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Many hospitals, and surgeons, are touting the benefits of their latest piece of technology–the DaVinci Robotic Surgery System.  This new piece of high technology allows the surgeon to sit at a video game-like console to perform many types of surgery.   Instead of performing minimally invasive surgery using  now time-tested techniques of laparoscopic surgery, surgeons are opting for the DaVinci system.  The claimed benefits are that the procedure is less invasive, has fewer complications, less pain and promises a quicker return to normal activities–all the same benefits derived from laparoscopic techniques compared to “traditional” techniques.  However, it is becoming clear that patients may be experiencing a myriad of complications as a result of the DaVinci Robotic Surgery system.

So how do the three surgery types differ?  In traditional “open” surgery the surgeon makes an incision and actually places his hands and instruments directly into the patient.  The benefits are that the surgeon has a normal view and can manipulate organs and structures directly with his hands.  The surgeon has tactile and other sensory feedback.  Most surgeons are taught that when they encounter complications using any other type of procedure, they can and should convert to an “open” procedure for the remainder of the surgery.  In fact, almost every consent form for either laparoscopic or robotic surgery will include permission to convert to an open procedure if needed.

The gold-standard for many surgical procedure in the last twenty years has been laparoscopy.  In laparoscopy, the surgeon makes several small incisions and uses these incisions to insert a camera and instruments into the patient to perform the procedure.  The surgeon directly manipulates the instruments but views what is going on in the patient on a video monitor.  Almost every surgeon practicing today was either directly trained in laparoscopy or has been performing laparoscopy for many years.  The benefits of laparoscopy are less pain and a quicker return to normal activities.

And now there is the DaVinci Robotic Surgery System, which takes laparoscopy to a whole new level.  The same types of small incisions are made in order to insert a camera and instruments.  However, once the instruments are placed, the surgeon does not hold them in his or her hands.  Rather, the instruments are attached to a robotic surgery platform and the surgeon sits at a video console and manipulates the instruments using video game-like controllers.  The alleged benefit of this system is that it allows the surgeon to make much more precise and controlled maneuvers, such that a 1/2 inch movement of the controller may equate to a 1mm movement of the instrument in the patient.  The concept sounds wonderful.  However, in practice, problems appear to have arisen.

DaVinci Robotic Surgery systems have been used for abdominal surgeries such as gallbladder remove, for gynecological procedures such as hysterectomies and for other procedures such as prostatectomies.  They are even being used for endoscopic procedures.

However, patients have experienced complications such as bladder and bowel perforations, injuries to the ureter and rectum, and burns and other complications.  One suspected problem is that the DaVinci system utilizes an electronic scalpel, called a cautery, to make cuts.  The makers of the DaVinci system, Intuitive Surgery, Inc., a California company, used a monopolar system rather than a bi-polar system to ground the electrical current.  It appears that this less expensive system allows the current used to make cuts to jump to places unintended by the surgeon, sometimes far remote from the spot where the surgery is occurring.

Complications such as bowel and bladder perforations and other injuries can be life-threatening.  Serious injuries or death can occur if these complications are not promptly recognized and treated.

If you or a loved one have been injured during a DaVinci Robotic Surgery, please contact T

I’m pleased to share 10 Red Flags in General Surgical Malpractice Cases, published in the September 2012 issue of Trial magazine. Trial is the peer-reviewed journal of the American Association of Justice, the national trial lawyer’s association.

I was honored to be asked to contribute to such a prestigious publication.

As reported here, the Missouri Supreme Court, in Watts v. Lester E. Cox Medical Centers declared that caps on medical malpractice cases are unconstitutional. So, if you have a medical malpractice case in Missouri, what does that mean for you?

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First, if your case involves a death, it is not clear whether the limitation on damages is still in effect in those cases. In April, 2012, the same Court upheld caps applied in a medical malpractice wrongful death case. That case, /Sanders v. Ahmed was actually decided based on the pre-2005 law on medical malpractice caps. However, that decision may be read as standing separate from the Watts decision. In short, whether caps apply in wrongful death medical malpractice cases is still an open question.

Second, in cases involving injuries, but not death, the Watts decision is unequivocal. Caps on the amount of damages that a jury can award on cases that existed under the common law, such as medical malpractice claims for injuries, are unconstitutional. Without an amendment to the Missouri Constitution, legislation seeking to impose such limits will not be upheld.

Third, for active cases, and cases yet to be filed, a Court cannot impose a limit on the damages awarded for non-economic injuries, such as pain and suffering. Under the law declared unconstitutional, the amount of those damages was limited to $350,000. While that may seem like a lot of money, in situations involving life long injury and disability, it is readily apparent that the limitation was crippling. Children injured a birth, who would deal with life-long disability, were not fully compensated. Now, that restriction is lifted.

Fourth, if you have had a medical malpractice case resolved under the old law, whether it resulted in a judgment or a settlement, you won’t be able to go back and re-open those cases to achieve a bigger settlement or verdict. If the decision wasn’t appealed, then the case is final and you won’t be able to reopen it.

Obviously, the actual monetary affect on a particular case is going to vary. If you have a current medical malpractice case you should consult with your attorney about the impact. If you believe that you or a loved one was injured as a result of medical malpractice and would like to discuss your case, please call 1-800-567-8176 for a consultation.

On July 31, 2012, the Missouri Supreme Court issued its opinion in the case of Watts v Lester E. Cox Medical Centers. In a well-reasoned and detailed opinion by Chief Justice Richard B. Teitleman, the Court found unconstitutional the legislatively imposed limitations on damages that a jury can award in medical malpractice case found in §538.210 of the Revised Statutes of Missouri.

The law, passed as a component of sweeping changes to tort law in 2005, placed a limit of $350,000 on non-economic damages that could be awarded in a medical malpractice case.

The Missouri Supreme Court found that the limitation infringed on a jury’s duty, under the Missouri Constitution, to determine the facts in a medical malpractice case. One of the facts that a jury is charged with determining is the amount of the damages. Because the Missouri Constitution declares that the right a jury shall remain inviolate, the Supreme Court looked to whether the right to a jury, as it existed at the time the Missouri Constitution was adopted, included the right to have a jury determine damages. The Court held that it did and, therefore, §538.220 infringed on that right and was, therefore, unconstitutional.

The result is that a jury is not artificially limited in the amount of damages it can award. Of course, the jury’s judgment is still subject to review and revision by the Courts, both at the trial and appellate level. Either can chose to reduce an award based on the judicial power of remittitur.

Another hip implant has been recalled. Stryker Orthopaedics has recalled two brands of its devices, as reported here. Unlike previous recalls by DePuy which were of the metal-on-metal implant contact surfaces, consisting of a metal ball and a metal hip socket, the Stryker recall is of femur stem implants.

Post-implant complications indicate that the Rejuvenate and ABG II modular-neck systems are experiencing fretting and corrosion at the modular neck junction. This corrosion and fretting appears to be leading to the same kind of patient reactions as the metal-on-metal head implants.

It would appear that patients may expect to encounter metalosis, pseudo tumors, aseptic loosening and other problems.

If you or a loved one have Stryker implant and have experienced any problems, please call our office at 314-721-8833.

Elizabeth Cohen, CNN’s senior medical correspondent, has posted Medical Mistakes: Patient’s Stores: 10 Shocking Medical Mistakes.

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In a well-written piece, citing real examples of patient victims, Cohen outlines 10 common medical mistakes that represent easily prevented, easily corrected medical malpractice. These mistakes are estimated to cause more than 250,000 deaths per year in the U.S., and injuries to millions more.

1. Treating the wrong patient–failing to identify the patient;

2. Surgical “souvenirs”–surgical instruments and sponges left in patients;

3. Lost patients–dementia patients being lost or wandering off;

4. Fake doctors–people posing as doctors or doctors who have had their licenses revoked continuing to practice;

5. ER waiting game–failure to properly triage patients;

6. Air bubbles in blood–a deadly and preventable complication of chest tubes and IV lines;

7. Operating on the wrong patient–failing to identify the correct patient and the correct procedure;

8. Infection infestation–bad hygiene by doctors and nurses;

9. Lookalike tubes–medication vials that look deceptively similar with terrible consequences;

10. Waking up during surgery–insufficient anesthesia, causing injuries when patients awake

These 10 mistakes seem so obvious, that many people think they simply can’t occur that often. But they do, with alarming frequency.

If you or a loved one were injured or killed as a result of medical negligence, please call for a consult. STLMedicalMalpractice.com

“American hospitals are capable of great medical feats, but they are also plagued by daily errors that cost lives.” So begins a recent article by the AARP, titled Hospitals May Be the Worst Place to Stay When You’re Sick.

The AARP reports several statistics that may be shocking to those who don’t deal with these issues, day in and day out. For example:

? Each year as many as 100,000 American die in hospitals from preventable medical mistakes

? A report on Medicare patients released in January found that hospital staffs don’t report 86% of harms done to patients

? An HHS study found that 1 in 7 patients suffered serious or long term injuries, or died as a result of hospital care

? 44% of the problems are preventable

? The patients who die each year from preventable hospital errors equal four full jumbo jets crashing each week

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If you suspect that you or a loved one are the victim of this type of medical negligence, please call me to discuss. 314-721-8833 or 800-557-8176 or view my website STLMedicalMalpractice.com.

There is a great resource for the most current information on medical statistics, including information on medical malpractice claims. It is statehealthfacts.org a Kaiser Family site.

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For any given state, you can access statistics on how many persons are without health insurance, health costs and budges, mortality rate, Medicaid and Medicare enrollment and much more.

Also of interest is information on medical malpractice claims. Statistics on the number of claims paid in 2010, as well as the total amount paid in claims, and the average amount paid per claim, all broken down by state.

The St. Louis Post Dispatch, in an in-depth article, reported that St. Anthony’s Medical Center in south St. Louis County, failed to report Dr. Surendra Chaganti to the Missouri State Board of Healing Arts, the state board that “regulates” doctors.

Dr. Chaganti, apparently one of the busiest psychiatrists in St. Louis County, was accused of negligent care of multiple patients, according to the Post Dispatch story. When St. Anthony’s took action to revoke his hospital privileges, Dr. Chaganti responded by suing St. Anthony’s. Dr. Chaganti was represented in the suit by his brother, attorney Naren Chaganti. Attorney Chaganti also represented his brother in several other lawsuits brought against others who accused Dr. Chaganti of improper care. The suit against St. Anthony’s was ultimately settled with an agreement that Dr. Chaganti would resign his privileges but St. Anthony’s would not report his resignation or their action to the National Practitioner’s Data Bank, a federally mandated repository for information on doctor discipline and malpractice. The data bank is not available to the general public, but hospitals and malpractice insurers have access and use the information in making decisions regarding whether to grant privileges or offer insurance.

The problems with reporting physicians for sub-optimal care are myriad, but in this particular case two specific problems are highlighted. First, St. Anthony’s entered into an agreement, which was approved by a judge, to not report Dr. Chaganti to the data base. By the data base’s definitions, reporting should have occurred. Resignations made after action is taken to revoke privileges is a reportable event and St. Anthony’s should have reported him. Their failure to do so apparently only came to light after a series of events in which Dr. Chaganti attempted to obtain privileges elsewhere and the other hospitals suspected or discovered the failure to report.

The second problem this highlights is the fact that the National Practitioner Data Bank is kept secret from those who would most benefit from being able to know if a doctor has been found to have given bad patient care–patients! By keeping this information secret, the public is being deprived of its right to make an informed decision.

You can read the complete Post Dispatch story here.

Dennis Quaid recently testified before Congress regarding the near fatal ovedose of his newborn twins at Cedar Sinai Medical Center in Los Angeles. See his testimony here on YouTube. Mr. Quaid testified very effectively on the need for FDA recalls of Heparin and the need to keep the path to the courthouse open for families devastated by medical negligence.Please, take the time to listen to Dennis Quaid’s story and his argument that the Supreme Court and Congress should not protect a drug company from liability because the drug and the labeling was approved by the FDA.