Medical malpractice companies benefiting from courtroom caps today must tell state regulators why they are not returning more of that money to doctors and the public. Insurance Commissioner Kevin McCarty has ordered executives of major malpractice insurers to attend public hearings today in Tallahassee on their rates. Consumer Advocate Steve Burgess, in the Department of Financial Services, estimates premiums should be cut 40 percent to 50 percent. Michigan-based ProNational Insurance instead offers to cut rates 8.6 percent.

The Legislature three years ago capped pain and suffering awards to $500,000 per physician and $1 million per case. Since then, Burgess contends, insurance data shows medical malpractice legal costs and payouts have dropped 43.6 percent, from $989 million to $557 million.

Posted by Scott J. Eldredge at 09:17 PM | Permalink | Comments (0) | TrackBacks (0)

For health care providers, North Dakota may mean being able to say you're sorry without fear of having the apology used in a medical malpractice lawsuit. "The way it is now, even if a doctor wanted to talk to a patient to express sympathy, they can't do it because of fear that it will be used against them in court," said Rep. Lawrence Klemin, R-Bismarck.

The North Dakota House voted 74-17 on Monday to approve legislation that says a health care provider's "expressions of empathy" may not be used against him or her in a malpractice lawsuit, arbitration proceeding or license hearing. The bill now moves to the state Senate. It covers doctors, nurses, therapists and anyone else licensed or certified by the state to provide health care. Twenty-nine states, including South Dakota and Montana, have similar laws in place, according to the Sorry Works! Coalition. As introduced, the bill also shielded a medical provider's admission of fault if something unexpected happened to the patient being treated. Legislators who initially reviewed the bill agreed the reference should be removed.

"If a doctor says, 'Gee, I'm sorry, your loved one just passed away,' or, 'I'm sorry, things didn't turn out the way we all had hoped,' that's an expression of sympathy," said Rep. Kim Koppelman, R-West Fargo. "If your doctor says, 'Gee, it was my fault,' maybe that is something else." Rep. Chris Griffin, D-Larimore, said he believed the purpose of the bill's promoters was to protect a medical provider's statement of fault. Without that provision, Griffin said, the bill is meaningless. "I don't foresee this bill, if it passes, to really change anything," Griffin said. "We are not putting much faith in the jurors and the courts of our state, if we don't think that a doctor, or a health care professional, showing some sympathy is actually going to end up in a medical malpractice suit."

Posted by Scott J. Eldredge at 09:12 PM | Permalink | Comments (0) | TrackBacks (0)

The Government Accountability Office (GAO) has issued a report that finds fault with the FDA for its oversight (or lack thereof) of the drug industry's Direct-to-Consumer (DTC) advertising. DTC advertising was authorized by Congress in 1997 and gave drug companies the ability to market directly to the public, resulting in a barrage of television, online, and magazine ads. And it works. Consumers see the ads, and ask their doctors for the drugs by name. Critics point out that DTC advertising creates a huge consumer demand for expensive, name-brand drugs, even though less expensive drugs may work just as well.

GAO's new report finds that the FDA doesn't properly regulate the content of the ads presented to the public by the drug companies, and also that it takes too long to review the commercials and put a stop to misleading or inappropriate ads. During 2004 and 2005, the FDA's 19 regulatory letters were sent an average of eight months after dissemination of the materials! The GAO recommends that the FDA: 1) document criteria for prioritizing DTC materials for review; 2) systematically apply its criteria to materials it receives, and 3) track which materials it reviews.

Posted by Kerry N. Jardine at 09:10 PM | Permalink | Comments (0) | TrackBacks (0)

According to researchers at UNC-Chapel Hill, 1 in 4 healthy newborns suffer from a minor brain hemorrhage. Minor brain hemorrhaging in young infants in usually associated with "Shaken Baby Syndrome." "Shaken Baby Syndrome" is a traumatic brain injury that occurs when an infant is vigorously shaken. The shaking causes intracranial bleeding in the brain that can cause severe brain damage and even death.

The study conducted by UNC-Chapel focused on early brain development in infants. They scanned newborns for brain bleeds using an MRI and found that an alarming number of newborns suffer from a brain bleed. Over 25% of newborns delivered vaginally suffered from a brain bleed, while those delivered through a cesarean section were less likely to have a brain hemorrhage. Other studies have shown much lower numbers but a UNC radiologist speculates that the occurrence was probably something that was always there. Improved technology and more sensitive tests have made it possible to identify these brain hemorrhages.

Brain hemorrhaging probably occurs more in vaginally delivered babies because the newborns flexible skull is compresses when passed through the birth canal. Hemorrhages that occur during birth appeared to be concentrated near the back of the brain and only span a small area. Newborns with birth related hemorrhages show no signs of brain damage. Brain hemorrhages associated with "Shaken Baby Syndrome" however, are concentrated at the top of the brain and are much larger - these are far more dangerous for the development of the brain. This important distinction discovered by the researchers at UNC will help physicians distinguish between normal brain hemorrhages and brain hemorrhages due to abuse.

The study will be published in the February issue of Radiology science journal.

Posted by Kerry N. Jardine at 09:07 PM | Permalink | Comments (0) | TrackBacks (0)

Even the judge acknowledged the sentence wasn't tough enough. Sean Patrick Armstrong, accused of striking a bicyclist with his pickup last February in south Charlotte and then fleeing the scene, will spend no more than a year in prison. His victim, Brian Hanley, suffered a traumatic brain injury and remains in a wheelchair. Hanley suffered head trauma and a broken pelvis, leg and ribs, spending weeks in a coma. "Brian has had to relearn how to breathe, eat, see, speak, sit. And it has taken him almost a year to be able to do those basic things," Brian Hanley's fiancé Laurie Griffin said. "He cannot walk, he does not remember the house he lived in, and he needs full-time care. "Not only did you take away life as he knew it, but you took away a father from two little boys. You took away their childhood. The youngest won't even ride his bike anymore."

Armstrong on Wednesday pleaded guilty as charged to felony hit and run resulting in injury. Mecklenburg Superior Court Judge Don Bridges told Hanley and his parents that the sentence, 10 months to a year, was the maximum that he could impose. "And yet everyone in this family, in fact everyone in this courtroom, probably knows this sentence is not severe enough for what has happened," Bridges said. "For that, I'm sorry."

Mecklenburg Assistant District Attorney David Graham said Armstrong's case shows that North Carolina's hit-and-run laws are inadequate to appropriately punish those who cause serious injuries. "Armstrong's sentence totally fails to address the devastating injuries to Brian Hanley," the prosecutor said. "I hope our legislators will make the punishments tougher for these extraordinary cases."

Posted by Kerry N. Jardine at 09:02 PM | Permalink | Comments (0) | TrackBacks (0)

For veterans returning from Iraq with traumatic brain injuries, life can spiral out of control. They lose memory and concentration, they cannot maintain relationships, they are unable to work and lose jobs. They feel isolated, frustrated and angry. The 10 in 10 Project, a New York-based nonprofit, is launching its Ticket to Hope campaign, sending brain injury recovery kits to people with traumatic brain injuries. The kit includes a DVD tutorial, teaching keys to recovery, finding a buddy, getting rest, accepting your new life and setting a routine, claims founder of 10 in 10 Karen Fowler. The kits, however, are not a cure-all. They are complicated and people with traumatic brain injuries might not have the cognitive skills to use them, said Diane Tripplet, director of the Brain Injury Association
of Maryland.

Fowler was inspired to start the project because her brother suffered a brain injury from a car accident 25 years ago. "Obviously, the whole family was devastated," she said. "It's like having a wheelchair in your head and nobody can see that wheelchair." At the time, Fowler lacked knowledge about these injuries. By watching the DVD with her brother, she was able to understand his injury. Not all of the 5.3 million Americans living with disabilities from a brain injury have the support system Fowler's brother has. Fewer than two in 10 sufferers receive the aid they need to return to a meaningful life, Fowler said.

Two-thirds of wounded soldiers in Iraq and Afghanistan have had traumatic brain injury, according to the Walter Reed Army Medical Center. Traumatic brain injury is often misdiagnosed in soldiers as post-traumatic stress disorder, said Dr. Ezriel Kornel, director of the Institute for Neurosciences. "People tend to think that maybe they've had a traumatic emotional event and all they need to do is be psychologically managed and they'll get better," Kornel said. "There are a lot of people who sort of fall by the wayside."

Posted by Kerry N. Jardine at 08:57 PM | Permalink | Comments (0) | TrackBacks (0)

Ashley Zauflik, the Pennsbury High School junior was the most seriously injured in an out of control bus accident Jan. 12 that hurt 16 other students. Surgeons continued to work on Ashley's left leg Friday morning, which was amputated above her knee more than one week ago as a life saving measure, said William L. Goldman Jr. the family's attorney. The Zauflik family is currently deciding what type of surgery is best to attend to Ashley's fractured pelvis and possibly fractured right ankle, he said. Although she is no longer in a medically induced coma, Ashley remains on heavy dosages of pain medication.

Ashley Zauflik was able to breathe on her own for more than five hours straight Thursday night. Doctors at the Hospital of the University of Pennsylvania are gradually trying to remove the 17-year-old from the ventilator. But it's being reattached so she can sleep more comfortably at night. The medical staff is closely monitoring how stressed her body becomes when breathing on its own. But doctors are optimistic that in the days ahead they can take her off the ventilator completely. Without the breathing device, Ashley was able to say a few words and she is aware of her circumstances.

Goldman referred to the Zaufliks as remarkably strong and buoyed by the community's support. Ashley's story has inspired dozens of friends, relatives, businesses and complete strangers from all over Bucks County, Pennsylvania and across the country to rally together to organize fundraising events and collect donations for her and her family.
Ashley's parents Paul and Marguerite told her about the community's involvement. Ashley responded with some head motion, Goldman said. "The family's prayers are being answered," he said. "Ashley knows people are pulling for her, which is wonderful."

Posted by Kerry N. Jardine at 08:07 PM | Permalink | Comments (0) | TrackBacks (0)

In October 2005, ESPN Magazine featured a study investigating the effects of brain trauma in football players. The study was conducted by researcher doctors on the Mild Traumatic Brain Injury Committee (MTBIC). The committee is commissioned by the NFL and is chaired by the New York Jets' team doctor, Elliot Pellman. The study focused on the occurrence of multiple concussions in NFL players. After the recent suicide of NFL player Andre Waters, the study's results have been called into question.

The MTBIC's credibility has been called into question for 2 main reasons: 1) It is funded by the NFL and 2) Elliot Pellman is a rheumatologist (only neurologists are trained to study the brain) and obtained his medical degree in Mexico, not Stony Brook as he claimed. Most of the data released from the study contradicts other research from major neurological organizations. For instance, the MTBIC reported that there is "no evidence of worsening or chronic cumulative effects of multiple MTBIs in NFL players." This finding contradicts the results of a study conducted by the University of North Carolina that reported that multiple mild TBI's can severely damage the brain. The MTBIC also concluded that a player returning to play after a concussion "does not involve significant risk of a second injury either in the game or during the season." Their conclusion contradicts a 2003 NCAA study that involved nearly 3,000 college football players. The NCAA found that players who suffer a concussion are more susceptible to further brain and head trauma for up to 10 days after the initial injury. It has also been reported that Pellman and his researchers did not include all relevant data on all players with concussions - they only chose to use information that would support their conclusions. These findings are alarming since the MTBIC study has prompted 52% of players to return to the game after suffering a concussion.

The MTBIC's study has sparked controversy in the medical field yet nothing has been done about it in the NFL. Perhaps there has been a lack of general public outrage because football fans are so blinded by the allure of the American sport.

Posted by Kerry N. Jardine at 08:53 PM | Permalink | Comments (0) | TrackBacks (0)

The parents of a 5-year-old boy run over by a school bus have filed a wrongful death lawsuit against the driver and the East Baton Rouge Parish School Board. Benito Miranda Lopez and Nancy Miranda Gonzaga contend that Marco Miranda would not have been killed on Jan. 18 if the school system properly had supervised driver Travis White and if he had been cautious enough.

It also accuses the school system of failing to make sure the bus had a crossing arm (a piece of metal or plastic that sticks out in front of the bumper at stops, forcing children to cross several feet ahead of the bus so the driver can see them). A number of states, including Illinois and Wisconsin, require such devices on school buses. Lopez and Gonzaga are seeking damages for wrongful death and emotional distress.

Domoine Rutledge, general counsel for the school system, said he could not comment on the lawsuit Friday because he hadn't seen it. According to the family's lawsuit, the boy was trying to cross the street when the bus "suddenly moved forward." School officials and police are investigating what happened. No charges have been filed. The school system has placed White on administrative leave, pending its own investigation. Randolph Piedrahita, an attorney for the boy's family, said the family wants to do its own investigation and to see any evidence school officials might have.

Posted by Kerry N. Jardine at 08:46 PM | Permalink | Comments (0) | TrackBacks (0)

The sudden death of an 18-year-old McCandless youth who collapsed at his family's dinner table in October likely was caused by a concussion he received in a rugby match 10 days earlier, the Allegheny County medical examiner's office has determined.

Studies conducted on the brain of Eric Pelly showed he died of post-traumatic primary cerebral vasculitis, the medical examiner's office said. The condition occurs when brain trauma, such as a concussion, causes blood vessels to become inflamed, which can lead to sudden death. Dr. Bennet Omalu of the medical examiner's office said "Within a reasonable degree of certainty, there was a causal association between the concussive brain injury and the vasculitis." A spokesman from the medical examiner's office said the head injury Pelly suffered led to inflammation of his brain tissue as it healed, which was determined to be the cause of death. Pelly's brain showed signs of swelling, and his death was likely related to his earlier injury.

Mr. Pelly, a senior at North Allegheny High School, lost consciousness shortly after receiving a concussion while playing in a non school affiliated rugby game in September. He was hospitalized for three days. By all indications, he had appeared to have recovered from the injury when, a week after being released from the hospital, he collapsed at the family dinner table. His family performed CPR, but he died later at the hospital.

Posted by Kerry N. Jardine at 08:21 PM | Permalink | Comments (0) | TrackBacks (0)

The nation's highest court turned down a request to hear arguments related to a catastrophic train derailment near Minot, N.D. The U.S. Supreme Court issued an order today that states which cases it will review in its coming term. The Minot cases were among dozens which were rejected for oral argument.

The decision pushes the cases back into Minnesota federal court, where Tom Lundeen and about 50 others will seek compensation for injuries suffered in a Jan. 18, 2002, derailment that blanketed a rural Minot neighborhood with
an anhydrous ammonia cloud. Minot-area residents suffered injuries to their lungs, eyes and upper respiratory systems from exposure to anhydrous ammonia, a common farm chemical.

The cases had been filed in Minnesota state court. Canadian Pacific Railway Co. asked to move the cases to federal court, where its lawyers argue the railroad is immune from liability. There are two other groups of cases -
representing more than 1,100 claims - at the federal level.

Posted by Kerry N. Jardine at 08:13 PM | Permalink | Comments (0) | TrackBacks (0)

A study conducted by researchers at the University of Southern California and the University of Iowa found that smokers who suffered from a specific brain injury quit smoking almost immediately after the injury. The University of Iowa provided information about smokers with brain injuries and the researchers at the University of Southern California analyzed the data. Subjects with injuries in the insula of the cerebral cortex reportedly stopped smoking after sustaining the injury. "It is immediate. It's not that they smoke less. They don't smoke, period," said Antonio Damasio, director of the neuroscience department at USC.

The study indicates that individuals stop smoking after an injury to the insula because of the insula's specific function in the brain. The insula is a small island enclosed by the cerebral cortex and appears to serve as a central point for feelings and emotions. The study reports that the pleasure and addiction of smoking derives from this central point. "Because the insula is now recognized as a key structure in processes of emotion and feeling, the fact that insular damage breaks down a learned habit such as smoking, demonstrates a powerful link between habit and emotion or feeling," said Hannah Damasio, co-director of the Brain and Creativity Institute.

The study looked at smokers with damage to the insula and those with injuries that did not include the insula. In total, 69 smokers who suffered brain injuries reported how hard it was to quit smoking and reported whether they had cravings to smoke after quitting. Nineteen of those subjects had insula injurie and 12 of the 19 quit smoking easily and lost all cravings to smoke.

This new study that was recently published in Science journal strays away from other addiction studies in the past that focused on the cortex of the brain. The study's results are innovative and they open up the question of whether a brain lesion can cure an individual's addictions. There is no definite answer yet, but the discovery of the insula as a platform for pleasure and addiction is promising. Researchers hope the results can be generalized for other addictions such as drug and alcohol abuse and overeating.

Posted by David P. Hersh at 05:48 PM | Permalink | Comments (0) | TrackBacks (0)

A little more than a year ago, McKenzie Bruce had just made the cheerleading squad. The self-described "socialite" was treasurer for Gilbert's Highland Junior High School seventh-grade student council. For winter break, her family decided to go on a cruise to Mexico. On Jan. 7, 2006 she suffered a traumatic brain injury in a boating crash that lead to seven surgeries and ongoing daily therapy.

McKenzie suffered her injury while riding in a recreational "banana boat" pulled by a larger motorboat, which family members say took off too fast and whipped her into the water. McKenzie walked out of the water crying, but with no visible trauma. Less than an hour later, she was disoriented, and her father, Jon Bruce, carried her to the cruise doctor. She needed surgery right away for brain swelling. Her heart stopped that night, and though the prognosis was grim, Mexican doctors worked on her nonstop until she was flown to St. Joseph's the next day. When an induced coma didn't work, doctors removed a portion of her right skull to relieve life-threatening pressure. A small part of her brain, which has no known use, was removed when the pressure was still life-threatening.

On Wednesday January 17th, the 13-year-old went back to school for the first time since the accident. Through classes at home, she's managed to keep up with her classmates at the school, where she was a straight-A honor student. On March 24, McKenzie will be presented the Spirit Award by the Brain Injury Association of Arizona for her recovery. She was nominated by her doctor, Peter Nakaji of Barrow Neurological Institute at St. Joseph's Hospital in Phoenix.

Posted by David P. Hersh at 05:43 PM | Permalink | Comments (0) | TrackBacks (0)

New York state has launched the first study of deaths among World Trade Center rescue and recovery workers, a grim toll that now exceeds 100. With a $165,000 federal grant from 9/11 health czar John Howard, the state is contributing at least twice that in staff and resources to study what killed the cops, firefighters and other workers who have died after searching for survivors or helping in the cleanup

"We want to know about every death, so we can evaluate any patterns with fatalities," said Kitty Gelber, chief epidemiologist with the state Bureau of Occupational Health. "People need to let us know who was there and who died." So far, the study has listed "over 100 deaths," Gelber said. The names were culled from the city's WTC health registry, labor unions and news reports, she said. The study is seeking data from the WTC medical monitoring program at Mount Sinai Hospital, the FDNY, medical examiners, and a class-action lawsuit for 9,000 Ground Zero workers.

About 95 workers, mostly cops and firefighters, have died of respiratory illness, heart failure or cancer, said lawyer David Worby. The state has yet to determine the causes of the 100-plus deaths it has identified. Several may involve car crashes or suicides, but all are of interest, Gelber said. The goal is to detect trends to help doctors monitor, test and treat 9/11 workers. The study will gather each worker's medical records before and after 9/11 and their time at Ground Zero or the Fresh Kills landfill or on trucks and barges that moved debris. Researchers will also interview relatives.

Posted by Kerry N. Jardine at 05:36 PM | Permalink | Comments (0) | TrackBacks (0)

An Acampo self-employed ranch butcher was critically injured when his truck was struck by a train. Mike McMahon, 48, was at one point comatose and doctors had told family members that it could be months before he would wake up. He has since regained consciousness and has begun walking, though doctors have yet to say when he might be able to leave UC Davis Medical Center in Sacramento. On the afternoon of Jan. 12, McMahon was driving and apparently didn't see an oncoming train. The oncoming train struck the driver's side door of McMahon's truck, and he was flown to the hospital by medical helicopter.

Stockton attorney Al Ellis said he will likely file a claim related to the collision, but said he does not yet know if that will lead to a lawsuit. "We feel there was negligence involved in the case and we're still investigating that," Ellis said, declining to add who could be named as negligent but that it could include property owners, the railroad and those responsible for maintaining the road. The rural intersection does not have a crossing arm and Ellis said that could have been a factor in the accident. "It's a very confusing intersection because the stop sign is on the other side of the tracks so a person wouldn't normally be stopping before the tracks," he said.

A spokeswoman for the California Department of Transportation said they do not have current data on that intersection because they have not studied it. Such studies may be triggered by requests from the public or law enforcement. The California Highway Patrol reported that McMahon's music prevented him from hearing the train's horn.

Posted by Kerry N. Jardine at 05:31 PM | Permalink | Comments (0) | TrackBacks (0)

An aging cracked asphalt strip of unclear origin has hurt several people. Kaufman and Dallas counties both say section isn't theirs to fix. Kaufman County says Lawson Road belongs to Dallas County. Dallas County says it's
Kaufman County's. It's a two-lane blacktop on crumbling clay soils. Lumber, rock and asphalt trucks pound it, widening and deepening the cracks that create hazards for bicyclists. Dennis Hochgraber is one of them. He
doesn't care who fixes the road as long as it just gets fixed. "My bicycle tire went down into a crack, the fork on the front of my bike snapped, and I did an immediate head-dive into the asphalt and broke my neck in two places," he said, recalling the accident that robbed him of his beloved sport of cycling forever. He had to wear a hard plastic collar for 17 weeks, and his doctor advised him not to cycle again.

A fellow cyclist who witnessed the crash, Byron McKnight, was an organizer of Mesquite's Rodeo Ride, which annually draws thousands of riders. He and other organizers soon decided to eliminate that part of Lawson Road from the route for the event. Mr. McKnight said he watched another cyclist fall on Lawson and break a shoulder. Another rider from Mesquite, Randy Rogers, said he saw a female cyclist take a bad spill.

No repairs have been made to the road since August 2003 when Dallas County officials say, the North Central Texas Council of Governments put the county line 25 feet to the west, placing all of Lawson in Kaufman County. Kaufman County Judge Wayne Gent said Dallas County always took care of the road and therefore is responsible for it.

Posted by Kerry N. Jardine at 05:23 PM | Permalink | Comments (0) | TrackBacks (0)

According to witnesses a bus carrying 17 Grant County Middle School students on January 17th slowly veered off the left side of the road, veered back onto the road and began to rock, crossing the centerline it slammed into a
utility pole and came to a stop in a ditch. State police, who were investigating the cause of the crash, said they believed no other vehicles were involved.

The trooper who arrived on the scene found several seriously injured students, some were on the bus, some ran in fear and others a neighbor had taken into her home to wait for help. According to a student, blood and glass were everywhere. That same student had hit his head on the emergency door bar at the back of the bus when he was tossed around resulting in three staples put in his head. Two of the students were flown by helicopter to Children's Hospital and one to the University of Kentucky Medical Center. Both children were in critical condition. Seven other students were taken on another Grant County school bus to St. Elizabeth Grant County where they were treated and released. The driver, Angel Young-Howe, was treated at St. Elizabeth Medical Center-South and released. She has been a full-time driver for the school district since August 2004, according to Grant County school officials.

On January 26th the driver of the bus, Angel Young-Howe, was arrested and is now in jail in Grant County. The driver is under arrest for drug possession. She has four charges against her including possession of marijuana and a
controlled substance, along with possession of drug paraphernalia. While coming to Young's house to continue the investigation the Police allegedly found the drugs.

Posted by Kerry N. Jardine at 08:43 PM | Permalink | Comments (0) | TrackBacks (0)

Michael V. Kaplen, Esq. president of the Brain Injury Association of New York State challenged NFL Players
Association Executive Director, Gene Upshaw and NFL Commissioner Roger Goodell to participate in a public forum on the dangers of concussions to athletes. "Both the NFL and the Players Associations are glossing over the
dangers of concussions and their impact on players lives," said Kaplen who is a member of the New York State Traumatic Brain Injury Services Coordinating Council.

Last year, Kaplen chaired a conference held at Madison Square Garden and sponsored by the Brain Injury Association on the topic of concussions in sports. Leading national medical authorities participated. Although the NFL and its medical consultant on concussions were invited to participate they declined to do so without explanation. The conference exposed the serious dangers associated with concussions in both amateur and professional sports. Kaplen charged both the NFL and the NFL Players Association with being disingenuous when it comes to concussions and life long consequences stemming from these invisible injuries. He has been a frequent critic of the NFL and other professional sports organizations regarding their reckless practices in allowing players with brain injury to prematurely return to play and the poor example that this policy sets for collegiate and high
school athletes.

Posted by Peter W. Burg at 08:32 PM | Permalink | Comments (0) | TrackBacks (0)

Notre Dame coach Charlie Weis' medical malpractice lawsuit against two doctors involved in his near-fatal gastric bypass surgery is scheduled to start in Suffolk Superior Court next month.

Weis had the surgery in June 2002 while he was still offensive coordinator for the New England Patriots after unsuccessfully battling chronic obesity for years. He has said he weighed about 350 pounds at the time. Weis
alleges in the lawsuit that Massachusetts General Hospital physicians Charles Ferguson and Richard Hodin acted negligently and left Weis so close to death that he received the Roman Catholic last rites. Weis began bleeding internally soon after the operation and was in a coma for two weeks.

Patriots quarterback Tom Brady, who sat at Weis' bedside when the coach was in a coma, is expected to appear as a witness. A lawyer for the doctors said they did nothing wrong. "It's our position that everything the doctors did fell squarely within the standard of care," William J. Dailey Jr. told The Boston Globe.

Posted by Scott J. Eldredge at 08:28 PM | Permalink | Comments (0) | TrackBacks (0)

Pediatric Traumatic Brain Injury (TBI) is a substantial contributor to the health resource burden in the U.S. according to a study published in the August issue of Pediatrics. The study was conducted by researchers at the Center for Injury Research and Policy (CIRP) in the Columbus Children's Research Institute at Columbus Children's Hospital. An analysis was conducted of data from the Healthcare Cost and Utilization Project Kids' Inpatient Database from January 1 through December 31, 2000, which included 2,784 hospitals in 27 states. Based on these data, there were an estimated 50,658 TBI-associated hospitalizations among children 17 years of age and younger in that year, with 15- to 17-year-old patients accounting for the highest hospitalization rate.

"Based on our research, pediatric TBI patients accrue more than $1 billion in total hospital charges annually," said CIRP Director Gary Smith, MD, Dr PHD, the senior author of the study and a faculty member of The Ohio State
University (OSU) College of Medicine. "Injury costs for children are often greater than those for adults because they include acute treatment, long-term rehabilitation and loss of productivity for the parent or guardian. TBIs resulting from unintentional trauma constitute the primary cause of death among U.S. youth and are often the most serious consequences of nonfatal injuries." The study identifies TBI as one of the top ten most costly hospital inpatient diagnoses for children. Primary prevention of TBI is the preferred means of reducing its impact on hospitals, families and society. Intervention strategies to prevent pediatric TBI and evaluations of these strategies are critical because TBI is especially devastating among children.

"TBI has been referred to as the 'silent epidemic' because it occurs so frequently, but is inadequately addressed in scholarly research," said Andrew Schneier, a study co-author with The OSU College of Medicine. "TBI is the most common traumatic event involving the central nervous system, far surpassing traumatic spinal cord injury."

Posted by Peter W. Burg at 08:15 PM | Permalink | Comments (0) | TrackBacks (0)

For some time now, drug-eluting stents have been associated with a higher risk of blood clots (late stent thrombosis). Stents are tiny metal mesh cylinders which prop open a coronary artery that has been reopened by an angioplasty balloon, and drug-eluting stents go a step further by slowly releasing a drug into the artery that prevents reclogging due to tissue regrowth (restenosis).

A recent study published in the New England Journal of Medicine describes a pilot trial in which patients received the drug via a coated angioplasty balloon rather than a coated stent. In this small study, 52 heart-attack patients were treated with angioplasty balloons, half of which were bare, and half of which were coated with the same drug which is slowly released by drug-eluting stents. The balloon was inflated as usual inside the blocked portion of a coronary artery, remaining in contact with the inner wall of the vessel for about 80 seconds, and then deflated.

After six months, re-blockages had occurred in almost half of the patients with uncoated balloons; but only one patient treated with a coated balloon suffered re-blockage. After one year, heart attacks and other serious events occurred more often in the uncoated-balloon group.

Although the study was small and will need to be repeated, the drug-coated balloon may be a gentler way to open an artery than a stent, which unavoidably causes some damage, with resultant scar tissue growth, as it's pressed forcefully into the artery.

Posted by Peter W. Burg at 08:09 PM | Permalink | Comments (0) | TrackBacks (0)

Burg Simpson Eldredge Hersh & Jardine, P.C., announced in November 2006 that it had filed a lawsuit against Johnson & Johnson, the makers of the Ortho Evra birth control patch, on behalf of a New York woman who suffered a pulmonary embolism due to her use of the Ortho Evra birth control patch.

At the age of 21, the plaintiff began using the Ortho Evra birth control patch in November of 2003. Within 3 months, she was hospitalized and diagnosed with a pulmonary embolism. As a direct result of the pulmonary embolism she suffered while using Ortho Evra, the plaintiff is precluded from using any hormone therapy treatment for contraception or menopause, and she is more inclined to experience future medical complications as a result of the injuries she sustained during her use of the Ortho Evra birth control patch.

Plaintiff alleges that at the time of use of Ortho Evra, Johnson & Johnson knew or should have known that the use of the Patch created an increased risk to consumers of serious personal injury, including stroke, pulmonary embolism, blood clotting, and even death. Johnson & Johnson's knowledge of the risks involved with using the Ortho Evra birth control patch and their failure to warn consumers solidifies their reckless disregard for the safety of the women using Ortho Evra.

Posted by Seth A. Katz at 08:07 PM | Permalink | Comments (0) | TrackBacks (0)

One of the most serious side effects identified with use of the Ortho Evra Birth Control Patch is blood clotting. In November 2005, Johnson & Johnson revised its labeling for Ortho Evra, admitting for the first time that the Patch exposed women to 60% more estrogen than a 35 microgram birth control pill. Because higher estrogen levels are known to increase the chance of blood clots, which can cause deep vein thrombosis, pulmonary embolism, as well as heart attacks, strokes and even death, the revised label proves that the Patch poses far more danger to women than the Pill. In fact, this increased exposure to estrogen makes the Patch comparable to the high-dose estrogen forms of the Pill that the FDA required to be removed from the market in 1988.

On September 20, 2006, Johnson & Johnson admitted in its revised product labeling that women on the Patch may be at greater risk of developing blood clots in the lungs and legs than women using birth control pills. In fact, a study sponsored by Johnson & Johnson indicates that the Patch may expose women to a doubling of the risk of blood clot injuries.

Posted by Seth A. Katz at 08:04 PM | Permalink | Comments (0) | TrackBacks (0)

In April 2002, Johnson & Johnson introduced the Ortho Evra Birth Control Patch, which is promoted as being more convenient then the Pill due to its weekly application for three consecutive weeks. Unlike oral birth control, which undergoes first-pass metabolism in the liver, the progestin and estrogen in the Patch are released directly into the bloodstream. The Patch was marketed to consumers as providing the same safety profile and efficacy as the birth control pill in preventing pregnancy, but with more convenience than birth control pills because it is worn on the skin for three consecutive weeks, with the fourth week being "Patch free." The aggressive marketing campaign, often describing Ortho Evra as "the Pill in a Bandaid," resulted in sales of more than $424 million in 2005, based on 9.3 million prescriptions.

In 2004, about a dozen women, mostly in their teens and early 20's, died from blood clots believed to be related to their use of Ortho Evra. Dozens more survived strokes and other blood clot related events. The first death known to be associated with Ortho Evra occurred in April 2005, when an 18-year old Manhattan woman collapsed and died in a New York subway station.

Many executives of Ortho-McNeil have given deposition testimony and about five million pages of documents have been produced. Discovery to date reveals that Ortho-McNeil's own studies documented the problems and that one study was suppressed because its outcome and conclusion was not favorable to Ortho-McNeil.

Posted by Seth A. Katz at 08:03 PM | Permalink | Comments (0) | TrackBacks (0)

The conditions of two teenagers injured in Friday January 19th's car-train accident in Syracuse remained unchanged Sunday morning at University Hospital in Syracuse. The injuries occurred after a van driven by their mother, Deborah Price, slid down a road and became trapped between the crossing arms of a railroad signal as a train was approaching. As they ran from the van, Zachary Price slipped and fell between the train tracks. Marylynn Price went back to help him out. The train struck the van and sent it rolling over both Zachary and Marylynn Price, state police said.

Zachary Price suffered severe chest and internal injuries, a broken pelvis and a broken leg. He underwent emergency surgery at St. Elizabeth Medical Center before being transported to University Hospital. Marylynn Price also underwent emergency surgery after suffering internal injuries, a broken pelvis and a broken leg. Zachary Price, 16, is in critical condition, and his sister, Marylynn Price, 18, is in serious condition, a hospital official said.

Posted by Kerry N. Jardine at 08:40 PM | Permalink | Comments (0) | TrackBacks (0)

Bus driver John McCleary, the man behind the wheel in an accident that injured 17 Pennsbury High School students, has been suspended with pay. McCleary has said he tried to brake, shift out of gear and turn off the
engine but could not stop the bus until he steered it into the wall. An attorney for the most seriously injured student Ashley Zauflik said Monday that the girl is improving but still in a medically induced coma. Zauflik can't speak because of a tube in her throat but has communicated with her family using head motions. She had to have her left leg amputated above the knee last week.

The National Transportation Safety Board said last week that, after a preliminary investigation, it has not been able to find any mechanical problems with the school bus that injured 17 students. Neil Harkins, the Falls Township public safety director, said last Monday he was told about the earlier accident by an investigator for the NTSB, which is trying to figure out why Bus 42 lurched forward Friday, injuring 14 students on a sidewalk, then rammed the wall, injuring three who were on the bus. "The same bus was involved in an accident in 1994 in the lot of the high school," Harkins said. "The driver indicated at that time that the accelerator stuck, causing her to lurch forward into another bus." Harkins said he had no additional details. "Our preliminary examination of it is the systems are
still operable in this bus," one official said at a press conference Thursday.

NTSB investigators said they don't know how the bus could have just roared off on its own or why, if engaged, the emergency brake didn't work. The NTSB said it has not been able to recreate these conditions, witnesses did
not report seeing any brake lights and there were no skid marks to be found. The school district has a few other models like the bus that reportedly went out of control, and those have been taken out of service.

Posted by Kerry N. Jardine at 08:35 PM | Permalink | Comments (0) | TrackBacks (0)

The cap on pain and suffering that's part of President Bush's health plan has its share of critics and supporters. In Tuesday's State of the Union address, President Bush said he wants "to protect good doctors from junk lawsuits" through changes in the medical malpractice system. Bush has touted a nationwide cap on malpractice awards for pain and suffering. The cap is modeled after a law that's been in place in California for decades.

Some say the California state law enacted in 1975, is outdated and unfair to injured patients. In contrast, insurers and doctors say it has lowered insurance premiums and kept doctors in the state. The Medical Injury Compensation Reform Act limits pain and suffering damages to $250,000. Steve Charbonneau lost his kidney after a surgical error in December 2005 when doctors at Hoag Memorial Hospital Presbyterian found a 1- by 2-foot blue towel that they left in his body during a previous surgery. Cases like Charbonneau's are typically not worth more than the quarter-million cap because economic damages are hard to prove. Lawyers can argue that he can work with one kidney and the future health care costs resulting from the loss are tough to predict.

An estimated 89,000 people die each year from hospital mistakes thousands more are sickened or injured. Most of these patients and families don't even file lawsuits. Although there's a common perception that frivolous or "junk" lawsuits abound, many patients, at least in California, have trouble finding an attorney to take their case. With costs of $50,000 to $100,000 to hire expert witnesses and other legal fees, the cases are a risk to take on. "There's a lot of malpractice that no one sues a doctor for because no attorney would take a case where they're going to risk so much of their own money to try to prove the truth," said James Daily, the lawyer representing Charbonneau. Most malpractice cases are settled in mediation discussions involving attorneys from both sides.

An alternative to litigation is gaining popularity. Its The Sorry Works Coalition (www.sorryworks.net). It proposes that hospitals and doctors practice full disclosure with apologies, with patients and families. The policy is based on a program practiced by the University of Michigan's health care system. Since the program was adopted in Michigan in 2002, the number of lawsuits has dropped by half, with an estimated yearly savings of $2 million in legal bills. Doctors may be reluctant to apologize or express sympathy to a victim of a medical error because of the culture of perfection in medicine. Also, hospitals and doctors have typically been encouraged by legal advisers to not discuss the error. "When you stop communications, cut off the relationship, not return phone calls, all in an effort to mitigate losses, it makes patients and families extremely angry," said Sorry Works spokesman Doug Wojcieszak. Medical malpractice lawsuits often are driven by a need for answers and a desire to prevent the error from happening to someone else. Admitting the mistake, offering to waive hospital bills, explaining how it won't happen again - it's just good customer service, Wojcieszak said. "It's a heck of a lot cheaper to do that than to go and fight it in court," he said. "If you cut people off, don't be surprised when they come back with a trial lawyer in tow."

Posted by Scott J. Eldredge at 08:22 PM | Permalink | Comments (0) | TrackBacks (0)

Emory University researchers have found that giving progesterone to trauma victims shortly following brain injury appears to be safe and may reduce the risk of death and the degree of disability. Emory's researchers designed a
clinical trial to assess the promise of progesterone for treatment of TBI. Their three-year pilot study, called ProTECT (Progesterone for Traumatic brain injury--Experimental Clinical Treatment), enrolled 100 participants. The researchers hoped to find preliminary evidence that the treatment might be effective.

People enrolled in the study had a "blunt" traumatic brain injury, which typically occurs from a car accident, motorcycle crash or a fall. Four out of every five patients (80 percent) enrolled received intravenous
progesterone, and one of every five (20 percent) received placebo. "We found encouraging evidence that progesterone is safe in the setting of TBI, with no evidence of side effects or serious harmful events," says David
Wright, MD, assistant professor in the Department of Emergency Medicine at Emory and lead author of the study. "In addition, we found a 50 percent reduction in the rate of death in the progesterone-treated group. Furthermore, we found a significant improvement in the functional outcome and level of disability among patients who were enrolled with a moderate brain injury."

Progesterone is a promising treatment because it is inexpensive, widely available and has a long track record of safe use in humans to treat other diseases. In fact, no new medical therapies have been developed for
traumatic brain injuries in over 30 years. Progesterone is naturally present in small but measurable amounts in the brains of males and females. Laboratory studies suggest that progesterone is critical for the normal
development of neurons in the brain and exerts protective effects on damaged brain tissue. "Our research has found that male and female rats with brain injury developed less brain swelling and recovered more completely when they are treated with progesterone shortly following the injury," Dr. Stein explains. "The hormone seems to slow or block damaging chemicals that are released after a brain injury, protecting the brain from the death of brain
cells."

The research team is now planning a large, multi-center, phase III clinical trial designed to test the effectiveness of progesterone in 1000 patients with TBI and hopes to secure funding from the NIH for this project. They also hope to study the effects of progesterone treatment in animal models of blast-related brain injury, a major cause of death among combat personnel. They plan to implement a study of progesterone to treat pediatric brain injury as well, because brain injury is a leading cause of death and disability in children.

Posted by Peter W. Burg at 08:19 PM | Permalink | Comments (0) | TrackBacks (0)

GRACE Labs LLC in Dekalb, GA has been working on a new technique to detect brain trauma such as stroke, epilepsy, and traumatic brain injuries. The new technique developed by the Georgia lab uses a blood test to predict and detect the occurrence of brain trauma. The blood test is simplistic and works quickly to detect brain trauma earlier than tests in the current medical market.

Early detection of brain trauma is important in the treatment and rehabilitation of brain injury sufferers. When a brain trauma is detected early on, less damage is done to the brain. This also leads to better chances of an easier recovery for the patient. GRACE Labs' blood test identifies brain trauma by detecting abnormal amounts of peptides in the brain. High levels of peptides in the brain are an indication of brain trauma.

The blood test is already being marketed overseas within the European Union and GRACE Labs expects US FDA approval within the next year. GRACE Labs also hopes to market the blood test to developing countries, such as Africa and European Block countries. Currently, the only tests available to those countries are MRI's that cost over $1500. Most citizens cannot afford such tests and often live with undetected brain trauma. GRACE's blood test costs less than $100 and can help alleviate this problem.

GRACE Labs LLC is part of CIS Biotech. CIS Biotech specializes in cost-effective blood tests that detect ischemic stroke and cerebrovascular abnormalities. Both of their tests have been approved for use in the EU.

Posted by Peter W. Burg at 08:12 PM | Permalink | Comments (0) | TrackBacks (0)

To see the latest front in the war over illegal immigration, take a look at Mordechai Orian. The 41-year-old owns Global Horizons, a Los Angeles-based service that supplies seasonal agricultural workers to apple, blueberry, and
potato growers across the country. In May, Orian lost one of his biggest clients: Munger Bros., a Delano, Calif., blueberry farm, which decided to use a rival labor supplier, J&A Contracting of Bakersfield, Calif. Munger Bros. executives say they switched suppliers when Global Horizons failed to live up to its contract, but Orian suspects a different motive. J&A, he says, provides cheaper, illegal workers, scooping workers up on street corners by the vanload and delivering them to farms. He says he has evidence of falsified Social Security cards to prove his assertions. And rather than filing a complaint with the federal government, Orian is taking both Munger and J&A to court.

70% of small-business owners declare illegal immigration a "very serious" or "serious" problem, according to a survey by the National Federation of Independent Business. Politicians have become mired in a morass of proposals for immigration reforms, guest-worker agreements, and border fences. Meanwhile, entrepreneurs who scrupulously follow the law are routinely victimized by competitors who hire cheap, illegal labor. Now, tired of waiting for the legislative branch to solve the problem, entrepreneurs are turning to the courts. Their actions have put illegal immigrant employers on notice: Break the immigration laws and you have not only the government to fear, but your fellow business owners as well. David Klehm, Orian's lawyer, says that his suit is the first of its kind, but
experts say it presages a new era. Some observers see the recent lawsuits as pointing to a potential solution to the country's immigration issue. If enough entrepreneurs and employees hold illegal employers accountable
through the courts, says Vernon Briggs Jr., professor of industrial and labor relations at Cornell University, fewer illegal immigrants will be able to find jobs here. "They will deport themselves if they can't find employment," he concludes.

But for Orian, whose case is expected to be decided this spring, the battle is a matter of pride as well as price. He's an immigrant himself - he arrived from Israel in 1997 - and while he has yet to become an American citizen, he is the proud holder of a green card. His example, he says, proves that immigrants can be successful in business while staying on the right side of the law. "I'm not against anyone trying to make a better life," he says. "But after doing it myself, it hurts to see people using shortcuts, and other people taking advantage."

Posted by David K. TeSelle at 08:58 PM |