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New York City Medical Malpractice Law Blog

Patients with LBD at risk of misdiagnosis

Lewy body dementia refers to a particular kind of dementia that has three possible initial presentations. New Yorkers who have LBD are sometimes misdiagnosed as having Alzheimer's because the two conditions have some of the same symptoms. This can be harmful to people with LBD because they may respond positively to some dementia medications that are less likely to be prescribed if they are erroneously diagnosed with Alzheimer's disease, and because people with LBD may respond negatively to some Alzheimer's drugs, sometimes with lasting side effects.

The symptoms of LBD that distinguish it from Alzheimer's disease include changes in movement or walking, visual hallucinations, heightened sensitivity to hallucination medications and unpredictable levels of attention, alertness or cognitive ability. In some cases, people who have LBD develop REM sleep behavior disorder, which causes people to act out dreams physically.

Heart attacks, stroke a risk after noncardiac surgery

A study published in JAMA Cardiology shows that those who undergo noncardiac surgery may develop complications that lead to heart attacks, stroke and even death. New York residents who are hospitalized for non-heart-related surgery will want to know what's involved in this trend; after all, more than 300 million noncardiac surgeries are performed worldwide every year.

Researchers analyzed more than 10 million hospitalizations between 2004 and 2013 and discovered 317,000 cases where complications developed. This comes to about 1 in 33 hospitalizations in the U.S. Those who underwent vascular, thoracic and transplant surgeries were the most widely affected with 7.7, 6.5 and 6.3 percent of them, respectively, developing complications. Obstetric and gynecologic surgery generated the lowest risk.

Dermatology consults could prevent cellulitis misdiagnoses

Typically, cellulitis is diagnosed based on how the affected area looks and what the patient reports as symptoms. There are a number of other skin conditions that might have symptoms similar to those of cellulitis, so it is sometimes misdiagnosed. Cellulitis is a bacterial skin infection that causes skin inflammation. New York residents might be interested in the results of a study from Brigham and Women's Hospital that demonstrates early dermatologist consultation for patients who were thought to have cellulitis improved outcomes and prevented misdiagnoses.

In previous work the researchers had determined that one-third of patients in the hospital's emergency department who were thought to have cellulitis in fact had pseudocellulitis. A dermatology team was brought in to consult and recommended that antibiotics be discontinued in 82.4 percent of the pseudocellulitis cases. The researchers estimate that dermatological consultations could prevent up to 91,000 cases of needless exposure to antibiotics and save up to $210 million in health care costs each year.

Rheumatology assessments may improve pulmonary disease diagnosis

When it's suspected that a New York patient has interstitial lung disease (ILD), diagnosis typically involves invasive techniques such as checking a tissue sample and performing a bronchoscopy with specialized instruments to view airways. According to a study specific to ILD and similar pulmonary conditions, routine rheumatology assessments may minimize the need for more invasive diagnostic procedures in some instances. Researchers also believe diagnosis accuracy may be improved with adjustments to testing processes.

With traditional methods, doctor misdiagnosis may occur partly because patients with ILD often have connective tissue disease (CTD), which can be a contributing factor to bronchiolitis and many other pulmonary conditions. The "gold standard" with ILD diagnosis is to make a determination based on a multidisciplinary team (MDT) approach that includes input from several specialists. To further complicate matters, an additional variation of CTD-ILD with autoimmune features has been identified. This is why researchers are stressing the importance of added insights from rheumatologists.

$3.34 million malpractice settlement after man loses arm

When people seek medical care in New York, they expect health care personnel to make reasonable treatment choices. The case of a 30-year-old man who ended up losing his right arm illustrates the extent of damage that can occur when medical errors take place. The outcome of arbitration produced a settlement of $3.34 million for his pain, suffering, medical expenses and the compromised ability to earn a living.

The incident happened while the man worked on a cruise ship as a waiter. He went to the ship's doctor when he developed a flu-like sickness with nausea. According to the arbitration records, the doctor chose an inappropriate drug and had it administered incorrectly. The waiter suffered severe tissue damage in his arm, which forced its amputation.

The role of communication issues in medical errors

If medical errors were classified as a cause of death, they would be ranked below heart disease and cancer as the third leading cause of death in the U.S. A 2016 study in the BMJ estimated that 250,000 deaths occur each year in this nation because of medical errors. New York residents should know that many of these errors grow out of simple communication issues.

These issues in turn arise from imbalances in the power dynamic found in any multidisciplinary team. For example, a surgeon will have to communicate with the anesthesiologist, a surgical nurse, a floor nurse, nursing aides and others in charge of tracking the patient's health. Yet doctors may choose not to listen to the nurses out of a feeling that they carry all the responsibility. This is despite the fact that nurses deliver most of the actual care.

Study looks at accuracy of cancer test

When New York men are diagnosed with prostate cancer, doctors might also use a test known as prostate-specific membrane antigen positron emission tomography imaging to determine whether the cancer has metastasized. When PSMA is detected as a highly expressive enzyme in tissue, it can be an indication that the cancer is spreading.

However, studies have also shown that PSMA may be expressive in benign tissue as well. A study published in The Journal of Nuclear Medicine examined 407 patients and PSMA-ligand uptake in coeliac, cervical and sacral ganglia. Researchers found similar results with PSMA appearing in benign tissue. If this leads to a misdiagnosis, there could be a change in the treatment the patient is receiving, and this could be harmful.

Study shows many acute optic neuritis patients misdiagnosed

People in New York typically approach eye doctors when they are experiencing eye pain or vision problems. Time constraints on doctors and their failure to think about alternative diagnoses could result in diagnostic mistakes when patients present with symptoms somewhat out of the ordinary. An analysis of 122 patients diagnosed with acute optic neuritis and referred to a university neuro-ophthalmology clinic determined that 59.8 percent of them had received the wrong diagnosis.

The researchers confirmed the presence of acute optic neuritis in 49 of the patients, or 40.2 percent. They concluded that ophthalmologists, optometrists and neurologists tended to over-diagnose acute optic neuritis instead of looking harder for alternatives. The authors of the study wrote that some of the misdiagnosed patients endured extra expenses because of unnecessary MRIs, treatments and lumbar punctures.

Overlooked factors that could lead to a medical error

Patients in New York and throughout the country could be exposed to a wide range of medication errors. These mistakes could result in a worsened condition or other negative consequences. However, not all types of errors are accounted for unless there is an adverse event. For instance, many medical offices and hospitals use electronic health records. One problem that can occur is ordering medication for the wrong person.

While it may be possible to retract an order before the wrong patient gets a particular medication, the original error may not be reported. Errors generally occur when an individual is interrupted while ordering or when there are multiple patient records called up at the same time. Medical professionals have mentioned that including a patient's photo on his or her chart or using RFID technology could reduce this type of error from happening.

NPA's quarterly report shows increase in pharmacist errors

The National Pharmacy Association has released its quarterly report on patient safety errors among community pharmacists. The three-month period between April and June 2018 has seen a startling 64 percent increase in the number of such errors compared to the previous quarter. Patients in New York will want to know what some of the factors are.

In the previous quarter, 4 percent of pharmacist errors were put down to workplace pressure. In the most recent report, however, workload and time pressures accounted for 45 percent of errors. Most of these were dispensing errors; pharmacists would give the wrong medication because of similar-sounding names, attach a prescription slip to the wrong bag and mix up names and addresses on prescription labels.

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Case of the month

$7,750,000 Recovery Due to Negligent Care in NYC Pediatric Intensive Care Unit

Our client, a 5-year-old patient, receives almost $8 million in compensation from an NYC hospital in a medical malpractice claim won by Rosenberg, Minc, Falkoff & Wolf. Representing the injured child with his team of legal and medical experts, Daniel Minc said, "It was great day for the family."

The case involved negligent care on the part of the hospital pediatric intensive care unit for failing to observe bleeding from a simple biopsy wound which caused neurological damage.

Medical Malpractice Blog

$25 million verdict against New York Methodist Hospital
When a child is born, parents expect the doctor, nurses and other staff to provide care that is up to the...
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