Medical Malpractice and the Differential Diagnosis

One of the most common types of malpractice we see is physicians who miss a critical diagnosis.  Sometimes, this leads to delays in treatment which causes unnecessary pain and suffering and diminishes the chances for full recovery.  Other times, a missed or delayed diagnosis can result in permanent disability or even wrongful death.

In medical school and their residencies, doctors are trained in the "differential diagnosis."  This is a routine diagnostic method whereby a physician formulates a hypothesis as to likely causes of the patient's symptoms.  The doctor then uses his or her medical judgment to eliminate unlikely causes by a deductive process of elimination.

The essential component of the differential diagnosis is the use of reasonable medical judgment.  If a doctor eliminates a possibility simply because a condition is rare, that is not enough.  The judgment must be reasonable, and it must be based on the information available.  This doesn't mean that doctors have to order every possible test to eliminate every possible disease--that's not reasonable (and don't worry--"defensive medicine" is myth).  But where a simple blood test or an inexpensive x-ray can eliminate a potentially fatal condition, it is reasonable to use those tests to reach a diagnosis.  Doctors and physicians are highly trained, and their patients trust them with their lives.

When doctors fail to exercise reasonable judgment and miss a diagnosis, that is medical negligence.  The law protects your rights to recover if you are a victim of malpractice, but you need experienced lawyers who understand the medicine and know the law.  Contact the Utah medical malpractice attorneys at G. Eric Nielson & Associates for a free, no obligation consultation today.

Utah Malpractice Lawyers and Their Clients

Utah Medical Malpractice Lawyers Assist Shoulder Dystocia and Erb's Palsy Patients

Shoulder dystocia is a relatively common complication experienced during childbirth. It occurs when the infant's shoulder's become impacted behind the mother's pelvic wall. Shoulder dystocia is usually encountered with large babies weighing in excess of 4,500 grams (fetal macrosomia), but that is not always the case. Other predictors of possible shoulder dystocia are significant maternal weight gain and gestational diabetes.

Most obstetricians can predict whether a delivery presents a risk of shoulder dystocia, and can take a number of precautions--including cesarean delivery--to avoid it.

In some cases, however, shoulder dystocia cannot be predicted. Doctors and nurses that encounter this condition can employ a variety of techniques to help avoid serious injuries, such as the McRoberts maneuver, application of suprapubic pressure, or something known as the "corkscrew" maneuver.

Unfortunately, in some cases, physicians or medical staff have not been properly trained in these procedures. Other times, doctors might rush to use an instrument such as a vacuum extractor or forceps to help extract the infant.  Such inappropriate actions often result in injury to the brachial plexus nerves in the infant's neck. These injuries can range from strain, which may heal over time, to complete avulsion. Depending on the severity of the injury to the brachial plexus nerves, a child may develop a condition known as Erb's Palsy.

Erb's Palsy can result in a crippling disability to a child's upper extremity. While some surgical procedures can increased the range of motion, many children never regain full use of their arms. Though children suffering from Erb's Palsy can be happy and confident, simple tasks such as eating with utensils and putting on socks serve as frustrating reminders that they are different from their playmates.

Utah Medical Malpractice Attorneys Can Help Recover for Birth Injuries and Cerebral Palsy

The delivery of a newborn child is one of life's most miraculous events. Often, it is the culmination of months of preparation and effort, and results in a joyful addition to a family.

It is during this process that expectant mothers and fathers put their trust in the care and professionalism of their doctors and nurses. With so much at stake, parents put a great deal of faith and trust in their health care providers.

In most cases, that trust pays off, and through the efforts of conscientious doctors and medical staff, new babies are born healthy and happy. But mistakes happen. The birth of a child--sometimes a once in a lifetime event for a family--can become routine practice for obstetricians and their staff. Additionally, the demands of the corporations that run the hospitals place increasing time and business burdens on doctors. Instead of giving each delivery the specialized attention it deserves, doctors are frequently rushed and distracted. Similarly, overworked nurses can get so busy that they forget to monitor the mother and baby's progress, or ignore critical signs that something may be wrong.

These lapses in judgment--simple mistakes--can have catastrophic consequences, resulting in profound, life-long injuries.

As difficult as delivery is for the mother, it is just as hard for the baby. The birthing process exerts stress on the baby, and if that stress is not closely observed and managed, it can become too much for the baby to handle on its own. Additionally, complications like umbilical cords being wrapped around the baby's neck can cause additional concerns.

If these conditions are monitored, they can be resolved with relatively mild medical interventions such as medication, or sometimes, delivery by cesarean section. If they are not monitored, however, then the baby's heart can malfunction, and the brain is deprived of oxygen. When this goes on for too long, the brain is irreversibly damaged.

Hypoxic ischemic encephalopathy (HIE) is a type of brain damage that affects various cognitive and physiological functions, and even death. Children who survive HIE often struggle with learning disabilities, mental retardation, epilepsy, poor motor coordination, and cerebral palsy, among other things. These special needs often require thousands--if not millions--of dollars in medical care and treatment.

Proving that medical negligence caused birth injuries is a difficult, complex process. The medicine and legal issues involved require skill, training, and experience. Not all cases of cerebral palsy or HIE are caused by medical negligence, but the only way to know for sure is to contact an experienced medical malpractice attorney.

The Utah medical malpractice lawyers at G. Eric Nielson & Associates specialize in complex birth injury litigation. We have handled many of the largest cases in the State of Utah, and recovered millions of dollars for injured children. If you have questions about cerebral palsy or the possibility that your child may have been injured by medical negligence, the medical malpractice attorneys at G. Eric Nielson & Associates offer free, no obligation consultations. We can have your medical records reviewed by national experts, and we can give you the answers you have been looking for.

Aortic Dissection - Delay in Diagnosis Can Be Fatal.

The aorta is the largest artery in the body.  It starts from the left ventricle of the heart, and extends down to the abdomen, where it branches off into smaller arteries.  The aorta itself has two walls: an outer wall and an inner wall. An aortic dissection occurs when a tear in the inner wall of the aorta causes blood to flow between the layers of the wall of the vessel, forcing the layers apart.

 

The aorta has an outer and inner wall, which is kind of like the inner tube of a tire.  If the inner wall develops a tear, blood then passes between the inner and outer walls of the aorta.  Since the heart is a pump, the pressure of the blood drives against the two walls like a wedge and continues to slowly tear away between the inner and outer walls.  The blood is in a false passage and has nowhere to go, so it accumulates until the pressure forces further dissection.  If the dissection tears the aorta completely open, massive and rapid blood loss occurs, often leading to death.

The symptoms of aortic dissection include sharp, "tearing" pain that starts suddenly, sometimes extending through the chest and into the back and neck or jaw.  There can also be other physical and neurological symptoms, such as fainting, lightheadedness, blurry vision, and numbness or tingling in the arms or legs. Sometimes it will cause nausea and vomiting.

Any time you have severe chest pain, you should consult immediately with a physician.  Emergency room doctors are trained to diagnose medical problems, including aortic dissection.  They should run a series of simple tests, including measuring your heart rate against the pulse felt in your extremities to check for adequate perfusion.  A chest X-Ray can be taken to look for abnormalities.  Because aortic dissections can be fatal if not treated on time, they are considered true medical emergencies.  Responsible medical professionals will run additional tests and consult with appropriate specialists to make the diagnosis.

In some cases, however, physicians don't follow the steps to make the diagnosis, and send patients home to face catastrophic consequences.  Delays in treatment of even a few hours can drastically decrease a patient's chances for survival.  It is therefore necessary that doctors be aware of, and properly diagnose, aortic dissection.


If a patient presents with symptoms of aortic dissection and a health care professional fails to make the correct diagnosis, it may be considered medical malpractice.  You should consult with a Utah medical malpractice attorney to discuss your legal rights to hold negligent health care providers accountable for their medical errors.  Contact the Utah Medical Malpractice Attorneys at G. Eric Nielson & Associates for a free consultation today.

801-424-9088

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.