Killer Pain Killers: The Dangers of Opiate Analgesics

Analgesic drugs are commonly used to relieve pain. Some analgesics, such as aspirin and acetaminophen, are relatively mild and are available over the counter.

Other analgesics, however, are powerful narcotics, and are available only with a prescription. Some common prescription analgesics include morphine and codeine, which are naturally occurring opiates; hydrocodone (Vicodin and Lortab) and oxycodone (OxyContin and Percocet), which are semi-synthetic opioids; and fully synthetic opioids, such as Fentanyl and Methadone. Under the close supervision of health care providers, these drugs can play an important part of a patient's pain management regimen.

Unfortunately, these drugs can also cause serious side effects, from nausea and constipation to respiratory arrest and even death. Additionally, due to their narcotic nature, there is a high propensity for addiction and abuse. Over-prescribing these drugs, or improperly supervising a patient's pain management regimen, can cause serious personal injuries and give rise to medical malpractice claims.

Sometimes, careless physicians can transition patients from one narcotic painkiller to another, with disastrous consequences. For instance, Methadone is metabolized very slowly, and has a half-life of 15-60 hours. Additionally, it is fat soluble, and can remain in your system longer than other drugs. Likewise, OxyContin, a popular brand of oxycodone, is formulated to be released over time (the name is an abbreviation of Oxycodone Continuous release). When a patient is taken off of a "slow" drug and transitioned to a fast acting, instant release version, overdose can easily occur. The results of overdose can include respiratory arrest, anoxic brain injuries, or even wrongful death.

The Utah Medical Malpractice lawyers at G. Eric Nielson & Associates are experienced in handling medical malpractice cases involving narcotics and pharmaceuticals. We work closely with a team of pharmacologists, toxicologists, and medical doctors to determine whether patients have been injured by dangerous drugs, medical negligence, or pharmacist error. If you or someone you know has been injured because of addiction, overdose, or death, contact the attorneys at G. Eric Nielson & Associates for a free, no obligation consultation today.

New Patient Safety Standards on Suicide Prevention

Depression is a serious illness that can cause suicidal thoughts and, in severe cases, result in suicide attempts.  Often, health care providers are in a position to prevent depressed patients from carrying out suicide attempts until treatment for depression or other underlying issues can take effect.

If patients are admitted to a health care facility because of a suicide attempt or other imminent danger, they are usually admitted to a special care unit that should take precautions against suicide.

But there are other patient safety risks for patients who may not have attempted suicide.  The hospital setting itself can be a place where the patient has access to tools or other implements to carry out a suicidal act.  As The Joint Commission notes in a recent report:

It is noteworthy that many patients who kill themselves in general hospital inpatient units do not have a psychiatric history or a history of suicide attempt – they are “unknown at risk” for suicide. Compared to the psychiatric hospital and unit, the general hospital setting also presents more access to items that can be used to attempt suicide – items that are either already in or may be brought into the facility – and more opportunities for the patient to be alone to attempt or re-attempt suicide. This Alert presents strategies that can be used and suggested actions that can be taken by general hospitals to help better prepare their staffs and their facilities for suicidal patients and to care for both their physical and mental needs.

 It is important that hospitals take precautions to prevent against suicide, both in specialized psychiatric treatment settings, as well as in general inpatient and emergency units.  Depending on the circumstance, these precautions include removing any instruments that could be used to inflict self-harm, maintaining continuous line-of-sight monitoring, and ensuring proper medication regimens.


For patients that are at "unknown risk" for suicide, health care providers need to properly screen the patient as a risk reduction strategy.  This includes checking for symptoms of acute depression or other behaviors that suggest risk for suicide.

If you, or someone you know, is depressed and contemplating suicide, please get help immediately.  Call 1-800-SUICIDE, or if the threat is imminent, dial 911.

If a family member has committed suicide while under the care and treatment of a health care provider, it may have been because risks were not properly assessed and the patient safety rules were not followed.  Depression is an illness just like any other disease and when it is not properly treated, it is medical malpractice.  The Utah medical malpractice lawyers at G. Eric Nielson & Associates  can discuss the circumstances of the case with you and advise you of your legal options.  Call today for a free, no obligation consultation with a licensed medical malpractice lawyer: 801-424-9088.

Adding Insult to Injury: More on the Medical Malpractice Myth

"Justice," as Thomas Jefferson said, "is the fundamental law of society."  Every election cycle, politicians and insurance lobbyists pepper the newspapers with calls for lawsuit "reform."  Invariably, these so-called reforms have one objective: to deprive individuals of the right to obtain justice.

The American legal tradition holds that justice involves a system of consequences that naturally derive from any action or choice.  When someone acts unreasonably, or negligently fails to act appropriately under the circumstances, the civil justice system ensures that there will be appropriate consequences.  These consequences accomplish the goal of compensating injured parties, as well as deterring wrongful conduct.  When these consequences are avoided, innocent parties are forced to bear the burden of the wrongdoer, and there is no incentive to refrain from future wrongful conduct.

In simpler terms, justice requires that we all follow the rules.  When we break the rules, we are accountable to those who have been harmed.

Election season is upon us, and so it is no surprise that the corporate interests behind the health care industry is calling for "more tort reform."  The reasoning behind this effort is that medical malpractice claims are expected to rise; thus, the industry will suffer an economic consequence.

But this begs an important question: Why minimize the consequences for negligent health care providers instead of minimizing the negligence itself?

Indeed, the real "crisis" isn't medical malpractice lawsuits, it is the increasing incidence of medical malpractice.  According to a recent report, "[s]erious medical mistakes...continue to occur despite recently implemented preventive measures."  And in another article, Dr. Martin Makaray, M.D. admits that "[c]atastrophic surgical errors are 'a lot more common than the public thinks.'"

Startingly, despite the increase of actual malpractice, patients only bring claims 22 percent of the time.  That means that nearly 80 percent of the time, health care providers who have negligently harmed their patients are not held accountable. In other words, eight out of ten times, a bad doctor breaks the rules and gets away with it.

The insurance industry and health care corporations aren't doing enough to minimize negligence, and that is why they are fighting for politicians to eliminate the consequences.  The Utah medical malpractice attorneys at G. Eric Nielson & Associates will fight to protect your rights, and fight to obtain justice for you.  We understand the medicine, and we know the law, and we will work diligently to hold negligent health care providers accountable when the break the rules.

And next time you hear about proposals to "reform" the civil justice system to benefit negligent health care professionals, consider another quote from Thomas Jefferson: "Law is often but the tyrant's will, and always so when it violates the rights of an individual."

Undiagnosed Postoperative Infections - A Fatal Mistake

Infections are a relatively common complication associated with almost any surgical procedure.  Sometimes infections can occur even despite the best efforts of doctors and hospital staff.  If a postoperative infection does occur, however, it is necessary for health care providers to recognize the signs of infection, and to act promptly to prevent disaster.

One of the earliest signs of infection is accelerated breathing, which is a result of the body's efforts to fight the infection.  The patient's temperature will increase as the infection worsens.  If the infection moves into the abdomen, the bowel can become toxic and distended.  If not diagnosed, the infection can cause paralytic ileus of the intestinal musculature, which disrupts the normal activity of the gastrointestinal track.  This inhibits transport of the contents of the intestine, resulting in worsening distension of the abdomen.  This condition is obvious and painful, and can be fatal if not promptly treated.

In a recent case we resolved for a Utah family, however, hospital nurses were inattentive and ignored the patient's complaints and overlooked these symptoms.  Had they been properly monitoring this patient, they would have noticed the clear signs of postoperative infection and notified a doctor.  Finally, after a shift change brought new nurses, they called the wrong doctor and simply left a message, all while the patient's condition was rapidly deteriorating.

When a physician finally arrived, there were no intestinal sounds cannot be detected by auscultation (deathly silence) and the patient had begun to vomit bile and gastric contents.  Despite surgical intervention, the infection had been allowed to persist too long, and it killed a husband and father.

Obviously, there was no way to replace this man, who was beloved by his family and friends.  But through vigorous legal representation and affiliating with some of the country's best medical experts, we were able to prove the negligence of the health care providers and recover money to help the family pay medical bills and funeral expenses, and to compensate them for the lost income of the head of their household. 

Infections are an undesirable outcome of many surgical procedures.  Even if the infection is not the result of negligent treatment, the failure to promptly diagnose a postoperative infection is a form of medical malpractice.  Unnecessary delays in diagnosis result in prolonged hospital stays, missed work, and extraordinary medical bills.  Worse, if an infection is untreated for too long, it can result in the wrongful death of the patient.

As Utah Medical Malpractice attorneys, we have helped many families of people injured by failure to diagnose postoperative infections.  If you have questions about postoperative infections, we have answers.  You can call and speak with attorney for a free, no obligation consultation today.

801-424-9088

Breast Cancer Awareness

For the past twenty five years, October has been recognized as Breast Cancer Awareness Month.  Efforts to increase awareness and raise funds for research include everything from Facebook memes to athletic events (shameless plug: join me for the Trek Bikes Breast Cancer Awareness Ride on October 9).  Although early detection has reduced mortality rates, data suggest that at least 1 in 8 women will be diagnosed with breast cancer.  Mothers, wives, sisters and daughters are all at risk.

Since there is no cure, successful treatment depends on early detection and prompt medical intervention.  Women should regularly perform self-examinations and get regular medical check-ups.  Most physicians are attentive, especially if there are attendant risk factors such as age or family history.  Some doctors, however, will rely solely on preliminary studies or dismiss complaints--especially among young women.  If this happens, breast cancer diagnosis can be missed, and the results of the delay can be devastating.

There are a number of circumstances where breast cancer can be missed.  For instance, when a woman discovers a lump on examination, reports it to her doctor, who then orders a mammogram that comes back negative.  Some doctors will incorrectly advise their patient that all is well.  But not all breast cancers are detected on mammography.  The standard of care for medical professionals requires additional clinical follow-up where there is a palpable mass and a negative mammogram.  The standard of care requires an ultrasound, and if that mass still persists, a biopsy.

Another scenario was discussed recently in the New York Times, where doctors regularly misdiagnose a type of breast cancer called ductal carcinoma in situ, or D.C.I.S., particularly in its earliest stages. According to the article, "17 percent of D.C.I.S. cases identified by a commonly used needle biopsy may be misdiagnosed."  Recent research reveals that women with dense breast tissue are at higher risk for D.C.I.S., requiring further vigilance.

Patients and their families must be their own advocates.  The stakes are too high, and women deserve to have their health carefully addressed.  As a medical malpractice attorney, I've seen far too many cases where women have presented to their physicians with complaints of breast lumps, only to have these concerns dismissed because they're "too young" to get cancer or because of a negative mammogram.  These cases have resulted in women having to undergo radical treatment that could have been avoided if the cancer had been detected sooner.  Most tragically, in some cases, the cancer wins and families lose their wives and mothers to the devastating disease.

During this month of increased awareness, take control of your health care.  Recommendations for getting good professional care are available HERE.  They include talking candidly with your doctor; following up with any recommended testing, and if necessary, getting a second opinion.

If you reported your concerns to a doctor, and he or she ignored them until it was too late, you may have a claim for medical malpractice.  You should contact a lawyer that will hold the doctor accountable.

Gentamicin Toxicity is a Preventable Medical Error

Antibiotics are frequently used to treat a variety of bacterial infections. There are a number of different kinds of antibiotics, and they are used to treat specific kinds of bacteria. Although all medications have risks, most antibiotics are relatively safe.

Aminoglycoside antibiotics are a potent class of antibiotics, and include such drugs as tobramycin, neomycin, vancomycin and gentamicin. All aminoglycosides are toxic to the sensory cells of the ear. Gentamicin is a vestibulotoxin, because it can damage the eighth cranial nerve. This results in the patient experiencing loss of balance and vertigo.

Because of the high risks associated with gentamicin, it should only be selected as a last resort. When a doctor prescribes gentamicin, he or she should closely monitor the levels of the drug, as well as the patient's kidney function.

Unfortunately, many doctors prescribe gentamicin without carefully considering what is best for the patient. Additionally, they fail to order periodic testing of serum gentamicin levels and basic renal function tests.

This can be catastrophic for patients, who are suddenly forced into a world of perpetual dizziness and imbalance. They can no longer operate vehicles, go out on boats, be in crowds, swim, or carry on many of the daily activities we take for granted. In some cases, patients suffer deafness and severe kidney damage as well.

There is a group called "Wobblers Anonymous" that offers support for those that have been injured by negligent gentamicin prescriptions. The group offers encouragement and advice for people learning to adapt to these difficult new conditions.

Often, treatment requires regular visits with specialists and physical therapists that help injured patients to compensate. But these therapies can be expensive, and it isn't the patient's fault that the doctor was negligent in prescribing gentamicin therapy. If you or someone you know has been injured by gentamicin poisoning, there is help. The Utah medical malpractice attorneys at G. Eric Nielson & Associates are experienced gentamicin lawyers, and have recovered millions of dollars for patients to help them pay for treatment, and to compensate them for the loss of quality of their lives. If you have questions, you can contact us for a free, no obligation consultation today.

801-424-9088

Medical Malpractice Increases While Payments Decrease

Insurance companies and their lobbyists have made much over the supposed "malpractice crisis." They have used this mantra, along with unfounded threats of rising costs and doctor desertion, to enact legislative restrictions on the rights of injured citizens to recover. I recently wrote about Utah's newest tort reform proposals in the Salt Lake Tribune, but to no avail. Although the bill was modified, it still imposes economic restrictions on the rights of recovery, and makes the process longer and more expensive for malpractice victims.

Of course, tort reform is nothing new in Utah. Utah has had some of the most aggressive tort reform laws in the nation for over thirty years. Ironically, while the legislature is busy passing even more pro-insurance, anti-victim laws, reports are coming out that medical errors are increasing. Today, the Deseret News reported that MEDICAL ERRORS ARE INCREASING IN UTAH. This should come as no surprise. Thanks to the legislature's special favors to the health care industry, there is no longer much accountability for medical errors.

So we're all at greater risk when we go into a hospital. At least this will lower doctors' malpractice rates, which will in turn save money in health care costs, right?

Wrong.

As reported in Healthcare Finance News on March 10, 2010, medical malpractice payments are steadily on the decline. Indeed, this simply continues a a five year trend.

The facts show that malpractice payments have been dropping for years. Why haven't malpractice premiums gone down, and taken health care costs with them?

Maybe the Utah State Legislature should ask the insurance lobby these questions before passing more laws reducing accountability for medical errors....

Study Shows that Some Heart Doctors Put Profits Before Patients

Today a report was released that showed that many heart doctors, or cardiologists, are not following the treatment guidelines recommended for treatment of coronary artery disease (CAD). The guidelines, published by the American College of Cardiology and the American Heart Association, recommend that in some cases, coronary artery bypass surgery should be done instead of angioplasty.



Bypass surgery, however, is a time intensive and complicated process. Some procedures can take all day. Angioplasty, on the other hand, is a relatively minor procedure, so cardiologists can perform--and bill for--multiple procedures in a single day.

It is much more lucrative for a cardiologist to do six or seven angioplasties in one day than it is to do a surgical bypass. This decision is made purely out of profit, and is contrary to professional medical standards.

To be fair, the demand for profits may not come from the doctors themselves. Rather, it may be that the corporations that run the hospitals where the procedures are performed are placing higher volume demands upon the physicians, in exchange for granting doctors hospital privileges.

Either way, however, cardiologists may be rendering substandard care to patients in order to make money, rather than to make quality health care decisions.

Injured by Medical Malpractice: Now What?

In most cases, a visit to the hospital or doctor's office is a routine event. Usually, everything goes the way it is supposed to.

Sometimes, however, things don't go right. Doctors and nurses are good people, but even good people make mistakes. When professionals make mistakes, the consequences can be disastrous. Not only will you have to endure additional pain and suffering, but you'll be facing expensive medical bills, costs of future treatments, and possibly the loss of your ability to work. It is not your fault that a health care professional committed malpractice. But you will need help to hold them accountable.

If you or someone you know has been injured by medical malpractice, here are somethings you can expect:

• You won't get answers. Medicine is not an exact science, and sometimes, complications can cause bad outcomes. If this happens, then your doctor will sit down with you and explain the complication, as well as how and why it happened. If a bad outcome is caused by negligence or other medical mistake, however, you won't get answers. Your doctor will suddenly be evasive about your questions, or may even transfer your care to another physician. If the doctors and other professionals aren't giving you answers, give us a call. Our experienced medical malpractice attorneys work with a team of nationally recognized medical experts, and together, we can get the answers for you.
  
  
• Risk Managers and Insurance Adjusters Will Try to Convince You to Settle On Your Own. If you're lucky enough to get a meeting with a Risk Manager or other hospital administrator, the first thing they will tell you is that you don't need a lawyer. Your first question should be, "Does the negligent doctor or hospital have a lawyer?" If they answer honestly, they will tell you that they have a team of high-paid lawyers working on their side. "But," they'll say, "if you hire a lawyer, they'll get all the money, and you won't get anything."
  
  This is absolutely not true. By hiring a lawyer, you will recover far more than the hospital will be willing to pay if you settle on your own, even after fees and expenses. Hiring a lawyer will get the negligent doctor or hospital to pay full value on your claim; otherwise, they will offer you pennies on the dollar. At G. Eric Nielson & Associates, we pride ourselves on maximizing recoveries for our clients, and working conservatively to ensure that the injured patient receives as much of the award as possible.
  
  
• Hospital Administrators Will Delay Your Case. We have seen a troubling practice a lot lately. A patient will be injured, and for two years, the negligent hospital or doctor will pay for minor medical expenses--maybe a few hundred to a few thousand dollars. The injured malpractice victim will assume that these payments will continue, but as soon as the statute of limitations runs (usually two years, but in some cases, as little as one year), the payments stop. At that point, the patient cannot bring a legal action. The negligent doctors or hospital administrators will lead you to believe that they're taking accountability for their mistakes, but as soon as they can cut you off without being sued, they will do it. You will be left with a lifetime of medical bills.
  
  
• You Won't Be Given Your Medical Records. The government has passed laws that provide patients with access to their medical records--it is a legal right. When you've been injured as a result of medical malpractice, however, negligent hospitals and doctors will try to stop you from finding out what happened. Your records may get "lost," or you may be asked to fill out complex forms and wait weeks--even months--to get your medical records. Once you receive those records, they may be incomplete, or inaccurate. The medical malpractice lawyers at G. Eric Nielson & Associates use all of our resources to ensure that we get a full, complete set of your medical records, and can give you the answers you deserve.

Medical malpractice cases are complex, and you need an experienced team of legal professionals on your side.

The Utah malpractice attorneys at G. Eric Nielson & Associates have the experience to give your attention the case it deserves, and the expertise to give you the answers you've been looking for.

When you call our offices, you'll speak to an attorney who can discuss your case with you. We will set up a free, no-obligation consultation where you can meet face to face with a lawyer to discuss what happened. If you have been injured by medical malpractice, we can tell you your options and discuss your legal rights.

Call today: (801) 424-9088.

Utah's Legislature and Special Favors for Insurance Companies

Article VI, Section 26 of the Utah State Constitution states, "No private or special law shall be enacted where a general law can be applicable."

Utah's constitutional framers included this provision in order to prevent the legislature from granting special privileges to individuals or corporations. The convention notes indicate that the framers were concerned with legislators who pass laws granting special privileges, for some at the expense of the rights of others. As Utah Constitutional scholar Jean Bickmore White has noted, this provision "express[es] the feeling that laws should not promote special treatment and should be administered even-handedly," and was specifically included as "a reaction to the corruption of some mid-nineteenth-century Legislatures." (The Utah State Constitution: A Reference Guide, at pp. 83-84.)

Notwithstanding this provision, the Utah State Legislature continues to enact special laws that permit negligent health care providers and their insurance companies to escape liability for their mistakes.

Last year, for instance, Utah enacted a law that raises the burden of proof for people injured by negligent emergency room doctors. This means that if you sue someone for causing a car accident, breaching a contract, or other civil wrong, you have a burden of proving your case by the "preponderance of the evidence;" in other words, you simply have to show that it is more likely than not that the other party is liable.

According to Utah politicians, however, Emergency Room doctors are "more special" than everyone else. The new law passed last year says that if an emergency room doctor is negligent, and causes you harm, you have to prove your case by "clear and convincing" evidence. This is a much higher burden, one that is almost impossible to meet in most civil cases. Indeed, this is the same standard murderers must meet to overturn their convictions. This special law was enacted by the Utah State Legislature to benefit insurance companies, and it has produced its desired effect. Since its passage in 2009, there has not been a single case filed against an Emergency Room doctor in the State of Utah.

What this means for you is that if you have an emergency and go to the hospital, the doctors can render substandard care, and there is virtually nothing you can do about it.

Interestingly, when the medical lobby was urging Utah's legislators to pass this bill, the hospitals promised that they would permit state officials to conduct a performance audit to ensure that Utah citizens were still receiving adequate care.

Not surprisingly, however, the medical and insurance companies have gone back on their word. They have refused to permit the state to investigate the quality of emergency care in Utah.

Thankfully, one legislator is trying to hold these companies to their promise. Representative Lorie D. Fowlke (R. Orem) is fighting for the citizens of Utah, and is demanding that the state be permitted to conduct its audit of Emergency Care in Utah.

Last year, the legislature did corporations and insurance companies a big favor. Make sure those companies keep up their end of the bargain, and allow the state to ensure that quality health care is still available.

Contact Lorie Fowlke and tell her that you support her fight to restore accountability in Utah:

Lorie Fowlke

lfowlke@utah.gov

596 West 1200 north

Orem, UT 84057

(801) 255-0721

Also, contact these officials and let them know that you will not tolerate the insurance companies' efforts to keep secrets from you and other Utah citizens:

John Schaff

Legislative Auditor General

jschaff@utah.gov

W315 State Capitol Complex

P.O. Box 140151

Salt Lake City, UT 84114

(801) 538-1033

Curtis S. Bramble

cbramble@utahsenate.org

3663 North 870 East

Provo, UT 84604

(801) 373-1040

John L. Valentine

jvalentine@utahsenate.org

857 East 970 North

Orem, UT 84097

(801) 373-6345

Health Care and the Malpractice Crisis Myth

There has been a lot of focus on health care lately. Any time the government addresses the skyrocketing costs of health care, many politicians and pundits use it as a platform to perpetuate the myth of a "medical malpractice crisis," and call for reform of the civil justice system.

Interestingly, data commissioned by proponents of so-called "tort reform" reveals that radical restrictions on injured patients' rights would result in--at most--a 0.5% savings on national spending. Five tenths of a percent. Clearly, the effect of malpractice lawsuits has been grossly overstated.

Another myth perpetuated by those seeking to limit the rights of injured patients is that physicians are abandoning the practice of medicine. Once again, the data tell a completely different story. The American Medical Association just released physician data for 2008, and it shows that overall, the number of physicians in the United States increased to 954,224. This means that there is an all-time high of 309 doctors for every 100,000 people. Indeed, this data reveals that there are now twice as many physicians practicing than there were in the 1960's, when the American Medical Association began tracking numbers.

Perhaps even more startling is the fact that there are more doctors per capita practicing in states that have not limited the amount of money malpractice can receive as compensation for their injuries. In states without damage caps, there are 346 doctors for every 100,000 members of the population. Conversely, in states that have limited the amount of economic recovery, there are only 285 doctors practicing per 100,000.

These facts show that there is no significant correlation between medical malpractice lawsuits and national healthcare costs or the number of practicing physicians. Powerful insurance companies and medical industry insiders, however, have misled the public in order to maximize their profits at the expense of injured people.

On the other hand, curtailing the rights of injured persons to recover would have catastrophic financial consequences.

As medical malpractice attorneys, the lawyers at G. Eric Nielson & Associates specialize in helping people harmed by medical negligence recover fair value for their injuries. Our clients are school teachers, receptionists, firemen, carpenters, and other regular people who went to the hospital expecting to receive professional care, but who were injured due to negligence. They are not looking for a windfall, but they each deserve fair compensation for their injuries. Most of them never thought about suing a doctor or hospital until faced with the prospect of living their lives in pain, being unable to work, or worse, losing a loved one to wrongful death. These are the people who are hurt most by the insurance companies who are spending millions of dollars lobbying politicians to close the courthouse doors.