CDC Admits to Improper Handling of Pathogens

Recent revelations out of the Centers for Disease Control (CDC) may raise doubts among citizens regarding the organization’s ability to keep the public safe from harmful pathogens.

According to the Washington Post, several Alabama laboratories run by the federal government failed to follow protocol five times in the past decade when they sent anthrax, bird flu, and botulism bacteria to partner laboratories.

In response to these incidents, the CDC halted operations at labs specializing in influenza and rapid bioterrorism responses. They also temporarily suspended other CDC labs from sending out any biological materials until they complete a full investigation.

Although up to 84 employees faced potential anthrax exposure during the incident, no illnesses or infections have resulted to date. In addition, the organization has disposed of the organisms in question.

How These Lapses Could Affect the Public

It seems as though the CDC is currently working to manage the situation and prevent similar mistakes from occurring in the future. However, individuals across the country ought to be aware of the potential risks associated with past or future errors in handling these dangerous pathogens.

In the wrong hands, only one package of transmittable organisms could result in widespread infection and disease. With more of the population embarking travel across the country and the world, one infected individual could begin a global chain reaction difficult to control or reverse.

Legislators and public interest groups alike will certainly continue to monitor conditions at the CDC in the expectation they will more thoroughly and strictly enforce safety procedures in the future.

Organizations such as the CDC assume a major responsibility in ensuring the health and safety of the public. When these entities experience security breaches and failures, the potential for devastating effects on citizens is far-reaching.

If you or a loved one has experienced illness or infection due to the failure of an organization charged with public health, contact a Washington, D.C. public health attorney to obtain help fighting for the justice you deserve.

Posted In Public Health
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Do Medical Malpractice Lawsuits Impact the Quality and Outcomes of Surgeries? [An Analysis of a Recent Study]

In February, Christina A. Minami and her colleagues published an article in the journal of the American College of Surgeons about the impact of medical malpractice lawsuits and litigation on surgeries in the United States: “Impact of Medical Malpractice Environment on Surgical Quality and Outcomes.” (links to abstract only)

The authors aimed to “perform a systematic review of the literature to examine the association between malpractice environment and outcomes in surgical specialties.”

What did they conclude, and why?

Before we analyze the paper, let's take a look at some interesting assumptions they made at the beginning of the research project. They wrote: “the annual cost of the medical malpractice system has been estimated to be $55 billion. The medical malpractice crisis that began unfolding in the late part of the 20th century continues to be a major concern. The intent of the malpractice system, based on classic tort deterrence theory, assumes that the looming threat of a malpractice suit will deter poor care because providers will be more vigilant and responsible. Proponents of the liability system believe that the threat of malpractice suits will encourage providers to adhere to standards of care, which, in turn, should lead to better patient outcomes.”

They also describe a recent study that “found that one-quarter of American surgeons had been the subject of a malpractice suit over the preceding two years.” They mention that some analysts worry that these lawsuits “may force providers to leave high malpractice risk environments.”

In other words, surgeons might be deterred from engaging in risky, but important medical practices because they don’t want to get sued.

There are several potentially problematic implications here.

First of all, when discussing the medical malpractice “environment,” you cannot leave out the Goliath role played by insurance companies. Many advocates of so-called tort reform want to blame trial lawyers for escalating insurance costs – and thus for indirectly creating stress for medical practitioners. However, a compelling case can be made that trial lawyers are not to blame; rather, insurance companies control the financial dynamics that make circumstances miserable for doctors.

Secondly, there's a troubling subtext in this article: a suggestion that lawsuits against surgeons are out of control. The authors wrote: “One quarter of American surgeons have been the subject of a malpractice suit over the past preceding two years,” thus seeming to imply that lawyers are going crazy and filing spurious suits against surgeons.

Compelling evidence, however, paints a decisively different picture. As recent Harvard University review of medical malpractice cases found, the vast, vast majority of malpractice cases are well-grounded. In fact, it’s likely that the lion's share of medical malpractice incidences go un-litigated and unpunished.

If you or somebody you love believes you’ve been the victim of some kind of malpractice, we invite you to contact the Regan, Zambri & Long team today for a free consultation with our DC medical malpractice lawyers at (202) 463-3030.

Posted In Medical Malpractice
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Common Signs of Sports Concussions in Adolescents

As a parent of a child involved in one or more sports activities, would you know how to detect a possible concussion?

Understand the signs and symptoms of this potentially serious head injury to keep your kids safe and healthy.

After a forceful jolt, bump, or blow that causes trauma to his or her head, a child athlete may begin exhibiting changes in their thinking, behavior, or physical functions. Ignoring such signs and symptoms can exacerbate a concussion and put the athlete at risk for further injury.

How to Detect a Potential Athletic Concussion

Several signs may indicate a child has sustained a sports concussion. These symptoms include:

•    Sudden nausea or vomiting

•    Sluggishness or a sense of “haziness” or fogginess

•    Forgetfulness related to instructions or events before or after the trauma

•    Loss of consciousness

•    Clumsy movement

•    Slow, labored speech

Should one or more of these indicators manifest in a child after a head injury, immediately remove him or her from play and seek medical treatment.

How Treatment Guidelines Differ between Children and Adults

Quick and thorough examination following a head injury is the best way to prevent lasting damage. Furthermore, new treatment guidelines from the American Academy of Pediatrics present differences in how adolescents heal from concussions compared to adults.

According to these guidelines, children under 18 years of age require an average of 7 to 10 days to recover fully from a concussion, a longer timeframe than that of the typical adult. As a result, adolescents with signs of concussion should stop engaging in activity immediately and not resume until whatever comes first – 24 hours without symptoms or a doctor’s permission.

Sports injuries may be common in young athletes, but with prompt and careful treatment, children can recover fully and return to their favorite activities.

Have the actions of another individual contributed to your child’s injury while playing sports? To learn whether you have a viable legal case, contact a Washington D.C. child safety lawyer.

Posted In Patient Safety , Pediatrics
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Have Medical Malpractice Lawsuits Caused a Dangerous Rise in C Sections? (Part 2)

In our last post, we discussed the curious implications of a highly cited, provocative medical paper, Yang et. al's "Relationship Between Malpractice Litigation Pressure and Rates of Cesarean Section and Vaginal Birth After Cesarean Section," which obliquely blames medical malpractice attorneys for skyrocketing rates of C-Sections.

The New York Post also recently brazenly asked: “Do Medical Malpractice Threats, Real Or Imagine, Lead to More C-Sections?”

As tantalizing as the thesis that "pressure from medical malpractice attorneys --> more C-Sections" may seem based on superficial analysis, upon deeper inspection, it just doesn't hold up.

There are two compelling problems with the thesis.

Problem #1. The correlation could be spurious.

Just because two trends “go together” does not mean that one causes the other. Correlation, as they say, does not imply causation. Spurious correlations happen all the time, for many different reasons. A popular website,, lists a whole bunch of ridiculous correlations. For instance, the consumption of organic food has been correlated very, very tightly with increasing rates of childhood autism over the past decade. But no one would say that eating more organic food causes babies to be autistic or that autistic children somehow make people more crave organic food. The correlation is just an odd statistical artifact with no meaning.

Problem #2. We could be overlooking other, better explanations for the trend.

In some cases, one unseen driver can cause both trends. In other words, some third force can lead to more malpractice pressure AND more C-Sections at the same time. That would nicely explain any correlation. Tellingly, Yang et al included, as one of their metrics, "increased malpractice insurance premiums."

So maybe the insurance companies' decisions to raise their rates -- which may or may not have been caused by any actual, real changes in lawsuits filed -- caused both the "increase in malpractice pressure" and the spike in C-Sections. By this read, the real "bad guys" would be the insurance companies, not the trial lawyers.

As this blog and many other more objective sources have confirmed, insurance companies have their own agenda and often work very hard to blame malpractice attorneys for problems that they, themselves, either create or exacerbate.

Perhaps the insurance companies raised premiums for their own insurance company reasons, which in turn scared doctors into taking overly-precautionary methods (such as opting for C-Sections instead of VBACs). Meanwhile, the medical malpractice attorneys were innocent. The broader point is that, to understand the cause and effect relationships in complex systems, you need hard science, not just epidemiological observations. (For a more detailed explanation of the problems with many epidemiological studies, see journalist Gary Taubes' fascinating 2007 New York Times piece, "Do We Really Know What Makes Us Healthy?")

For thorough, effective assistance dealing with your potential case, call the medical malpractice attorneys here at Regan, Zambri & Long for a confidential consultation at (202) 463-3030.

Posted In Medical Malpractice
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Have Medical Malpractice Lawsuits Caused a Dangerous Rise in C Sections? (Part 1)

Have medical malpractice lawsuits changed how American women give birth?

That thesis, while seemingly far fetched, is growing in popularity among academics and tort reformers alike. Why do people believe this idea? How much good research supports it? In today's post and one to follow, we'll follow this discussion.

In 2009, researchers Yang et al published a provocative paper in the journal Medical Care, entitled “Relationship Between Malpractice Litigation Pressure and Rates of Cesarean Section and Vaginal Birth After Cesarean Section.” The paper tried to answer the question of whether our modern, increasingly litigious environment has caused a spike in the rate of cesarean sections ("C sections").

The authors in the abstract made the following observation: “Since the 1990s, nationwide rates of vaginal birth after cesarean section (VBAC) have decreased sharply and rates of cesarean section have increased sharply. Both trends are consistent with clinical behavior reducing obstetricians' exposure to malpractice litigation.”

The researchers tried to figure out how and whether the malpractice environment impacted VBAC and cesarean section rates. They used “state level longitudinal mixed effects regression models” to take a look at birth statistics in the U.S. from the early 1990s to 2003. They also tried to operationalize “malpractice pressure” by measuring the effect of tort reform and the size of liability insurance premiums.

The researchers DID find an association between increased “malpractice pressure,” as they defined the term, and an increase in a number of cesarean sections and VBACs. The New York Post jumped on this story and published its own interpretation, making it sound like medical malpractice lawyers caused a dismal, dangerous trend in the birthing industry.

Even the Post's headline -- “Do Medical Malpractice Threats, Real Or Imagined, Lead to More C Sections?” -- is a leading question, if there ever was one. The Post quoted an expert, Naomi Riley, who said “there’s universal agreement in the medical community that too many C-sections are taking place, but the fact is that doctors don’t have much choice.”

The implication is clear: malpractice lawyers have made the birthing system more complicated and dangerous for moms and doctors alike.

Or have they?

In fact, this seemingly cut and dry case is anything but. In our next post, we'll explore two huge problems with this thesis.

For now, if you need help with a potential D.C. medical malpractice case, contact the attorneys at Regan, Zambri & Long at (202) 463-3030 for immediate assistance.

Posted In Medical Malpractice
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A Look into the VA Waiting List Debacle

The Veterans Health Administration is responsible for the healthcare of 8.76 million veterans and their families every year, representing “America’s largest health care system.” The VA’s crucial role in the life and wellbeing of some of our most honored citizens makes the recent waiting list scandal exponentially more appalling to medical malpractice attorneys as well as the public at large.

The Cover-Up

The VA crisis emerged in April, when a retired clinic director came forward with allegations that the Phoenix VA had falsified their electronic waiting list. Their “secret waiting list” concealed the number of veterans waiting for care, as well as their exorbitant wait times.

Since word of the cover-up has come out, investigators have identified at least 18 veterans that died while waiting for medical care. It is currently unclear whether these individuals’ deaths directly resulted from the delay in care. However, autopsy reports, death certificates, and medical records should provide more conclusive evidence.

The Solution

As the investigation continues, the VA has responded by opening up several mobile medical units throughout Phoenix to give more veterans access to the care they need. In addition, the Senate Veterans Affairs committee is working on a bill that would help veterans by expanding their network of healthcare facilities and providers, eliminating ineffective executives and administrators while increasing facilities and hiring across the country.

Hopefully, these measures will begin to turn around a seriously flawed system whose mismanagement and dishonesty have harmed countless American heroes. However, as more information emerges, we will likely learn that many more veterans have died or suffered needlessly due to the practices of VA facilities across the country.

Medical Malpractice

Each state creates its own medical malpractice laws, but the National Institutes of Health defines medical malpractice as “any act or omission by a physician during treatment of a patient that deviates from accepted norms of practice in the medical community and causes injury to the patient.” The VA, like any other medical provider, has an obligation to provide its patients with timely and effective healthcare and to abide by the law while doing so.

When healthcare organizations break their trust with those who depend on them for their care, they must be held accountable. Washington D.C. medical malpractice attorneys Regan Zambri & Long work with individuals who have suffered harm at the hands of their medical providers. For a free consultation to explore your legal options, contact us at (202)463-3030.



Posted In Medical Malpractice
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Virginia Medical Malpractice Suits Against VA Clinics Settle for Over $1 Million

The Center for Investigative Reporting just released a report announcing that the families of four deceased military service members will collect around $1.4 million in settlement money. Caregivers treated the veterans at the Coatesville Veterans Affair Medical Clinic in Virginia.

  • One VA medical malpractice case (which settled for $100,000) concerned accusations that caregivers did not monitor a veteran who later died.
  • Another case, which closed back in February 2008 for nearly $500,000, concerned the VA's failure to manage a psychiatric patient.
  • A third case closed in August 2011: A misdiagnosed VA patient died.
  • A fourth case closed in December 2011 for $500,000: a caregiver failed to monitor a sick veteran.

Amazingly, those four cases constitute just a drop in the bucket. VA facilities around the country currently face over 1,000 wrongful death actions; the government has already settled various matters for over $200 million.

Why is this happening, and what are lawmakers doing about it?

Patrick Mayhem, a Democratic Congressman, lashed out recently against President Obama for allowing the situation at VA facilities to get so bad. Mayhem said “the President spoke of accountability at his press conference today but is showing none… The horrors that have been exposed at the VA facilities across the country are shameful, and addressing them requires less talk and more decisive action.” Among other things, Mayhem had wanted Obama to fire VA Secretary Eric Shinseki.

Obama did meet with Shinseki at the Oval Office, and he exchanged harsh words. The President said: "I told the Secretary I will not stand for [what is happening with the VA facilities] – not as Commander-in-chief but also not as an American.”

Nationwide outrage has been building, following repeated allegations of patients dying at VAs due to misdiagnoses or bad treatment. Patients and their families also complain about costly, nonsensical delays.

There has been a massive influx of soldiers back from campaigns in Iraq and Afghanistan over the past several years. These people often need more than just temporary assistance with medical problems. They also need long term psychiatric help as well as therapy for chronic issues caused by head injuries, PTSD and war-related depression.

Patient rights advocates want to see positive action to fix the VA facilities to make them more functional and make the system fairer. Obama reassured voters last week: “we are going to fix whatever is wrong, and so long as I have the privilege of serving as Commander In-Chief, I am going to keep on fighting to deliver the care and benefits and opportunities that you and your families deserve, now and for decades to come.”

Hopefully, that will be the case.

If someone you love was hurt, misdiagnosed, or otherwise poorly treated at a VA facility or any other medical center, call Regan Zambri & Long today for a free consultation at (202) 463-3030.

Posted In Medical Malpractice
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Impassioned Forbes Magazine Piece Shows That Malpractice Lawsuits "Aren't Just About Money"

How widespread is medical malpractice? What are the real costs for patients, for the medical system, for doctors and for insurers? And what can be done to fix the system's fundamental structural problems? A compelling recent piece in Forbes Magazine, “Malpractice Lawsuits Aren’t Just About the Money,” dissects the scope and breath of the problem; it’s truly breathtaking.

The piece begins with the tale of a woman named “Karen,” a Board Certified physician whose mother had been rushed to the hospital, because she had been on the wrong medication. Terrified and enraged, Karen called her mother’s doctor, who proclaimed that he was “on vacation” and could not be bothered to come in and see the sick patient.

Even though Karen was “Board Certified in three specialties,” she felt helpless to navigate the system. Should she file a lawsuit? Perhaps she could complain to the Joint Commission on Safe Accreditation – a watchdog organization that promotes safety and quality care at hospitals. Good idea in theory. Unfortunately, only a third of the 3,000+ hospitals accredited by the Joint Commission have the distinction of being “top performers.” What's more: 2,400 hospitals throughout the country do not even have this accreditation.

The Scope of the Malpractice Debacle

Nearly 100,000 people die and 300,000 people suffer injuries every year at U.S. hospitals due to avoidable errors, per the National Institute of Medicine. This is simply an unacceptable situation.

And reformers are frustrated.

In 2004, reformers created the Institute for Health Care Improvement, which urged hospitals to sign on to evidence-based strategies to protect people from the dangers of malpractice, using objective metrics, and to implement positive changes. 1,000+ hospitals signed on, but these hospitals were notoriously slow to implement key recommendations and often behaved in recalcitrant fashion.

Hospitals have not been the only institutions resistant to change.

The American College of Obstetricians and Gynaecology (ACOG) famously failed to implement powerful changes that helped New York Presbyterian Hospital drop its rate of “sentinel events” (those causing death or serious injury) from 1 out of a 1000 to zero, over a span of just a few years.

Why did ACOG refuse to make these changes? According to the Forbes article, ACOG rejected the reforms “on the grounds they [might] infringe on individual doctor or hospital prerogatives.”

In other words, ACOG made a choice that it's more important to preserve doctor/hospital autonomy than it is to prevent sentinel events in patients.

That's a cynical calculus, if there ever was one.

By contrast, consider what the American Society of Anesthesiologists did back in the early 80s, in the wake of a series of awful patient incidents. That organization did a thorough work over of its processes and, within a decade, dropped the rate of death from anesthesia from 1 in 6,000 to 1 in 200,000.

If you or somebody you love needs legal assistance with a potential case, contact the Washington D.C. malpractice attorneys at Regan Zambri & Long today at (202) 463-3030 for a free consultation.

Posted In Medical Malpractice
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Don't Buy into These Four Myths about Tort Reform

Medical malpractice attorneys are refuting the notion that claims are out of control. Many lawmakers, insurance companies, and medical practitioners, however, are championing tort reform, which seeks to place limitations on litigation or damages awarded in civil claims. These non-legislative proceedings have long been a way for individuals who have suffered harm to gain compensation from those responsible.

Tort reform proponents, however, believe (or would like the rest of us to believe) that medical malpractice claims pose undue hardships to doctors, insurance companies, the legal system, and the economy. Their messages often capitalize on several misconceptions about tort litigation, including:

•    Medical liability expenses hurt the economy. According to the Harvard School of Public Health, the United States spent $55.6 billion, or 2.4 percent, of 2008’s healthcare spending on “medical liability costs.”

•    High claims payouts lead to financial burdens on medical malpractice insurance companies. Regardless of whether a state imposes caps on claims payouts, insurance companies continue to rake in enormous earnings. For example, between 2003 and 2010, insurance companies in Florida reported 4300 percent profits, a staggering amount that should leave no question as to their profitability.

•    We need damages caps in medical malpractice cases to keep insurance costs down. According to a ruling by the Florida Supreme Court, no apparent correlation between medical malpractice settlement caps and insurance rates exists. The American Association for Justice further cites several sources that attribute high insurance rates to stock speculation and “mismanagement” of insurance company resources.

•    Healthcare providers will abandon states without medical malpractice caps for states that do. This myth is based on the faulty premise (see #3) that caps lower insurance rates. According to the American Association for Justice, the overall number of practicing physicians in every state has been steadily increasing.

Examining these falsehoods propagated by tort reform enthusiasts seems to reveal either a lack of understanding in the financial realities of medical malpractice claims, or a determination to increase profits for insurance companies at the expense of vulnerable patients.

The medical malpractice attorneys at Regan, Zambri & Long have been working with clients for many years to obtain fair and equitable compensation for those who have suffered harm. If you or someone you know has suffered from medical malpractice, contact us today to set up a free consultation.

Posted In Tort Reform
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Could 12 Million People Be Really Misdiagnosed Every Single Year?

A very alarming new study puts DC medical malpractice cases -- and indeed, the entire issue of malpractice -- in a disturbing new light.

Researchers at Houston Veterans Affairs Medical Center, publishing in BMJ’s Quality and Safety Journal, suggest that one out of 20 Americans every year gets misdiagnosed by a physician. That means that doctors misdiagnose 12 million Americans every year.

Fortunately, most of these misdiagnoses likely do not result in serious injury or death. But that is still a staggering number, and if it’s even remotely accurate, it should set off alarm bells throughout the medical care system and instigate process improvements ASAP.

The researchers concluded that up to 50 percent of the errors in diagnoses could lead to major harm (not that they necessarily DO, fortunately). They wrote that their analysis “should provide a foundation for policyholders, healthcare organization, and researchers to strengthen efforts to measure and reduce diagnostic efforts.”

Traditionally, it has been challenging to identify misdiagnosis statistics outside of hospital and clinical settings. In this study, researchers examined hundreds of patient medical records as well as records of clinical doctor visits, and they then made estimates based on these data and extrapolated their conclusions to the population at large.

Obviously, this study has its limitations. For instance, perhaps the sample that they analyzed was just unlucky; and they endured many more misdiagnoses than typically happen to the patient population. Or perhaps the methodology was somehow flawed or the statistics used to measure and compare patient groups were not accurate or appropriate.

Most Costly Errors?

The researchers noted that “delayed cancer diagnoses is believed to be one of the most harmful and costly types of diagnostic care in the outpatient setting,” especially since early treatment can save lives for patients who develop some cancers and progressive, chronic diseases.

Whether the study accurately gauged the “true” number of misdiagnoses or not, many patients (and families of patients) don’t understand their rights or possible means of recourse after a misdiagnosis-related injury or illness.

The team here at Regan, Zambri & Long can help you understand your legal options. Our Washington D.C. medical malpractice attorneys are standing by to provide a free and confidential case evaluation at (202) 463-3030. Call or email us now for sound insight.

Posted In Medical Malpractice
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