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April 15, 2014

Neonatal Encephalopathy and Neurologic Outcomes - Revised Criterea from ACOG



In 2003 the American College of Obstetricians and Gynecologists(ACOG), along with the American Academy of Pediatrics, published Neonatal Encephalopathy and Cerebral Palsy: Defining the Pathogenesis and Pathophysiology ("NEACP"). This monograph became more commonly known as "the Green Book" and it has been roundly criticized as an attempt by its authors to use "junk science" to create hard an fast "essential" criteria to diffuse obstetrical malpractice claims against Ob/Gyns. In the more than 10 years since its publications its authors have backed off the allegedly essential nature of its core criteria and physicians have been forced to admit that factors like cord blood ph levels above 7.0 can still occur in births where the fetus experiences perinatal asphyxia that is the result of negligence.

Recently, ACOG published an update to the Green Book titled Neonatal Encephalopathy and Neurologic Outcome, Second Edition. This update changes some of the so-called "essential" criteria that expert witnesses have relied upon to defend causation in birth injury cases.

The update defines Neonatal Encephalopathy as a clinically defined syndrome of disturbed neurologic function in the earliest days of life in an infant born at or beyond 35 weeks of gestation, accompanied by early onset seizures and difficulty initiating and maintaining respiration and depression of fetal tone and reflexes. The update relaxes the criteria which obstetricians and pediatricians feel demonstrate the likelihood of peripartum or intrapartum ischemia playing a role in the pathogenesis of neonatal encephalopathy.

Specifically, the monograph identifies four essential signs and their revised values and includes, Apgar scores of less than 5 at five and ten minutes, cord blood gas pH levels of less than 7.2 (and/or a base deficit greater to or equal to 12 mmol/L), evidence of brain injury shown on MRI at a time early in the childs life (before 21 days of life) and the presence of multisystem organ failure consistent with HIE.

These revised numbers reflect the growing understanding that pH levels above 7.0 can still reflect fetal injury caused by perinatal asphyxia. This is something that we have known and understood for quite some time. It is interesting that the authors of this update have taken a more intellectually honest approach at defining the criteria they use to define asphyxia related neonatal encehalopathy and have become more inclusive in their definitions. As attorneys who routinely face defenses of birth injury cases that are based entirely on Green Book factors, these definitions, while not exactly a breath of fresh air, are a step in the right direction.

May 1, 2012

Neurological Injuries Related To Humira Use



Abbott Laboratories best selling drug, Humira, has been linked to a host of serious side effects, including severe neurological injuries. Abbott's is on track to sell $15 billion worth of the drug per year by 2015. Abbott already expects to sell close to $10 billion worth of Humira in 2012. Humira is used to treat a variety of rheumatological conditions, including, Rheumatoid Arthritis and Ankylosing Spondylitis as well as Crohn's disease.

In 2009, Abbott included the following warning in the package insert for Humira under section 5.5 titled, Neurologic Reactions:

"Use of TNF blocking agents, including HUMIRA, has been associated with rare cases of new onset or exacerbation of clinical symptoms and/or radiographic evidence of demyelinating disease. Prescribers should exercise caution in considering the use of HUMIRA in patients with preexisting or recent-onset central nervous system demyelinating disorders."

If you, or a loved one has been injured by Humira, please do not hesitate to call us at 800-368-0255.

January 27, 2011

How Walking 10,000 Steps Each Day Enhanced my Insulin Sensitivity in a Couple of Months



The following blog entry comes courtesy of a guest blogger, Stacy H. Federico, who has a blog devoted to raising awareness of Type II Diabetes and the benefits of healthy eating. We would like to thank her for her contribution to our blog.

Taking 10,000 steps every day (or walking about five miles) is incredibly useful to you.

I started walking 30 days ago. I wake up every day at 5:30 and walk about 5 mls (with my dog).

I had been so happy with myself. Recently a buddy told me, "What are you currently doing for exercise today?" I informed her about the walking, and she said, "Yeah, but what exactly are you doing for exercise?"

She declared that walking does not get the heart rate up sufficiently and won't do one thing to enhance my overall health or my waist line and that if I needed to lose any weight, I needed a true workout.

Well , I informed her the 10,000 steps philosophy isn't new...the good news is the 10,000 steps regimen has additionally been linked with an increase in insulin sensitivity in over 50 adults.

In a 5 years Australian analysis of nearly 600 men and women averaging fifty years age, walking a lot more steps was linked to reductions in BMI (Body Mass Index), waist to hip ratio, and insulin sensitivity.

The analysis, authored by professionals from the Murdoch Children's Research Institute in Melbourne, was released inside the British Medical Journal (BMJ). (Available here: http://www.bmj.com/content/342/bmj.c7249.full.pdf?sid=fc7e7b28-17b4-4173-894c-b3e493b71805)

The authors determined that the sedentary person who modified behavior over 5 years to satisfy the 10,000 daily step criteria could have a threefold improvement in insulin sensitivity compared to someone that worked up to 3,000 steps 5 days weekly.

In line with the experts, the connection of step activity with improved insulin sensitivity was principally accounted for by lower bmi.

So you? Are you still reading this report? Move out and walk!

1. Get yourself a pedometer.
2. In case you have a desk job, stand up and walk every hour.
3. Park farther away from entrances.
4. Put down the telephone, eliminate that e-mail, and walk.
5. Walk or jog in place during your preferred tv show.
6. Consider the stairs.
7. Pacing....
8. Go ahead and take puppy for a walk.
9. Hit the shopping center.

Who am I ?: Stacy H. Federico is posting for the diabetic snacks on the go website, her personal hobby blog devoted to tricks to help website visitors to stop Type 2 diabetes and help the awareness on healthy eating.

October 15, 2010

Low Apgar Score at Birth Associated with a Later Diagnosis of Cerebral Palsy



A low vitality score, better known as an Apgar score, at birth is a strong predictor of a later diagnosis of Cerebral Palsy according to a new study published on bmj.com. The authors learned that children with an Apgar score of less than 3 at birth had a 100 times more likely chance of developing cerebral palsy than those with an Apgar score of 10. The correlation between a low Apgar and cerebral palsy was highest in children with normal birth weight and modest in children with low birth weight.

The study measured these correlations in more then a half million Norwegian children born between 1986 and 1995. Of those children almost 2 in 1000 were given the diagnosis of Cerebral Palsy before they reached the age of 5.

The most important conclusion to be drawn from this data is that Cerebral Palsy is closely related to factors that also effect infant vitality, something that has been strongly suspected in medicine for years. Low Apgar scores can be indicitive of a brain injury that has occured at the time of birth.

At Goldberg & Goldberg we have been representing children with traumatic brain injuries caused at the time of birth for over forty years. If you suspect that a loved one has been the victim of medical malpractice at the time of birth and that malpractice has caused a brain injury, please do not hesitate to call us for a free consultation.

August 24, 2010

Medicare Liens and Medical Malpractice Litigation



The Deficit Reduction Act of 2005 (DRA) overhauled Medicare's perspective on payment for medical care related to "never events" including a list of delineated hospital acquired conditions. Hospitals will no longer receive reimbursement for conditions that are (a) high cost or high volume or both, (b) result in the assignment of a case to a DRG that has a higher payment when present as a secondary diagnosis, and (c) could reasonably have been prevented through the application of evidence-based guidelines. The ten categories for hospital acquired conditions are: Foreign Object Retained After Surgery,.Air Embolism,,Blood Incompatibility, Stage III and IV Pressure Ulcers, Falls and Trauma including, Fractures, Dislocations, Intracranial Injuries, Crushing Injuries, Burns and Electric Shock, Manifestations of Poor Glycemic Control including, Diabetic Ketoacidosis, Nonketotic Hyperosmolar Coma, Hypoglycemic Coma, Secondary Diabetes with Ketoacidosis and Secondary Diabetes with Hyperosmolarity, Catheter-Associated Urinary Tract Infection, Vascular Catheter-Associated Infection, Surgical Site Infection Following Coronary Artery Bypass Graft (CABG) - Mediastinitis, Bariatric Surgery, Laparoscopic Gastric Bypass, Gastroenterostomy, Laparoscopic Gastric Restrictive Surgery, Orthopedic Procedures and Deep Vein Thrombosis (DVT)/Pulmonary Embolism (PE).

While the Centers for Medicare and Medicaid Services (CMS) have prohibited hospitals from recovering payment for the treatment of secondary conditions acquired in the hospital, practically, these charges are often submitted and paid by Medicare long before and attorney becomes involved and makes a claim for medical malpractice. Careful examination of the supporting documentation Medicare provides at the time they require reimbursement often reveals that benefits were paid for hospital acquired events.

We pay close attention to each and every aspect of our clients cases and work very hard to insure that they receive the maximum recovery. This includes the work we do to check and negotiate all of our clients liens, including Medicare liens.

July 12, 2010

Goldberg & Goldberg Secures A $1,625,000.00 Settlement In Wrongful Death Case



Goldberg & Goldberg is pleased to announce that they have settled a wrongful death case involving the death of a newborn child for $1,625,000.00. The case, Vega v. St. James Hospital, et al, involved the negligent diagnosis and management of fetal distress of mother and child during labor and delivery at St. James Hospital in Chicago Heights, Illinois in 2002. The baby survived a little over one hour before he ultimately died due to complications surrounding his resuccitation.

The defendants claimed that the child suffered from a microscopic pathologic defect which prevented him from being able to adequately perfuse oxygen in utero. The child is survived by his parents and three brothers and sisters.

June 3, 2010

Goldberg & Goldberg Secures A $1,000,000 Settlement In Rockford Medical Malpractice Case



Goldberg & Goldberg partner, Ian R. Alexander, secured a $1,000,000.00 settlement in the case of Newburg v. Swedish American Hospital, et al 02 L 263 which is pending in Winnebago County, Rockford, Illinois. In 2001, the day before Thanksgiving, Margaret Hoffman went to Swedish American Hospital complaining of chest and back pain. Doctors in the Emergency Room were able to determine that she was not having a heart attack. Her cardiologist ordered the hospital to perform a CT Scan of Ms. Hoffman's chest in order to rule out an aortic aneurysm as the cause of her pain. The hospital did not carry out the order for a CT scan until 48 hours later when Ms. Hoffman experienced a drop in her hemoglobin which indicated that the aneurysm had ruptured. Unfortuntely this intervention came to late and Ms. Hoffman, a 61 year old clerk at Zion Development Corporation, passed away on the operating table.

Ms. Hofman was survived by her two adult children. Records indicate that this settlement was one of the largest recoveries in recent history in Winnebago County for a wrongful death case where the survivors were adult children, and one of the few cases to settle in Rockford for in excess of $1,000,000.

We are very proud of the hard work that we did for Ms. Hoffman's family. From the beginning all of the defendants claimed that Ms. Hoffman's death was a result of her own poor health and had nothing to do with the numerous mistakes that they made in caring for her while she was a patient at the hospital over the Thanksgiving holiday in 2001.

March 17, 2010

Goldberg & Goldberg Secures A $5 Million Dollar Settlement For A Brain Injured Child



Lawyers at Goldberg & Goldberg secured a $5 million dollar settlement on behalf of a 22 year old man who was brain injured at birth when his labor and delivery at Northwestern Memorial Hospital was negligently managed by resident physicians. The labor and delivery was managed by residents because the plaintiff was a low income patient and in 1988 Northwestern Memorial Hospital had a policy of allowing residents manage the delivery of patients who did not have private physicians.

The plaintiff was able to file his lawsuit against Northwestern thanks to a law in Illinois that preserves the rights of brain injured people against the statutes of limitations and repose which would have ordinarily run. Goldberg & Goldberg challenged the statute of limitations law in a prior lawsuit and helped create this protection for brain injured children in a prior piece of litigation.

The settlement money in this case will be used to buy our brain injured client a handicap accesible home, electric wheelchair and a special van with a lift, among other things. He and his mother have had to do without this assistance for the past 22 years.

February 5, 2010

Illinois Supreme Court Rules In Favor Of Patient On Medical Malpractice Reform



The Illinois Supreme Court in a 4-2 decision struck down limits on damages awards in medical malpractice cases with its decision in Lebron v. Gottlieb Memorial Hospital on thursday. The court held that the legislation was unconstitutional. The majority opinion, authored by Justice Fitzgeral held, in part: "[W]e necessarily consider...the legislature's goal in enacting the statue-responding to a health-care crisis. Our separation of powers analysis, however, does not stop there. The crux of our analysis is whether the statue unduly infringes upon the inherent power of the judiciary. Here, the legislature's attempt to limit...damages in medical malpractice actions runs afoul of the separation of powers clause."

This is a major victory for patients and consumers in Illinois. The legislature has tried, on three seperate occasions, to enact caps on damages in medical malpractice cases. For years lobbiests for the insurance industry have argued that medical malpractice awards have contributed to the high cost of health care in Illinois despite the fact that insurace payouts on these claims have remained level for the past two decades.

All citizens of Illinois should have a right to ask a jury of their peers for redress when they have been victimized by negligence, regardless of the profession of the guilty party. To see a copy of the Supreme Courts landmark opinion look here.

January 15, 2010

What Is Over Radiation In The Context Of Cancer Treatment As It Relates To Medical Malpractice?



Radiation therapy in cancer treatment uses high doses of radiation to kill cancer cells and helps prevwent them from spreading throughout the body. The use of radiation therapy is one of the primary means that physicians have to help treat patients who have been diagnosed with cancer and is prescribed in 60% of all cancer treatment scenarios. Radiation is typically prescribed and administered through the use of an external beam which is provided by a machine called a linear accelerator. The beam is localized and given in precise measures of energy, or doses, to specific areas on the human body for treatment.

Over radiation occurs when some element of error occurs during the treatment process and the patient gets more then the prescribed dose of radiation over a period of time. While the linear accelerator is a very precise provider of radiation, there is a human component involved in doing the math and physics required to set up the machine to provide accurate treatment dosage. The system sometimes fails when these human failsafes are ignored and the patient receives the wrong amount of radiation.

The results for over radiated patients are devastating. The extra radiation, even in seemingly small doses, weakens and kills healthy tissue causing skin and organ damage, and often death. At Goldberg & Goldberg we have handled over radiation cases which have resulted in record recoveries for our clients including a verdict of $16 million and a settlement of $7.5 million.

January 12, 2010

GOLDBERG & GOLDBERG SECURES $7.5 MILLION SETTLEMENT FOR WRONGFUL DEATH OF A 60 YEAR OLD WOMAN IN CHICAGO MEDICAL MALPRACTICE LAWSUIT



Barry D. Goldberg and Peter A. Nicholson of the Chicago law firm of Goldberg & Goldberg have settled a wrongful death case on behalf of the Estate of Patricia Quirk for $7.5 million. Quirk v. Little Company of Mary, et al., 05 L 00379. The case was assigned for trial to the Hon. Thomas Hogan in the Circuit Court of Cook County. Little Company of Mary is represented by Marilee Clausing and Susan Hannigan of Anderson, Rasor & Partners, Radiation Oncology, S.C. is represented by David Burkter of Cunningham, Meyer & Vedrine and the radiation oncologist is represented by Mary Cunningham of Kominiarek, Bresler, Harvick and Gundmundson, all of Chicago.

Beginning on March 26, 2003, Patricia Quirk received an overdose of radiation to her pelvis as she underwent radiation therapy for a stage 3 endometrial cancer. She received 50% more than the prescribed dose of radiation on 17 separate occasions during her radiation therapy. This radiation overdose ultimately perforated her bowel, causing her to become septic and leading to her death on May 8, 2004 at the age of 60. Mrs. Quirk is survived by her husband Thomas Quirk and two adult children. Mrs. Quirk was a life long resident of Chicago who resided in the West Lawn neighborhood. She was a social worker who was considered an expert in the field of community relations and the concurrent politics of mental health care. She was previously honored by four Chicago Mayors, the City Council and the Illinois General Assembly for her work with the mentally disabled citizens of Illinois.

Goldberg & Goldberg is a premier Chicago, Illinois law firm that concentrates its practice in the representation of plaintiffs in medical malpractice lawsuits. In addition to this settlement Goldberg & Goldberg has secured other significant results in over radiation cases, including a $16 million jury verdict in 2005. Barry D. Goldberg, one of the firms senior partners, also has the largest personal injury verdict in the history of the state, a record setting $127 million result. Goldberg said, "we are pleased to be able to deliver some measure of justice to the Quirks who have suffered such a terrible loss of this wonderful person."

This settlement is a record settlement in Cook County for the wrongful death of an adult leaving no minor children as survivors, the previous record was $7.3 million, and is a record settlement for an over-radiation wrongful death case in Cook County.

December 11, 2009

Actor James Woods Settles Medical Malpractice Case And Gets An Apology



Hollywood actor James Woods setttled a medical malpractice case brought on behalf of his brother who died while he was a patient in the Emergency Room of Kent Hospital in Kent County, Rhode. The Providence Journal Online Edition is reporting that while the financial terms of the settlement are confidential, the hospital took the unusual step of apologizing to the Woods family for their mistake.

james woods.jpg

Woods said the impetus for the settlement came with a phone call from hospital president Sandra Coletta. In that call, he said he heard something he'd never heard from Kent Hospital before, someone saying she was sorry for his family's loss.

It has been widely reported that apologizing for medical mistakes is the number one way a doctor or hospital can help curtail a medical malpractice claim. Often times patients and their families are looking for closure after the loss of a loved one. An apology is often the piece of the grief puzzle that helps wounds heal and allows people to move on after a tragedy.

For his part, Woods said the conclusion would give him, if not closure, some piece of mind about the meaning of his brother's death. "It makes it possible for me to go to my brother's grave and ask if I've done the right thing," he said.

December 7, 2009

Don't Get Sick On Christamas: Medical Malpractice Over The Holidays



Conventional wisdom says don't get sick over the holidays. Hospitals are understaffed, doctors are distracted and the overall quality of medical care is diminished at even the finest of institutions. Over and over again we see cases at otherwise fine Chicago area hospitals that have one thing in common. The negligence occurs over the Thanksgiving, Christmas or New Year's holidays. Unfortunately, we can't choose when we get sick and people certaintly need medical help over the holidays, so keep the following in mind:

Become an advocate for yourself. Hospitals run on skeleton shift over any major holiday. Do not simply assume that Doctors and Nurses are thinking about you and your condition, they are not. they are thinking about the holidays like everyone else. Remind them of critical information and ask questions. If you are not satisfied with a response make sure they explain it to you again in plain english until you understand.

Go up the Chain of Command. if you are unhappy with the care you are receiving or if you are felling neglected, ask to speak with a supervisor, the head of the department or the vice-president of nursing. Doctors are accountable to the chairman of their service as well. Demand someone pay you the proper amount of attention.

Do not accept substandard or substitute care just because it is a holiday weekend. Hospitals are required to maintain full operating staffs and are required to provide services like Ct scans and MRIs over a holiday weekend. If these things are unavailable due to a holiday staffing shortage then the hospital is required to transfer you to a facility that is operational. Do not accept the excuse that a service cannot be provided because it is a holiday weekend.

Follow this tips and advice and hopefully you holiday hospital stays will be short and uneventful.

November 12, 2009

Medical Malpractice And Tort Reform: Enough Already



Joanne Doroshow wrote an excellent article in the Monday, November 9, 2009 edition of The Huffington Post called Medical Malpractice Tort Reform - We Are Already Suffering And Don't Need More. She points out that unless you are currently living under a rock you have heard the term "tort reform" but, sadly, probably don't know what it really means.

In Illinois we have tort reform as it relates to medical malpractice. Starting in 1985, and every ten years thereafter, the state legislature has based some sort of restriction on the publics right to sue for personal injury. In the late 1990s the Illinois Supreme Court struck down these restrictions, overruling the legislature, and finding them to be unconstitutional. The legislature, bowing to pressure from the insurance industry, tried again in 2005 and passed limits on jury awards as they relate to doctors and hospitals only. That legislation is currently being reviewed for constitutionality by the Supreme Court and we expect a ruling on the issue in the near future.

The term tort reform implies that its results would be beneficial to everyone. Sadly, this is not the case. Tort reform in Illinois will only make it harder for average hard working men and women to seek redress for the harms caused to them as victims of negligence. The tort reform movement was started by and is funded by insurance companies. The same companies that have the most to gain financially by limiting jury awards.

The benefits of our current tort system are far reaching and relatively unsung. Innovations in product and medical safety, health care innovations and auto safety are some of the by products of our jury system. What motivates insurance companies? Money and the bottom line. Are they interested in protecting the little guy? Not at the expense of profits.

September 25, 2009

Actor Dennis Quaid Appeals Ruling Dismissing His Medical Malpractice Case In Chicago



The National Law Journal is reporting that the actor Dennis Quaid and his wife have filed a lawsuit in Cook County, Illinois against Deerfield based Baxter Healthcare Corp. concerning a drug overdose his children suffered at Cedars-Sinai Hospital in Los Angeles, California. The actor and his wife claim that the overdose occured, in part, due to confusing drug-labeling by the manufacturer of the drug Heparin.

Quaid.jpg

The lawsuit was filed in Chicago and dismissed by the trial court on jurisdictional grounds. The drugmaker claimed, and the trial and appellate courts have agreed, that the case would be more appropriately filed in California. The Quaids have petitioned the Illinois Supreme Court to hear the case.

The Quaid children were given 1000 times the recommended dosage of the drug Heparin while being treated at Los Angeles's Cedars-Sinai Hospital. While there have been no adverse effect from the overdoes as of yet, the Quaids are concerned about the effect of the overdose on the twins health and well-being in the future.

Goldberg & Goldberg has extensive experience prosecuting cases involving drug and prescription error, including medical malpractice and product liability cases involving the misuse of drugs. In 1991, Barry D. Goldberg obtained a $127,000,000 verdict in a drug product liability cases that is still the largest personal injury verdict in the history of the State of Illinois.