A MEDICAL MASK OF DEATH

By DAREH GREGORIAN
May 23, 2007 -- Dr. Sherrell Aston, one of the world's most acclaimed cosmetic surgeons, is being sued by a Connecticut man who claims the renowned doctor's "gross negligence" led to his wife's death.

Susan Malitz, 56, had gone to Manhattan Eye, Ear and Throat Hospital in 2004 for what was supposed to be a routine face-lift operation by Aston, whose patients have reportedly included Tipper Gore, Anna Wintour and Catherine Deneuve.

Two hours later, Malitz was dead - the second patient to die during cosmetic surgery at the hospital in a two-month period.

Malitz's doctor husband, Alan Malitz, filed a $3 million suit against the hospital, Aston and two other physicians, charging them with medical malpractice that caused his wife's wrongful death. Aston, who is known as the "Aesthetic Magician of the Stars," took the witness stand yesterday to say he hadn't done anything wrong.

"You're saying nothing you did, your staff did, did anything to harm this patient?" Malitz's incredulous lawyer, Tom Moore, asked Aston.

"Absolutely," Aston answered.

Moore noted that the city Medical Examiner's Office found Malitz, who'd gone to see Aston for a face and eyelid lift, had died of "Lidocaine toxicity" - an overdose of the painkiller Lidocaine.

Aston admitted ordering the amount of Lidocaine that Malitz was to receive, and acknowledged that he hadn't taken the 5-foot-1, 115-pound mom's weight into account, but he maintained that's not what killed her. Asked if the coroner who worked on the case was wrong, he said, "Yes."

"She made one mistake after the other," Aston said. "She didn't even understand the drugs she'd been given."

He also disputed the M.E.'s finding that the drug had accidentally been injected into her larynx, and suggested evidence of a needle track in her neck was the result of shoddy handling of the mom's organs by the M.E.

Aston, who will be cross-examined by his own lawyer today, is the chairman of the hospital's plastic-surgery de partment.

The husband of socialite Muffie Potter Aston, he was labeled an "Aesthetic Magician" in the current edition of L'Uomo Vogue, which reported that he counted former presidential candidate Bob Dole among his celebrity clients.

The year Malitz died was a bad one for the hospital. "First Wives Club" author Olivia Goldsmith died during cosmetic surgery just weeks before Malitz.

Later that year, another woman suffered brain damage during plastic surgery at the hospital. The victim in that case also was represented by Moore, and settled her suit for $7 million.
source : www.nypost.com

Doctors 'forged medical records to hide malpractice'

By Ran Reznick

Medical records were forged and evidence falsified in a medical file by at least one of three pediatricians at the Bnei Zion Medical Center in Haifa, northern district prosecutors said yesterday. The three stand accused by the state of medical malpractice.

In an urgent communique to Judge Mordechai Argaman of the Krayot Magistrate's Court in Kiryat Ata, the prosecution said the falsified evidence created the impression that proper care had been given to Ziv Shriki, now 8 years old. Shriki became brain-damaged allegedly after being administered an overdose of medication and then not being properly treated.
The prosecution said at least some of the doctors knowingly submitted this evidence to the court. The police were informed of these suspicions yesterday, and began questioning staff at Bnei Zion's records department.

Ziv Shriki was treated in Bnei Zion's cancer ward. She recovered from cancer, but in June 2001 she was diagnosed with irreversible brain damage due to alleged failures in the medical and nursing care she received. According to the indictment, a nurse gave Shriki 100 times the dosage she was supposed to have received. After this incident, the three doctors involved behaved in a seriously negligent manner.

The indictment was issued by attorney Bassem Kundelfat, the northern district deputy prosecutor, against Professor Michael Yaffe, then-head of the Bnei Zion pediatrics department (now retired); Dr. Dina Atias, head of the pediatric hematology and hematology-oncology department; Dr. Yulia Nobikov, then-pediatric resident at Bnei Zion, who now works for a health maintenance organization; and nurse Lilia Oskatz, who admitted to the infractions and was sentenced to six months in prison commuted to community service, and a monetary fine.

The doctors are charged with ignoring signs of deterioration in Shriki's condition. Yaffe is also charged with "showing indifference" to Shriki's worsening situation, and with not examining Shriki thoroughly, even though he passed through her ward on rounds.

In March, Yaffe's attorney Nimrod Lipsker asked Gila Inbar, a pediatric nurse at Bnei Zion who witnessed Shriki's treatment, about Yaffe's examination of Shriki on June 25, 2001. Inbar was also shown a document from the child's medical file allegedly written that night by the duty physician, Nobikov. According to the document, Shriki's condition was normal; Yaffe examined the child and reported by phone to Atias. The defense submitted the document as supporting evidence to show Shriki received proper medical follow-up and Yaffe had personally checked her.

Then, in April, at the request of the defense, the court ordered Shriki's original medical file from the hospital, which the prosecution received on Thursday. The file contains Nobikov's notes as they were presented to the court. However, the prosecution discovered in Bnei Zion's records department another photocopy of Shriki's file, apparently made the day after the incident. This file contains the same page, but lacks Nobikov's alleged real-time notation on Shriki's normal condition and her examination by Yaffe.

"In comparing the documents, it appears the medical notation was allegedly forged by the accused (or some of them), who added details ... to make it appear that the notation was made in real time ... of examinations ostensibly carried out on the girl and instructions for treatment ... this interpretation is being sent for police investigation on suspicion of forgery by a public servant, falsifying evidence and knowingly making use of false evidence to mislead the judicial authority."

Attorney Doron Caspi, representing Ziv's parents, Ilan and Ayala Shriki, said the family had rejected Yaffe's claims all along. "Having been present at their child's hospital bedside the whole time, we said all along that Prof. Yaffe's claim that he examined her in real time is not true. The suspicions now revealed support our claims and show how far the medical staff is willing to go to cover up its negligence."

The doctors yesterday denied the allegations. "Instead of properly conducting the trial," Lipsker said, "the prosecution prefers to spread baseless accusations." Lipsker also said the allegation that the records were falsified is illogical since it was the defense that had requested the original records.

Attorney Ofer Doron, representing Nobikov, said, "The medical record as it was presented in court accurately reflects the girl's treatment, and when a note was added after the events, this was specifically stated."

Attorney Erna Lin, representing Atias, declined to comment, saying the issue was under police investigation.

source : www.haaretz.com

Dealing with medical malpractice in court

By SARAH STARR
Register Citizen Staff
The serious illness, injury or death of a loved one - or of oneself - is one of the most draining experiences that most people ever face. These feelings are only made worse when you begin to suspect that the doctor or hospital may not have done all they could to help the situation, or that something done by a health care provider may have actually caused the injury or death.
About 80,000 people die in the United States each year due partly to medical malpractice, according to an study entitled "Patients, Doctors and Lawyers: Medical Injury, Malpractice Litigation, and Patient Compensation in New York," published by the Harvard Medical Practice Study in 1990 and cited by the Consumer Action and Information Center of Hawaii.
Only about 2 percent of those injured by physicians' negligence seek compensation through a lawsuit, according to a 1991 article in the New England Journal of Medicine also cited by the group.
The first thing you should do if you think you have experienced medical malpractice, according to attorney Andrew Groher of the Hartford, Conn.-based law firm Riscassi and Davis, is retain a lawyer to help you sort through the complexities of the case, and to determine if you have a case worth pursuing in court.
"It's even hard for us [to determine what is and isn't malpractice]," Groher said. "That's why we use consultants from the health care field concerned."
Groher stresses that you do not have to come to the lawyer's office armed with sheafs of damning evidence in order to have a successful case.
"People come to us sometimes with nothing more than benefit statements," he said. "Or they just come in and tell us their story, or their loved one's story."
He warns, though, that you do not have an unlimited timeframe to file suit if you think you have been injured by medical negligence, stating that the statute of limitations is usually two years from the time you reasonably should have discovered the malpractice, and no more than three years from the date of the actual alleged negligence.
Another concern is how long a case takes to bring to fruition, from the time you go to a lawyer until the case has come to a conclusion in court. According to Groher, a case can take anywhere from one year in an area with less crowded court dockets, up to two to three years in a large city or other area with very busy courts.
"A year is optimistic," Groher said.
Medical malpractice also has another side, however. A February 2006 study, prepared by PricewaterhouseCoopers for America's Health Insurance Plans and cited by the Insurance Information Institute, found that medical liability costs and defensive medicine account for 10 percent of medical care costs. Defensive medicine is when doctors order tests and medicine, or make referrals to specialists, that they do not really feel are necessary, in order to protect themselves from being accused of negligence.
An obstetrician in Florida, one of the states with the highest premiums, may pay up to $260,000 per year on malpractice insurance, according to William G. Plested, President of the American Medical Association.
According to Plested, high premiums regularly drive doctors who have never been accused of malpractice out of business, because they cannot afford to swallow the cost anymore. It compels other physicians to go without any malpractice insurance, which is not actually required to practice.
If you are injured through negligence by a doctor who has no malpractice insurance, you can go after their assets, but doctors who are doing so will typically be employing a number of dodges, such as having all their accounts in their wife's name or putting assets overseas, Plested said.
However, Plested stresses that this is not the main problem.
"The whole system is upside down," Plested said. "It goes after the most qualified people we have."
source : www.registercitizen.com

Medical Malpractice - Vetting The Case

About 95-98% of medical malpractice inquiries to my office are rejected. Having previously discussed medical malpractice law and the economics of bringing such an action, mostly for the med-bloggers and tort "reformers" who tune in to this station, let's turn to the decision-making process for a short step-by-step. Remember that, since the case will not settle easily, and the painful economics of the contingency fee punish you harshly for picking poorly, the case better be strong. And one can safely assume that, as Ronald Miller points out at the Maryland Injury Lawyer Blog, the doctor or hospital will not admit an error.

1. The Phone Call: Most inquiries don't make it past this stage. Often, the complaint is of a bad result, discourteous conduct that leads to suspicions, or a plain old failure to understand what happened. This can be related to bad bedside manner, or an individual that unexpectedly finds himself listening to complicated medicine while in a state of high anxiety and distress. The potential client often doesn't know how, if at all, the doctor departed from accepted medical practice. (When the call is made by another attorney seeking to forward the case on to me, the rejection rate is lower since s/he has already done a vetting process.)

2. The Interview: You find out more in person than by phone. Some people already have records or portions of records that help to reconstruct what happened. Friends and relatives may have bits and pieces of information that help. The reliability of the potential client(s) can also be evaluated.

3. The Record Review: This is often the first real expenditure, so you have to have a pretty good idea that the matter is worth pursuing. In New York, you'll be hit for 75 cents a page, and the page totals can be daunting for substantial injuries. Then comes the hours of review. Assuming the matter still warrants attention after these three steps, we go to the expert(s).

4. The Expert Review: There is no case without an expert, unless you have a rare res ipsa case. And your expert has to be good, or s/he will get chewed up during a trial. If you hire an expert that is, shall we say, flexible with the standards of care and willing to go the extra mile for you, you will likely find yourself bankrupt. Bad cases don't settle. About 70% of malpractice cases are lost at trial, and juries don't like to bring back verdicts against doctors. The expert who reviews a bad case and tells you "no" is helping you while the expert that tells you "yes" is hurting you. Choose wisely.

5. The Other Expert Review: Remember that the negligence must be a substantial cause of the injuries. It doesn't help you to win the liability phase of the trial if there is no causation. While an internist might be able to testify on the breast lump that should have been biopsied, it is the oncologist that you need for discussion of whether the length of the delay in treatment was significant. There is a good chance you need multiple experts, just to decide if a case should be brought.

This process, a form of which exists in any law office that takes such cases on a regular basis, results in substantially weeding out the bad claims.

Finally -- and this is not an issue often discussed -- those that advocate dismembering the malpractice system and replacing it with some type of no-fault or other system with lower barriers fail to realize that it would result in an absolute flood of matters pouring in, significantly eclipsing that which now exists. But that, I suppose, is a question for another day.
source : www.tortdeform.com

Why Attorney General Gonzales Should Resign

by Richard D. McLellan
After it looked like he may have dodged a bullet in U.S. Attorney firing matter, Attorney General Alberto Gonzales is again drawing heavy fire from the Congress and the media.

Should he resign for the good of the country and to help the Bush
Administration regain some credibility?
The slow motion collapse of General Gonzales’ reputation and ability to lead the Justice Department is painful to watch, unfair and damaging to both the Administration and the Justice Department. But the time has come for Gonzales to depart for Texas and give the President the opportunity to name an Attorney General who can serve undistracted for the remaining 2 1/2 years of the Bush Presidency.

This is unfortunate since the evidence to date suggests there has been no misconduct on the part of the Attorney General that would require the President to discharge him. There is, however, a growing public record of mistakes, misjudgments, revised explanations and weak oversight to suggest that the Attorney General should voluntarily step down.

As a lawyer in private practice with more than 30 years of experience hiring, firing and managing lawyers, I looked at General Gonzales situation from the framework of what would happen in private practice.

When large law firms get in trouble -- and they all do -- certain strategies have proved to be effective in managing a serious malpractice claim or similar disaster. Let’s look at how these strategies might apply in the Gonzales situation.

First, when allegations are made against a lawyer, no matter how senior, a firm immediately removes that lawyer from direct involvement in evaluating the claim.

Removing the lawyer involved does not imply that the firm agrees improper conduct occurred. It recognizes that no individual can fairly investigate his or her own conduct. Any well run law firm immediately wants an independent evaluation of the facts before mounting a defense.

The clumsy way the Gonzales Justice Department has responded to attorney firing issue seems to reflect a department in disarray. Whenever an allegation is met with explanations involving multiple revisions it is almost impossible to regain credibility.

Unfortunately, the Attorney General of the United States cannot duck appearing before a hostile Congress to explain his conduct. But by mishandling the initial reactions and investigation in the first instance, General Gonzales has destroyed his ability to recover.
Second, in private law practice the client is always right.

All law firms have had a situation develop where a client loses confidence in a particular lawyer or the law firm. Frequently the lawyer or law firm has not mishandled the matter or given the client any reason for the mistrust.

But lawyers and law firms recognize that the client’s judgment is what counts. When a client loses confidence in a particular lawyer, the wise lawyer will immediately withdraw and assign another lawyer to the case. This is for the benefit of the firm and the client and usually works to the long term benefit of the lawyer involved.

Similarly, a law firm may voluntarily give up a representation even though the client is mistaken regarding the cause of the loss of confidence. It is often better to part company amicably than to wait for the curt pink slip letter from the client.

General Gonzales needs to recognize that he is the Attorney General of the United States and the People are his ultimate clients. He is not the Attorney General of the George W. Bush White House. And he should recognize that he has lost the confidence of a large number of his clients.

Like it or not, the U.S. Attorney firing matter has given visibility to a wide range of judgment errors, lack of oversight and memory lapses that raise questions as to competence of the Attorney General.

In my view, none of these matters suggest that General Gonzales has engaged in unethical or improper conduct. They do, however, suggest that he is deeply enmeshed in a series of matters that call in to question his competence.

The country and the President need a competent Attorney General for the remaining 20 months of the Bush Presidency. There is no shortage of highly qualified and respected Republican lawyers that could honorably serve the President and restore the integrity of the Department of Justice.

Lawyers in private practice need to know when to step aside for their own and their firm’s benefit and in fairness to their clients.

General Gonzales should do the same and step aside for the benefit of the Department of Justice and in fairness to his clients -- both the President and the People.
source : www.humanevents.com

Doctor convicted of fraud

Paul Egan / The Detroit News
DETROIT -- A Detroit doctor faces a possible 15-year prison sentence after a federal jury on Monday convicted him and his medical biller of 80 counts of conspiracy, health care fraud and mail fraud.

U.S. District Judge Marianne O. Battani ordered Dr. Zack Brown, 61, taken immediately into custody following the unanimous guilty verdict on all counts.

"I think that he is a danger to the community," Battani said of the physician, who has two previous felony convictions.

Brown's medical biller, Davell Culberson, 68, also of Detroit, was released on bond until Sept. 6, when he and Brown are to be sentenced.

Together, Brown and Culberson were charged with defrauding Blue Cross Blue Shield of more than $750,000 between 1999 and 2004. Assistant U.S. Attorney James Mitzelfeld told jurors the pair used the insurer's health cards like ATM cards.

The jury deliberated less than an hour following a trial that spanned three weeks.

Health care fraud "increases the cost of health care for all citizens of Michigan, which is something we can't afford," said U.S. Attorney Stephen Murphy.

Brown's lawyer, John Minock of Ann Arbor, said he will appeal the verdict based on evidence he said should not have been admitted.

Culberson's lawyer, Paul Muller of Farmington, argued his client never knowingly submitted a fraudulent bill. Muller could not immediately be reached.

In 1996, Blue Cross removed Brown's rights to bill the insurer directly, meaning Brown's patients had to bill. Brown was accused of recruiting patients who submitted bills for physical therapy, injections and other treatment they never received and split the proceeds with the doctor.

But Brown got sloppy, the court was told, billing for ultrasound and hot pack treatments on Aug. 15, 2003 -- a day the entire region was under a massive blackout.

Brown was convicted of mail fraud in 1987 and dispensing drugs without a license in 1995.

source :www.detnews.com

Pair charged in Brockton slaying

By Maureen Boyle, Enterprise staff writer

BROCKTON — Two men are accused of killing a 22-year-old Brockton man with a single gunshot to the head last week.

Ronnie Perry, 21, of 10 Danube St., Boston and Christopher Williams, 24, of 57 Forest Ave., Everett, were to be arraigned today on murder charges in Brockton District Court.

The two are accused of killing Luodgy Colas, 22, in a Rutland Street apartment May 15.

“It does not appear to be a random act,” Assistant District Attorney Bridget Norton Middleton said of the killing.

Details of what led police to the suspects or what sparked the killing were not released Sunday. Additional information is expected to be released when the pair appear before a judge today.

State and Brockton police arrested the two without incident at their homes Saturday following an intensive investigation.

Colas was at the home of an acquaintance when the shooting occurred at about 12:30 p.m. at 19 Rutland St.

Colas was found inside, suffering from a gunshot wound to the head. He was taken by ambulance to Caritas Good Samaritan Medical Center, where he was pronounced dead.

An autopsy by the medical examiner determined the cause of death was a single gunshot wound to the head.

At the time of the shooting, a neighbor said a woman carrying a child came out of the house, her shirt covered with blood.

Neighbors had described the area as a quiet neighborhood with few problems.

Plymouth County District Attorney Timothy J. Cruz, in a prepared statement, said the arrests followed an intensive investigation by police.

“They have worked around the clock to solve this murder and their talent and their hard work are to be commended,” he said.

source :www.enterprise.southofboston.com

Jail paying more for inmates' medical expenses

Associated Press
Monday May 21, 2007
EVANSVILLE

The Vanderburgh County Jail has spent so much money on medical care for inmates this year that the sheriff is asking the county for more money to cover expenses, and some say bigger medical bills for inmates are becoming more common statewide.

Vanderburgh County is on pace to spend more than $800,000 this year for inmates' medical expenses - more than four times the amount spent six years ago.

Some Indiana sheriffs say the cost increases are caused by several reasons, including price hikes in the cost of medicine, jails providing more expensive services, drugs for HIV-positive inmates and treatment for methamphetamine addicts in poor health.

"It's one of those expenses that nobody enjoys," Vanderburgh County Sheriff Eric Williams said. "But it is an expense that is a burden to us."

Vanderburgh County spent $152,153 on medical and dental expenses for inmates in 2002. So far this year, the county has spent more than $300,000. Williams has asked the County Council for an additional $500,000 to cover expenses the rest of the year.

Howard Williams, an attorney for the Indiana Sheriff's Association, said increasing medical expenses are a statewide problem.

"The jails have become a poor man's HMO," he said. "What happens essentially is that when an individual gets arrested, he may not have seen a doctor in years, but as soon as he's booked into the jail, he wants his teeth checked. He's got bad headaches, so he wants his eyes checked. Or he claims to have some other issue. We've got people in jail who have kidney dialysis that costs us $6,000 a month to take care of that. And they are there on some petty crime."

Dr. Ruston Stoltz visits the Vanderburgh County Jail at least once a week and sees up to 80 patients a day.

"We've moved toward more of continuing the care that the patient had when they came in rather than doing it as a temporary depot," Stoltz said. "I don't think we used to be as aggressive with psychiatric medicine as we are now. It's really expensive."

Chief Deputy Sheriff Dave Wedding said the problem is widespread.

"That's kind of a nationwide epidemic - mental health care being cut so drastically," Wedding said. "It's happening in prisons, jails. We get them straightened out; they get released; they can't afford it or don't follow up to stay on it and come back."
source : www.reporter-times.com

Diabetes Pill Tied to Heart Risks

By MARILYNN MARCHIONE
The Associated Press
Monday, May 21, 2007; 11:04 PM

-- A widely used diabetes pill raises the risk of heart attacks and possibly death, according to a scientific analysis that reveals what some experts are calling another Vioxx-like example of the government failing to protect the public from an unsafe drug.

More than 6 million people worldwide have taken the drug, sold as Avandia and Avandamet, since it came on the market eight years ago to help control blood sugar in people with the most common form of diabetes. About 1 million Americans use it now.
Pooled results of dozens of studies on nearly 28,000 people revealed a 43 percent higher risk of heart attack for those taking Avandia compared to people taking other diabetes drugs or no diabetes medication, according to the analysis published online Monday. The study, published by the New England Journal of Medicine, also found a trend toward more heart-related deaths.

The findings are frightening because two-thirds of diabetics die of heart problems, so a drug that boosts this possibility is especially hazardous for them.

Still, the actual risks to any single patient appear small. Diabetics should talk to their doctors before stopping any medication, said a statement issued by the American Diabetes Association and two groups of heart doctors.

Avandia's maker, British-based GlaxoSmithKline PLC, disputed the results of the analysis but acknowledged that its own similar review found a 30 percent increased risk _ information it gave last August and possibly even earlier to the U.S. Food and Drug Administration. But the company said that more rigorous studies did not confirm excess risk.

FDA officials issued a safety alert on Monday and said they likely would convene an advisory panel, but planned no immediate changes to the current side effect warnings on the drug's packaging.

Several members of Congress expressed alarm. Rep. Henry Waxman, D-Calif., chairman of the House Committee on Oversight and Government Reform, announced a hearing for June 6 on FDA's role. On the Senate floor, Charles Grassley, R-Iowa, criticized the agency for not acting more swiftly.

"Do we have another Vioxx on our hands with Avandia? I am not sure, but I intend to find out," he said, referring to the blockbuster arthritis drug withdrawn in 2004 because of safety problems. "Tens of millions of prescriptions have been written for Avandia, and Medicare and Medicaid have paid hundreds of millions of dollars for this drug."

Avandia is used to treat Type 2 diabetes, the most common form of the disease, which is linked to obesity and afflicts 18 million Americans and 200 million people worldwide. This form of diabetes occurs when the body does not make enough insulin or cannot effectively use what it manages to produce.

Avandia, or rosiglitazone, helps sensitize the body to insulin and was considered a breakthrough medication for blood-sugar control. It also is combined with metformin and sold as Avandamet. Only one other drug like it _ pioglitazone, sold as Actos and Actoplus Met by Takeda Pharmaceuticals _ is sold in the United States.

Avandia had total U.S. sales of $2.2 billion in 2006, slightly trailing $2.6 billion for Actos, according to IMS Health, a healthcare information company. About 13 million Avandia prescriptions were filled in the U.S. last year. A one-month supply of Avandia sells for between $90 and $170.
source : www.washingtonpost.com

State: Doctors forged medical records to hide malpractice

By Ran Reznick, Haaretz Correspondent

Medical records were forged and evidence falsified in a medical file by at least one of three pediatricians at the Bnei Zion Medical Center in Haifa, northern district prosecutors said on Sunday. The three stand accused by the state of medical malpractice.

In an urgent communique to Judge Mordechai Argaman of the Krayot Magistrate's Court in Kiryat Ata, the prosecution said the falsified evidence created the impression that proper care had been given to Ziv Shriki, now 8 years old.

Shriki became brain-damaged allegedly after being administered an overdose of medication and then not being properly treated.

The prosecution said at least some of the doctors knowingly submitted this evidence to the court. The police were informed of these suspicions on Sunday, and began questioning staff at Bnei Zion's records department.

Ziv Shriki was treated in Bnei Zion's cancer ward. She recovered from cancer, but in June 2001 she was diagnosed with irreversible brain damage due to alleged failures in the medical and nursing care she received.

According to the indictment, a nurse gave Shriki 100 times the dosage she was supposed to have received. After this incident, the three doctors involved behaved in a seriously negligent manner.

The indictment was issued by attorney Bassem Kundelfat, the northern district deputy prosecutor, against Professor Michael Yaffe, then-head of the Bnei Zion pediatrics department (now retired); Dr. Dina Atias, head of the pediatric hematology and hematology-oncology
department; Dr. Yulia Nobikov, then-pediatric resident at Bnei Zion, who now works for a health maintenance organization; and nurse Lilia Oskatz, who admitted to the infractions and was sentenced to six months in prison commuted to community service, and a monetary fine.

The doctors are charged with ignoring signs of deterioration in Shriki's condition. Yaffe is also charged with "showing indifference" to Shriki's worsening condition, and with not examining Shriki thoroughly, even though he passed through her ward on rounds.

In March, Yaffe's attorney Nimrod Lipsker asked Gila Inbar, a pediatric nurse at Bnei Zion who witnessed Shriki's treatment, about Yaffe's examination of Shriki on June 25, 2001. Inbar was also shown a document from the child's medical file allegedly written that night by the duty physician, Nobikov.

According to the document, Shriki's condition was normal; Yaffe examined the child and reported by phone to Atias.

The defense submitted the document as supporting evidence to show Shriki received proper medical follow-up and Yaffe had personally checked her.

Then, in April, at the request of the defense, the court ordered Shriki's original medical file from the hospital, which the prosecution received on Thursday. The file contains Nobikov's notes as they were presented to the court.

However, the prosecution discovered in Bnei Zion's records department another photocopy of Shriki's file, apparently made the day after the incident. This file contains the same page, but lacks Nobikov's alleged real-time notation on Shriki's normal condition and her examination by Yaffe.

"In comparing the documents, it appears the medical notation was allegedly forged by the accused (or some of them), who added details ... to make it appear that the notation was made in real time ... of examinations ostensibly carried out on the girl and instructions for
treatment ... this interpretation is being sent for police investigation on suspicion of forgery by a public servant, falsifying evidence and knowingly making use of false evidence to mislead the judicial authority," the judge's report reads.

Attorney Doron Caspi, representing Ziv's parents, Ilan and Ayala Shriki, said the family had rejected Yaffe's claims all along. "Having been present at their child's hospital bedside the whole time, they said all along that Prof. Yaffe's claim that he examined her in real time is not true. The suspicions now revealed support their claims and show how far the medical staff is willing to go to cover up its negligence," he said.

The doctors denied the allegations on Sunday. "Instead of properly conducting the trial," Lipsker said, "the prosecution prefers to spread baseless accusations." Lipsker also said the allegation that the records were falsified is illogical since it was the defense that had requested the original records.

Attorney Ofer Doron, representing Nobikov, said, "The medical record as it was presented in court accurately reflects the girl's treatment, and when a note was added after the events, this was specifically stated."

Attorney Erna Lin, representing Atias, declined to comment, saying the issue was under police investigation.
source : www.haaretz.com

Monitoring pain at execution almost impossible, doctor says

RALEIGH

A doctor who served as the attending physician at several state executions said yesterday that it would have been “practically impossible” to monitor pain and suffering of the condemned inmates from where he stood while observing their deaths.

Dr. Obi Umesi, the doctor at the Wake County Jail who has worked shifts at Raleigh’s Central Prison for about 10 years, said he was not assigned to monitor any medical equipment during the executions. He only signed the forms to certify the inmate’s death after the execution.

Umesi testified before Administrative Law Judge Fred Morrison as defense attorneys for several death-row inmates argued against the state’s death-penalty procedure.

Kevin Bradley, an attorney representing inmate Archie Billings, told Morrison that he and others were unfairly denied a chance to speak to the Council of State before the panel approved a new process for executing prisoners in February.

Yesterday’s proceeding is the latest in the series of legal battles about the fate of the state’s death penalty, which is effectively on hold as state officials try to figure out how to execute inmates while appeasing both a federal judge, who has demanded last year that a doctor oversee the process, and the state medical board, which threatened in January to punish doctors who participate in an execution.

Umesi’s testimony matched comments that he made in March to the News & Observer of Raleigh, and defense attorneys said then that the comments suggest that the state didn’t follow the orders of U.S. District Judge Malcolm J. Howard last year when executing Samuel R. Flippen and Willie Brown Jr.

Howard allowed the executions to proceed only after he was satisfied that the N.C. Department of Correction planned to have a doctor and a nurse ensure that the inmates were fully unconscious before being killed.

Following the medical board’s ruling that doctors cannot ethically take part in an execution, state correction officials altered North Carolina’s execution protocol in an attempt to find a compromise.

A Wake County judge, however, citing a law passed in 1919, ruled that the Council of State must approve such a change.

The council, made up of Gov. Mike Easley and nine statewide elected officials, did so. But adoption of the new protocol hasn’t been enough to fully smooth over the legal fallout of the medical board’s ruling.

The N.C. Attorney General’s Office’s sued the board in March, after trying and failing to reach a compromise that would allow executions to continue.

That suit, which is still pending, said that correction officials have been unable to find a doctor willing to take part in an execution since the board issued its threat.
source : www.journalnow.com

N. Texas Man Calls For Medical Help, Gets Tasered

CBS 11 News) WAXAHACHIE A Waxahachie man says a call for help turned out be his worst nightmare.

According to Allen Nelms a 911 call for paramedics ended with him being tasered by police. Nelms says excessive force was used for no reason.

Nelms called 911 to get medical attention for a diabetic seizure, but says at least three Waxahachie police officers kicked in his front door and asked him to get on the floor.

"He said I launched at him, but I turned this way. I didn't go at him, otherwise I would have got hit in the face with the tasers," Nelms said.

Nelms says he still has no answer as to why police broke down his door with their guns drawn before shooting him multiple times with a taser as he lay in bed.

Nelms attorney, Rodney Ramsey, says the story just doesn't add up. "Police officers don't normally respond to a 911 call, talk to the homeowner outside in the driveway, and then kick the door in and rush in, unless there's some sort of criminal action."

Chuck Edge, the new Waxahachie police chief, agrees with Ramsey and says police usually don't show up to medical calls.

After Nelms filed a written complaint he says he received a one-paragraph statement from police that indicated the department had concluded an investigation into his allegation of excessive force. He says the investigation took less than five days and the department found that officers operated within policy guidelines.

Nelms plans to file a lawsuit against the City of Waxahachie, the police officer's involved n the incident, and the police department.

Nelms attorney says he believes the incident probably wouldn’t have occurred had the 911 call come from a different location. "The residents of the east side of Waxahachie do not get treated the same as the residents of the other parts of the town. That's a fact," Ramsey said.
source : www.cbs11tv.com

Dealing with medical malpractice in court

By SARAH STARR
Register Citizen Staff
The serious illness, injury or death of a loved one - or of oneself - is one of the most draining experiences that most people ever face. These feelings are only made worse when you begin to suspect that the doctor or hospital may not have done all they could to help the situation, or that something done by a health care provider may have actually caused the injury or death.
About 80,000 people die in the United States each year due partly to medical malpractice, according to an study entitled "Patients, Doctors and Lawyers: Medical Injury, Malpractice Litigation, and Patient Compensation in New York," published by the Harvard Medical Practice Study in 1990 and cited by the Consumer Action and Information Center of Hawaii.
Only about 2 percent of those injured by physicians' negligence seek compensation through a lawsuit, according to a 1991 article in the New England Journal of Medicine also cited by the group.
The first thing you should do if you think you have experienced medical malpractice, according to attorney Andrew Groher of the Hartford, Conn.-based law firm Riscassi and Davis, is retain a lawyer to help you sort through the complexities of the case, and to determine if you have a case worth pursuing in court.
"It's even hard for us [to determine what is and isn't malpractice]," Groher said. "That's why we use consultants from the health care field concerned."
Groher stresses that you do not have to come to the lawyer's office armed with sheafs of damning evidence in order to have a successful case.
"People come to us sometimes with nothing more than benefit statements," he said. "Or they just come in and tell us their story, or their loved one's story."
He warns, though, that you do not have an unlimited timeframe to file suit if you think you have been injured by medical negligence, stating that the statute of limitations is usually two years from the time you reasonably should have discovered the malpractice, and no more than three years from the date of the actual alleged negligence.
Another concern is how long a case takes to bring to fruition, from the time you go to a lawyer until the case has come to a conclusion in court. According to Groher, a case can take anywhere from one year in an area with less crowded court dockets, up to two to three years in a large city or other area with very busy courts.
"A year is optimistic," Groher said.
Medical malpractice also has another side, however. A February 2006 study, prepared by PricewaterhouseCoopers for America's Health Insurance Plans and cited by the Insurance Information Institute, found that medical liability costs and defensive medicine account for 10 percent of medical care costs. Defensive medicine is when doctors order tests and medicine, or make referrals to specialists, that they do not really feel are necessary, in order to protect themselves from being accused of negligence.
An obstetrician in Florida, one of the states with the highest premiums, may pay up to $260,000 per year on malpractice insurance, according to William G. Plested, President of the American Medical Association.
According to Plested, high premiums regularly drive doctors who have never been accused of malpractice out of business, because they cannot afford to swallow the cost anymore. It compels other physicians to go without any malpractice insurance, which is not actually required to practice.
If you are injured through negligence by a doctor who has no malpractice insurance, you can go after their assets, but doctors who are doing so will typically be employing a number of dodges, such as having all their accounts in their wife's name or putting assets overseas, Plested said.
However, Plested stresses that this is not the main problem.
"The whole system is upside down," Plested said. "It goes after the most qualified people we have."
source : www.registercitizen.com

Pocono Medical Center settles overtime suit with workers

EAST STROUDSBURG — Pocono Medical Center will pay up to $280,000 to settle a class-action overtime dispute involving perhaps hundreds of workers.

The East Stroudsburg hospital's parent company — Pocono Health System — and plaintiff attorney Peter Winebrake of Dresher announced the out-of-court settlement of a federal lawsuit in a joint press release.
The May 4 agreement, filed with the Middle District Court of Pennsylvania, stipulates that neither party comment on the terms beyond the wording of their joint news release.

The suit, initially filed on behalf of two kitchen workers, contends the hospital consistently shorted some employees out of legally entitled overtime payments through an "8 and 80" work schedule.

This consists of a four-day work week (then three days off), followed by a six-day work week (then one day off).

Former dietary worker Traci Otto of Stroudsburg and former chef John Junker of Bushkill filed suit objecting to the medical center's failure to pay eight hours of overtime — at time and a half — for each of the six-day, 48-hour weeks.

They claimed this violated federal law.

Hospital management, which admits no wrongdoing in the settlement, contends another provision of federal law allowed them to use the "8 and 80" work schedule for health workers without paying overtime. They said overtime payments are mandated only when the two-week pay period exceeds 80 hours, or if an employee works more than 8 hours in a single day.

"While we firmly believe that our actions were in compliance with the Fair Labor Standards Act, we wanted to resolve the matter in an equitable, timely manner given the significant expense associated with ongoing litigation," Pocono Health System CEO and President Richard J. Henley said in the joint news release.

Winebrake, an attorney specializing in representing workers in wage and hour disputes, said the agreement is fair to past and present employees.

"I'm pleased with the settlement, which allows the hospital's dedicated workforce to receive timely payments and avoid the delays and uncertainties of further litigation," Winebrake said in the press release.

The statement doesn't say The statement doesn't say how many employees are entitled to share in the payments, but that the hospital will pay $280,000 if at least 90 percent of eligible workers opt into the settlement. If 70 percent opt-in, the settlement fund will total $265,000. If 60 percent opt-in, the fund will be $250,000.

Junker — employed at PMC from June 2004 through September 2005 — reached a separate agreement in March for a $10,000 settlement of his claim. The hospital had argued, in part, that Junker was a management employee not entitled to overtime. Junker said he was paid an hourly wage and was treated as a regular wage employee.

Otto — employed from April 2004 through May 2005 — will receive $5,000, in addition to a share from the settlement fund. The agreement says the $5,000 is for her service on behalf of other workers who will share in the settlement, and for "off-the-clock" claims when she says she worked during breaks and meals without compensation.

Winebrake and other plaintiff attorneys will apply to the court for 30 percent of the settlement fund proceeds, plus up to $5,000 for out-of-pocket costs.

Service Employees International Union 1199P, which wasn't a party to the class action lawsuit, won the right last December to represent 525 service and skilled and maintenance workers in collective bargaining. The union and management are in the process of negotiating their first contract.

Neal Bisno, the union's secretary-treasurer, said his organization will work with the plaintiff's attorney to make sure every employee entitled to a share of the settlement gets it. He said the overtime dispute points to the need for the union.

"We'll be working in the contract negotiations so that everyone is paid fairly so that they don't have to go through the courts," Bisno said.

Bisno said he isn't sure how many PMC employees worked the "8 and 80" schedule and might be entitled to compensation under the agreement.
source : www.poconorecord.com

Lawyer: Couple robbed Colchester bank to pay medical bills

NORWICH -- Charles Orbann is a retired former teacher of the year, a grandfather, husband and, now, in what his attorney said is a "bizarre situation," a suspected bank robber.

Charles Orbann, 58, and his wife of 38 years, Dianne Orbann, 56, were arraigned Monday in Norwich Superior Court on charges connected to a midday robbery Friday at the Colchester branch of People's Bank.
The East Hampton couple, who have no prior criminal record, were pulled over and arrested 16 minutes after Charles Orbann allegedly left the bank at 139 S. Main St. with a bag of cash. His wife allegedly drove the waiting getaway car. Police said they found two loaded pistols along with the stolen cash -- an undisclosed amount up to $10,000 -- in the vehicle.

Mounting medical bills, compounded by psychiatric issues, may have motivated the alleged robbery by the couple, said attorney Ron Murphy of New Britain-based Advocates Law Firm.

"It's a sad, sad situation, your honor," Murphy said. "He freaked out over his financial situation."

Charles Orbann was diagnosed with bipolar disorder in 1998, the year he retired from teaching after 25 years at a school outside Philadelphia, Murphy said. At the school, he was twice voted teacher of the year and coached three different sports teams. He was also recently diagnosed with skin cancer and underwent cataract surgery, Murphy said.

Shackled at the ankles and wrists, Charles Orbann patted his hand to his heart and broke into tears as he entered the courtroom.

Two men, identified by Murphy as the son and brother of Charles Orbann, stood as he approached the judge.

"They're here to lend support for Mr. Orbann," Murphy said.

Murphy and attorney Hope C. Steely of the Hartford Firm Santos & Seeley, who represented Dianne Orbann, said the couple had moved from Pennsylvania to follow their son, first to Chicago and three years ago to Connecticut. They are taking care of two grandchildren and collecting Social Security disability, she said.

Dianne Orbann takes medication and is suffering from panic disorder, anxiety, depression and migraines, Seeley said.

"This is one of the most bizarre situations I've ever seen," Murphy told Judge Jack Fischer in arguing for a lower bond.

Fischer, under the recommendation of state prosecutor Thomas Griffin, ordered Dianne Orbann held on $150,000 bond and Charles Orbann on $350,000 bond. Dianne Orbann was later released after posting the money.
source : www.norwichbulletin.com

Hollywood hospital adopts new policy for homeless

LOS ANGELES -- Hollywood Presbyterian Medical Center, whose discharge of a paraplegic man onto skid row earlier this year was widely publicized, says it will adopt new guidelines meant to end the dumping of homeless patients.

The hospital said Friday that it would create new protocols and provide more staff training for discharging homeless patients. The country's largest health maintenance organization, Kaiser Permanente, announced similar reforms on Tuesday.

In February, a 54-year-old paraplegic homeless man discharged from the hospital was found crawling on a street wearing a soiled hospital gown with a colostomy bag still attached.

Chief executive Kaylor Shemberger said Hollywood Presbyterian wanted to become "one of the first hospitals in Los Angeles to respond to the city attorney's request to get on board with the protocols."

City Attorney Rocky Delgadillo is investigating the February dumping.

"This announcement by itself doesn't impact our investigation," Delgadillo said.

Delgadillo had filed criminal charges against Kaiser Permanente over a dumped patient in November, and said he wanted to send a message to hospitals countrywide engaged in patient dumping.

Los Angeles authorities are investigating allegations that a dozen area hospitals have dumped more than 50 homeless patients downtown.
source : www.ctv.ca

Emilio's short life likely to be long remembered

Monday, May 21, 2007

Emilio Gonzales didn't even live 19 months, but his struggle probably will be remembered for years to come.

The poignant case of the toddler who died Saturday evening after spending his last five months on life support at Children's Hospital of Austin will continue to be debated by medical professionals, lawmakers, medical ethicists, theologians and others concerned with end-of-life care, lawyers familiar with the case said.
"Where do we draw the line between the patient's autonomy, on the one hand, and respecting the rights, interests and wishes of the family and the medical and ethical judgments of the health care providers?" asked Michael Regier, general counsel for the Seton Family of Hospitals, which operates Children's Hospital. "His life and death and his experience will serve to illuminate that discussion."

At issue in the case was a basic question that struck a nerve with people around the world: Should doctors have the right to stop treating a patient against a family's wishes?

Under Texas' 1999 Advance Directives Act, doctors have that authority. But many Texans might not have known that until they heard about Emilio, said Jerri Ward, the lead lawyer for Emilio's mother, Catarina Gonzales of Lockhart.

Gonzales wanted every effort made to keep Emilio alive, but doctors urged that the terminally ill child be allowed to die in dignity and peace.

Born blind, deaf and developmentally delayed on Nov. 3, 2005, he was eventually diagnosed with Leigh's disease, a fatal neurometabolic disorder that causes the central nervous system to collapse.

As right-to-life organizations, which oppose abortion and euthanasia, and disability rights groups got involved, Emilio became a cause célèbre.

The organizations' members sent hundreds of e-mails to Gov. Rick Perry and petitioned him to "save Emilio."

"I think his story has educated thousands of Texans about this law, which is pretty much about a stealth law," Ward said. "Most people were unaware that their choices could be overridden in a way that could hasten their death."

The law allows doctors to stop treating a patient whose ongoing care they deem to be medically futile and gives families 10 days to find another doctor or facility willing to treat their loved one.

Gonzales couldn't find a hospital to take her son, whose care was being paid for by two governmental programs, Medicare and Medicaid.

She went to court to stop doctors from unplugging his respirator and planned to challenge the law on constitutional and other grounds at a hearing in Travis County Probate Court on May 30.

Gonzales, who is 23, cried frequently Sunday. She said that although she was interested in pursuing the court case, she wasn't sure what she will do now.

"My son's gone," she said. "Right now, I can't do anything."

Because of complications during her pregnancy, she said, she cannot have more children. She believed that her Catholic faith compelled her to keep Emilio alive, regardless of doctors' beliefs that he could not recover and that continued treatment was prolonging his suffering.

Greg Hooser, chairman of the Advance Directives Act Coalition, helped write the state law. Hooser said Emilio's death could lend greater urgency to passage of proposed changes in the law as the legislative session draws to a close.

"Emilio helped to educate the Legislature with a real-life example, with all the agonies, pain and real-life conflicts that cases such as these bring to bear on all of the parties involved," he said.

Senate Bill 439, authored by Sen. Bob Deuell, R-Greenville, and amended by Rep. Dianne White Delisi, R-Temple, gives families more time to prepare to move their loved ones when doctors want to stop treating patients.

Under current law, families have two days to prepare for an ethics committee review of the doctor's decision to stop treatment. The proposed law would change that to seven days. And the time allotted for a transfer would be extended from 10 days to 21.

Other states are watching how Texas resolves this issue, and Emilio's case could indirectly affect what other legislatures do, Hooser said.

He said that legal scholars are preparing to cite the case in new articles and that Emilio's name has already been invoked by those arguing both sides of the issue.

"This is going to be a case that is going to be talked about for some time to come in a lot of different ways," Regier said. "We're going to see legal experts talk about it in the legal sphere; you're going to see medical experts talk about it, moral theologians talk about it; and legislators and legislative bodies will struggle with what is the right balance."

Regier said Seton supports the changes in SB 439.

Ward said that although the measure improves the law, "that doesn't mean I'm not going to sue."

Ward said she will wait for Gonzales to decide whether to proceed with a legal challenge to the Advance Directives Act. Their case contends that the law is unconstitutional and discriminates against people who are disabled.

Although Emilio's story is about those legal and ethical issues, Ward said, first and foremost, it is about a mother's love for her son. And now, that mother is grieving.

Gonzales knew that doctors had diagnosed Emilio with a terminal illness, but she hoped that she might take him home to die even as doctors said he could not be weaned from a respirator, which required him to be in the intensive care unit.

By Thursday, Emilio had taken a turn for the worse, with a high fever. Gonzales said she knew his time was short, so she stayed with him.

The next day, he worsened. By Saturday, his heart was racing, and Gonzales said she knew he was dying.

"They said he had an infection," she said, adding that he did not receive antibiotics until 6 p.m. Saturday.

An hour later, she called Ward. Her family, including four sisters, a brother and her parents, had already gathered at the bedside. They all held Emilio, she said.

"I told him it was OK to go," she said.

She did not request an autopsy. Regier said an official cause of death was not available Sunday.

Despite her grief, Gonzales said she knew that Emilio was "in a better place."

"I have a lot of peace, but it hurts so much," she said.

She wants her son's funeral to be open to the public.

"I don't know what to do about the funeral expenses," said Gonzales, who quit her cashier job to be with her son last year.

De Leon Funeral Home in Lockhart is in charge of arrangements, which were pending Sunday night.
source : www.statesman.com

Medical Ethics Cannot Control Chinese Military System's Organ Harvest

The communist China State Council announced its first Human Organ Transplant Regulation on April 6, 2007. The regulation indicated that no organization or individual is allowed to sell or buy organs for profit.

Dr. Huang Shih-Wei, an urologist from Chiayi, Taiwan, has been following organ transplant development in China and Taiwan for several years. Dr. Huang pointed out that the most conspicuous problem for China's organ transplant system is that the sources of the organ are unclear.

Sources show that most organ transplants in China take place in military hospitals, which are not under the jurisdiction of the Chinese State Council and Health Ministry.

Dr. Huang said the most ethically questionable fact about the Chinese Communist Party's (CCP) organ transplant system is that the sources of the organs are unclear. A report by two Canadian independent investigators reported that between 2000 and 2005, there were 45,000 organ transplants from undisclosed sources, while another 15,000 organs were thought to be from executed prisoners. The Medical Ethics Commission does not have jurisdiction over organs from unidentified sources.

In the past, there were very few cases of organ donations from living and brain-dead donors in China. The Medical Ethics Commission does not need to give approval since there are no such cases.

The new regulation requires organ donation authorization form, but such an authorization is just a piece of paper, since the regulation is unable to control the authorization and under what circumstances it is obtained. Many say that the CCP forced, induced or forged such authorizations in the past. A regulation will not resolve public suspicion over past practices by the CCP.

The World Medical Association officially disallows organ transplants from executed prisoners, because prisoners are generally granted very few if any rights in prison. In China's prison system, prisoners often suffer inhumane tortures.

The China State Council regulation states that hospitals performing transplants must meet certain criteria. For example, clauses 11 and 14 detail the qualification approval process. From the provision, one can infer that the Chinese government may want to reduce the number of hospitals that are qualified to perform organ transplants.

However, considering the severe and pervasive corruption in China, it is questionable whether such provisions would truly improve the quality of organ transplants, or it may become another way for officials to embezzle while hospitals fight for the qualification.

Dr. Huang said the revised report by the two Canadian independent investigators clearly indicated that the main sources for China's organ transplant are from the military medical system. The two investigators found compelling evidence that the Chinese military hospitals were involved in organ harvesting from living Falun Gong practitioners.

China's communist political system is different from that of other countries. In China, the army is controlled by the Central Military Commission of the CCP, not by the State Council. Similarly, military hospitals are managed by the People's Liberation Army General Logistics Department.

Last November in a speech during the National Organ Transplant Management Summit in Guangzhou, Deputy Minister of Health Huang Jiefu admitted that his Health Ministry had no control over military hospitals.

If the largest source of organ transplants are military hospitals, and the new regulation has no jurisdiction over military hospitals, then the regulation is just an empty shell. Dr. Huang heard from many Taiwanese people who went to China for organ transplants. These patients said that they went to the military hospitals for organ transplants or the operations were performed by military doctors in civilian hospitals.

Many organ transplant agents unequivocally claimed that one must look to the military hospital system for organs, and that civilian hospitals do not have the infrastructure to obtain organs. The statements of these agents agree with the findings in the Canadian investigators's report.

To resolve the crucial issues related to organ transplants in China, the following must goals must be set:

1. Resolve the unclear source for organ transplant problem;
2. Set up a system to register and assign organs for transplant;
3. All organ transplant documents must be available for inspection.

The focus on the unclear source of the organ harvesting is because they suspect that the military system harvests organs from Falun Gong practitioners and executed prisoners. The military medical system is independent from the Health Ministry. The two Canadian investigators provided some insights on how to resolve this problem:

1. The military in China should get out of the organ transplant business.
2. Organ harvesting in China from prisoners should cease.
3. The repression, imprisonment, and mistreatment of Falun Gong practitioners should stop.

However, all these problems are not under the control of Health Ministry or State Council.

In Taiwan or other countries, it is very important to set up a system to register and assign organs for transplant. It is clearly required by Taiwan's Organ Transplant Regulation. This is necessary to maintain ethical accountability and transparency of organ transplants. However, in China organ transplants are used as a tool for profit-making by medical institutions. There is even competition among hospitals to obtain organs.

If China's government truly wants to eliminate such a phenomenon, they should set up a system to register and assign organs for transplant. Even if it does not measure up to acceptable standards for organ transplantation, at least it must require all medical institutions to register the organ transplant cases. Nevertheless, it is important to set up such a system because many Chinese officials and medical professionals are not willing to give up the considerable profits they are making.

There is only one clause in the newly published Organ Transplant Regulation—clause 22 that requires a waiting list for patients in need of organ transplant and provides that Ministry of Health will make rules for fair and open organ assessment on the basis of medical needs.

If such rules are only a principle for hospitals to follow on a voluntary basis, then the rules are useless. A system to register and assign organs for transplant should be required, whether at national or local levels.

For the records about organ transplant, it is most important to preserve the information about the organ donor and recipient. There is no record keeping clause in the regulation at all, which means forced donors's remains are very likely to be destroyed.

There are several common phenomena among Taiwanese patients who went to China for organ transplant. First, many patients used fake names and addresses. Second, patients who did not survive the organ transplant would be cremated immediately and all the documents including death certificates and medical records would not mention organ transplant at all. Last, all the patients were required to pay cash and there were no official receipts.

Based on these, we suspect that all the organ transplant records in China's hospitals are destroyed; this is not good for either the patient's rights protection or investigation.

There are laws in China in many other fields but the CCP chose not to follow them. For example, the Chinese Constitution clearly states that its people enjoy freedom of religions and democracy, yet the Tiananmen Square Student Movement in 1989 was suppressed with tanks and guns. In addition, Falun Gong practitioners, members of underground Christian churches, Catholics and human rights advocates all have suffered tortures and persecution in China.

Mr. Huang said, "In summary, I don't expect such a regulation could resolve the problems related to organ transplants in China."
source : www.en.epochtimes.com

Gun bill advances to Senate floor

Copley News Service,

SPRINGFIELD -- Reacting to last month's shooting deaths at Virginia Tech, an Illinois Senate panel Thursday advanced a proposal from Attorney General Lisa Madigan that is intended to prevent such a tragedy from happening here.

The Senate Public Health Committee sent Senate Bill 940 to the Senate floor on a 10-0 vote.

One provision in the legislation requires Illinois authorities to share information with a national database about residents who are barred from buying or owning guns because of state or federal law.

At present, just 22 states share that kind of information with the database, called the National Instant Criminal Background Check System, Madigan said. Sharing the information will prevent people from crossing state lines in an effort to evade laws that prohibit them from buying firearms, she said.

"We don't want Illinois residents to be able to purchase guns in other states simply because Illinois has failed to share critical information with the national database," she said.

Madigan said a second part of the bill makes it clear that every hospital in Illinois, as well as any other institution dealing with mental illness, must notify state police about individuals who represent "a clear and present danger" to others or to themselves. State police then can determine whether that person should be able to buy a firearm or possess a firearm owner identification card.

The bill's main sponsors are Sen. Dan Kotowski, D-Park Ridge, in the Senate and Rep. Harry Osterman, D-Chicago, in the House.

LAWSUIT DAMAGES

The Senate passed legislation that would allow juries to award damages for grief, sorrow and mental suffering to families in wrongful death lawsuits.

State law now permits families to collect damages for loss of consortium and loss to society. Supporters of House Bill 1798 said 23 other states also allow awards for grief, suffering and mental anguish. They have said it would not affect medical malpractice lawsuits.

The Illinois Trial Lawyers Association, the Illinois AFL-CIO and Citizen Action are among proponents of the legislation.

The Illinois State Medical Society opposed the bill, fearing that a judge could interpret it to apply to medical malpractice suits. A 2005 law capped jury awards in those cases.

Other opponents said they feared the bill would increase insurance premiums.

The legislation passed 31-23. It now goes to Gov. Rod Blagojevich.

Among central Illinois lawmakers who supported the bill were Sens. Deanna Demuzio, D-Carlinville, and Dave Koehler, D-Peoria. Opposing it were Sens. Larry Bomke, R-Springfield; Dale Risinger, R-Peoria; Bill Brady, R-Bloomington; and Dan Rutherford, R-Chenoa. Sen. John Sullivan, D-Rushville, did not vote on the legislation.

WORLD SERIES TROPHY

Senate Republican Leader Frank Watson beamed like a proud parent as he played host Thursday to St. Louis Cardinals president Mark Lamping, who brought the team's 2006 World Series trophy to the state Capitol.

Watson allowed visitors to view the trophy in his office in the morning, and he later accompanied it and Lamping during brief appearances on the floors of the Senate and the House.

In remarks to the Senate, Lamping took a good-natured jab at the Cardinals' longtime rival, the Chicago Cubs, and that team's failure to win a World Series in almost 100 years.

"Illinois is home to some of the greatest baseball fans in the country, some of the most patient baseball fans in the country," Lamping said.

Sen. Rickey Hendon, D-Chicago, said he hoped senators would use the World Series trophy as a source of inspiration for their annual softball game against the House next week. The Senate lost to the House in last year's game.

source : www.daily-journal.com

Fairness sought for victims of state

TALLAHASSEE — Wilton Dedge received $2 million in a state settlement in 2005, compensation for an innocent man who spent 22 years in prison for a crime he didn't commit.

Alan Crotzer is innocent, too. He spent 24 years behind bars on a wrongful rape, burglary, robbery and kidnapping conviction before DNA evidence cleared him in 2005. So far, the state's paid him nothing.

That disparity has the original authors of Florida's relief process saying the system they devised is broken. Critics say politics and happenstance now are more important than the merits of each case.

"It's not politics, it's policy," said former state House member, Robert Trammell, a Marianna Democrat who served from 1986-96. "The leadership has been more tightfisted. But I think the policy should be to treat people fairly."

Crotzer agrees.

"I feel like what happened to me was horrible," Crotzer said. "I had a living death."

Gov. Charlie Crist supported compensating Crotzer, but his claims bill died in the legislative session just concluded, a victim of a political web some say shows the imbalance of the claims bill process.

"There were reports senators didn't have enough time," said Crotzer's lawyer, Michael Olenick. "That was always a quandary to me because they had the bill since August. That haunts me."

Though 11 local and two state claims bills were passed this year — notable because no claims bills have passed in two previous regular sessions — many say the claims bills process needs to be changed.

Sen. Al Lawson, D-Tallahassee, said Crist's openness toward claims bills and the publicity surrounding the Martin Lee Anderson case, along with new leadership, helped clear a path for other claims to be successfully heard.

"The philosophy of the last two Senate presidents and House speakers was that they didn't want to entertain any claims bills," Lawson said.

Anderson's parents received $5 million in compensation for the death of their 14-year-old son, who died a day after being beaten at the Bay County boot camp by drill instructors in January 2006.

Still, Crotzer's stalled relief and the Legislature's failure to pass a "global" plan to pay freed inmates $50,000 a year for lost time when they are proved innocent is an ongoing frustration.

In the last week of session, Sen. Majority Leader Daniel Webster, a Winter Garden Republican and proponent of the global plan, said he didn't know why it died in session.

"It passed every committee but got stalled in criminal and civil justice appropriations," said Sen. Arthenia Joyner, D-Tampa, sponsor of the global bill. "I don't know why."

By some accounts, the claims bills policy has been stagnated with politics or opinions about how state money should be used, and the result is too many claims that deserve to be heard are being ignored.

Some former lawmakers say the system used to be more fair in years past, and less political.

"I like the way we did it because politics weren't involved," said two-time former Florida House Speaker Donald Tucker, who designed Florida's claims bill process in the late 1960s.

Today, getting a claims bill passed requires a savvy lobbyist, a high-profile claim, lawmakers (in both chambers) willing to go to bat for settlement and a lot of patience.

Having all those elements come together at once isn't easy.

In 1969, Tucker was asked by then-House Speaker Fred Schultz to craft a claims bill process, one that left out politics.

At the time claims bills were voted on by the Legislature without any independent investigations.

Tucker came up with a procedure that required the House to hire an attorney to act as special master, or judge, of a hearing to investigate the claim.

The master then delivered a report to the House.

Tucker said he would chair a committee with three House members, who were not from the area where the claim originated, to hear the claim before a House vote.

"We came up with some good ideas and were fair to people," said Tucker, a Democrat from Tallahassee who served from 1967-78. The Senate eventually adopted the same process.

Now, Tucker looks at how the Legislature handles claims bills, and is disappointed.

"I sit and wonder, what's going on," he said. "These people who were wronged, deserve compensation."

In Crotzer's case, his claims bill passed the House, but stalled in the Senate.

In 2005, when the Dedge bill passed in a December special session, the Senate approved the claims bill (listed as a general bill) unanimously.

This year, when House members attached Crotzer's bill to the Anderson claims bill, Senate leaders — feeling rushed to approve a measure they'd not fully studied — threatened to kill both claims if Crotzer wasn't removed. A bill with only an Anderson settlement passed.

Senate President Ken Pruitt, who supported the Anderson claims bill, said he had his chamber take up another state claims bill for Minouche Noel because it was a priority for the House. Noel received $8.5 million from a malpractice judgment after a botched spinal surgery at a state clinic left her paralyzed.

Meanwhile Crotzer, while he waits for another opportunity to get a state settlement, tries to rebuild his life.

"The biggest problem I have is finding a job," said Crotzer, who has moved to Tallahassee from St. Petersburg. "The only thing I have to bring to the table is that I was wrongly convicted, and survived it."

Tucker hopes legislators give the claims bill process another look.

"Our system isn't perfect," he said. "We can't restore the time, life ... but we can make a compensation monetarily."

source : www.news-press.com

Ex-Jerome County commissioner disciplined for ethics violations

By Jared S. Hopkins
Times-News writer
EDEN - Attorney and former Jerome County Commissioner John D. Elorrieta has been put on two years of probation by the Idaho Supreme Court after violating at least four parts of the state bar association's rules of professional conduct in a case involving his mother and stepfather.

Another violation would result in a six-month suspension for Elorrieta, now the deputy prosecutor in Lincoln County.

The decision ends one legal battle for Elorietta, an attorney, as another could be getting under way. Elorrieta was recently asked by the Jerome County commissioners to return $16,200 of the nearly $70,000 in overtime pay that he and his colleagues received illegally for four years beginning in 2001.

Elorrieta could not be reached for comment Friday and repeated phone messages were not returned.

This matter arose in 2002 after Elorrieta agreed to represent his stepfather, Tom Webb, in a divorce claim against his biological mother, Glenda Elorrieta.

Shortly after the two were married, a depressed Webb tried to kill himself and underwent extensive medical care. The couple decided to divorce but live together to curb rising medical costs.

In 2004, Webb filed a malpractice action against Elorrieta. In October, the Idaho State Bar filed a charge alleging professional misconduct in summer 2002.

The charges included:

Not consulting with Webb before filing the divorce papers, not explaining matters for Webb to make informed decisions and not keeping Webb up to date during the divorce.

He had a conflict of interest representing Webb against his own mother, that she received nearly all the couple's assets and for disregarding the condition that Webb was in.

During the investigation, Elorrieta acknowledged that he never should have represented his stepfather against his mother.

According to Elorrieta's testimony, he explained the conflict of interest to Webb and his mother, but they insisted he take the case.

He also said that he assumed Webb could make accurate decisions because he overheard Webb's doctors in March 2002 that he was capable of making decisions.

Elorrieta was admitted to practice law in Idaho in 1995 and has no prior disciplinary history.

source : www.magicvalley.com

Fla. below national average in amount of paid medical malpractice claims

Friday, May 11, 2007

A state-by-state examination of medical malpractice claims paid in 2006 shows that Florida’s average payout was lower than the national average, resurrecting the debate about the merits and pitfalls of tort reform that is expected to change the malpractice climate in the state.

As in the past, trial attorneys, the medical community and the insurance industry are far apart as to how injured patients and their families will fare from medical malpractice reforms in 2003 and 2004.

Florida’s average claim payout, whether by settlement or jury verdict, was $241,800 last year while the national average was $308,600, according to the Kaiser Family Foundation.

Thirty-three states had higher averages than Florida’s; Illinois was at the top with an average claim paid of $629,100, according to Kaiser, a nonprofit health-policy research institute in California and Washington, D.C.

Kaiser didn’t conduct an analysis of the findings; it simply put the numbers together for public education, said David Rousseau, who works with Kaiser.

The data comes from the National Practitioner Data Bank, a federal registry of medical malpractice claims paid on behalf of physicians and other health-care providers.

Insurance companies paid a total of $198.7 million arising from 822 paid claims in Florida last year, according to Kaiser. That’s 14.7 claims paid for every 1,000 physicians in the state.

The state with the lowest average malpractice payout was Michigan at $132,380 with 389 claims paid in 2006.

The numbers for Florida come as no surprise to Orlando trial attorney Scott McMillen, who points to a $500,000 cap on noneconomic damages approved by the state Legislature in 2003 after pressure by then-Gov. Jeb Bush.

"The Legislature in Florida has been steadily chipping away the rights of Florida consumers," he said. "It is resulting in smaller settlements and more cases going to trial because the defendants have no fear. The insurance companies know the worst it will be is $500,000 — so why settle."

Bob White, president of First Professional Insurance Co., which insures 7,000 physicians in the state, the most of any medical malpractice insurer in the state, counters that Florida cannot be compared to other states.

"The average doctor (nationwide) carries a $1 million policy and in Florida the majority only carry a $250,000 policy. So if the maximum is $250,000, that compresses the average claim," White said. "Only 17 percent of doctors in Florida have million-dollar policy limits. In low-policy states, you just can’t draw comparisons."

Doctors don’t carry more coverage because of the expense, White said, acknowledging that malpractice insurance is more expensive in Florida than in other states. He blames that on more medical malpractice claims being filed and more payouts from settlements or damages from jury verdicts.

"We pay claims more frequently in Florida," White said, adding that 49 percent of claims closed last year in the state resulted in a payout.

Nationally, 26 percent of claims closed last year resulted in payouts, he said.

The issue of high premiums even when a physician hasn’t faced any prior lawsuits or settlements led to a bitter fight for reform five years ago, where the medical community lobbied for a $250,000 cap on noneconomic damages, or pain and suffering.

The compromise passed by the Legislature in 2003 was the $500,000 cap. Doctors said that was no compromise and wouldn’t reduce their premiums because in the event a patient dies, the cap on noneconomic damages increases to $1 million.

The medical community and trial attorneys sparred again in 2004, which led to three constitutional amendments on the November ballot that addressed other medical malpractice issues.

Voters approved limiting contingency fees of plaintiffs’ attorneys, opening up hospital records of adverse incidents, and revoking the licenses of physicians with three malpractice judgments.

Regarding the limit on contingency fees, attorneys began circumventing the limit by having clients sign waivers, the legality of which was upheld by the Florida Supreme Court in September 2006.

Stuart Ratzan, a trial attorney in Miami and member of the Florida Justice Association, the lobbying arm of trial attorneys, said the impact of the 2003 law capping noneconomic damages cannot be felt yet.

"It’s highly unlikely that payouts in Florida would be affected yet by the legislation passed in 2003 because cases don’t get through the system that quickly," he said, adding that he expects cases going to trial this year will be the first to be affected.

He attributes Florida’s average claims payout being below the national average to a conservative attitude among juries, which he says tend to side with physicians.

"The white-coat effect still exists," Ratzan said. "Doctors do better than injured patients."

White, president of First Professional Insurance, contends Florida judges and juries are liberal and willing to award large verdicts beyond policy limits. The state’s warm climate has attracted top-notch trial attorneys and that has led to larger awards, he said.

Bill Bell, general counsel for the Florida Hospital Association, said the average payout in Florida last year was to be expected, given that the majority of physicians carry only $250,000 in coverage. However, it is too early to see consequences of the limit on noneconomic damages awards passed by the Legislature in 2003.

"It takes four or five years to get a final verdict under that new law," Bell said. "The law has had an impact on settlements but not jury verdicts."

The number of claims filed is declining due to the noneconomic damages cap and that was to be expected, Bell said.

A long-standing position within the medical community is that medical malpractice lawsuits are often frivolous and that insurance companies are quick to settle cases, marring the reputation of physicians, rather than going to trial to defend their physician clients.

"There’s never been a doctor who will say, ‘I’ve been sued today and it’s a good case,’" McMillen, the Orlando trial attorney, said.

At the same time, Florida law requires a plaintiff’s attorney to sign an affidavit that he or she has done a reasonable investigation into the merits of the case and has obtained an affidavit from an expert witness that malpractice occurred.

The counter argument from doctors that plaintiffs’ attorneys hire doctors who will say anything a lawyer wants as an expert witness doesn’t stand up against an insurance industry able to spend more on its own expert witnesses, he said.

"I have spent over $200,000 on a single case to get to trial," he said. "That comes out of our pockets and we are not willing to advance that with crummy expert witnesses at trial and the insurance industry counters with their own expert witnesses."

Florida law allows insurance carriers to have sole discretion to make the decision about settling or going to trial, regardless of what a physician wants, pitting doctors against their insurance carrier, which evaluates how to proceed with a lawsuit from the standpoint of financial risk.

Ratzan, the trial attorney from Miami, said most cases settle because they have merit but he contends insurance carriers are more willing nowadays to let cases go to trial.

"In recent years the insurance industry is more willing to try a case. They are more comfortable with the idea the jury will stand on the side of the doctor," he said.

A study released last month by researchers at the University of Missouri-Columbia found that tends to be the case, at least in New Jersey, Michigan and North Carolina, the three states where the researchers examined jury verdicts from 1986 to 2006.

Juries are more sympathetic with physicians for a variety of reasons, including the social standing of physicians, attitudes that the injured are trying to profit, that insurance companies have greater resources to spend at trial and lastly, that juries are willing to give doctors the benefit of the doubt when the issue of negligence is conflicting, according to the Missouri study.

Bell, with the state hospital association, agrees trial outcomes tend to favor the doctors.

"Most cases that go to trial are won by the defense and that is probably typical across the United States," he said. "If the defense is willing to bring a case all the way to a jury, they must feel pretty good about it. If there is pretty clear negligence and liability, then cases settle but if there’s only $250,000 in coverage, that physician settles for that amount or less."

The other gamble for the insurance industry is questionable liability on the part of the doctor or hospital but the patient sustained damages, Bell said.

"There’s the concern the jury may feel sorry for the family," he said. "All kinds of different strategies factor in making a decision about letting a case go all the way."
source : www.naplesnews.com

Jury can’t decide malpractice trial

After deliberating for 12 hours, a Madison County jury was unable to reach a verdict in the medical malpractice trial of Dr. James Dalla Riva.

Late Tuesday morning, Circuit Judge Barb Crowder declared a mistrial.

The jurors began their deliberations at 10:30 a.m. on Monday and were sent home around 7:30 p.m. They returned Tuesday morning at 9 a.m.

Reached by phone, St. Louis attorney David Damick said that he will discuss the options with his client, Mary Baugus, and that they will decide soon whether to refile the case.

“Dr. Dalla Riva appreciates the work of the jury, and we’re disappointed that the time spent - five days - did not result in a finding,” said Dalla Riva’s attorney Michael Pitzer, also of St. Louis.

In closing statements, Damick did not ask jurors to award a specific amount to Baugus. He noted, however, that Baugus had $34,261 in medical bills, and he suggested pain and suffering compensation of “a couple of hundred thousand dollars.” Baugus had surgery after the incident and returned to the hospital a total of nine times, Damick said.

Dalla Riva was on medical staff at Anderson Hospital on Jan. 4, 2002, when he performed an abdominal hysterectomy on Baugus, and removed her ovaries.

Damick maintained that Dalla Riva was negligent because he chose to use the “blunt dissection” method. While it is a common method, it should not have been used in Baugus’ situation because she had adhesions from earlier caesarean sections. “When you’ve got that kind of adhesions you don’t hurry through with blunt dissection,” he said. “Why is it wrong? Because the bladder is unique. It’s soft. It bloodies easily.”

Baugus developed severe pain and abnormal bleeding and was later found to have a half-inch perforation to her bladder.

Eventually, the severe bleeding was stopped, and she was discharged from Anderson Hospital.

Damick also faulted Dalla Riva for not “oversewing” to protect the bladder. In summary, Damick alleged that Dalla Riva knew about the adhesions and should have been more cautious. “He acted like a driver who knew he was approaching heavy traffic but acted like he wasn’t,” Damick said.

But Pitzer said Dalla Riva exercised sound judgment and that “he didn’t gamble or take risks.” He chastised Damick for flying in Dr. James Tappan from California and paying him $23,000 to testify.

Baugus, he said, had a history of medical problems before the surgery, and she had been given a pamphlet to read that clearly spelled out the risks. Dalla Riva, he said, did not puncture the bladder. In fact, the bladder performed well for 10 days after the surgery. Pitzer said it was not clear why the perforation developed. “In this case, for whatever reason, the bladder opened up,” he said, “but it did not appear to be weakened during the surgery.” Dalla Riva, he said “did exercise his judgment the way a careful, reasonable physician would do.”

Also on Tuesday, a mistrial was declared before the start of another medical malpractice trial. Plaintiff Jessica Cooper alleged that on May 2, 2002, Dr. Geoffrey Turner was negligent during the delivery of her daughter, Rainee Cooper. The delivery occurred at St. Anthony’s Hospital in Alton. The suit was filed by St. Louis attorneys Mark Bronson and Marc Wallis. It alleges that, among other things, Turner, during the delivery, used “excessive downward lateral traction, causing a brachial plexus during delivery.”

Court officials declined to comment about why a mistrial was declared.

Judge David Hylla was not available for comment Tuesday afternoon.
source :www.goedwardsville.com

Jury Deliberating Malpractice Suit Against EIRMC

The three week trial against Eastern Idaho Regional Medical Center has come to an end.

Since 1:30 Thursday, a jury has been deciding if EIRMC is to blame for severe brain damage in a former patient and it wouldn't be surprising if it's not until Friday before a verdict is reached.

Brock Higham alleges that he went in for wrist surgery in 2002 and came out with a brain injury.

Higham believes the incident is the result of a medication mix-up.

EIRMC denies they had anything to do with the damage.

On Thursday morning, both sides presented their closing arguments. The courtroom was packed, probably more than it has been in the three weeks the trial has been going.

As evidenced by the length of the trial, there is a lot of issues covered. Here are some of the key points brought up in the trial.

First, most of the evidence, including the IV bag and tubing was thrown out by hospital staff the morning after Brock was brain damaged.

The hospital says nurses looked at the medicine and confirmed with their own eyes Brock got the medicine he was prescribed. They then threw it out, so narcotics weren't lying around.

But Higham's legal team thinks it's all an attempt by the hospital to cover up a mistake. They cite EIRMC paperwork that says if a questionable event happens, then all the evidence should be preserved.

Another big issue is the care given by nurses to Brock the night of the incident. The hospital says the nurse assigned to Brock checked in on him more frequently than the every four hours that's required by hospital rules.

But the Highams think the nurses missed some big warning signs including itching, that often precede a bad reaction with narcotics.

They also say he was at a higher risk for a reaction to narcotics because of the way the IV dripped the medicine, even when he didn't call for them and the fact he wasn't sedated to taking narcotics.

Finally, there's the issue of a possible medication mix-up.

The hospital says everyone who treated Brock reported he received the correct prescription.

The Highams say none of the drug Dillaudid showed up in none of the blood tests taken around the time of the incident.

"Bad things do happen to good people all the time, it's a reality of life, and it's not your role to translate emotion and sympathy and desire to help into this forum," said Robert Roth, lead attorney for EIRMC.

"Few moments of neglect can lead to a life of disability and heartache, he is the reason why casual approach to standards cannot be tolerated in this community," said Ken Pedersen, lead attorney for Higham.

For the first time, we found out how much Brock Higham is asking for in damages. Between economic damages and pain and suffering, Higham's attorney says he deserves $8.25 million.

EIRMC maintains Brock's brain damage wasn't preventable.

One of their doctors even said he could have had a stroke.

Two alternate jurors were dismissed on Thursday after closing arguments. They'll only be called back if another juror gets taken off the case.

source : www.localnews8.com

Ex-doctor suing for $40 million

ublished: Sunday, May 20, 2007
Sam Hemingway
Free Press Staff Writer

A former St. Albans doctor who resigned from the Northwestern Medical Center in St. Albans in 2004 after claiming surgical fluids at the hospital had been intentionally contaminated has sued the hospital and six other defendants for $40 million.

According to documents on file at federal court in Burlington, orthopedic surgeon Raymond A. Long claims the hospital set out to destroy his career because he reported the contamination to state authorities and confronted hospital officials about other problems at the facility.

Lawyers for the hospital say in court papers that Long resigned in 2004 because the hospital was about to undertake an internal investigation of quality of care issues regarding Long and what it viewed as his disruptive behavior in front of patients and employees.

Long, who no longer holds a license to practice medicine in Vermont and now lives in Plattsburgh, N.Y., is facing three medical malpractice lawsuits in Vermont; a fourth was settled in 2006. He is the author of a 2006 instructional book on anatomy for yoga teachers.

The Long case has been contentious from the start. Still a year away from trial, it has already generated 10,000 pages of documents and involved 25 attorneys. At a May 11 court hearing, Long's lawyer claimed the hospital had employed 19 private investigators to delve into Long's background.

Long, under orders from his lawyer, George Parry of Philadelphia, declined comment on his case after the hearing. The hospital's attorney, Kathleeen Chancler of Philadelphia, also declined comment, but a lawyer for Quorum Health Resources, a Texas firm that helps manage the hospital, issued a statement denying Long's allegations.

"This is a longstanding dispute and we contest all of the plaintiff's claims, which are baseless," Philip Zane said in his statement. "The defendants expect to prevail."
Early confrontation

Long, a graduate of the University of Michigan medical school, joined Northwest Orthopedics in St. Albans in 2001 after completing a residency in orthopedic surgery at the University of Montreal. He obtained provisional operating privileges at Northwestern Medical Center in September 2001.

According to court papers, Long's first dispute with hospital doctors and administrators occurred shortly after a Montgomery Center man became paralyzed in his arms and legs after Long operated on his shoulder on Jan. 25, 2002.

Long alleged that the quadriplegia was caused by improperly administered anesthesia. The anesthesiologist, in turn, told the patient that surgical errors by Long caused the paralysis, Long's lawsuit said.

The paralysis later subsided, but when the patient told Long he could not pay the hospital bill because the paralysis made it impossible for him to return to work, Long told him to file a lawsuit for malpractice. The case is now pending in Franklin County Superior Court.

The case was the beginning of a series of disputes between Long and other doctors at the hospital and hospital administrators that, based on allegations in Long's lawsuit, read at times like a mystery novel.

Long claims he collected proof that an anesthesiologist's mistakes had caused neurological damage to a surgical patient, only to discover that a hospital employee had "illegally entered" Long's office and removed the damaging evidence.

Hospital administrators once interrupted Long during a complicated surgery to tell him his hospital pager bill was overdue. In another incident, Long said an administrator pressured him to curtail a surgical procedure on a Medicaid-eligible patient in order to free up an operating room for more lucrative, elective surgery operations.

On March 31, 2004, shortly after suspending Long's operating privileges and recommending he undergo a psychiatric evaluation, the hospital reinstated Long's privileges so he could conduct a difficult ball-and-socket shoulder replacement surgery the following day, April 1.

The hospital, in papers it has filed with the court, denied the first two allegations listed above but admitted it did grant him temporary privileges for the April 1 surgery. The hospital also confirmed in court documents that Long was told he needed to undergo "certain evaluations" just before he decided to resign.

The hospital also included in its court papers a 2000 performance evaluation of Long when he was a resident doctor at the University of Montreal that showed he had received "below average" marks in the categories of "ability to work with others" and "relationship with medical staff."
Contamination question

Long claimed in his lawsuit that he discovered the contamination of surgical fluids in an operating room after three of his patients developed life-threatening infections following surgeries that he had performed on them.

The hospital does not dispute that two of the three patients suffered from post-operative life-threatening infections.

When Long discovered the contamination, he reported it to hospital authorities. Long, in court papers, said that the hospital failed to properly investigate the contamination. Unsatisfied with the hospital's response, he claimed in court papers that he later intercepted an operating room solution prior to a Feb. 6, 2004, surgery and had Fletcher Allen Health Care test a sample of it.

"FAHC advised Dr. Long that testing conclusively established that the sample of irrigation solution was heavily contaminated with coagulase positive Staphylococcus aureus, a deadly infectious agent," Long's lawsuit said.

Long, through an attorney, also alerted the Attorney General's office about the contamination. Attorney General William Sorrell confirmed his office conducted a criminal investigation into the claim, but the probe ended with no one being charged.

"We did not find evidence to satisfy us at all that criminal conduct had taken place, let alone by whom," Sorrell said in an interview.

The state Health Department, in a statement released April 6, 2004, also said it did not find evidence of contamination at the hospital. "We find nothing to suggest that there is any increased risk of infection at Northwestern, as compared to any other hospital," then Health Commissioner Paul Jarris said in the statement.

The following day, Long resigned. In a statement he sent to the media at the time, he lambasted the hospital for conspiring to ruin his career for speaking out about problems at the facility, including the contamination issue.

"As a result of raising such questions, Dr. Long has been the subject of multiple adverse actions intended to force him out of the hospital and the community," Long's statement said in part.
source : www.burlingtonfreepress.com