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New York City Medical Malpractice Law Blog

Cause of disease linked to childhood seizures identified

Statistically, not too many new parents in New York will have an infant with infantile epileptic encephalopathy (EIEE), an early childhood seizure disorder. But when children do have it, it can contribute to intellectual and developmental delays and issues with physical movements related to cognitive processing. Even when children with EIEE are on medication, frequent and debilitating seizures may still occur as much as 50 times a day. Researchers have now identified the genetic cause of this neurological disorder.

It is possible to acquire EIEE as a result of a birth injury or structural brain malformations. It's also believed the disorder can develop because of genetic reasons. Researchers made their discovery by evaluating 14 patients with EIEE without an underlying diagnosis. By using a process known as whole-genome analysis (WGA), researchers were able to identify specific genetic mutations in all subjects, including some mutations not previously associated with EIEE.

Facts about hand, foot and mouth disease

New York residents and others may have heard of something called hand, foot and mouth disease. It is an ailment that causes symptoms such as a rash, fever and blisters. It can also cause a person to feel tired for several days. While the symptoms generally go away after a few days, children can remain contagious for several weeks after this happens. Generally, the condition afflicts young children, but is possible for adults to get it too.

As it primarily impacts children, it can spread quickly in day care centers, schools or anywhere else kids tend to get together. Adults can catch it by coming into contact with a child's bodily fluids or feces. Hugging or kissing someone who has this illness can result in an individual contracting it him or herself. To reduce the risk of becoming sick, children and adults should wash their hands and generally adhere to other hygiene best practices.

Avoiding medical errors in the hospital

People in New York who have to seek medical care at the hospital may be better served by not going in the afternoon. Like in other occupations, people who work in the hospital are likely to experience fatigue and a reduction in productivity after lunch. However, when nurses and doctors experience fatigue, the outcome can be life-threatening.

According to a university review of 90,000 hospital surgeries, anesthesiologists are more likely to make errors when taking part in procedures that start during the hours of 3 p.m. and 4 p.m. According to the researchers of this particular study, the errors are the result of the anesthesiologists experiencing afternoon circadian lows, which causes a reduction in physician vigilance.

Mothers at risk of injury or death in childbirth

When mothers in New York go to the hospital for childbirth, they may expect to receive exceptional care to protect their health and lives during delivery. However, the United States has the highest maternal injury and mortality rate among developed countries. Every year, around 700 mothers die in childbirth and 50,000 mothers suffer severe injuries.

One investigation of these maternal injuries and fatalities found that at least half of all of the deaths could have been avoided and half of the injuries reduced or prevented if a better standard of care was applied. In addition, researchers found that hospitals and healthcare workers may be too slow to intervene in case of serious problems.

Abdominal X-rays may do more harm than good

Doctors in New York and around the country are increasingly discouraging the practice of taking X-rays when children have abdominal pain. Overall, the practice of medicine changes with the evolution of science and the collection of evidence that points to a particular treatment method. However, while it is highly uncommon for doctors in adult emergency medicine to give an X-ray to patients who arrive complaining of abdominal pain, they are commonly given to pediatric patients.

The X-rays used for abdominal scans use as much ionizing radiation of 35 chest X-rays, a substantial amount of exposure for relatively little benefit. One study showed that 63 percent of children diagnosed with constipation at the emergency room had received an X-ray before their diagnosis. Advocates of the use of the test say that it could identify when causes of pain more serious than constipation are present. However, these types of X-rays show very low sensitivity and specificity and may actually lead doctors to confirm an incorrect diagnosis.

A rapid and accurate diagnosis is crucial for stroke victims

The effects of a debilitating stroke can be greatly reduced when patients in New York and around the country receive thrombosis quickly. Thrombosis, which is also known as thrombolytic therapy, breaks down blood clots to relive pressure on the brain. However, accurately identifying stroke victims can be difficult for even experienced emergency room doctors as several other conditions present similar symptoms. Doctors at the Helsinki University Hospital studied 1,015 cases involving possible stroke victims to determine whether or not the pressure to generate a speedy diagnosis was affecting their accuracy, and they discovered that only two of these patients received thrombosis unnecessarily.

Medical guidelines call for thrombosis to begin less than an hour from the time patients are admitted. The emergency room physicians at Helsinki University Hospital have been able to reduce door-to-needle times to under 20 minutes, which prompted some doctors to worry that patients were being screened and diagnosed too quickly. While the study revealed that diagnostic errors were made 6.9 percent of the time, these errors only led to worse patient outcomes on eight occasions.

New tool can help diagnose breast cancer

Although breast cancer is among the most common form of cancer among woman, it is possible to treat the cancer and survive. However, some patients in New York and elsewhere have lesions that are hard to detect, which can make it harder to treat in time. A project called MAMMA is turning to computers to help find those lesions and obtain positive outcomes for patients.

Tumors that are hardest to detect are difficult to distinguish from background tissue. By using MAMMA software, it may be possible for doctors to properly detect these lesions and determine whether they are benign or malignant. The software uses both spatiotemporal descriptors and radiomics to get more information about the tumor. According to researchers, this is superior to the Breast Imaging-Reporting and Data System descriptors that are commonly used today.

Physician burnout and medical errors

The results of a national survey indicate that over 50 percent of doctors in New York and the rest of the nation are burned out. The results also indicate that those doctors have a higher likelihood of committing medical errors.

Almost 6,700 hospital and clinic physicians were polled about workplace safety, fatigue, suicidal thoughts, medical errors and indications of workplace burnout. Over 20 percent of the respondents stated that they had made at least one serious medical error in the last three months before they participated in the survey. The investigators conducting the poll determined that the doctors with burnout were twice as likely to commit a medical mistake.

Errors with electronic health records vary across systems

A study published in the Journal of the American Medical Informatics Association indicates that the reliability and usefulness of electronic health records may vary widely across different systems. EHR error rates also varied among the different tasks physicians were asked to perform, and were as high as 50 percent for certain tasks. That could be important information for New York patients.

The study collected input data from keystrokes, video and mouse clicks. Two different EHR platforms, Cerner and Epic, were used across four different health care systems. Emergency medicine doctors were asked to complete different ordering scenarios via EHR. Between 12 and 15 doctors from each of the sites went through two laboratory, two medication and two diagnostic imaging tasks.

PMF and Gaucher: similar symptoms can cause misdiagnosis

New York has many experienced and respected doctors, but no medical professional is immune to making mistakes. A medical case from Europe that spanned over 20 years illustrates the problems that can be caused by a misdiagnosis. In this case, two diseases, Gaucher disease and myelofibrosis, were confused.

A 32-year-old female patient in Rome was diagnosed with myelofibrosis in 1994. Primary myelofibrosis, or PMF, is disease of the blood, bone marrow and liver. The diagnosis was made after an analysis of the patient's liver and bone marrow. She opted for treatment with chemotherapy rather than a stem cell transplant.

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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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