Friday, June 22, 2007

Error kills would-be doctor
Dileepan Raj, the boy said to have carried out a Caesarean section.

Lucknow, June 21: A Dileepan who isn’t a doctor has been performing surgery in Tamil Nadu, but a Dilip who deserved to be one has died here after being denied by a computer error.

Six days after Dilip Gautam, 19, hanged himself from disappointment at failing the Uttar Pradesh Combined Pre-Medical Test, a corrected merit list today showed his name.

It also had the names of hundreds of others the original results had left out. A probe committee has admitted that 75 per cent of the original list was erroneous because of “a programming error”.

“What can we say? We are stunned. It has cost the life of a young man who aspired to be a doctor,” said Dilip’s uncle Pratim Gautam, speaking a day after news broke that a doctor had allowed his 15-year-old son, Dileepan, to perform a Caesarean in his hospital in Tamil Nadu.

Dilip’s friends, who said the youth was “above average” as a student, have demanded action against officials. “We want the government to punish the university officials,” said Rajat Sharma, who too finds his name among the successful candidates after being left out.

Dilip’s family said the young man had locked himself in his room on the evening of June 14, the day the erroneous results were published, and refused his dinner. The next morning, he was found hanging from the ceiling.

Other students expressed their frustration in a different way. Hundreds took to the streets across the state on June 14, stoning cars and vandalising shops. Many threatened to move court.

The Mayavati regime, eager to build a reputation for good governance, acted fast and set up a nine-member probe panel on June 15. When the tests were held, Mayavati was not in power.

The investigation found that the computer programming had been faulty and the results were not “cross-checked manually”.

The mess prompted Poorvanchal University vice-chancellor K.P. Singh, the examination committee chairman, to put in his papers. “I am taking moral responsibility,” he said, “but I assure you the errors were not intentional.”

The state government today publicised the correct answers to all the questions, and promised to make available to students their answer scripts if they doubted the evaluation.


Doctor apologies prevent lawsuits for medical malpractice

New Virginia (VA) law allows doctors and hospitals to apologize to the people they hurt by medical errors and not have it used against them in court. This law was part of a compromise worked out between doctors and lawyers in a recent Legislative Session.

Getting this law passed was a smart play by the medical malpractice insurance lobby. Allowing the doctors to do an early apology may prevent them from being sued even when they made a clear error causing serious injury.

In our firm's decades of helping families who have been harmed by surgical or medical mistakes, we have found that often the bedside manner of the healthcare provider makes a big difference. Frequently a reason that the client has contacted a law firm about medical malpractice is not being treated well by the doctors. If someone had simply been outwardly caring, many times the patient would not contact a personal injury lawyer at all. Sometimes, it is the bad bedside manner that causes the patient to call us, even when there was a catastrophic injury caused by a clear violation of the medical standard of care. These patients are more upset by how they were treated, than what has happened to them from the standpoint of the medical result.

I agree with the idea of the new law which is to have surgeons and hospitals be able to admit an error and take responsibility without having that used against them in the lawsuit. This might cut down on the anger that leads to prolonged litigation. However, what would be even smarter would be for the risk managers at the hospitals and the doctor's insurance companies to also follow up with concept called "full disclosure/early offer". Under this method of handling medical mistakes, the meritorious claims will be dealt with promptly. The doctor and the health care providers would be in a position to be able to be honest and frank about what had happened in the treatment. In health care systems where this is being used, the Plaintiff's attorneys handling medical malpractice cases have been receptive. Things can be worked out by having two professionals sitting across the table discussing a claim it without all the expense and drama associated with full blown litigation.

Such a system is a far cry from what normally happens in Virginia (VA). Typically in Virginia (VA) any medical malpractice case has got to be fully litigated the insurance companies, before the doctors will take the case seriously. As Plaintiff's personal injury lawyers, we typically have to hire numerous expensive experts to prove what the doctor did wrong and how that caused a serious and permanent injury to the client. Only once we have shown our cards and have this proof in hand will the insurance companies handling the medical malpractice claim even discuss settlement. Unlike an automobile accident claim where the vast majority of cases are resolved without the need for litigation, medical malpractice cases in Virginia (VA) typically are hard fought, knock down, drag out battles. I think our medical malpractice clients would be very receptive to a more human and civilized method of resolving these conflicts. I hope that this new concept catches on. Some of the best healthcare systems in the world, including John's Hopkins Medical in Maryland (MD), are trying this approach.

Flashback to ‘baby-friendly’ clinic

IMA member recounts month-old camcorder show by father of ‘boy surgeon’

Manapparai (Tamil Nadu), June 22: Dr K. Murugesan’s hospital here wears its badge proudly. At the entrance is displayed an Indian Medical Association certificate declaring the Mathi Surgical and Maternity Nursing Home “baby friendly”.

It’s a 15-year-old “baby surgeon” that has now brought the hospital under the national spotlight.

The IMA’s local branch, whose members say they watched a video of Dileepan Raju doing a Caesarean section at his father’s clinic, claims it had informed the association’s state and national chapters early in May.

But not much was done till a leak, presumably by a local doctor, raised an outcry on Wednesday.

The “baby friendly” tag came a few years ago after an assessment by the IMA’s national task force. Along with the certificate are displayed photographs of “rare surgeries” at the hospital, including the delivery of male triplets.

The rarest of these, local doctors say, was the one to which they were treated at an IMA meeting on May 6. Dr Venkata Prasad, secretary of the IMA branch in Manapparai, 40 km from Tiruchirappalli, confirmed that it was Dileepan doing the operation on video — an allegation Murugesan has denied.

A senior IMA official said that at the meeting, Murugesan sprang a surprise by “asking to show the video of a Caesarean”.

The meeting had been convened for guest lectures by a urologist and an orthopaedist. “But we allowed Dr Murugesan to show the CD, as we usually do when doctors want to present some unique case,” said the official, who didn’t want to be named.

“I am Dr Murugesan, giving spinal anaesthesia (to the patient) and my son is doing the surgery,” the father allegedly said as his camcorder tape started showing the pictures on a screen with the help of a projector and a laptop.

Shell shocked

“We were shell-shocked and looked at each other in utter disbelief. The screen showed the surgery being done by his teenage son, a Class X student (he is now in the first year of plus II). Murugesan, who’s a surgeon, himself administered anaesthesia without the services of an anaesthetist,” the IMA doctor said.

When the boy pulled the infant out, “we could see it was a malformed baby — there was a lump on its back”. He clarified that the operation was successful and the lump had nothing to do with the surgery being done by unskilled hands.

“There was an uproar. But Dr Murugesan wanted to take this to the media and, apparently, to the Guinness World Records,” the doctor said. “We pleaded with him not to; we told him this was unethical. But he wouldn’t listen.”

The local IMA’s complaint, sent to the state chapter the next day after an emergency meeting, says: “He (Murugesan) reacted very arrogantly and threatened to sue the local IMA without accepting his mistake.”

The emergency meeting passed a resolution making it clear that the local IMA was “in no way responsible for his way of practice”.

“We had to collectively condemn this, else Dr Murugesan may have tried to gain mileage out of the screening at an IMA meeting,” said the local IMA secretary, Dr Prasad.

“Our role ended after reporting the matter to higher authorities. We did it so we would not be hauled up for remaining silent spectators to an unethical practice by a fellow doctor.”

Dr M.M. Nazurudeen, the chapter’s president, who wasn’t at the meeting where the video was allegedly shown, said: “We condemned this very strongly.”

Sources said the state chapter wrote to Murugesan asking him to explain his action. The doctor, they said, denied the allegation. The matter seems to have rested there despite the local doctors’ eyewitness account.

CD confusion

The line of patients at the hospital had thinned today. Murugesan and his gynaecologist wife Gandhimathi, also alleged to have been present at the Caesarean, attended to patients but kept away from the media.

Their lawyer, Kasturi, did the talking.

“The boy only watched the operation done by his father,” the lawyer said. “It doesn’t violate any law as people are televising operations these days.”

Kasturi claimed that Murugesan had shown the video because the patient — a relative — had two uteruses, which is unnatural.

The IMA complaint speaks of Murugesan showing a CD but the lawyer said: “There is no CD.”

The reference to a CD could be an error because some doctors said the video was shown directly from a camcorder.

The investigators’ problem is compounded by the failure of the patient, Neela, to file a complaint. Efforts to trace her have been unsuccessful. Her parents’ home at Pallarnatham village, 20 km from Manapparai, was locked this afternoon.

The local doctors now seem to hold the key to the case. Some of them have spoken to the investigators, led by the district revenue divisional officer.

“The probe will be over in another three days and once we get the full report, we will decide on the next course of action,” said Tiruchirappalli collector Ashish Vachhani.

No medical error in treatment of the late professor

There was no medical error in the treatment of the pathology professor Karposh Boshkovski.

The special panel comprised of doctors at the Thoracal Surgery Department at the Skopje Clinic Center established today, announcing their finding as a response to the anonymous letter suggesting that Boshkovski was inadequately treated.

Nevertheless, the Health Minister Imer Selmani unveiled plans for setting out a new probe to be carried out by an expert commission.

The results of the Pathology Institute showed that Boshkovski died as a result of severe damaged of the aorta.

Assembly Passes Moriarty.Greenstein.Fisher Bill Requiring Public Reporting Of Hosptial Errors

(TRENTON) - The Assembly today passed legislation Assembly members Paul Moriarty, Linda R. Greenstein, and Douglas H. Fisher sponsored to require annual public disclosure of serious medical mistakes made in New Jersey.

"Vital consumer information like hospital error reports should not be hidden away from public scrutiny," said Moriarty (D-Gloucester). "Patients shouldn't have to wonder if a clerical error will leave them recovering from an operation they didn't want or need."

The Moriarty/Greenstein/Fisher legislation (A-4327) would seek to make the public aware of the number of serious preventable adverse events that occur at each health care facility in the state. The legislation would require that a report be made available to the public that would list how many of these events took place at each facility. The report would not include identifying information about patients and facility employees to avoid exposing the facility to greater legal liability.

"Going to a hospital for an operation or procedure is stressful enough without having to worry about whether the hospital staff might make a mistake," said Greenstein (D-Middlesex). "Allowing the public access to hospital error reports will improve patient peace of mind and continue to place New Jersey at the vanguard of patient safety."

According to the bill sponsors, hospital error reporting is already required under New Jersey's 2004 "Patient Safety Act," which established a medical error reporting system for health care facilities in an effort to minimize errors. These reports, however, are not readily available to the public.

"Knowing that the public will have access to error reports will make hospitals work that much harder to ensure patient safety," said Fisher (D-Cumberland). "And that knowledge should make every visit to the hospital a little less unnerving."

The bill would require the Departments of Health and Senior Services (DHSS), in consultation with Human Services (DHS), to prepare a report on hospital performance on patient safety measures. The report is to include, at a minimum, the number of serious preventable adverse events that have resulted in either:


Loss of a body part:

Disability or loss of bodily function lasting more than seven days or still present at the time of discharge from a health care facility.
The report would be presented in a format which enables comparison among health care facilities in particular facility categories with respect to the information. In the event of general hospitals, the information is to be included in the New Jersey Hospital Performance Report annually issued by DHSS that measures the performance of general hospitals in the Senate. The report would be available to the public via the DHSS Web site:

The provisions of the bill would become effective either one year after enactment or one year after the adoption of the regulations for the "Patient Safety Act," whichever comes later.

According to information from the Institute of Medicine, approximately 98,000 deaths occur nationally each year as a result of major preventable medical errors. In 2005, New Jersey hospitals reported 376 medical errors.
The Assembly passed the bill 74 to 4 with one abstention. It now heads to the Senate for further consideration.

Medical Error is the Fifth-Leading Cause of Death in the U.S.

Clinical Information Systems Implemented to Prevent Errors and Enhance Patient Safety
WALTHAM, Mass. -- Millennium Research Group (MRG), the global authority on medical technology market intelligence has conducted a detailed and thorough analysis of the acute care clinical information systems (CIS) market and finds that a major driver in the US is the demand for improvement in patient safety.

Medical errors are the fifth-leading cause of deaths in the US, with up to 98,000 deaths annually. According to the new report entitled US Markets for Acute Care Clinical Information Systems, hospitals are adopting CIS to help them provide adequate, timely care and reduce the frequency of preventable errors.

"Medical errors in the healthcare system arise from miscommunication, physician order transcription errors, adverse drug events, or incomplete patient medical records," says David Plow, Senior Analyst at MRG. "Generally, medical errors are caused by overcrowded, understaffed clinical areas with complex workflow patterns, and incomplete or inefficient communication between clinical areas. Through the use of a CIS, professionals within each clinical area are able to access and use information pertinent to a patient's medical profile and history. As a result, CIS can effectively help prevent errors and enhance patient safety.

"The CIS market -- comprised of radiology information systems, pharmacy and medication management information systems, cardiovascular and cardiology information systems, laboratory information systems, emergency department information systems, and critical care information systems -- was valued at over $900 million in 2005. By 2010, revenues in the CIS market will exceed $1.5 billion.

MRG's US Markets for Acute Care Clinical Information Systems report includes coverage of all key industry competitors, including Misys Healthcare, Cerner, GE Healthcare, McKesson, Siemens Medical Solutions, Philips Medical Systems, MEDITECH, Systems, Picis, Heartlab, Camtronics, Epic Systems, Soft Computer, Allscripts, MEDHOST, Mediware, Orchard Software, Eclipsys, LUMEDX, Aspyra, Wellsoft, Stryker, Agfa Healthcare, Emergisoft, Amicas, CPSI, QuadraMed, DR Systems, Eastman Kodak, Emageon, Meta, Emdeon, Fujifilm Medical Systems, iMDsoft, Impac, InStar Systems, OptiMed, ScImage, CAOS, and T-System.

A CIS is a computer-based inpatient information system designed for collecting, storing, manipulating, and making available clinical information that is important to the health care delivery process.

It provides access to a patient's electronic medical record-clinical data storage technology that encodes the patient's previous medical history, responses to medication, test results, and current treatment.

Doctors' beliefs can hinder patient care

New laws shore up providers’ right to refuse treatment based on values
Lori Boyer couldn't stop trembling as she sat on the examining table, hugging her hospital gown around her. Her mind was reeling. She'd been raped hours earlier by a man she knew — a man who had assured Boyer, 35, that he only wanted to hang out at his place and talk. Instead, he had thrown her onto his bed and assaulted her. "I'm done with you," he'd tonelessly told her afterward. Boyer had grabbed her clothes and dashed for her car in the freezing predawn darkness. Yet she'd had the clarity to drive straight to the nearest emergency room — Good Samaritan Hospital in Lebanon, Pennsylvania — to ask for a rape kit and talk to a sexual assault counselor. Bruised and in pain, she grimaced through the pelvic exam. Now, as Boyer watched Martin Gish, M.D., jot some final notes into her chart, she thought of something the rape counselor had mentioned earlier.

"I'll need the morning-after pill," she told him.

Dr. Gish looked up. He was a trim, middle-aged man with graying hair and, Boyer thought, an aloof manner. "No," Boyer says he replied abruptly. "I can't do that." He turned back to his writing.
Boyer stared in disbelief. No? She tried vainly to hold back tears as she reasoned with the doctor: She was midcycle, putting her in danger of getting pregnant. Emergency contraception is most effective within a short time frame, ideally 72 hours. If he wasn't willing to write an EC prescription, she'd be glad to see a different doctor. Dr. Gish simply shook his head. "It's against my religion," he said, according to Boyer. (When contacted, the doctor declined to comment for this article.)
Boyer left the emergency room empty-handed. "I was so vulnerable," she says. "I felt victimized all over again. First the rape, and then the doctor making me feel powerless." Later that day, her rape counselor found Boyer a physician who would prescribe her EC. But Boyer remained haunted by the ER doctor's refusal — so profoundly, she hasn't been to see a gynecologist in the two and a half years since. "I haven't gotten the nerve up to go, for fear of being judged again," she says.

Doctors refusing treatment
Even under less dire circumstances than Boyer's, it's not always easy talking to your doctor about sex. Whether you're asking about birth control, STDs or infertility, these discussions can be tinged with self-consciousness, even embarrassment. Now imagine those same conversations, but supercharged by the anxiety that your doctor might respond with moral condemnation — and actually refuse your requests.

Air Sahara denies entry to cerebral palsy patient

Rajeev Rajan, a disability activist who got the government of Chennai to bend its knees before him by getting two disabled friendly buses moving in the city was himself denied an entry into the aircraft by the ground staff of Air Sahara.

Humiliation did not stop there as the airlines also asked for police intervention. Inspite of the police officials identifying Rajan as a frequent flier due to his social activities, the airlines departed without him. Rajan who suffers from Cerebral Palsy was traveling from Chennai to Delhi for a meeting with the National trust, a government body.

According to Rajan, the ground staff refused him an entry as he was unescorted and he also did not have a fit-to-fly certificate. Upon contacting another private airline, SpiceJet for a ticket, Rajan was yet again turned down. Though the Jet Lite CEO Gary Kingshot admitted that such an incident occurred. “Jet Lite only followed IATA medical manual in respect of wheel chair passenger Mr Rajiv Rajan a cerebral palsy patient,” he said.

A SpiceJet spokesman said that the passenger did not contact them directly. “Jet Lite had asked us to take the passenger but we do not have a internal arrangement with them for passenger sharing. We would have taken him if he had made a fresh booking,” he said.

According to Javed Abidi, a social activist, “Any person suffering from cerebral palsy does not require an escort for travel. Simply because one looks different, does not mean he is unfit. Each person ought to be treated with utmost dignity.”

“Even after one whole day since the incident, there has been no intervention from the National Trust, Department of Disability (Ministry of social justice) or the Office of Chief Commissioner for disabilities is extremely distressing,” said Abidi.

Only recently an autistic child was refused admission into an Air Deccan flight in Bangalore. “While Indian, which is a government owned carrier is careful in dealing with the physically challenged while most private carriers acts irresponsibly as they do not have any policy for the disabled.”

As his next recourse, Rajan will file a PIL against these airlines. Even in the past Rajan has never shied away from fighting for his rights and yet again he would wrestle for justice inspite of his handicap. Disability Legislation Unit, a wing of Vidyasagar, a group of social activists from the South shall file a case in the consumer forum.

While most disability groups, led by Disabled Rights Group, a conglomerate of all disability groups across the country have asked for an unqualified apology from the two airlines; failing to which these groups shall go on a protest march.

Meanwhile, the Director General of Civil Aviation has issued a notice to the managements of SpiceJet and JetLite (Air Sahara's new name) asking for an immediate explanation. The airlines could face action if the DGCA is not satisfied with its reply.

Airline says sorry for turning away cerebral palsy patient

Social activists and members of communities for the disabled staged a two-hour dharna at the domestic airport in the Capital on Thursday, protesting Jet Lite airlines’ decision against letting cerebral palsy patient Rajiv Rajan board a flight on grounds of being unfit and not in possession of a fitness certificate.

Despite letters to the CEO of Jet Lite, Gary Kingshott, and the Civil Aviation Ministry, the Disabled Rights Group received no reply, leading to a two-hour demonstration of nearly 200 activists.

Social activists Vandana Bed, Kamaljeet Singh and Asha Mehra also took part in the demonstration. Some protesters even threw black paint on Spice Jet and Jet Lite airlines’ windows.

“At 5 pm, some staff of the Jet Lite airlines offered a written statement, stating regret and tendering an apology to Rajiv Rajan for the treatment he received. The company admitted that it was at fault and stated the event occurred due to untrained staff,” said Javed Abidi, a prominent social activist present at the dharna.

Gary Kingshott, however, refuted such claims. “We regret the incident, but there is no reason for us to apologise to anyone,” said Kingshott. Jet Lite stuck to their stand that they had followed the norms set by the Internation Air Transport Association manual.

Rights blow to elderly in private care

housands of people who use hospital or school services contracted out by local authorities are without the protection of human rights laws, after a landmark ruling yesterday.

In a split 3-2 decision, the law lords ruled that private care homes contracted out to care for elderly people for a local authority are outside the scope of the Human Rights Act.

The judgment could affect up to 300,000 residents in England and Wales and also a range of other services contracted out to private bodies, such as intermediate treatment centres or foundation schools.

The law lords rejected the view that a private home is exercising a public function when it cares for people referred to it by a council. As a result, they said, it was not bound by the Human Rights Act and its residents could not claim protections under it.The ruling came in the case of an 83-year-old Alzheimer’s patient, whose lawyers argued that her threatened eviction from a private home would violate her right to family life.

Six months ago the Court of Appeal said that it was bound by previous rulings that a private care home could not be classified as a public body and was not covered by the Act.

The patient, identified only as YL, has lived at the home since January last year, when she was placed there by her local authority, Birmingham City Council.

The home, which cannot be named for legal reasons, is run by Southern Cross Healthcare, which wants to remove the woman because of disagreements with her relatives.

Liberty, the human rights group, which was represented in the case, said that the law lords’ reasoning “seems to have been largely that private care providers are motivated by profit and governed by contract rather than public service values”. Its lawyer, Anna Fair-clough, said: “It is open to Parliament to be the last court of human rights and enact specific care home legislation to prevent local authorities from contracting out of dignity for Britain’s elderly.”

Gordon Lishman, director-general of Age Concern, said: “This is a catastrophe for the 300,000 vulnerable older people who live in independent care homes.”

The Alzheimer’s Society said: “All care home residents should be protected by the Act. This is a basic entitlement, which should not be compromised by the type of home they live in or the source of funding. We urgently need legislation to close this glaring loophole.”

Asbestos suit by former BHS teacher settled for $3.8 million

BLOOMINGTON — A former Bloomington High School teacher who died in March received about $3.8 million in settlements from an asbestos lawsuit filed last year, according to documents filed in McLean County Circuit Court.

Daniel Malcolm and his wife, Nancy, agreed to settle claims against several defendants, including Pneumo Abex Corp, a manufacturer of asbestos.

Malcolm was a Bloomington High School teacher from 1968 to July 1994 and worked at a foundry at Caterpillar’s East Peoria plant from June to August 1964.

The complaint filed in May 2006 states that Malcolm was exposed to asbestos at the school and foundry assignments. That same year, Malcolm was diagnosed with mesotheloima, a disorder commonly linked to exposure to asbestos.

The settlement agreements allocate a portion of the funds to Malcolm’s wife, who has been obligated for her husband’s medical expenses, said court documents.

Former UTSW doc files whistleblower suit against med school

A former division chairman at the University of Texas Southwestern Medical Center at Dallas is suing the school, alleging he was retaliated against for voicing concerns about residents performing unsupervised procedures on Parkland Hospital patients.

Dr. Larry Gentilello was chairman of the division of burn, trauma and critical care at UT Southwestern and held the C. James Carrico MD Chair in Trauma. Gentilello, in a lawsuit filed last week in a Dallas County District Court, said he was removed from both positions after voicing concerns about what he felt were violations of Medicare and Medicaid rules. The lawsuit was filed under Texas' whistelblower act.
John Walls, assistant vice president for public affairs at UT Southwestern, declined to comment on the allegations because of pending litigation.

According to the lawsuit, Gentilello observed that UT Southwestern trauma residents were performing surgical procedures on patients at Parkland Hospital without the supervision of attending trauma surgeons.

"The patients at Parkland typically consist of indigents and are primarily minorities," according to the suit. "On the other hand, when patients are being treated at Zale Lipshy, attending physicians are present at the time that the patients are treated and during the time that surgical procedures are performed. Of course, the patients at Zale Lipshy are not indigent."

Parkland Hospital declined to comment on pending litigation. The hospital was not named in the suit and is not accused of wrongdoing in the lawsuit.

In March, he received a letter from a UTSW official, Dr. Robert V. Rege, saying he was being stripped of his chair positions. Rege sets the policies regarding presence of attending physicians during surgery and had the power to investigate the allegations, the suit contended.

Gentilello said in the lawsuit that he believes he lost the positions because he reported the "illegal patient care and supervisory" practices he observed. | 214-706-7106

St. Jude Medical Receives European Approval to Sell OptiSense Pacemaker Lead

ST. PAUL, Minn. (AP) -- Heart device maker St. Jude Medical Inc. said on Friday it received European approval to sell its OptiSense pacemaker lead.

Pacemaker leads are the thin wires that deliver and sense electrical impulses from the heart.

The OptiSense lead is designed to allow more accurate sensing of the heart's upper chamber, or more specifically, the right atrium, and to block out signals from the heart's lower chambers, according to the company.

The greater sensitivity allows doctors to be more accurate and flexible in programming the pacemaker to suit the patient's needs, the company said.

St. Jude shares fell 62 cents, or 1.4 percent, to $42.80 in afternoon trading.

Questions or comments about this story should be directed to Wallace Witkowski of AP Financial News at 212-621-7190.

Abortion procedure caused death, lawsuit alleges

The mother of a Riverside woman who died of toxic shock syndrome after allegedly undergoing an abortion procedure at Planned Parenthood filed a malpractice suit against the organization and a Riverside County hospital this week.

The lawsuit alleges that Edrica Goode, 21, went to a Planned Parenthood clinic in Riverside for an abortion Jan. 31 and that a nurse inserted cervical dilators, used to gradually expand the cervix in preparation for second-trimester abortions, despite the fact that Goode had a vaginal infection.

The dilators, which are shaped like small sticks and consist primarily of seaweed, became a conduit that spread the infection to the rest of her body, the lawsuit alleges.

Goode, a Riverside Community College student who enjoyed traveling and reading, died Feb. 14.

"My daughter made a choice, but she didn't choose to die," said Aletheia Meloncon, Goode's mother, who said her daughter hadn't told her she was seeking an abortion. "A lost dog gets more attention than my daughter did. This has really torn at my family."

Goode did not return to the clinic to have the dilators removed, even though the devices are supposed to stay in place only one or two days, the lawsuit states.

According to Goode's patient profile at Planned Parenthood, which is in her mother's possession, Planned Parenthood mailed two letters to Goode stating the dilators needed to be taken out.

But Meloncon said the family never received the letters. She also contends that Planned Parenthood should have taken more aggressive steps to contact her daughter.

Vince Hall, director of communications for Planned Parenthood of San Diego and Riverside counties, said his office could not comment on pending litigation. But he said that the "health and safety of our patients is our highest priority."

Planned Parenthood bills itself as the "nation's leading sexual and reproductive healthcare advocate and provider." Its services include abortion procedures; emergency contraception; screening for breast, cervical and testicular cancers; and counseling.

Goode's is the third known death among Planned Parenthood patients in California in the last four years. Holly Patterson, 18, of Livermore, Calif., died of an infection after a nonsurgical abortion in 2003. Diana Lopez, a 25-year-old Huntington Park woman, bled to death a year earlier after her cervix was punctured during the procedure.

Meloncon's lawsuit was filed in Riverside County Superior Court on Tuesday.

After the dilators were inserted, Goode began to experience fevers and started vomiting, Meloncon said. She became mentally unstable, not knowing what the day was and acting aggressively, her mother said.

The dilators are meant to stay in place over one night, and the abortion usually occurs the following day.

With her condition deteriorating, Goode was taken to Riverside County Regional Medical Center in Moreno Valley on Feb. 4.

A hospital blood test confirmed that Goode was pregnant, and Meloncon said she asked that a pelvic examination be performed. The hospital, the lawsuit contends, said it couldn't perform one because Goode would not consent.

"She was confused and disorientated," Meloncon said. "It was totally out of character for what her behavior normally is."

After staying in the medical ward five days, Goode was transferred to a psychiatric unit and then immediately returned to the medical ward, the lawsuit contends. Before the transfer, the lawsuit states, Goode received a gynecological consultation, but no pelvic examination was performed to remove the seaweed sticks.

"If it wasn't for the negligent medical care that Edrica Goode received, she would be alive today," said Jack M. Schuler, Meloncon's attorney.

A Riverside County Regional Medical Center spokesperson said the hospital could not comment on a pending lawsuit.

After Goode returned to the medical ward, her condition continued to deteriorate, Meloncon said. The hospital, she said, performed a pelvic examination Feb. 13 and found the seaweed sticks and gauze. Goode had a miscarriage that day and died the next.

A Riverside County coroner's report listed the causes of death as toxic shock syndrome, prolonged retention of laminaria cervical dilators and intrauterine pregnancy.

"They need to do things different so that patients won't be in risk of great injury or death," Schuler said.

Mother blames Riverside abortion procedure for daughter's death

The mother of a woman who died after a Planned Parenthood abortion procedure filed a lawsuit blaming malpractice for her daughter's toxic shock syndrome death.

Aletheia Meloncon filed the Superior Court lawsuit this week, claiming her daughter Edrica Goode, 21, died Feb. 14 because cervical dilators used in advance of second-trimester abortions were left in too long.

Goode allegedly went to a Planned Parenthood clinic in Riverside for an abortion on Jan. 31 and a nurse inserted the dilators, which are usually left in overnight before an abortion.

The suit said Goode, who didn't return to the clinic to have the dilators removed, had an infection and the dilators became a conduit, spreading it throughout her body.

"My daughter made a choice, but she didn't choose to die," Meloncon said. "A lost dog gets more attention than my daughter did. This has really torn at my family."

Planned Parenthood mailed two letters to Goode stating the dilators needed to be taken out, but Meloncon said the family never received the letters. The woman said Planned Parenthood should have been more aggressive in contacting her daughter.

Vince Hall, director of communications for Planned Parenthood of San Diego and Riverside counties, said his office could not comment on pending litigation.

With her condition deteriorating, Goode was taken to Riverside County Regional Medical Center in Moreno Valley on Feb. 4. A blood test confirmed Goode was pregnant, and Meloncon said she asked that a pelvic examination be performed.

But the hospital said it couldn't perform one because Goode would not consent, the suit said.

"She was confused and disorientated," Meloncon said. "It was totally out of character for what her behavior normally is."

The hospital performed a pelvic examination Feb. 13 and found the dilators. Goode had a miscarriage that day and died the next, the lawsuit said.

The hospital also declined comment because of the pending lawsuit.

The coroner's office listed the causes of death as toxic shock syndrome, prolonged retention of laminaria cervical dilators and intrauterine pregnancy.
Information from: Los Angeles Times,

Malpractice lawsuits are lawyer's cup of tea

Jeffrey A. Walker, who made partner at Snyder, Walker & Mann in 2004 at the age of 33, has made a name for himself as an up-and-coming trial defense attorney, winning as lead counsel in a number of complex medical malpractice disputes.

Walker has been fascinated with various aspects of the medical profession ever since his college days, although he opted to pursue a legal career rather than attend medical school. Of particular interest, Walker has handled and tried multiple cases involving cardiology and gastroenterology issues.

His experience is broad in the area of medical malpractice, managing a diverse caseload of medical matters also involving related claims of fraud, elder abuse, premises liability, indemnity and medical devices. In addition, he has handled general liability cases that involve disputes over property ownership, premises liability, catastrophic injury, trucking liability, E&O coverage disputes, regulatory defense, breach of contract and legal malpractice.

Walker graduated from Southwestern University School of Law in Los Angeles in 1995 with a juris doctorate. In 1992, Walker completed his undergraduate work at the UC Riverside, where he earned a bachelor's degree in economics and a minor in psychology.

Walker is a member of the Association of Southern California Defense Counsel, the Defense Research Institute, the Southern California Association of Healthcare Risk Management and the Professional Liability Underwriting Society. He is also a member of the Riverside, San Bernardino and Los Angeles Bar Associations.

Walker sat down for Six Questions with Business Editor Michael Rappaport this week.

Question: Doctors are spending huge amounts on malpractice insurance. What effect is this having on certain specialties, such as obstetrics?

Answer: Unfortunately, higher insurance premiums are becoming commonplace even for nonspecialized practices.

For higher-risk practices, such as obstetrics, the impact of higher premiums has placed a heavy burden on specialists, leaving those doctors feeling: (1) like they don't want to specialize any longer; (2) that they need to be more selective about where to practice and what patients to accept (which works against higher-risk and HMO patients); and (3) resentful about paying so much to protect themselves.

Q: People seeking tort reform sometimes overestimate the cost of lawsuits on medical care. What is the significance of litigation in the overall picture?

A: Litigation can be costly, burdensome and an extreme deterrent. Litigation is a necessary evil, as most claims can, and should be, challenged through our legal process.

There are premium increases related to claim frequency, reporting mandates to state boards and federal databanks, and "reputation" damage for those in repeated or drawn out litigation.

In turn, litigation leads to fear, fear leads to premature, excessive or unnecessary settlements, and payouts and litigation costs become a focal point for promoting tort reform.

Q: Your mission statement talks about "cost-effective" defense. What do you mean by that?

A: SWM provides a "cost-effective" defense by having a streamlined litigation team assigned to each matter, a working expertise with the medicine, being heavily invested in technology to accomplish tasks faster and with greater precision, and by ensuring that the firm's successes are measured solely by what is in the client's best interest.

We believe in forming partnerships with our clients for every step in their defense, thus developing effective strategies early on in the process, and determining whether cases need to be settled versus tried.

Q: How have people changed as far as their willingness to sue over bad outcomes?

A: It has been my experience that litigation over "bad" outcomes has, and will always be, heightened where one of three scenarios exist.

First, a sense of not understanding what happened and no one willing to answer the tough "what," "how" and "why" questions; second, the grieving process can be so overwhelming that comprehension of the outcome is virtually impossible to fathom; and third, having a sense that none of the providers cares about or acknowledges the loss or bad outcome.

When one or all three exist, the willingness to sue is far greater.

Q: What's the toughest sort of malpractice case for a jury to understand?

A: In my experience, the tougher cases for a jury are those when the emotions or sentiments of a case are far easier to relate to than a technical medical procedure or treatment.

What sounds "reasonable" to a jury years later in retrospect is not always what was necessary, prudent or even recommended years before at the time the care was rendered.

Today's society is far more skeptical, and is much more willing to accept that which is familiar ("that sounds about right") versus what a doctor or expert will testify to is actually done in the medical trenches.

Q: How do we solve the problem of high malpractice insurance costs while still protecting patients from bad doctors?

A: If I had the answer to this question, I could easily claim my seat in Congress. Simply put, there is no clear answer.

Malpractice costs are costly being balanced with supporting our health-care community, offering quality treatment to patients, and trying to weed out the bad apples.

Insurance companies do reward "good" physicians with reduced premiums and rebated renewals. There are also a growing number of high-risk insurance organizations for high-risk doctors, which require the insured to carry high SIRs (self-insured retentions), thus requiring the riskier doctor to pay for some of any judgment or settlement.

These types of retention groups may be a way to contain malpractice costs by segregating those health-care providers deemed to be higher risks.

$7.7M settlement in malpractice suit

MORRISTOWN: A 23-year-old Sussex woman who is a paraplegic due to an unde tected spinal tumor won a $7.7 million settlement yesterday in a medical malpractice lawsuit, her attorney said.

Cindy Hotalen's case was about to go to trial before Superior Court Judge Thomas Harper in Morristown when the parties reached the settlement, said Jeff Korek, the Englewood attorney who worked on the case with his associate, Michael Fruhling.
The defendants were: Radiologic Associates of Northern New Jersey and Pennsylvania; Matthew T. Skalla; Neuro Specialists of Morris-Sussex; In fanta A. Stephen; the Orthopedic Center; Mark Rieger, Spine and Orthopedic Center of New Jersey and doctors David Basch, Allan L. Gardner and Eugene Hrabarchuk, according to court papers.

In 2001, Hotalen, then 17, went to a physician complaining of numbness in her right leg. Radiologists misread her MRI, Korek said. The MRI report followed her over the next two years as she sought help for her condition, Korek said.

She finally was diagnosed with the tumor in 2003, after another MRI was performed. Over the years, the condition worsened and she is now ex pected to be in a wheelchair for the rest of her life, Korek said.

"Anyone who doesn't understand why there should not be curbs on malpractice suits should look at this case," Korek said.

The tumor, had it been de tected early, had a 95 percent cure rate, he said.

Public rallies around

abused 'bait' dog DENVILLE: The township's animal control officer has received phone calls from more than 60 people offering to provide a home or foster care or contribute toward the medical bills for a dog found on the side of Route 10 last week.

Authorities believe Benson -- named for a police officer who helped retrieve him -- is a greyhound and Labrador retriever mix and was used as a bait dog to train other dogs to fight. He was covered with more than 50 old and new bites, police said.

Soroka ER doctors found negligent in two medical malpractice cases

Two recent rulings by the Be'er Sheva Magistrates Court reveal medical malpractice at Soroka Medical Center's emergency room.

In one case, an emergency room doctor told a patient with a transplanted kidney to take a medication that severely damaged the kidney, although the patient himself warned the doctor against giving him the drug and begged him to consult a specialist.

In the second case, a Soroka emergency room physician who was treating a woman for facial injuries left pieces of the patient's teeth embedded in her tongue, which were discovered only months later.
Judge Tahar Shahaf handed down the verdicts in a civil suit brought by the patients against the Clalit Health Maintenance Organization, which operates Soroka. The judge criticized the doctors harshly and last week awarded NIS 100,000 in damages to the kidney patient, including damages for pain and suffering, emotional distress and fear of losing the kidney. Two weeks ago, the judge set damages for the woman with the injured face at NIS 80,000.
The 47-year-old transplant patient, from southern Israel, received a kidney from his sister about a decade ago. In September 2001, he went to the Soroka emergency room complaining of back pain. He informed Dr. Yefim Shot, who examined him, that he had a transplanted kidney.

Shot recommended that he take the anti-inflammatory drug Vioxx. The patient told the doctor that he had been instructed not to take medication of this type. According to his lawyer, Dr. Shai Feuerberg, the doctor responded "impatiently and even rudely" and "was angry at the patient," who asked him to consult a kidney specialist. In fact, after taking the medication, the patient suffered muscle and joint pain, fever, weakness and chills, and considerable damage to the kidney was diagnosed.

He was hospitalized in December 2001 and was told that he would have to go back on dialysis and prepare for another kidney transplant. Eventually, however, the transplanted kidney began to function again.

The judge said the doctor had violated "all the proper rules" and standards expected of an emergency room. She rejected Shot's argument that he only suggested that the patient take the medication and advised him to consult his family doctor first.

Soroka responded that "the hospital is studying the verdict and considering its steps," but noted that the court determined that there was no damage to the kidney.
The woman who sustained injuries to her face had fallen down the stairs in her home in Rahat, near Be'er Sheva. She was treated in the emergency room by Dr. Ella Even-Tov, who at the time was in her first year of residency in ear, nose and throat medicine. The patient was diagnosed with a cut to the tongue and was prescribed mouth rinses and painkillers. However, she continued to suffer pain and complained of a strange feeling in her tongue. A few months later, it was discovered that two tooth fragments, which had not been discovered during her initial treatment, were embedded in her tongue. The woman said that she suffered neurological damage to her tongue.

The court determined that the treatment the woman received in the emergency room was "negligent and insufficient." Even-Tov, she noted, "did not see fit to carry out primary, urgent and necessary tests," such as an x-ray, which would have caught the problem in time; nor did she refer the patient to the hospital's mouth and jaw clinic.
Even-Tov told the court that she did not refer the patient to the clinic because if she did so with every patient who suffered cuts to the tongue, the clinic would be overloaded. She also said that if foreign bodies like teeth are not identified by tests in the emergency room, "a lot of energy and public money should not be wasted" in locating them, "because they can't cause many problems"

In her ruling, the judge said that Even-Tov's statements were "unacceptable and insufferable" and that "in retrospect, at the forefront of the doctor's mind was not the good of the patient, but rather that of the system employing her." The judge also said that the Clalit HMO physician in Rahat, Dr. Nasri Yusef, had been negligent in not refering the patient to a specialist earlier.
Soroka said that it intended to appeal the ruling, since according to the information in its possession, the damage to the patient was entirely caused by the fall and not by the medical treatment she received.

Delta Opens Medical Malpractice, Professional Liability Division

Delta General Agency announced the formation of a professional liability division with specialized focus on medical malpractice coverage. The company has tapped Marla Timmons, senior health care and professional liability broker, to lead the division.
Timmons will be based in Houston and guided by Dave Van Tiem, senior vice president.

Timmons has many years insurance experience and in the last ten years developed significant expertise in the health care segment of the industry. She has worked for several large insurance brokerage firms including Willis, Sedgwick James and Aon. She was also an account executive in the health care division of a large Houston wholesaler.

Prior to joining Delta, Timmons was a senior health care broker for Aon's Healthcare Practice Group. Her responsibilities included marketing primary and excess medical professional liability for hospitals, physician groups, nursing homes, and miscellaneous / allied healthcare accounts.

Timmons has obtained her Associate in Risk Management (ARM), Certified Insurance counselor (CIC), Associate in Surplus Lines (ASLI) and Associate in Insurance Service (AIS) designations. She has been the instructor of several insurance education courses for insurance professional organizations, insurance brokers and a community college.

Medical malpractice risks served by the new unit include: physicians, surgicenters, home health agencies, medical staffing agencies, specialty and community hospitals, medical clinics, imaging centers, and counseling/social service organizations.

Source: Delta General Agency

New rules in malpractice cases

New rules designed to speed up medical malpractice cases have been established in Madison County.

The changes include a requirement of mediation in malpractice cases, as well as the appointment of a panel of circuit judges to review those cases.

The changes, announced by Chief Judge Ann Callis Monday, were created by the Medical-Legal Committee formed during the spring to address malpractice issues.

The rules were formed after the committee met with a number of people, ranging from members of the Illinois State Medical Society and representatives of local hospitals to a number of attorneys.

Under the new rules, the court will hold a case management conference in which deadlines for depositions, as well as other legal matters and possible settlements, will be addressed.
Allmedical malpractice suits will have to go into mediation within 90 days of the completion of depositions. A circuit or associate judge not assigned as the trial judge will act as a mediator, unless all involved agree to an alternate mediator.

All parties must attend the mediation sessions and must "act in good faith," and a report from the mediator will be sent to the trial judge.

All medical malpractice suits must also be reviewed by a panel of circuit judges. The Medical Malpractice Review Panel will include Circuit Judges John Knight, Barbara Crowder, and David Hylla.

For all medical malpractice suits involving incidents prior to Aug. 25, 2005, if the court grants a motion to dismiss without prejudice - meaning the case may be refiled - due to procedural issues involving a certificate of merit, the plaintiff will have 45 days to file an amended certificate of merit.

The certificate, which is usually filed at the same time as the lawsuit, but not always, is a document from a doctor saying that the suit has merit.

"The new rules are designed to get them settled without a trial," said Hylla, who chaired the committee. "I think it's going to be very beneficial as long as both parties come to the mediation and bargain in good faith.

"We're very optimistic," Hylla said. "Our goal is not just to push cases, our goal is for just results."

He noted that the mediation will be beneficial for both sides in malpractice suits, in part because of the expense involved because of expert testimony and other matters.

Hylla said the idea of mediating such lawsuits is becoming more common.

"It's going to take a while to see how mediation will go," he said. "(Medical malpractice) is a relatively small percentage of the cases we have, but they are important cases.

Sunday, June 17, 2007

Patient claims surgery increased back pain

Johannes Quelle has brought a medical malpractice lawsuit against Dr. Robert Phelps, claiming the physician failed to perform the "normal procedure" on him.

Quelle filed his original petition with the Jefferson County District Court on May 31. Judge Bob Wortham, 58th Judicial District, will preside over the case.

According to the plaintiff's petition, Quelle had a history of back problems and back surgeries. He was complaining of pain following one back surgery and on June 9, 2005 another surgery was performed.

"Dr. Phelps violated the duty of care ... and was negligent during the course of the treatment given to plaintiff on June 9, 2005," the suit said.

The suit faults Dr. Phelps with the following acts of negligence:

* The standard of care for Defendant would require that he be knowledgeable on intrathecal narcotic pumps and possible complications related to the pump and how to treat them. Defendant was not knowledgeable in this area of medicine.

* The defendant performed surgery upon the plaintiff wherein he severed and removed a portion of the intrathecal narcotic catheter, which was not the normal standard procedure when treating a small seroma.

* The seroma was not life threatening and the defendant should not have operated on the Plaintiff for there was no medical emergency reason to do so.

* Given the history of the plaintiff, the defendant, upon examination and finding a small seroma on plaintiffs back, should have referred the patient back to the original physician.

As a direct and proximate cause of the defendant's negligence, plaintiff was caused to endure pain and suffering and further surgical procedures," the suit said.

"Consequently, the plaintiff has never gotten the same pain relief as before and continually suffers from low back pain and leg pain. Prior to the Defendant removing the intrathecal catheter or a portion thereof, plaintiff had pain relief approaching 80 percent," the suit added.

Quelle is suing for past and future medical expenses, mental anguish and physical pain.

"Plaintiff alleges that the above-captioned incident injured his body as indicated above," the suit said. "In the event the evidence shows that there was any pre-existing problems with any of these parts of his body, then plaintiff alleges that the incident aggravated and/or exacerbated any such pre-existing condition or problems."

Quelle is represented by Gerald Eddins of the Eddins & Bennett Law Firm. He is demanding a trial by jury.

Case No. A179-412

Melanoma patient wins malpractice suit

DOWNTOWN SAN DIEGO – A terminal skin cancer patient whose doctor missed his symptoms has won a $5.7 million malpractice judgment from a San Diego Superior Court jury.
Under a 1975 law, the money Regis M. Reilly and his wife actually stand to collect will be reduced to about $2 million, his lawyer, N. Denise Asher, said Wednesday.

Beyond the money, the verdict, delivered last week, is significant because “my clients can hear someone tell them that they have heard them and they understand,” Asher said.

“This was a particularly wicked cancer,” Asher said. “It grew very fast and it needed to be caught immediately.”

Reilly, 54, said in his lawsuit against dermatologist James C. Powers that the doctor failed to biopsy a cyst when Reilly went to see him for bumps on his shoulder in August 2006.

“Essentially, the doctor just missed it,” Asher said.

By the time Reilly was referred to another doctor in December, Asher said, the cancer had spread. She said Reilly underwent surgery to remove the cancer from his shoulder three times but it had metastasized to other parts of his body and was determined to be terminal.

Had the cancer been caught in its early stages, Asher said there was a 95 percent chance that Reilly would have recovered. He is now confined to his home and receives 24-hour care.

Judie Rappaport: My 87-year-old dad wears a Speedo in public; it's embarrassing!

DEAR JUDIE: My 87-year-old Dad is wearing a Speedo bathing suit at his condo pool because his new girlfriend (88) thinks he looks sexy! Are they crazy? I'm mortified. What can I do to end this humiliation?

Celeste, Vero Beach
DEAR CELESTE: End your embarrassment by staying out of Dad's pool area. This is not about you. Dad's bathing suit is within legal limits, he's wearing the proper attire for a pool, and he's enjoying his life.

DEAR JUDIE: When I found out my favorite 81-year-old uncle had terminal cancer, I immediately went to Pennsylvania to help. My aunt, 80, has her own health issues and was glad to see me. She was always there for me when I needed her and I wanted to return her love by relieving her of the responsibility of taking care of my uncle. After I set up live-in home care, called Hospice, went grocery shopping, cleaned, cooked — everything I could think of — my aunt changed from nice to cool and resistant to my help. What happened?

Penny, Stuart

DEAR PENNY: I can hear readers saying, "I could use help, Penny, come to my house!" If they actually expressed those feelings, that would constitute an invitation. Taking charge of your uncle's needs was your aunt's domain. Unless she invited you or agreed to your help before your visit, your loving and well-meant reaction must have felt like an invasion of her privacy.

Call your aunt and apologize. Tell her how much her love and kindness meant to you through the years. Show your love and respect by asking her permission, "Can I help?" If she declines, say you love her and not to hesitate to call if she needs help or just wants to talk. Send cards, write warm letters, and call her frequently to respectfully repeat your offers and expressions of love.

DEAR JUDIE: I'm concerned about Mom's care in her nursing home. She's fallen twice, amazingly with no damage, but I don't think she should be falling at all. What's my next step?

Phil, Stuart

DEAR PHIL: Accidents happen, but falling twice suggests problems. Visit the director of nursing and ask for details: Where was the fall? Who found her? Could Mom's medications cause dizziness? Who examined her to determine whether she was injured? What was the cause of her fall? Has the staff made arrangements to prevent another fall?

Ask to attend the patient care conference (staff meeting to discuss Mom's plan of care). Keep records of the dates you visit, whom you talk to, questions asked, answers given and other problems witnessed or discussed. If the nursing home refuses to answer your questions or Mom falls again, file a formal complaint with the Agency for Health Care Administration at (888) 419-3456 (www.ahca.myflorida/com/contact). Your written record will help. Stay involved. Supportive family members often help improve the level of care for nursing home patients.

Man Leading Nation in $10 Billion Suit On Behalf of America’s Fathers Speaks Out!

The poor poverty stricken man who is pursuing a $10 Billion Civil Suit against the State of Oregon, the Federal Government and 49 other States on behalf of himself as lead plaintiff and hundreds of thousands of fathers across the nation has given this author permission to publish his account of his current circumstances for the public record.

“On May 13th, 2007 I got a letter from an attorney who I paid $100 to review my case. The first attorney who reviewed my case over the phone without any documentation also charged me $100. The first attorney referred me to the second attorney. The second attorney consulted with a third attorney more her superior and qualified to deal with my “complex” case.

"The letter dated May 7th, 2007 included a copy of the original letter sent from the same attorney who had not responded since getting paid the $100 for more than a month.

The original letter was dated April 24th, my 51st birthday which I spent alone crying for several hours on the shores of the Pacific Ocean in Venice Beach because I have not been able to see my two minor children, age 5 and 11 for more than three years.”

Originally the father had contacted the law firm just to get child visitation rights established by getting a court appointed attorney for the children who live in Eugene, Oregon.

The mother, over the past 13 years has had the man arrested on at least five occasions on false charges given to various local police, mostly after arguments about money and how to discipline the children.

Some of those charges included a felony which the father pled no contest to but which prevents the father from getting a job as a licensed real estate sales person in California, a profession in which he was successful prior to moving to California. A hearing with the State of California is set for August on that issue.

A no contest plea is treated the same as pleading guilty and usually avoids lengthy and costly trials, but leaves a permanent record on any mans life, barring him from many rights and opportunities, something which isn’t always explained by lawyers and judges to those accused of things they didn’t really do.

After much patient waiting by the father, the law firm finally wrote him a letter stating that in order for the law firm to represent him, he had to agree to authorize them to file a motion to appoint Robert Loveland or some other qualified psychologist to conduct a comprehensive custody evaluation for the purpose of generating a comprehensive custody and parenting time recommendation pertaining to the father, the mother and his two minor children,.

The letter stated that the law firm would prefer to use Dr Loveland who works out of Portland but provided no information about him, his practice or his qualifications. The letter went on to state that there are a few other qualified psychologists in Eugene who would also suffice. Their fees range from $4,000 to $6,000 and the father would need to pay that up front, directly to the psychologist.

It is a well documented fact that “the psychiatric profession is made up of more quacks and idiots than all the mental institutions in the world combined, their pseudo science is full of jargon not even a rocket scientist could fathom, and psychology is nothing more than the brainwashing gibberish that lists more than ten thousand ‘mental disorders’ that only exist as idea’s and concepts in the minds of the people who invented them and who perpetually and ignorantly foist their pseudo knowledge and phony wisdom upon the unsuspecting victims erroneously seeking their help”, at least according to the philosophy of Scientology – “The Science of Knowing How to Know”.

Unfortunately, the mental health profession leaves much to be desired for society. If it really were a mental health profession, we would have no crime, no war and no insanity, or at least these things would be diminishing in the world rather than expanding.

Any human being who looks around at current planetary conditions could easily see from doing a tiny bit of research that the psychiatric profession has co-opted the legal and justice system in America.

Every lawyer and judge in America has been duped into believing that these “experts” know something about how to improve the conditions of their patients. The exact opposite is true.

Just take a look at how much more profitable drug companies are today than they were thirty years ago. The greatest demand for prescription drugs comes from those written by psychiatrists. And psychiatrists are also the largest direct and indirect stockholders in publicly traded drug cartels.

Without justice, there can be no peace, without love, there can be no peace, without peace there can be no love, without love, there can be no justice, without justice, there can be no love, and there are no absolutes of these things, peace, love, justice, but they are interlocked into triangular degrees of sanity...for as one side of the triangle of peace, love and justice diminishes in power, capacity or application, the other two sides diminish correspondingly, and these three sides of the triangle are the building blocks of a sane civilization.

To the degree that peace, love and justice are blocked in any society, to that degree that society is insane, and there comes a point when insanity reaches a point where that society is doomed. Just ask any Roman, Greek or Babylonian...what went wrong?

The lawyer wrote that they would ask the Court to order the mother to pay some portion of the cost of the psychiatric evaluations, but that request would not be ruled on until the close of the case, so the father would need to front the money.

This case involves complicated histories on both parents’ parts of allegations of drug and alcohol abuse, alleged domestic violence, criminal allegations and convictions, all of them now expunged, etc.

The mental health, domestic violence and chemical dependency issues render this case complex and it would not serve the father or the children to go forward without the assistance of a mental health professional skilled and trained in custody evaluations, all according to the opinion of one attorney and her senior legal partner.

“In general, it is a given understanding among the legal profession that these types of cases are dictated solely by ‘the children’s best interests’ but the complicated circumstances render it exceedingly difficult to flesh that out”, said the lawyer.

The law firm insists that the father resort to a custody evaluation conducted by a qualified mental health professional / custody evaluator. “The ONLY issue before the court in a custody/parenting time case is ‘what will serve the children’s best interests?”, according to the lawyer.

How many psychiatrists does it take to figure out what is in the best interests of a child and what say do the children have in the matter if they wish to see their father regardless of what their mother tells them about him?

According to research conducted online, Dr. Ira Daniel Turkat, PhD says that “Divorce related child visitation interference is a national problem, affecting six million children.

"Such interference may be acute or may represent chronic disorders, such as Parental Alienation Syndrome and Divorce Related Malicious Mother Syndrome. In certain cases, visitation interference is accompanied by vicious behaviors toward the noncustodial parent, including violence and violations of law.”

It would appear that if the children’s best interests were at the real core of all child visitation issues in the current legal system, there would not be six million children crying at night before bed time for their Daddy’s, let alone the six million plus fathers who have been psychologically trained to “bite the bullet, be a man, hang tough, and be strong”, but who suffer great grief from their losses nevertheless, and are currently powerless to enforce their rights as fathers and men.

The psychologist would meet and observe the father, the mother, and the children, any other significant people in the children’s lives, which in this case includes an alcoholic grandmother who is financially supporting the mother who is on welfare and who works for another law firm in Eugene.

The psychiatrist would have numerous interactions with the parties and the children; he would sift through and investigate all the allegations and circumstances. The father would need to fly up from Los Angeles to Eugene at least 3 times for that purpose.

That could prove difficult for a man who himself is now on food stamps, is collecting unemployment and is on the waiting list for surgery at UCLA Medical Center involving three hernias and other internal complications which have caused internal bleeding on and off for the past five years. The man is very close to being permanently disabled.

The lawyer went on to say they would file a motion to set a hearing to occur about 21 days from the date of filing to establish a temporary parenting time / access plan for the father and the children.

This would moist likely result in initial supervised parenting time for the father. In light of the history of this case, most critically the fact that the father has been out of the children’s lives for so long, even assuming that it is on account of mom’s bad behavior, and the fact of alleged abuse, and the fact that the father has filed numerous, lengthy and somewhat renting pleadings on his own behalf in the State and Federal court system, the judge’s will be likely to err on the side of caution when it comes to assessing the father’s emotional and mental stability.

This all according to the attorney who is too obviously also a woman.

In other words, if you file renting complaints using the Court system without an attorney your emotional and mental stability are in question? Could only a woman could come up with that kind of logic, or is this ingrained within the legal profession – “if you need a lawyer you are mentally incompetent”.
“What the father and half the men in this country are not aware of is that if you hire an Esquire, a member of the BAR, you are basically stating and admitting to the court and the world that you are mentally incompetent and unable to represent yourself before society on the particular case in question, according to Master of Psychology drop out, Karl Chromy of Portland, Oregon. Chromy studied psychology for twelve years at Portland State University and never graduated.

After becoming a professional psychology student he eventually became permanently disabled after a hockey accident. Is there any connection between accidents and psychiatrists? Another story indeed!

In this instance, according to the attorney, parenting time would realistically need to begin on a supervised basis, but with the assistance of parenting time supervisors and several successful interactions between the father and his children, parenting time would likely expand, hopefully in fairly short order. Why does a father need supervised visits when the mother and grandmother kidnapped his children and haven’t allowed them to see their father for over three years?

The lawyers say they know a good supervisor in Eugene and told the father he could fly up from Los Angeles twice a month or more to visit. There is only one crime in America. That crime is not having enough money to take care of your own personal business affairs and satisfy your personal needs.

Unfortunately the true criminals who create scarcity in this world – the Bankers and the Lawyers – are the ones in control of the global economy, so is it any wonder that well over $50 billion is now owed in back child support by more than a million hard working fathers from the 50 states? After all, 99.99% of Congress is composed of lawyers.

The lawyers said that “after a few months, they would seek to release the supervision requirement and expand the visits. If you impress the evaluator, you could anticipate less frequent, but lengthy visits in California, to coincide with your kids’ academic breaks”.

So if all courts deal in the best interests of the child then why would anyone need to impress an evaluator? Why would the BAR be set so high that it excludes 95% of all hard working men from seeing their children by creating an invisible tax of unaffordable legal services?

The children always know the truth deep inside – they already know who really loves them from a distance, like God might admire his children and let them make their own mistakes, and they also know who tortures them with daily doses of verbal abuse and lies. The dichotomy is real! It is mothers who raise most men in this country. The women’s movement has seemed to have forgotten that fact.

Unfortunately, according to Dr. Turkat “the desire for ongoing and liberal visitation between child and nonresidential parent has frequently not kept pace with actual practices. The Children's Rights Council (1994) estimates that six million children in the United States have their visitation interfered with by the custodial parents.

“Two surveys support the range of this problem. Arditti (1992) reports that approximately 50% of divorced fathers relate that their ex-wife has interfered with visitation with their offspring. Similarly, approximately 40% of custodial mothers admit denying their ex-husband visitation in order to punish him (Kressel, 1985). In some cases, visitation interference has been associated with malicious unlawful acts against the father of such children (Turkat, in press). On rare occasions, a parent may actually kidnap the child.”

Kidnapping is defined as when “A child was taken in violation of a custody agreement, court order or decree, the kidnapper failed to return a child at the end of a legal or agreed-upon visit, with the child being away at least overnight. An attempt was made to conceal the taking, or the whereabouts of a child, or to prevent contact with the child. The child is transported out of state, or there is evidence that the abductor had the intent to keep the child indefinitely, or to permanently alter custodial privileges,” according to the Federal Bureau of Investigation.

In this particular case the woman took the children from Reno without the father’s knowledge after the woman found out through confidential emails with business associates that the father intended to divorce the mother and give her $2.4 million as a settlement of their marriage thereafter.

Where that money was to come from is a whole different story, perhaps even a book or a movie. It took the father three months to find the children living with the children’s grandmother in Eugene, Oregon. The woman abandoned the home in Reno.

In 2008, there will be an estimated 5 million divorces, affecting more than 5 million children. Out of those families that are being broken up by a financial, economic and legal system that destroys incentive and continues to ship jobs overseas, while the cost of gas skyrockets at home, on any given day, at least 1,000 children will be taken away from the other parent without their knowledge and kidnapped away according to the National Crime Information Center.

There are more than 40 million children in America today, living with a single parent who is separated, or divorced. In 2008 there may be more than 2 million additional new divorces as millions of families lose their homes to foreclosures from the housing depression that is well underway and could last another decade.

150,000 divorces a year, or 1 in 7 involve child custody battles. Today’s average marriage will last about five years. Single-parent families have increased by over 1000% since 1960 as have divorces.

Not politics, law nor religion have provided an effective antidote to this spreading social disease.

The lawyers told the father that he would need to deposit $2,500 into their client trust account. Can anyone really trust bankers and lawyers these days?

“In light of our review of your financial history and circumstances, we are not willing to proceed with less than that up front. With a custody evaluator on board, however, that really minimizes, potentially, the amount of work that the attorneys have to do. At any time that your trust account balance fell below $1,200, you would need to deposit an additional $500 within one week of being so notified,” wrote the lawyer to the poor father.

There is only one thing worse than being insane. That is “not knowing” that you are insane. The court system that the legal profession has dreamed up and foisted upon the fathers of America is insane and they do not know it, but fathers all over the country do and they will eventually do away with the entire lot in the process of seeking justice.

As a homeless man once wrote in a poem written for a song for a soundtrack of a yet to be finished major screen play, “The Bankers and the Lawyers they all fall down”.

A group of people in California known as Fathers for Justice are now in discussions to form a legal offense fund to change the laws and mandate equally shared parenting time, regardless of the circumstances surrounding disputes among couples and their legal separation issues. Their recent support of Alec Baldwin at a rally for father’s rights was very well publicized elsewhere.

Another group out of Indiana is moving forward with their class action lawsuits in each state of the union. To demonstrate how insane lawyers and politicians have become, the following story should give the reader a tiny peek into absurdity.

According to Glenn Sacks, “It would be difficult to make California's controversial domestic violence policies more irrational and unfair to men, but Senator Sheila Kuehl (D--Santa Monica) is trying.

“California law has long excluded men and their children from receiving state-funded DV services, even though research demonstrates that a third of domestic violence-related injuries are incurred by heterosexual males caused by women.

“The legislature reiterated this exclusion last fall by passing AB 2051, which references services for ‘battered women’ 31 times yet never once mentions "male victims," "men," or even simply ‘victims.’

While California funds over 100 domestic violence shelters for women, there are only two facilities in the state which even accept male victims, and both of them are in remote areas.

Recently Kuehl and the California Senate Judiciary Committee took the state's DV policies to a new level of absurdity by passing a law to address the issue of domestic violence and...Pets!

Kuehl's SB 353 amends Section 6320 of the Family Code so that women claiming domestic abuse can more easily gain custody of the family's pets. The bill also allows women to obtain restraining orders which prevent alleged abusers from having contact with their pets.

While legislators focus on protecting dogs, cats, rabbits and hamsters from being exposed to domestic violence, they've failed to offer any services to men, and still the children’s longsuffering weeps, deep into the night, asking, where is my Daddy?

Isn’t it amazing that intelligent people practicing law cannot come up with simpler solutions that are really in the best interests of their potential clients’ children? Is there anything more important to the future survival of the human race than our children?

Has the United States Government, the State of Oregon and many of their attorney’s, employees and agents also become unwitting accomplices in what appears to be a developing story of kidnapping?

This is the third article written by Alex S. Gabor on the subject of individual father’s rights versus the State and Federal Government. A book, “Domestic Family Terrorism” by the same author is in the works, seeking a publisher.

Lung patient sues for clean oxygen

Firm says it's never had other complaints
Littleton - Norman "Jack" Newell, 75, who is battling chronic lung disease, has spent a decade trying to get clean breathing oxygen, according to a suit he and his former wife filed in Jefferson County District Court this month.

Jack and Linda Newell allege that Apria Healthcare Group Inc., a supplier of home oxygen breathing equipment, has delivered equipment visibly contaminated with mold and insect parts.

That, the Newells contend, led to additional lung infections and required several trips to hospitals for Jack Newell.

"His immune system can't fight anything off anymore," Linda Newell said. "People expect their medical equipment to be clean, safe and healthy, and it's not."

Apria Healthcare officials said in a statement that they have repeatedly offered the Newells an opportunity to use another supplier of home oxygen, and the couple has refused.

The U.S. Food and Drug Administration inspected Apria's Littleton facility in 2005 and issued no citations, said Lisa Getson, executive vice president of Apria at the company's Lake Forest, Calif., office.

The FDA also inspected the site in 2001 and did find problems, according to a report.

"The facility was not maintained in a clean and sanitary condition," the 2001 FDA inspection document concluded.

The problems noted include:

No tracking mechanism to ensure preventive maintenance was done in accord with company or manufacturer recommendations.

Dirt coating two of 37 oxygen units.

Dirty and torn fiberglass ceiling insulation hanging down over storage areas.

Company staff could not determine if one randomly chosen oxygen unit had been cleaned between patients, the inspectors noted.

The staff claimed they received only one complaint in the previous year, but it "was not the complaint that prompted this inspection," according to the report.

Apria's Getson said only the Newells have complained about the cleanliness of her company's oxygen delivery systems.

"In the 10 years these patients have used our service, Apria has cared for at least 1 million other oxygen patients across the United States, and we have not had any complaints," Getson said.

The company is certified for 18 years by the Joint Commission, a company that evaluates health organizations, Getson said.

Still, Linda Newell said inspections aren't catching problems.

Nine 3-foot-tall oxygen tanks stand to the side of Jack Newell's bed, in the wood-paneled room in which he has spent the past six months.

Linda Newell cleans the oxygen containers with bleach mixtures and sends water condensation bottles through her dishwasher on a sanitize cycle.

Fatherly advice from Cape dads

Being a parent, as almost any mom or dad will tell you, is the single most challenging and important job you will ever have. The hours can be grueling, but the joys can be unsurpassed.

So for Father's Day, we sought out some of the brave men who took on that job and asked what advice they would give to other men about to embark on the most critical task of their lives: becoming a great dad.
We found men with toddlers and ones with grandchildren, some with one or two children and one with five. Their advice varies, but much of it centers on a few key principles: Spend time with your children; savor that time; be there for them; and recognize that life is not about you anymore.

And they wouldn't have it any other way.

Chris Guyette of Hyannis, who has a 15-month-old son and 18-year-old daughter

"Be prepared for big changes! You are going to have another life in your house!�

"You will appreciate the little things in life that you used to take for granted, like taking the time to study your child's face and learn their little quirks. You learn more about yourself and how fast life changes at any given moment. Our son gives us something new to look at every day — a Cheshire Cat grin, a new word. Appreciate those little things, and value every minute, because it is all those little moments in life that will lead him or her to the bigger moment in life when they are adults.

"And those little milestones will never repeat, so keep a scrapbook so you can reflect back when your child is

older. Treat older kids and teens with respect, and understand that each child is an individual, and understand those differences — you have to be a chameleon, changing parenting tactics from child to child to suit their personalities, while being fair and equitable between them all."

Bob Johnson of Centerville, who has four grown daughters and two grandchildren

"My kids and family always come first, and I never treat one daughter better than the others. I have always tried to reason with them and explain my decisions, and I think by doing that, we have a very open, talkative relationship. Don't preach to your children, rather talk to them and explain right and wrong.

"Keep them away from drugs, which can destroy their lives.

"My door will always be open to my children, no matter what they have done or what trouble they may be in. I brought them into this world, and it is my responsibility to protect them and provide for them."

n Mark Sundman of Sandwich, who has an 18-year-old son and 14-year-old daughter

"I have always taught my children that the best way to avoid getting into drugs is simply to never try it. If you never try it, you will know for sure that you will never desire it or become addicted to it.

"My children and I are very close, and I think that is because we participate in things together that we like. Many parents go to soccer games or gymnastics but don't actually participate. My son and I love mountain biking together, and my daughter and I are into music (she is in a hand-bell choir, and I am learning the guitar)."

Dan MacDonald of Mashpee, who has two daughters, ages 2 and 3

"Being a father changes your perspective — life is not about you anymore, it is about your kids. You start to enjoy things that you haven't enjoyed in 30 years when you are a dad. You appreciate the small things in life and the absolute joy of watching them grow."

n William Murphy of Brewster, who has four grown sons

"I think that you realize that the world doesn't revolve around you anymore — that your kids come first, and you need to be there for them, no matter what. And you need to realize that your children will follow in your footsteps — they see you as their role model, and so you need to make sure that they are learning from you what you want them to learn. You can inadvertently be a bad role model if you are not careful."

Lee Flanagan of Bourne, who has a 4-year-old son and 2-year-old daughter

"The rewards of being a parent go along with the effort you put in. Be 100 percent involved — don't be a part-time father. Being a dad is not a spectator sport. There is a huge difference between being a 'father' and being a 'dada' — anyone can be a father, but you must really work at it and devote the time and effort to your children to become a dad."

Rob O'Regan of Forestdale, who has a 4-year-old son

"You learn as you go. Being a dad fills up so much empty space that you never even knew was there. I couldn't imagine my life without him. You have to love them unconditionally. Go with the flow, and have rules, but be flexible as well. Do things with them every day, because the time goes by amazingly fast.

"Children make you remember the simple joys of life and how exciting the smallest feat can be."

Steve Tordone of Sagamore Beach, who has a 4-year-old daughter and 2-year-old son

"I am still learning, and it is always a learning process. I never thought I could love someone as much as I do my children. Be patient with your children, and realize that your time is no longer your own."

Justin Bousquet of Mattapoisett, who has a 1-year-old son

"Bringing up another human being is enormous work. Be patient, because when you look back when they get older, you realize it wasn't so hard. You understand more about yourself as a man as well, and you eventually realize that being a dad gets easier as long as you put your children first."

Jeff Allen of West Barnstable, who has an 8-year-old son and 5-year-old daughter

"Sleep while you can, have great patience, and get a good sense of humor. Your life will change, but don't give up your passions — expose your children to your hobbies and what you enjoy. Take them to restaurants and on vacations from the time they are babies, and they will be easy to go places with and do things with as they grow, because they are used to it."

Bernie Milton of Sandwich, who has three grown children and four grandchildren

"You learn patience and moderation. You may get the urge to be really angry, but you must learn to moderate that anger and understand that they

make mistakes. Treat them like adults, even when they are young."

n Gary Cardeiro of Falmouth, who has a 21-year-old son and four daughters, ages 16, 15 and 13-year-old twins

"Be part of your children's lives — go to sporting events, school functions — it will run you ragged, but you will never regret it."

Steve Pothier of Sandwich, who has two daughters, ages 24 and 21

"Learn patience, and don't be quick to judge them, especially as teens. You need to let them make mistakes, even though it may cause you pain as you watch them learn from their falls."