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Chicago Medical Malpractice Law Blog

"What Else Could It Be?" - The Importance of Differential Diagnosis

IMG_4392.JPG"What else could it be?" These are five powerful words that you should be ready to ask your doctor during a visit.  If you are like most people you probably aren't looking forward to a visit to see the doctor. As a patient you don't have the luxury of always knowing exactly why you are seeing a doctor. All you know is that you have a handful of symptoms which are currently adding up to a decrease in your quality of life. Unfortunately your doctor doesn't know why you are seeing him either.  He must play the role of detective and use all the clues he can find to discover what is ailing you. So here you are in the exam room as your doctor asks you a bunch of questions and examines you to validate your symptoms and discover any others that might present themselves. During this examination it is your doctor's job to piece together the information gathered and come up with a diagnosis. This is done through a process called Differential Diagnosis. 

Your doctor's process should be similar to the Sherlock Holmes adage "When you have eliminated the impossible, whatever remains, however improbable, must be the truth." Using clues provided by your descriptions of the symptoms, data from any medical tests you have had, and his medical knowledge your doctor makes a list of all the possibilities. Then using the same information used to make the list he dismisses the items by ruling out those that don't fit the clues, until he is left with one diagnosis that fits all of the data.

Weekend Surgery is Risky for Children

weekendsurgery.jpgAny patient undergoing a surgical procedure can be frightened. No matter how routine an operation may be, there are still risks and the potential for complications to arise. When that patient is a child, the experience can be that much more upsetting for the child and his or her parents.

Researchers at Johns Hopkins have been investigating a particularly worrisome phenomenon in regards to children's surgeries. According to reports, a so-called "weekend effect" has put the lives and health of young surgical patients in danger. Researchers have observed an increase in the number of deaths and injuries stemming from operations performed on children over the weekends. Their study, published in the the July 2014 issue of the Journal of Pediatric Surgery, confirms this trend and now people are trying to find out why this is happening.

Is July a Bad Month to go to the Hospital?

beach.jpgIn the month of July, a new batch of first year medical residents walk through the doors of academic hospitals around the country. Unfortunately those same hospitals see the rate of medication errors rise exponentially, contributing to what has been dubbed "the July effect."

A study published in the Journal of General Internal Medicine found that teaching hospitals experience a sharp increase in medication errors like clockwork every July - which just happens to coincide with the arrival of new residents and the departure of many of the seasoned staff members.

The study also found that the number of surgical errors at the teaching hospitals did not increase with the number of medication errors. The reason for this is because first year residents do not perform surgeries, but they do write prescriptions, leading to the spike in medication errors.

Prescription Reviews Reduce Costly Medical Errors

pills.jpgMedication errors are caused by many things. With so many factors it can seem like a daunting task to avoid them.  The FDA has indicated that drugs with very similar names, drugs with similar packaging, and sometimes even a physician's bad handwriting all contribute to medication errors. In the emergency room getting the right drug, in the right dose, to the right patient is critical.  For some hospitals the answer might be as simple as putting pharmacists in emergency rooms.

Every year there are 7000 deaths as a result of medication errors.  That trend has led the emergency department at Children's Medical Center in Dallas to staff 10 full-time emergency pharmacists.  Their primary focus, to review every medication and verify that it is the correct dose of the correct medicine for the correct person.  The pharmacists are on call 24 hours a day and act as a safety net for doctors as they move from patient to patient in the ER.

An Epidemic of Preventable Medical Errors

ambulance.jpgWhen someone is injured by the negligence or misconduct of others they can seek justice through the American civil justice system. The civil justice system allows victims to hold those who have hurt them accountable for their actions. It casts a light on improper practices and can be the first step in causing those practices to change. This is an important role for the civil justice system because it makes the world we live in a safer place.

Today the third leading cause of death in America is preventable medical errors (440,000 deaths/year). These deaths are not caused by illnesses or the medical conditions that caused these victims to seek medical care in the first place. They are caused by mistakes made in the hospital that could have been prevented. These mistakes can include a sponge or surgical tool left inside a patient, incorrect medicine dosages, or contaminated equipment. The scary statistic in this story is that preventable medical errors have been on the rise since 2011 when they were only the sixth leading cause of death in America, accounting for only 98,000 deaths.

Cerebral Palsy: Signs and Symptoms

Even though it may not be noticeable cerebral palsy is present at birth. Parents and caregivers may not notice the signs until the child becomes a toddler.  This usually happens as they notice their child failing to reach the developmental milestones reached by other children.

The signs of cerebral palsy usually show up between the ages of one and three years old.  Each child's case is unique and their impairments may be minor or they can be very significant.  

How Do Outpatient Surgery Centers Track Infections?

handwashing.jpgWhile it can be very troubling to hear about infection rates at medical facilities, it is important to have this information. Without it there is no way to recognize pattens and improve patient safety. Unfortunately, there are some facilities for which some of this information is not available.


Ambulatory care centers, where many outpatient surgical procedures are performed, are gaining popularity across the United States as many people want to avoid the wait times and complications that are associated with visits to the hospital. For many patients, these care facilities offer a more efficient solution for outpatient surgeries. However, these facilities are not required to track infections stemming from procedures, which has some people quite concerned about the health of patients who use the facility. 

How Much is a Medical Malpractice Case Worth?

story.jpg"How much is my case worth?"

This question is a very important one. In our civil justice system money is the only thing clients can recover and money is often the only difference between whether their family survives or thrives following the catastrophic injury or death of a loved one. Still, it is a question that even we lawyers sometimes hesitate to answer because the factors that determine value are often hard to pin down with any accuracy, especially at the beginning of a case.

I often do not discuss a specific dollar amount until the case matures to settlement or trial stage. Nonetheless, I do explain at the outset the factors that influence value. When I first meet with my clients I tell them that all medical malpractice cases are stories, but to be a good story it must have the following elements: a likable protagonist, an unlikable opponent, and a loss a jury can do something about.

Patient-Controlled Analgesia is Safer When Hospitals Follow 8 Steps (Infographic)

pca.jpgPain is one of the major reasons a person goes to see a doctor. It shouldn't be a surprise that the way in which pain is managed or controlled is a big factor in how patients rate their health care experiences. Dermot Maher, MD along with a group of researchers surveyed over 2900 surgical patients and he said "Patients consider a number of factors when evaluating physicians and hospitals. One of the most influential factors is a patient's perception of pain." He further noted that especially after a surgery that the pain a patient feels "has the potential to negatively impact overall satisfaction if not optimally managed." 

Thumbnail image for 1stPCA.PNG
Click on the image for the full Infographic from PPAHS.org.

Hospitals, aware of the relationship between pain management and patient satisfaction, are looking for ways to improve. One practice that has been adopted is Patient-Controlled Analgesia (PCA). This involves using pumps that can be programmed to deliver specific doses that can be triggered by the patient rather than requiring a nurse to administer them. The patients and the nursing staff both realize the advantages of this, especially nurses who are under a lot of pressure to keep up with the pace of efficient operating room turnover. PCA does, however, present some risks to patient safety. The risks are due in large part to a lack of consistent safety procedures followed by hospitals nationwide and were the subject of the 1st National Survey of Patient Controlled Analgesia Practices.

Should Hospitals be Performing Random Drug Tests?

drugsandstethoscope.jpgWhen we go to a hospital or doctor's office we do so with the intent to be healed. We have an ailment or injury and we trust our health care provider to help us find a solution for it. Now even the best healthcare involves some degree of risk and we are made aware of that through the forms we sign and the warnings on the medications we are prescribed. What we aren't aware of is whether or not our health care professional is struggling with a dangerous addiction. According to USA Today over 100,000 medical professionals (including doctors, nurses and medical technicians) are struggling with prescription drug abuse. Abuse which is not only dangerous to them but puts the patients they care for at risk. [Tweet This]

Nearly 8000 patients in eight different states needed hepatitis tests after David Kwiatkowski was caught stealing pain medication by injecting himself first and refilling the same syringes with a saline solution. Not only did those patients not receive the pain medication they needed but they were needlessly exposed to hepatitis C and at least 46 of them contracted the disease. The risk to patients is not always due to actions as malicious as Mr. Kwiatkowski's, but impaired medical professionals can miss critical warning signs, administer medication incorrectly, or be unable to perform surgery safely.

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