real math of the bill was to raise the malpractice cap from the current 2 million, to a cap of 3 million over the next 20 years. The cap would be raised by 50K per year until it reached the 3 million in the year 2031. HB 771 basically was considered a mathematical increase over 20 years, with an eye toward the time value of that period of years.  

     Despite the compromise and expected passage and signature of the Governor, Governor McDonnell vetoed the bill and stated that, “While I commend the affected stakeholders for working diligently together; increasing the medical malpractice will ultimately lead towards higher health care costs for doctors, hospitals, businesses and, most importantly, patients”.

     In my next blog, I will speculate as to why Governor McDonnell vetoed this bill. I’ve always wanted a part 2.  I captioned this blog “Bedtime for Governor McDonnell’s Veto” because I think that his veto has a reason. When the Legislature overturned the Governor’s  veto and  made HB 1459 a law, they were, by an overwhelming vote in both chambers, disagreeing with the Governor’s statement.  It officially goes into effect on July 1.

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Dollars For Docs Follow-Up

Sunday, January 9th, 2011

     In my previous blog, ”Drug Companies Paying Doctors“ , I cited a database called “”Dollars for Docs” that has attempted to compile  information on payments, that drug companies have made to doctors.

     It is not my opinion that just because a doctor receives compensation from a drug company, that it should mean that such payment means influence over that doctor.

     Unfortunately, there is not enough funding for doctors. Many times, the difficulty in even filling out the paperwork to try to receive research grants, can be overwhelming. Plus, many doctors, that I know, are already working long hours and fighting insurance companies to even get a portion of their entitled billing.

     I just thought that I would attach the website (here) which will allow you to plug in the name of any healthcare provider, to determine what monies that they might be receiving from the Pharmaceutical Industry.

     To me, it’s no different than lobbyists interacting with legislators on Capitol Hill. We know that industries contribute to campaigns. That doesn’t mean that every legislator is being “bought” by every contribution. 

     The reality is that medical treatment and research does cost money;  just like political campaigns cost money. I just think that it’s good to know who is paying and who is receiving.

     This website is not an exhaustive list. There are many doctors and payments still not listed. It is a good place to start. It goes along with the old saying that “information is the greatest commodity”.

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Fake Medical Research

Tuesday, January 26th, 2010

Imagine the following wonderful television advertisement. A friendly announcer's voice tells us that, "It has now been proven that eating chocolate increases muscle definition, causes weigh loss and, in certain circumstances has shown to regrow hair in men 55 and older." The ad then goes on to say, "new research has also shown that chocolate is the fountain of youth. Ask your doctor if chocolate is right for you".

First, as I was typing this blog, I wanted to believe this myself. In fact, I gave some thought to just hitting the publish button, to make myself feel good. However, the title of this blog is "Fake Medical Research", so you know that the ending here is not what we want. Second, this doesn't mean that chocolate doesn't have some value. I do like chocolate!  I just wish that what I am blogging below, only related to the humor or benefits of chocolate. Unfortunately, fraud is the culprit.

I post on fake research because the Associated Press has reported that federal prosecutors have announced that they have filed a health care fraud charge against a Massachusetts anesthesiologist, who reportedly used fake research data. In 21 published studies he suggested that Vioxx and Celebrex provided certain after-surgery special benefits. According to findings, Dr Scott Ruben has admitted to making up some or all of his supportive data for these studies, that were published during 2002-2007 and that the published findings had no scientific basis.

    This tale of phony research came to light last year when the hospital where he worked, found that this doctor had faked the data. At that time the Boston US attorney began looking into his conduct, as well. It was also found that during the period of these published studies, Pfizer had give Dr. Reuben five research grants, in conjunction with his published findings. Pfizer is the distributor of Celebrex.

 I blog on this for two reasons:  there is a connection to Pfizer and this law firm's hormone therapy litigation. The primary defendant in most of these lawsuits is Wyeth. In October, Wyeth was purchased by Pfizer. In the hormone therapy jury trials, the defense has called experts to testify on behalf of the drug company. I also blog on this because it shows that just because a drug company advertises benefits does not mean we shouldn't question the statements.  

Back to the fraud, an analysis of Reuben's relationship to Pfizer also shows that he was a member of the company's speakers bureau and gave talks to other colleagues about Pfizer's drugs. Despite this relationship, I didn't see any mention of Pfizer's concern over Reuben and his false data, when reading this Associated Press article. 

The FDA relies on the published data, when these drug companies seek approval. It's obvious that the advancement of science and cure is greatly effected by fraud. Plus, fraud is not the only concern when there is evidence that Celebrex and Vioxx are responsible, in certain instances, for causing death. Considering that, what responsibility does a drug company  owe when relying on such information? Is it fair that they can just keep their profits and turn a blind eye to such? Hopefully, juries will hold drug companies accountable for such actions or omissions.

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Categories : Drug Reactions
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