The Legal Examiner Regional Blogs

How Many Car Recalls is Too Many? GMC’s Cadillac SUV Recall One of Many in Recent Months

Greg Webb — Thu, 23 May 2013 22:49:16 GMT

"If the parts fail, drivers could lose control of the cars, the agency (Maserati) said." Yesterday (May 22, 2013) General Motors issued a recall for 2013 Cadillac SRX SUVs for faulty wheel lug nuts. The wheels could eventually fall off. How does relatively new car model get past the safety reviews for something as basic as wheel lug nuts? This is not a complicated component part we are talking about.

GM isn’t alone in issuing recalls this year. The list includes, but isn’t limited to:

* Maserati recalls 7438 cars for rusting rear tie rod assemblies (May 20, 2013)

Chrysler recalls 5000 Jeep Wranglers, 5000 new Ram 1500s, and 469,072 Jeep Commanders and Grand Cherokees (May 13, 2013)

Mitsubishi recalls 8,263 Outlander crossovers (early May, 2013)

Toyota recalls 510,000 vehicles for air bag issues (April 29, 2013)

Honda recalls 204,000 SUVs and Minivans (April 23, 2013)

According to Car Connection, over the last several weeks millions of cars have been recalled. Are we seeing an unusual number of manufacturing mistakes, indicating a massive problem with the safety of our automobiles? Or, as the article suggests, are we simply receiving "great news for consumers and for the industry as a whole"? Car Connection cites a Detroit news source for this ‘good news’ so I’m suspicious. It may indeed be proactive rather than reactive, but the fact remains that millions of cars, in the United States, were recalled in April and May due to defects. Why aren’t automakers doing a better job? Is this sloppy workmanship, inadequate supervision or something more insidious like cutting corners to increase profits?

To check for recalls on your car go to the National Highway Traffic Safety Administration website: http://www.nhtsa.gov

Originally posted at The Legal Examiner by Greg Webb

The Costly Problem Of Preventable Adverse Health Events

Randy Appleton — Thu, 23 May 2013 21:19:47 GMT

Most people who are sick and decide to go seek treatment at a hospital expect their visit to the doctor to improve their condition, not make it worse. Unfortunately, that is not always the case. In some cases, patients are actually harmed by their medical care. For example, patients who develop infections or those who are misdiagnosed and treated for a condition they do not have suffer what are known as “adverse health events.”

A study recently released by the U.S. Department of Health and Human Services found that 44 percent of all adverse health events experienced by Medicare patients who have been hospitalized are preventable. The data revealed that these preventable adverse events are typically caused by medical error, substandard treatment and poor patient monitoring by doctors and nurses.

The study also broke down individual medical events and identified which preventable problem patients most often experienced. The answer? Infection. According to the Department of Health and Human Services, 60 percent of all infectious incidents were found to be preventable.

The study focused on Medicare patients and was meant to identify ways that the U.S. healthcare system overspends, wasting taxpayer money on health services that are not absolutely necessary. The research indicated that almost 14 percent of Medicare patients experienced an adverse health event while in a hospital. Doctors discovered that if the preventable errors were stopped, then only 7.4 percent of patients would suffer an adverse health event.

Beyond patients the patients who suffered and recovered from adverse health events, another 1.5 percent of Medicare patients were found to have died as a result of such adverse events. An additional 13.5 percent of Medicare beneficiaries were also discovered to have experienced temporary harm resulting from their medical care, meaning that 27 percent of all Medicare beneficiaries experienced healthcare-related harm.

Beyond the human cost of such mistakes, there are troubling financial implications as well. The Office of the Inspector General did an analysis of the data and determined the cost to Medicare of adverse health events totaled $324 million for one month. This means an estimated $4.5 billion each year are wasted due to preventable health problems. The report concluded that, given the human and financial toll of such mistakes, hospitals need to redouble their efforts to reduce the incidence of adverse health events.

About the Editors: The Shapiro, Lewis & Appleton & Favaloro personal injury law firm, which has offices in Virginia (VA), North Carolina (NC) and Massachusetts (MA), edits the injury law blogs Virginia Beach Injuryboard, Norfolk Injuryboard and Northeast North Carolina Injuryboard as pro bono services.

Originally posted at The Legal Examiner by Randy Appleton

Train Operators Crack Down On Employee’s Use Of Personal Electronics

Richard N. (Rick) Shapiro — Thu, 23 May 2013 21:13:12 GMT

A recent incident discussed by the Federal Railroad Administration reveals just how important it is for railroad workers to abide by all federal regulations, even those that might not seem especially critical or safety related. As the unfortunate episode reveals, failure to do so can result in termination.

The case occurred in Montana and involved a locomotive engineer who took a photograph while inside the engine of a train that was in motion. The picture reveals that the camerawork did not take place while the train was racing at fast speeds; the photo shows that the speed was only 13 miles per hour.

A short time later, the engineer then logged into his Facebook account while still on the moving train and posted the photo to his Facebook profile. Two friends of the engineer, who were also on moving trains, noticed the picture and posted responses, commenting on the photograph of the engine. The comments from the friends widened the circle of people who were able to see the picture and included an inspector for the Federal Railroad Administration.

After the inspector saw the photograph, an investigation was commenced into the matter. Inspectors decided the actions by all three men amounted to violations of the General Code of Operating Rules, specifically GCOR 2.21, which deals with electronic devices. The rule states: “railroad operating employees on duty (including supervisors) must have each electronic device turned off and stowed out of sight… when on moving rolling equipment.”

The FRA investigation culminated in the firing of all three workers (the photographer and his two friends). It’s unfortunate for the workers who may not have even realized that their behaviors would result in such swift punishment. Though 13 miles per hour may not seem like a big deal, it still qualifies as a violation of federal law and a fireable offense, something that other railroad employees need to be aware of in the future.

In a related incident, the Washington Metro system announced last month that a train operator who was caught using a cellphone while behind the controls of the train has been fired. Metro, like almost all rail operators around the country, has a zero-tolerance policy regarding the use of personal electronic devices by train operators. The policy is incredibly strict and requires the termination of any worker found violating the rule, even for a first time offense.

This was apparently not the first time such a violation has occurred. News reports revealed that last year nine Metro employees were fired for violating the cellphone policy while on the job. A spokesperson says there is never an excuse for a train operator to be using a cellphone while on duty, except in an emergency situation. The spokesperson says that the department takes the matter very seriously, especially in the wake of a 2008 train crash in Southern California which left 25 people dead and another 130 injured. Reports revealed that the engineer had been sending text messages while on duty.

About the Editors: The Virginia and North Carolina injury law firm of Shapiro, Lewis, Appleton & Favaloro provide legal articles on health and safety as a pro bono service. Our firm also blogs on railroad & FELA worker injury claims.

Originally posted at The Legal Examiner by Richard N. (Rick) Shapiro

Snake-Bite Season

Dottie Perry — Thu, 23 May 2013 14:19:10 GMT

My 5 year-old niece spent some time in a Raleigh, North Carolina hospital recently after an encounter with a copperhead snake in her front yard. Even though the ER doctors say her finger was merely grazed by the snake, whose fangs didn't excrete much venom, she was in excruciating pain, her finger looked like a swollen purple grape, and it kept oozing all manner of unpleasantness. My adorable toe-headed niece with Shirley Temple curls and more energy than both of her siblings, combined, was rendered immobile after the event. She is not alone in her experience. It's that time of year again.

Between 7,000 and 8,000 venomous bites occur per year in the U.S., alone. Instances of snake bites increase exponentially in the spring and early summer when snakes are becoming more active and looking for mates. They are cold-blooded vertebrates whose activity level is strongly controlled by temperature.

There are two main types of venomous snake indigenous to the United States: pit vipers and elapids. Pit vipers include rattlesnakes, copperheads and cottonmouths (water moccasins). Pit vipers have glands that are connected to their hollow fangs, which act like hypodermic needles when the snake bites its prey. Their fangs are easily replaced by extra fangs below or behind a damaged or broken-off fang. Their venom damages vascular and red blood cells, causing muscle and tissue death.

Elapids indigenous to the U.S. only include coral snakes. Theirs are the most dangerous bites of the venomous snakes native to the U.S.The coral snake does not have multiple rows of teeth; they are fixed. Their venom is a neurotoxin and affects the nervous system, which can cause paralysis and respiratory arrest, but the onset of symptoms is often delayed many hours.

Avoid creating a welcome environment for snakes by following this simple advice: cut your grass. Keeping it less than four inches high is ideal. This applies to borders, too. Some types of snakes like to hide from the sun, and tall monkey grass is thick and dark and makes the perfect nest for a copperhead (this is where my niece stumbled across her slithery assailant).

Snake bites can be prevented by a little preparation and a lot of common sense. Wear leather boots and long pants in the woods; watch where you are walking and putting your hands when outdoors; give snakes in the open a wide berth and they will return the favor; and don't ever handle a snake for any reason. Even dead snakes can envenomate you.

Pets fall victim to snake bites far more frequently than humans. The ASPCA has a list of safety and prevention tips on their site that will be helpful to keep in mind when enjoying your neighborhood and yard with family pets this summer.

EASY CHART ON IDENTIFICATION OF U.S. SNAKES:

Nonvenomous Pitviper Coral Snakes

Head: round triangular round

Pupils: round elliptical round

Facial Pits: absent present absent

Fangs: none/regular teeth retractable fixed

Subcaudal Scales: double row single row double row

Rattles: absent in rattlesnakes absent

Color: variable variable red/yellow/black

Originally posted at The Legal Examiner by Dottie Perry

Pradaxa May Increase Risk of Flu and Other Viral Infections

Eric Chaffin — Thu, 23 May 2013 13:17:00 GMT

Patients who take the anticoagulant Pradaxa to reduce their risk of stroke now have another reason to discuss this choice with their doctors. The FDA approved Pradaxa in October 2010 for use in those with non-valvular atrial fibrillation, but since then, the drug has been linked to serious complications, including excessive bleeding that can lead to death.

Now, a new study from North Carolina suggests that there may be other risks with Pradaxa—mainly, that the medication can increase risk of viral medications, including the flu and myocarditis.

Pradaxa Convenient, but Lacks Antidote

Though Pradaxa was initially marketed as being more effective and convenient than the other main anticoagulant on the market—warfarin—as the number of prescriptions went up in 2011 and 2012, so too did the complaints. In November 2012, a study published in the Archives of Internal Medicine reported that patients taking Pradaxa after an acute coronary syndrome were three times as likely to suffer a bleeding event.

What’s most concerning about excessive bleeding associated with Pradaxa is that to date, there exists no readily available antidote. Patients taken warfarin who experience a fall or other injury that creates excessive bleeding can be treated with injections of vitamin K, which encourages blood clotting. There is no such treatment for patients on Pradaxa, making a bleeding event especially dangerous and even deadly.

A New Concern

Elderly patients and those with weakened immune systems may now have new reason to be concerned about Pradaxa. In an animal study, researchers from North Carolina and Berlin, Germany treated normal, healthy mice with Pradaxa, then studied their response to viral infections. They wanted to study how the body responds to viruses on a cellular level—they didn’t expect to discover the results that they did.

The results showed that when the mice taking Pradaxa were exposed to a virus that causes myocarditis—inflammation of the heart muscle that untreated, can lead to heart failure—the virus displayed an increase buildup in the heart and increased impairment of heart function. In other words, the Pradaxa seemed to increase the risk and severity of the infection.

Pradaxa May Inhibit the Immune System

As to why Pradaxa may have this effect on the body during viral exposure, researchers pointed to thrombin. An enzyme in the blood that causes clotting, thrombin is inhibited by Pradaxa. Researchers have recently discovered that thrombin also plays a large role in triggering the immune response against invading viruses.

It seems that when Pradaxa inhibits thrombin, it also inhibits the body’s ability to respond to viral infections. "Our findings show that blocking thrombin reduce the innate immune response to viral infection," said Nigel Mackman, Ph.D. and senior author of the study.

The researchers stated they are now working on a new study to find out if warfarin may create the same effects, or if these are specific to Pradaxa. Patients who are at risk of serious health complications from infections should talk to their doctors about their options.

Meanwhile, manufacturer Boehringer Ingelheim faces an increasing number of lawsuits filed around the country, with federal cases consolidated in the Southern District of Illinois.

Originally posted at The Legal Examiner by Eric Chaffin

More Patients Experience Complications After Skin Cancer Removal Procedures Than Doctors Anticipate

David Mittleman — Thu, 23 May 2013 10:45:00 GMT

Skin cancer is the most common type of cancer in the U.S., and that's even among young people. Thanks to inventions like the indoor tanning bed, as well as not wearing sunscreen when spending time outdoors, more people are putting their skin at risk of developing skin cancer. Nearly 3.5 million new cases of skin cancer are diagnosed in Americans each year; that's more than the number of prostate, breast, lung and colon cancers combined.

Although you've probably heard of melanoma most often, it isn't the only type of skin cancer. There are also basal and squamous cell cancers that affect the skin. These types of cancer are actually the two most common types of skin cancer, and doctors commonly treat them to prevent the cancer from spreading to other parts of the body where it would be harder to treat and potentially fatal. However, in a new study conducted by researchers at the University of California, San Fransico, more patients complain of complications after being treated for non-melanoma skin cancers.

Common complaints included pain, slow healing and infections. In comparison to the number of patients who complained, only 3% of doctors reported complications after completing a procedure. To reach these results, the researchers followed 866 patients, primarily men, being treated for non-melanoma skin cancers. The researchers then sent questionnaires to patients for up to five years after the surgery. Thirteen percent reported a non-medical complication, such as issues with a scar or difficulty getting a follow-up appointment, while 14% said they experienced a medical complication such as pain, numbness, itching, problems with wound healing or infection. In comparison, the researchers found that just 3% of those patients were recorded as having problems in the doctors' charts.

The current study points to the need for doctors to provide adequate post-operative advice and information to patients. The same is true for patients in other healthcare settings; just because doctors have a certain expectation for what patients will experience, does not make this a reality. One of the researchers from the study, Dr. Eleni Linos, had the following to say about the results of the study:

If a quarter of Toyota customers were unhappy after service, they would take that very seriously--the same as if a quarter of Apple product buyers didn't like their purchases.

Really makes you stop and think about the importance that we place on our gizmos and gadgets and how well they meet our expectations and the totally different set of standards that are placed on the one lifelong "gizmo" that we have--our bodies.

Originally posted at The Legal Examiner by David Mittleman

San Francisco Pedestrian Struck By SUV, Hospitalized

Claude Wyle — Thu, 23 May 2013 10:22:57 GMT

A woman was recently hospitalized after suffering a serious head injury one recent Monday evening. The 56 year old pedestrian was crossing at the intersection of Geneva Avenue and Prague Street, just south of Crocker Amazon Playground, when she was struck by a Sport Utility Vehicle. The driver, who allegedly ran a red light, hit the woman just before 7:30pm.

The police initially reported the accident as a hit and run. They have since revised the report, stating that the driver did indeed stop at the scene to cooperate with officials.

The woman remains in San Francisco General Hospital with life threatening injuries. Her condition is still unknown. Why do pedestrians keep getting run over in San Francisco? I know other cities must have serious pedestrian injuries as well, but is San Francisco the most dangerous city for pedestrians in the U. S.? What are the statistics on San Francisco Bay Area pedestrian injuries? I will do some research and post about this topic in the near future. If you can contribute more facts or statistics about San Francisco pedestrian injuries I would greatly appreciate your input.

Hello, I'm Claude Wyle. Have an idea for a topic you'd like to see covered here? Feel free to contact me: cwyle@ccwlawyers.com or visit www.CCWLawyers.com.

Originally posted at The Legal Examiner by Claude Wyle

Publicly Accused Minnesota Priests

Mike Bryant — Thu, 23 May 2013 09:16:00 GMT

With the passage of the Child Victims Act, survivors who were sexually abused as children now have an open window in Minnesota to bring classes that have been previously barred by the statute of limitations. It will be important that every person who was abused, knows of abuse, or suspected abuse come forward and make sure that justice is done.

BishopAccountability.org has a very good list of publicly accused Minnesota priests broken down by state. There is also break downs by names and Diocese:

Diocese of Crookston
Diocese of Duluth
Diocese of New Ulm
Diocese of St. Cloud
Archdiocese of St. Paul-Minneapolis
Diocese of Winona

The names are out there and there are many more to find.

Abuse of children and the continued silence by the offenders needs to be prevented. If you suffered, saw, or suspected such events, it is important to know that there is help out there.

Originally posted at The Legal Examiner by Mike Bryant

Critical Thinking is Patriotic

Michael A. Stratton — Thu, 23 May 2013 06:55:00 GMT

When I try a case, the most important people in that courtroom are sitting on the jury. If the members of the jury have never been taught how to critically think, the ultimate result will be skewed and justice will not be served. Instead emotion and bias take over where critical thinking leaves off.

This lack of education creates what some have called judicial hell holes. This moniker is usually reserved for places that regularly find for plaintiffs despite strong evidence favoring the defendant. But judicial hell holes can also be found that regularly favor defendants despite clear evidence favoring the plaintiff.

In a certain borough of New York City, where the achievement gap is most pronounced, a corporate or insurance defendant cannot get a fair trial. The predominating stereotype of the oppressive Goliath corporation overwhelms the limited education possessed by the jurors. Similarly, in South Carolina whose educational performance ranks among the lowest in the country it is almost unheard of for a doctor to lose a medical malpractice case. Lawyers do not even bother bringing these cases to court anymore. A public relations campaign demonizing plaintiffs easily overmatched the limited critical thinking skills of the populace.

If you have any doubt about South Carolina, just look at the recent election of Mark Sanford who won despite using state money to visit a mistress in Argentina while Governor.

The Seventh Amendment gives all of us the right to a jury trial. But this right is meaningless if jurors are not properly educated. If jurors cannot rise above base prejudice and public relations campaigns our constitutional democracy is at great risk. Critical thinking is not only important to a satisfying life, it is patriotic.

Originally posted at The Legal Examiner by Michael A. Stratton

Ultrasounds Effective and Low-Cost Way to Detect MoM Hip Complications

Roopal Luhana — Wed, 22 May 2013 13:09:00 GMT

In the summer of 2012, the Medicine and Healthcare products Regulatory Agency (MHRA) in the U.K. suggested that patients with certain types of metal-on-metal (MoM) hip implants should have annual checkups for as long as they have their implants. Because these implants are more likely to loosen, dislocate, or cause metal contamination than those made of other materials, doctors suggest more frequent checkups to catch problems early.

Now, a new study shows that ultrasounds may be one of the best tools to use to detect MoM hips that are failing prematurely. Many patients may not experience symptoms in the early stages of hip replacement complications, but an ultrasound can detect issues before they cause extended tissue damage and bone loss.

FDA Warns About MoM Hip Complications

On January 17, 2013, the FDA released a new safety communication warning that MoM hip implants have unique risks in addition to the general risks seen with all hip implants. "In metal-on-metal hip implants," the agency stated, "the metal ball and the metal cup slide against each other during walking or running. Metal can also be released from other parts of the implant where two implant components connect."

This fretting and corrosion can cause serious complications, including soft tissue and bone damage, pain, implant loosening, pseudotumors (pockets of swelling) and premature implant failure requiring revision surgery.

In the absence of pain, however, sometimes these damages can occur inside the joint without the patient’s knowledge. Like the MHRA, the FDA recommended that even patients who are not experiencing symptoms of complications should be examined every 1-2 years.

The Ultrasound Works as Well as MARS, but Costs Less

Researchers from Vancouver, British Columbia recently presented the results of their study at the Hip Society Specialty Day Meeting in Chicago. They looked at 40 patients—28 men and 12 women—who had been implanted with MoM hip devices. These patients went through checkups where doctors looked for any complications through both an ultrasound and a metal artifact reduction sequence (MARS) MRI.

The results showed that both tests were able to detect the presence of pseudotumors. The ultrasound was the preferred method because of its high sensitivity and lower cost.

Other Studies Show Similar Results

Other studies have also suggested the ultrasound as an effective method to use in MoM hip implant checkups. A 2013 study examined 25 hips from 16 patients, all of which were subjected to revision surgery for painful complications. Ultrasound and MRI tests were done prior to revision surgery. The ultrasound successfully showed the presence of pseudotumors in over 78 percent of patients, while the MRI showed them in just over 76 percent.

A study published in 2012 also showed that ultrasound was effective in detecting adverse reaction to metallic debris (AMRD). "Ultrasound is cheap, non-invasive and dynamic investigation and has been shown to be reliable in diagnosis of AMRD," the researchers wrote.

Thousands of patients in the United States and worldwide have been implanted with MoM hip devices. Many of these individuals have filed lawsuits across the country to recover damages for premature failures and other injuries. Those devices that have been named in lawsuits include the recalled DePuy ASR, the Zimmer Durom Cup, Biomet M2A Magnum, Wright Conserve, and Smith & Nephew R3 Liners.

Originally posted at The Legal Examiner by Roopal Luhana