DC Metro Area Medical Malpractice Law Blog

Understanding the Implications of a Possible Supreme Court Ruling Against the Affordable Care Act (Obamacare)

Posted in Patient Safety

This summer, the Supreme Court will hand down a decision in King v. Burwell that could have profound ramifications for the future of the Affordable Care Act, known colloquially as Obamacare. If the Supreme Court decides to rules against the Obama Administration, defenders of the President’s plan worry that the results could be catastrophic for adults and children alike.

According to a recent Washington Post blog, possible implications of a ruling against the Obama Administration in this case include:

• A loss of insurance coverage for millions of Americans.
• A loss of coverage for 730,000 children whose parents would no longer receive subsidies from the federal government.
• A loss of coverage for 1.1 million children if Congress fails to provide more money to Children’s Health Insurance Program (CHIP).
• A loss of coverage for up to 2 million children if lawmakers also allow states to tighten income guidelines on Medicaid programs.

The picture painted above represents the worst case scenario for the outcome of this case. For example, even if the Supreme Court rules against Obamacare, Congress could still decide to continue to provide increased funding for CHIP programs, which would decrease the number of uninsured children significantly. Nonetheless, the results of the Supreme Court’s ruling will undoubtedly have an effect on Congress’ decision-making process.

Since nobody can accurately predict what will happen with Obamacare in the coming year, it is important to make the most out of your insurance coverage. If you or a member of your family is suffering from an injury or illness, be sure to:

• Take advantage of preventative care by scheduling your appointments as soon as possible.
• See your doctor now if you have a low deductible and you need medical care for an injury or illness.
• Schedule any necessary testing or treatment at your earliest convenience.

When choosing medical providers, remember to choose reputable doctors with solid histories of providing quality care. Otherwise, you may end up misdiagnosed: Could 12 Million People Be Really Misdiagnosed Every Single Year?

National Nutrition Month is Overshadowed by Uncertain, Controversial Guidelines

Posted in Men's Health Issues, Women's Health Issues

March is National Nutrition Month, a campaign managed by the Academy of Nutrition and Dietetics. The goal of this campaign is to highlight the important of making smart, informed nutritional decisions in order to promote a healthier lifestyle. However, making the right choices can be difficult when the information available to the public is contradictory or uncertain.
According to a recent op-ed by Nina Teicholz of the New York Times, new studies have debunked established nutrition guidelines a number of times in recent history. For example, Americans have been avoiding fat and cholesterol for years based on information indicating that consuming too much of either of these compounds would be dangerous to their health. However, the government has now repealed both of these guidelines after reports showed their original assumptions to be false.
Even the guidelines that remain in place have faced challenges. The government’s current recommendations maintain that saturated fats are linked to heart disease, in spite of several recent contradictions. Likewise, an influential Institute of Medicine study has also contradicted the government’s call to reduce salt intake.
To establish healthy eating habits in the face of contradictory advice:

• Take governmental nutrition recommendations in context, work with your doctor, and do your own research. Scrutinize the research studies that led to recommendations before accepting them as valid.
• Consider adopting the same nutritional principles that worked for previous generations: significant amounts of real, whole foods (including natural fat and protein and vegetables) with limited sugar and refined grains.

Interested in the most recent guideline changes? They indicate that Americans are eating too much sugar: New Dietary Guidelines Call for a Drastic Reduction in Sugar Intake – Cholesterol and Fat Limits Raised.

World Health Organization Data: 1.1 Billion People at Risk for Hearing Loss

Posted in Community Service, Public Health

Picture of Salvatore J. Zambri

Posted by: Salvatore J. Zambri, founding member and partner

Around the world, 360 million people have moderate to profound hearing loss. Half of these cases of hearing loss are estimated to be avoidable. According to a recently-released news report from the World Health Organization (WHO), “some 1.1 billion teenagers and young adults are at risk of hearing loss due to the unsafe use of personal audio devices, including smartphones, and exposure to damaging levels of sound at noisy entertainment venues such as nightclubs, bars and sporting events.”  Physical and mental health, education and employment are all significantly impacted by hearing loss. Studies from middle- and high-income countries were analyzed by WHO indicated that among teens and young adults aged 12-35, nearly 50% are exposed to unsafe sound levels from personal audio devices and almost 40% are exposed to potentially damaging sound levels at entertainment venues.

As noted by Dr. Etienne Krug, WHO Director for the Department for Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, “As they go about their daily lives doing what they enjoy, more and more young people are placing themselves at risk of hearing loss. They should be aware that once you lose your hearing, it won’t come back. Taking simple preventive actions will allow people to continue to enjoy themselves without putting their hearing at risk.”

Recommendations by WHO experts say that the highest permissible level of noise exposure at work is 85 dB up to eight hours each day. Because nightclubs, bars and sporting events typically have noise levels of 100 dB – a level that is safe for only about 15 minutes. Suggestions for teens and young adults for hearing protection include:

  • Keeping volume down on personal audio devices,
  • Wearing earplugs when visiting noisy venues,
  • Using carefully-fitted, noise-cancelling earphones or headphones,
  • Limiting time spent in noisy activities by taking short listening breaks,
  • Restricting daily use of personal audio devices to less than an hour,
  • Using smartphone apps to monitor safe listening levels,
  • Heeding warning signs of hearing loss and getting regular hearing check-ups.

In addition to personal efforts to protect hearing better, other useful initiatives include:

  • Developing and enforcing strict legislation on recreational noise,
  • Raising awareness of risks of hearing loss with public information campaigns,
  • Educating young people about safe listening,
  • Managing entertainment venues by using sound limiters, offering ear plugs and “chill out” rooms,
  • Designing personal audio devices with safety features,
  • Displaying information about safe listening on products and packaging.

“To mark International Ear Care Day, celebrated each year on March 3rd, WHO is launching the “Make Listening Safe” initiative to draw attention to the dangers of unsafe listening and promote safer practices. In collaboration with partners worldwide, WHO will alert young people and their families about the risks of noise-induced hearing loss and advocate towards governments for greater attention to this issue as part of their broader efforts to prevent hearing loss generally.”

About the author:

Mr. Zambri is a board-certified civil trial attorney by the National Board of Trial Advocates and a Past-President of the Trial Lawyers Association of Metropolitan Washington, D.C. The association recently named him “Trial Lawyer of the Year”.  Super Lawyers recently named him among the “Top Ten” lawyers in the Metro Area (out of more than 80,000 attorneys). He has been rated by Washingtonian magazine as a “Big Gun” and among the “top 100″ lawyers in the entire metropolitan area. The magazine also describes him as “one of Washington’s best–most honest and effective lawyers” who specializes in personal injury matters, including automobile accident claims, premises liability, product liability, medical malpractice, and work-accident claims. He has successfully litigated multiple cases against truck and bus companies, the Washington Metropolitan Area transit Authority, and other automobile owners.  His law firm, in fact, has obtained the largest settlement ever in a personal injury case involving WMATA.  Mr. Zambri has also been acknowledged as one of “The Best Lawyers in America” by Best Lawyers (2014 edition) and has been repeatedly named a “Super Lawyer” by Super Lawyer magazine (2014) — national publications that honor the top lawyers in America.

If you have any questions about your legal rights, please email Mr. Zambri at szambri@reganfirm.com or call him at 202-822-1899.

 

 

March Is Brain Injury Awareness Month

Posted in Uncategorized

Every year, the Brain Injury Association of America (BIAA) devotes one month to raising awareness about the latest treatment opinions and efforts to improve the lives of those suffering from traumatic brain injury (TBI).
Did you know?

• 2.5 million Americans will experience a brain injury this year alone.
Falls are the leading cause of TBI (35.2 percent), followed by motor vehicle accidents (17.3 percent).
• Incidences of TBI have increased across all age groups.
The annual cost of TBI in the United States is estimated at $48.3 billion.

Since brain injuries involve so many different body systems, they are difficult to treat, and doctors struggle to predict the long-term prognosis. Living with TBI can be a difficult and frustrating experience as cognitive and memory functions come and go, making progress hard to chart. It can be a lonely experience as well.

That’s why the theme for the 2015-17 BIAA campaign is “Not Alone” (#NotAloneinBrainInjury). The organization’s goal is to remove the stigma associated with brain injury through a combination of community outreach and education.

For further information regarding  your potential case, contact Washington brain injury attorneys.

Falls and motor vehicle accidents aren’t the only cause of traumatic brain injury. See how the NFL is also raising awareness in our post The Hottest Topic in Pro Football: How Concussions Are Changing the Game for the NFL.

Unapproved Knee Replacement Device: OtisKnee Used Before FDA Approval

Posted in Patient Safety, Product Liability, Public Health, Uncategorized

Picture of Salvatore J. Zambri

Posted by: Salvatore J. Zambri, founding member and partner

Currently, the most common elective surgery in the country is for knee replacements, approximately 700,000 per year.  With an aging population driving demand, more companies are creating opportunities to get into the market. OtisMed Corporation marketed OtisKnee before FDA clearance, resulting in numerous knee surgeries that ultimately failed.

According to a recent NY Times article, the OtisMed Corporation did not obtain FDA approval for their device before selling and shipping them. When OtisMed did apply, the FDA rejected it, indicating that the company did not show that their product was safe and effective. According to the Justice Department, before the rejection, between 2006 and 2009, OtisMed sold and distributed 18,000 OtisKnee devices. As a result, in December, 2014, the former CEO of OtisMed pleaded guilty to criminal charges as part of an $80 million settlement.  Sentencing is scheduled for March 18, 2015.  “Americans must be able to trust that they are treated with medical devices that have been shown to be safe and effective,” said Deputy Assistant Attorney General Jonathan Olin for the Justice Department’s Civil Division.  “The Department of Justice will not tolerate companies and individuals that cut corners when it comes to the public’s health.”

A principal reason why the OtisKnee was an appealing option for the surgeons who installed it was how fast the device could be installed, allowing them to perform as many as twelve knee replacements in one day.  OtisMed marketed the OtisKnee directly to providers as an option to simplify surgery and bring in extra income.  However, problems with the alignment of the device in turn caused the procedures to frequently not go as planned. Eventually, it was determined that the cutting guide materials had been changed and may have warped during the sterilizing procedure.

It is not known how many patients were harmed by the unapproved OtisKnee.  Are knee replacement patients being used as guinea pigs for unapproved devices? Are medical device companies pre-marketing or mis-classifying devices so that they can bypass F.D.A. regulations? Until more mistakes are discovered, the answers to these questions remain unknown.  But what is known is that consumer safety should always be placed ahead of corporate profit.

About the author:

Mr. Zambri is a board-certified civil trial attorney by the National Board of Trial Advocates and a Past-President of the Trial Lawyers Association of Metropolitan Washington, D.C. The association recently named him “Trial Lawyer of the Year”.  Super Lawyers recently named him among the “Top Ten” lawyers in the Metro Area (out of more than 80,000 attorneys). He has been rated by Washingtonian magazine as a “Big Gun” and among the “top 100″ lawyers in the entire metropolitan area. The magazine also describes him as “one of Washington’s best–most honest and effective lawyers” who specializes in personal injury matters, including automobile accident claims, premises liability, product liability, medical malpractice, and work-accident claims. He has successfully litigated multiple cases against truck and bus companies, the Washington Metropolitan Area transit Authority, and other automobile owners.  His law firm, in fact, has obtained the largest settlement ever in a personal injury case involving WMATA.  Mr. Zambri has also been acknowledged as one of “The Best Lawyers in America” by Best Lawyers (2014 edition) and has been repeatedly named a “Super Lawyer” by Super Lawyer magazine (2014) — national publications that honor the top lawyers in America.

If you have any questions about your legal rights, please email Mr. Zambri at szambri@reganfirm.com or call him at 202-822-1899.

 

 

Comprehensive Pediatric Concussion Guidelines Released by Canadian & US Pediatric Emergency Medicine Researchers

Posted in Pediatrics, Uncategorized

Picture of Salvatore J. Zambri Posted by: Salvatore J. Zambri, founding member and partner

Developed by a panel of 30 medical experts from Canada and the United States, Guidelines for Diagnosing and Managing Pediatric Concussions (first edition) was published in June, 2014. In a review of the guidelines, Physicians Weekly summarizes: “The guidelines provide healthcare providers with evidence-based recommendations to standardize the diagnosis and management of concussion in children aged 5 to 18 years old, from the initial assessment through to the period of recovery, which can last months.” The recommendations provide a useful step-by-step approach to understanding the concussion “timeline” from pre-participation screening to management of acute symptoms, discharge, interim assessment, and re-assessment after one month.

Listed below are Key Recommendations from the Guideline:

♦ “For children participating in high-risk sports (contact and collision sports), consider baseline neurocognitive testing.

♦ On initial presentation, assess and treat physical, cognitive, and other neurologic deficits:

– Manage acute symptoms, including identifying any so-called red flags and assessing need for emergent neuroimaging.
– Perform an acute concussion evaluation based on a standardized tool.
– Prescribe physical and cognitive rest.

♦ On discharge, provide education and a postconcussion care plan with explicit direction for teachers and school-based activities:

– Educate about the risks for persistent symptoms including managing sleep, headaches, and fatigue.
– Counsel patients on avoiding alcohol, recreational drugs, and driving during recovery.
– Instruct patients to have close primary care follow-up and referral to a specialist in concussion management if symptoms persist beyond 1 month.

♦ On interim assessment, have return-to-learn and return-to-play stepwise plans and refer children with multiple concussions to specialized care by a concussion expert.

♦ At 1 month, if symptoms persist, patients should undergo a more comprehensive health evaluation to:

– Look for underlying physical or mental health modifiers.
– Consider a program of sleep hygiene.
– Prescribe short-term medications as needed for sleep and headaches.
– Refer patients with neurocognitive or mental health needs to relevant specialists.”

I have been coaching youth soccer for more than 12 years. As a coach, I am always mindful of my players’ safety and health. Whether on the field or off, any head injury should always be taken seriously.

About the author:

Mr. Zambri is a board-certified civil trial attorney by the National Board of Trial Advocates and a Past-President of the Trial Lawyers Association of Metropolitan Washington, D.C. The association recently named him “Trial Lawyer of the Year”.  Super Lawyers recently named him among the “Top Ten” lawyers in the Metro Area (out of more than 80,000 attorneys). He has been rated by Washingtonian magazine as a “Big Gun” and among the “top 100″ lawyers in the entire metropolitan area. The magazine also describes him as “one of Washington’s best–most honest and effective lawyers” who specializes in personal injury matters, including automobile accident claims, premises liability, product liability, medical malpractice, and work-accident claims. He has successfully litigated multiple cases against truck and bus companies, the Washington Metropolitan Area transit Authority, and other automobile owners.  His law firm, in fact, has obtained the largest settlement ever in a personal injury case involving WMATA.  Mr. Zambri has also been acknowledged as one of “The Best Lawyers in America” by Best Lawyers (2014 edition) and has been repeatedly named a “Super Lawyer” by Super Lawyer magazine (2014) — national publications that honor the top lawyers in America.

If you have any questions about your legal rights, please email Mr. Zambri at szambri@reganfirm.com or call him at 202-822-1899.

New Dietary Guidelines Call for a Drastic Reduction in Sugar Intake – Cholesterol and Fat Limits Raised

Posted in Uncategorized

The Dietary Guideline Advisory Committee (DGAC) has changed its recommendations for the U.S. Department of Health and Human Services’ dietary guidelines, which are used to create menus for schools and public food services and to outline food assistance programs like WIC and SNAP.

The Committee seeks to heavily restrict the amount of added sugar Americans use on a daily basis, along with some other changes:

• The guidelines recommend no more than 12 teaspoons of added sugar per day. Currently the average American consumes between 22-30 teaspoons.

• Sugary drinks and sodas will no longer be available in schools. A tax may be imposed on these products.

• Nutritional labels will now be required to have a line clearly defining the amount of added sugar. Labels may be moved to the front of packaging.

• SNAP and WIC policies may restrict people from buying “unhealthy” foods.

Previous guidelines have failed consumers by doing nothing for the population’s obesity and sickness rates. The guidelines – new and old — have been met with skepticism from contradicting research:

• When the guidelines were first issued in 1980, they encouraged Americans to cut back on fats. Trying to restrict fats led to the creation of highly processed foods, a staple of the American diet that is packed with sugars and stripped of fats. Last fall, the committee admitted that it is no longer following this restriction.

• The long-standing cholesterol-intake restrictions told Americans to stay away from foods with high dietary cholesterol, like egg yolks and shellfish. The claims that these foods drastically raise blood cholesterol have been debunked, and the committee finally acknowledged that by removing the restrictions.

• In 2013, an Institute of Medicine Study contraindicated the guideline’s sodium restrictions. The study initially found that lowering dietary salt intake too much may actually lead to adverse health effects.

• Several studies have found that saturated fats may not be directly linked to heart disease, and that replacing saturated fats with polyunsaturated fats could exacerbate blood cholesterol problems and cause inflammation.

Diet is not the only element that can influence heart heath: check out Broken Heart Syndrome Leads to Increased Risk of Cardiovascular/Other Illnesses

Broken Heart Syndrome Leads to Increased Risk of Cardiovascular/Other Illnesses

Posted in Men's Health Issues, Women's Health Issues

The physical pain you feel after the loss of a loved one is real. Studies conducted in the UK indicate the first 30 days of grief bring immediate increased risk for heart attack and stroke. The body’s response to loss starts psychologically and impacts physical responses. Over a period of time, this can lead to adverse health outcomes.

Evidence of “broken heart syndrome” provides insight into how to cope after loss. Research shows that maintaining health during that first critical month after a loss significantly decreases the risk of death. Consider these shocking statistics from a UK study of 30,000 broken hearted individuals ranging in age from 60-89, when compared to those who had not experienced the recent loss of a partner:

  •  The risk of heart attack or stroke doubles in the first month after a partner’s death.
  •  The risk of blood clots found in the lungs is 2.5% greater.
  •  Older adults face a 25% increase in the risk of death stemming from grief within the first year of loss.
  •  After a year, the evidence suggests that increased risk of death starts to decline.

Protect yourself and your loved ones with these tips:

Encourage Stress Relief

Take advantage of loss support groups, yoga, meditation, and other stress relief exercises. These focused activities directly decrease the effect of stress on the body, thereby reducing the chance of cardiovascular events.

Take Cardiovascular Support Medicines and Improve Your Diet

 Aspirin or cholesterol reducing prescriptions may be able to support the body’s blood flow. Reducing consumption of sugar, refined carbohydrates and rancid vegetable oils may also provide some modicum of protection against inflammation and CVD risk. Ask friends and family to help you remember to take your medicines regularly.

Seek Advice From a Health Care Provider

 Everyone handles grief differently. Don’t be afraid to ask your physician about additional support methods. You or a loved one may need further medical care or emotional support to cope.

Disturbing Study Shows Psychiatric Illness More Likely After Brain Injury

Posted in Men's Health Issues, Patient Safety, Women's Health Issues

A 1999 study, Rate of psychiatric illness 1 year after traumatic brain injury, published in the American Journal of Psychiatry, sought to determine whether patients who experience traumatic brain injury might be at increased risk of developing psychiatric illness. No prior study that had considered this possibility used accepted research standards or chose a sufficiently large sample size.

The researchers who designed this study relied on a traditional two-state diagnostic method. Over the period of a year, Wales’ Cardiff Royal Infirmary admitted 3,667 adults (over age 17) with a head injury. Each patient, admitted between July 1994 and June 1995, suffered from traumatic brain injuries. All participation was voluntary, and the study included 196 patients, 65% of whom were male. Patient ages ranged from 18-94 years. Each participant completed a questionnaire, and doctors conducted a standardized interview on 164 patients who exhibited high indicator levels for psychiatric illness.

One year following their TBI trauma, of 62 patients identified by the questionnaire, 30 had been diagnosed with a psychiatric problem, per the ICD-10’s criteria, and 20 patients had been diagnosed with multiple psychiatric issues.

The most common illnesses in the test group included depression and panic disorder. The study noted a higher rate of psychiatric illness in those who had suffered a prior traumatic brain injury. No statistically significant relationship existed between those who tested positive for mental illness and those who sought compensation in a legal claim.

As we’ve discussed in previous posts about scientific studies of TBI, correlation does not imply causation. In other words, just because researchers can find associations between two variables does not mean one has caused the other. In this study, for instance, many factors could have contributed to higher rates of psychological illness, including:

History of mental illness;

  • Age;
  • Diet;
  • Level of formal education;
  • Degree of brain trauma;
  • Nature of the TBI-induced disability;
  • Etc.

To strategize effectively to obtain fair compensation and excellent medical care after a brain injury, you need qualified, smart and skilled people on your side. Consider connecting with the Washington D.C. brain injury lawyers at Regan, Zambri & Long today for a consultation. Our D.C. medical malpractice attorneys can help you and your family understand your potential options to seek compensation.

As we’ve reported before, brain injury in sports is a huge and growing problem. Learn more here: How Is the NFL Handling Its Concussion Problem? A Look at the Statistics

9 Winter Safety Tips From the Red Cross

Posted in Patient Safety, Public Health

This winter is set to be one of the coldest on record, with massive cold air fronts predicted for most of the United States. Fortunately, the American Red Cross offers steps anyone can take to ensure their safety during this inclement season.

While we settle into the winter season, get acquainted with appropriate seasonal safety habits. A little bit of preparation can go a long way toward ensuring everyone has a great time in the snow. Follow these 9 safety tips from the Red Cross to avoid possible dangerous situations this winter:

  • Know the symptoms of frostbite, which can include: numbness, flushed gray, white, or blue skin, or numb or waxy skin.
  • Always shut down space heaters and ensure fireplace embers are fully extinguished prior to leaving a room or going to bed.
  •  The signs of hypothermia include shivering, dizziness, confusion, and exhaustion. If you notice these symptoms, seek immediate medical attention.
  •  Layers of lightweight clothing trap heat and regulate body temperature. Also, don’t overlook necessities like gloves and a hat.
  • Continuously run water, even at a trickle, to prevent frozen pipes. Maintain a consistent thermostat night and day.
  •  Set space heaters on a firm, level surface, and keep flammable objects a minimum of three feet away.
  •  Stoves and ovens are not designed to heat homes; they are a fire hazard if left on.
  •  When using a fireplace, make sure you have a metal or glass fire screen large enough to prevent rolling logs or sparks from escaping.
  •  Protect your pets. If they must reside outdoors, ensure they have adequate shelter for warmth and a secure source of drinkable water.

The coldest, darkest poses quite a few safety challenges. Adhere to the tips above and stay safe, no matter what Old Man Winter throws your way.

For more insights, please see our earlier post: Tips to Protect Yourself Against Extreme Cold