It turned out the lump was cancer - stage III melanoma that had spread to her lymph nodes.
Unfortunately, this young woman died three years later. But, she might not have, had her doctors not made a skin cancer misdiagnosis years earlier.
]]> Cancer Could Have Been Detected Years EarlierLike many in her generation, the young woman had been fond of getting a suntan in order to improve her appearance. In the summertime, she worked as a lifeguard, spending more than 40 hours a week outdoors. In the offseason, she frequented local tanning salons.
She knew that tanning might damage her skin in the long run, but she didn't know that it could lead to deadly skin cancer. Still, when she noticed an unusual mole on her leg, she went to the doctor to have it tested and removed. The lab reported the mole was benign.
That was back in high school. When the young woman was diagnosed with cancer -just weeks after graduating from college - her surgeon went back to take another look at that mole. It turned out that the lab had made a deadly error; the mole was actually early-stage melanoma.
If that cancer misdiagnosis hadn't been made, there is a good chance that the young woman would have survived. Instead, by the time her cancer was detected, it had metastasized into her lymph nodes, becoming almost certainly incurable. Eventually, the cancer formed lesions on her brain and she began wasting away.
The cancer killed her in 2008. She was 26 years old.
This young women's tragic death occurred because of an oversight at a testing lab. Unfortunately, failure to diagnose cancer is far too common. While nothing can turn the clock back, victims of cancer misdiagnosis do have a right to hold doctors accountable for their errors. This right also extends to the families of cancer victims who have died as a result of misdiagnosis.
If you or a loved one has been the victim of a doctor's failure to diagnose cancer, a Rhode Island medical malpractice lawyer can help you understand your rights.
]]>About 2.5 percent of newborns and about 2.5 percent of mothers experienced complications related to a vaginal birth after a prior C-section. For those who instead elected to undergo a Cesarean delivery again, less than 1 percent of both infants and mothers experienced complications from the C-section according to the results of an Australian study.
]]> Researchers admitted that the difference in risk for repeat C-sections versus vaginal births were small, but less than half of those who attempted a vaginal birth after C-section were able to deliver that way. The remaining mothers who'd planned a vaginal birth ended up delivering via delayed C-section. Of those who'd planned a C-section, no children were lost during delivery; for those who'd planned a vaginal delivery, two children were stillborn.Whether a trial labor period is appropriate for childbirth after a prior C-Section is something to discuss with your OB-GYN prior to starting contractions. The National Institutes of Health (NIH) has recommended that a trial labor period may be appropriate for women who've had a prior C-section.
While vaginal delivery is possible, it does carry certain risks, including a ruptured uterus. The important piece, as with in any childbirth, whether vaginally or by C-section, is understanding the risks and making an informed decision as to how to proceed. If a vaginal birth after Cesarean is chosen, it is important that your doctor and other delivery health care professionals recognize and properly respond to signs of fetal distress and do not delay a C-section if conditions indicate that it is more appropriate. A delayed C-section may be medical malpractice and may result in preventable injury to the baby and/or the mother.
Source: Fox News, "Repeat C-section may be safer option for moms, babies," March 14, 2012
]]>One reason given for the higher rate of death among female heart attack patients is the difference in symptoms that women tend to experience versus those of men. Heart attack misdiagnosis often starts with failing to recognize symptoms other than chest pain as an indicator of heart problems.
A review of 1.1 million heart attack patients revealed that as many as 35 percent of people who have a heart attack report no chest-related symptoms at all. Women are less likely than men to experience chest pain related to a heart attack.
]]> It's not just gender that makes a heart attack misdiagnosis more likely either. Age also plays a role in whether health care professionals are presented with typical symptoms leading to a heart attack diagnosis. Women under 55 are less likely to experience common heart attack symptoms than those older than 55. Women under 55 are also less likely to experience classic heart attack symptoms than men of the same age.Younger women tend to have more generalized pain than the typical elephant-sitting-on-your-chest pain associated with a heart attack. Women under 55 tend to feel pain in the shoulders, neck, jaw and even their stomach during a heart attack.
Chest pain, however, should not be ignored. The majority of heart attack sufferers do experience some form of pain in the chest. But, those who have additional risk factors, such as high blood pressure, elevated cholesterol, diabetes or who smoke should be aware of additional signs of an impending heart attack and seek professional health care.
Source: Time Healthland, "Heart Attack in Women: Different Symptoms, Higher Risk of Death," Alice Park, February 22, 2012
]]>Administration of methotrexate during the first trimester of pregnancy can cause a miscarriage, can result in the pregnancy being terminated or can cause severe deformities in a child born despite taking the drug. Rhode Island medication errors attorneys remind expectant mothers that the side effects of an unnecessary drug administered as a result of a misdiagnosis are preventable and the patient should not be left to dealt with them alone.
]]> Risks of Ectopic PregnanciesAn ectopic pregnancy occurs when a fertilized egg begins to develop before reaching the uterus. Typically, the egg implants itself to the wall of the fallopian tubes, rather than of the uterus, and then does not have the space to grow and develop without threatening the life of the mother.
Statistics show that an ectopic pregnancy occurs somewhere between once in every 40 to once in every 100 pregnancies. An ectopic pregnancy cannot be carried to term; allowing the egg to develop if it actually does, poses a serious risk to the mother's health. An untreated ectopic pregnancy can lead to rupture, requiring surgery and possibly a blood transfusion.
Diagnosis of an ectopic pregnancy is not a clear-cut process. Symptoms often are the same as those expected with a normal pregnancy. An ultrasound may be used to visually confirm an ectopic pregnancy, but it is possible that the mother may not yet be far enough along for an ultrasound to be effective and she may have to return for a repeat.
Once diagnosed, methotrexate is often given to women still in early stages to dissolve the ectopic pregnancy rather than using surgical measures. But, as the study has shown, a misdiagnosed ectopic pregnancy can lead to improper administration of methotrexate for a normal pregnancy and have dire consequences for the mother and her unborn child.
Source: Heatlh.com, "Normal Pregnancies May Be Misdiagnosed as Ectopic," 13 January 2012
]]>Errors in patient diagnoses account for 40 percent of all medical malpractice claims. A good proportion of these claims stem from the failure of medical personnel to pass along test results to patients. With malpractice payouts due to communication failures more than quadrupling over the period from 1991 to 2010, getting your test results has never been more important.
]]> The Changing Role of PatientsSome doctors are calling for patients to take a more active role in their health care. American Academy of Family Physicians president Dr. Glen Stream states that by doing so, patients can participate in their own "culture of safety." He suggests that patients should expect test results even in the instances where they come out to be completely normal. Dr. Stream also suggests asking a doctor what tests are being performed and specifically asking when to expect the results. Make sure you encourage your doctor to spell out everything to your satisfaction.
National Patient Safety Foundation president Diane Pinakiewicz suggests that if you are having multiple tests done by different providers, make sure to ask your doctor from where you should expect the results. Also, she suggests that if online resources are available for viewing results, to definitely sign up.
In any event, the best thing a patient can do is to be vigilant in finding out the results of any medical testing. Do not sit around waiting for a doctor to call when that might never happen. While no news may be good news, it's better to confirm the good news than to assume it is such. Also, make sure that test results are fully explained, no matter what the case may be. Taking charge of your health care may be the most important decision you make.
Source: NPR, "Test Results: Too Important To Wait For A Doctor's Call," 29 November 2011
]]>However, concerns are emerging that this transition may not be in patients' best interests. Rhode Island medical malpractice lawyers and patient advocates are warning Americans that electronic medical records could subject them to increased risk of medical error.
Hospital errors kill between 44,000 and 98,000 people every year. Electronic medical records were initially sold as a way to reduce this number - for example, they can automatically notify a doctor who attempts to prescribe a drug a patient is allergic to and can warn of potential dangerous interactions between medicines.
]]> Unfortunately, little evidence exists to suggest that electronic medical records have lead to increased safety across the American medical system. To the contrary, the Institute of Medicine recently published a report warning that electronic medical records systems add a layer of complexity to an already convoluted health care delivery system.Technical glitches, software incompatibility and user error can lead medical professionals to overlook signs of a fatal illness and make medication errors. Problems with electronic medical records can also cause delays in needed treatment.
How Can Patients Protect Themselves?
The Department of Health and Human Services is developing a safety and surveillance plan to monitor issues with electronic medical records. However, this will take at least a year. Even then, the system is not expected to be without risk of error.
Good communication is the key to patient safety. Patients shouldn't take it for granted that their doctor knows everything about their health history. They should be sure to tell their doctor about all the medicines they are taking and all the symptoms they are experiencing. Patients should not be shy about asking questions to ensure they fully understand their medical treatment.
Most importantly, if something doesn't seem right, speak up. Many times, a patient will recognize an error that a doctor won't.
If you or a loved one has been harmed by a medical error, you may have legal recourse. Contact an experienced Rhode Island medical malpractice lawyer who can advise you of your options.
Source: Insurance Journal, "Electronic Medical Records Not Without Risks to Patient Safety: Report," 10 November 2011
]]>As the most common cancer affecting American women other than skin cancer, the American Cancer Society reports that 1 in 8 women will develop some form of invasive breast cancer in her lifetime. Breast cancer is also the second most likely to be fatal in women, exceeded only by lung cancer in female cancer-related fatalities.
As with many cancers, the key to a successful battle begins with early detection and correct diagnosis. Women diagnosed at stage 0, stage I or stage IIA have over an 80 percent change of living five or more years following diagnosis. Those diagnosed with stage IV breast cancer, the most advanced stage, historically have only a 15 percent chance of living five or more years beyond the diagnosis.
]]> Understanding Risk Factors and Early Detection of Breast CancerThe most basic risk factor for developing breast cancer is being female. Although men also develop breast cancer, women are about 100 times more likely to do so than men. The risk of breast cancer increases with age. Women over age 45 are more likely to experience an invasive breast cancer than those who are diagnosed at a younger age. On top of age and gender, those with a family history of breast cancer are more likely to develop breast cancer themselves.
A missed diagnosis or cancer misdiagnosis can delay proper treatment and lower an individual's odds of surviving a battle with cancer. Understanding your risk factors and identifying early warning signs of breast cancer are your first defense in working with your physician to discover and begin cancer treatment as soon as possible.
The American Cancer Society recommends that women over 40 undergo an annual mammogram screening for breast cancer. Clinical breast exams and breast self exams are recommended for women in their 20s and 30s.
Source: "Walkers make strides against cancer," 30 October 2011
]]>Only 15 percent of women with ovarian cancer are properly diagnosed early enough to improve survival rates. Once the cancer has spread, which is often when it is correctly diagnosed, five-year-survival rates can be as low as 30 percent. Rhode Island cancer misdiagnosis attorneys want everyone to understand the early warning signs of ovarian cancer and encourage all women to get a second opinion if they feel their symptoms are being ignored.
]]> Top 4 Missed Warning Signs of Ovarian CancerIgnoring known symptoms of ovarian cancer or brushing them off as signs of other non-threatening illnesses are the main hurdles to timely diagnosis and treatment. Four common misunderstood warning signs of ovarian cancer are:
If you've experienced more than one of these symptoms, talk to your doctor. Open and full communication with your doctor of what you're experiencing is also important to early detection and treatment.
A study at the University of Washington of 1700 women diagnosed with ovarian cancer revealed that of 36 percent were initially misdiagnosed. Another 12 percent were told that their symptoms were just in their heads. Understanding the symptoms of ovarian cancer that are commonly missed may help you or another woman in your life win the battle against ovarian cancer and stop your doctor from missing a life-saving diagnosis.
Source: 4 Silent Ovarian Cancer Warning Signs Your Doctor Misses
]]>C-sections are common among women who give birth to twins, triplets or more, as well as those who have been identified as at-risk during delivery because of high blood pressure, diabetes. The use of an epidural and inducing labor can also lead to complications that may warrant a C-section.
But, the fact is that many C-sections that happen do not happen for medical reasons, but rather as a matter of convenience. Some women and their physicians schedule C-sections so the timing of the birth is right. The concern surrounding the rising rate is related to C-sections that are performed even when signs that a C-section may be necessary are not present.
The Joint Commission and the Agency for Healthcare Research and Quality asserts that the number of c-sections performed in certain types of pregnancies should be reduced and that data does not support a medical necessity for the rising rate of C-sections.
]]> Injuries Related to a Caesarean BirthA C-section, although widely known and considered safe, is still major surgery and is not without risks itself, to both the mother and the new baby. Dr. Divya Cantor notes that injury to the mother, including organ and tissue damage, blood clots and a lengthened recovery period, all weigh in favor of vaginal delivery unless a medical reason exists to perform a C-Section.
There may also be risks to the new baby if a C-section is scheduled prior to reaching full term. During the final month of pregnancy, a baby is continuing to grow and his or her organs are continuing to develop. Allowing a baby to proceed to term, rather than delivering early via C-section, gives the baby additional time to develop within the protection of the mother's womb.
]]>Standard medical protocols advise medical personnel to transfer heart attack patients to a hospital able to perform lifesaving medical procedures to open blocked articles within 30 minutes of the patient's arrival at an ill-equipped hospital. Yet, according to a study conducted at Duke University, only about one in 10 patients were moved to another hospital within the recommended timeframe.
The study revealed that over half the patients spent more than an hour at an ill-equipped hospital; almost a third of those heart-attack patients stayed longer than an hour and a half. The median time a heart-attack patient was kept at a hospital unable to perform lifesaving artery-opening procedures was slightly over an hour.
]]>Data from the National Cardiovascular Data Registry's Acute Coronary Treatment and Intervention Outcomes Network was analyzed for the study and included patients who had an angioplasty procedure between January 2007 and March 2010. Of the patients transferred within the recommended 30 minutes, only 2.7 percent died in-hospital, while patients whose transfers were delayed longer than recommended 30 minute died at more than twice that rate - six percent.
Misdiagnosis? Delays in Diagnosis? Hospital Errors?
While one doctor commenting on the study suspects that the time delays are attributable to difficulties or delays in diagnosing the heart-attack patient's actual condition at the first hospital, the study did not specifically determine the cause of the delays in transfer.
Dr. Wang, of the Duke University researchers who published the report, noted that the study examined only the correlation between delays and patient deaths. Some speculate that system-level issues are places for improvement, including the time it takes to run an ECG at the first hospital, arrange transportation to the better-equipped hospital and schedule the heart-attack patient for the cath lab at the second hospital.
Source: TheHeart.Org, "30 minutes or less! STEMI patients' delay in referral hospital increases mortality," 6/21/2011
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For children under age two, the labels instruct parents to ask their doctor for an appropriate dose. The recommended dosing instructions are intended to protect young children from the risk of a drug overdose or medication error by supplying guidelines for dosing children between 6 months and two years old.
Protecting Children from Acetaminophen Overdosing
According to FDA data, acetaminophen-related overdoses are most common in children under two years old, and the number of these types of overdoses has increased over the past 10 years. The American Association of Poison Control Centers reported 270,000 overdoses of acetaminophen in 2010, and dosing errors accounted for 7,500 of those cases.
]]> While acetaminophen is generally considered safe for young children, too much can cause liver toxicity, potentially leading to poisoning and liver failure, according to an Associated Press news report.Dr. Richard Dart, president of the American Association of Poison Control Centers said that acetaminophen overdoses are rare but present potentially severe events that could lead to a child's death. The recommendation to change medicine labels "will lessen the chance that parents will give their children the wrong dose," he said, improving safety for our children.
Recommending Acetaminophen Dosing
The panel recommended that medicines containing acetaminophen provide dosing information based on children's weight. Considering the variation in children's weight in their early years, weight is a more accurate measure than age to determine an appropriate dose.
It is still best to verify dose amounts with doctors, but the FDA panel determined that providing dosing instructions for children age 6 months to two years is better than having parents guess the proper dose amount and unintentionally give too much to their children.
Source: FDA Advisers Urge Infant Doses for Kids' OTC Fever Relievers
]]>Insurer Circo/RMF suggested organizational changes in hospitals and emergency rooms can improve patient care and reduce medical malpractice costs. The insurer also noted, "While diagnosis-related missteps are often attributed to cognitive error on the part of the physician, the group identified communication problems and information gaps as present in many of the malpractice cases."
]]> The critical outcome related to these information gaps (misdiagnosing a patient and discharging them, only to have them suffer a substantial worsening of their condition or, in the worst case, death) illustrates the importance of correcting the systemic issues that allow errors to happen.Gaps in "key information streams," revealed in the report included:
Medical malpractice cases function as a check on a hospital's emphasis on efficiency, the casualties of that focus being patients who die or are injured because a doctor had to make a rushed or inadequately informed decision.
The data used for the insurer's report was taken from closed malpractice cases from the insurer. While not often acknowledged by insurers, many system improvements are triggered by lawsuits.
Source: Wall Street Journal, "Hospitals Overhaul ERs to Reduce Mistakes," 5/10/2011
]]>Job Loss Often Leads to Loss of Insurance Coverage
Rising unemployment has created an insurance coverage gap for many Americans. Approximately 43 million working-age adults lost their job and health insurance benefits in the last two years; over half of those people then went without health insurance, according to a study by the Commonwealth Fund. "This is largely because there are few affordable options for health insurance when job-based coverage is lost," explained an author of the Commonwealth Fund Study, Sara Collins.
]]> "We found that more than 70% of an estimated 26 million adults who tried to buy coverage in the individual market in the past three years reported difficulties finding affordable plans that met their needs. Nine million were turned down, charged a higher price or had a condition excluded from their coverage because of a preexisting condition," stated Collins.Affordability of health insurance is an issue for those with insurance as well. The Commonwealth Fund Study reported a 40 percent increase in premiums between 2003 and 2009 for employer-sponsored plans; deductibles increased by almost 80 percent in the same period.
Health Care Reform and Hope for the Future
The cost of rising health care ultimately means one of two things: delaying routine health care visits or ignoring health issues altogether. Both are symptoms of the affordable health care problem in the United States.
The Patient Protection and Affordable Care Act of 2010 is a step toward addressing the need for health care reform and access to health care for millions of Americans. In the near future, the Act promises to improve medical coverage for all Americans, provide prescription drug savings for Medicare recipients, require full coverage of preventative health care screenings by in-network providers and eliminate exceptions for pre-existing conditions that may have kept people from being insurable previously. Although a step in the right direction, there is certainly much more to be done.
Source: More adults going without medical care because of costs
]]>One medical researcher recently tried to quantify what hospital errors cost society. By adding the cost of care following a medical mistake to the loss of income resulting from the injury, he was able to collect costs that could easily be compared to one another (costs that did not rely on the differences in tort law and punitive damages caps from state to state). Based on his analysis, he uncovered common medical mistakes that can lead to very expensive and severe injuries, such as brain trauma and quadriplegia.
]]> Seven of the 10 most expensive medical malpractice cases resulted in severe brain injuries. These brain injuries occurred in a variety of different ways, from birth trauma and a bad fall to a malfunctioning shunt and toxic doses of a blood anti-coagulant. The remainder of the top 10 list is rounded out by errors resulting in quadriplegia and death.The most common medical errors that lead to these catastrophic injuries included:
For the most part, these instances of medical negligence or hospital error could have been prevented had the treating physician or healthcare professional taken the time to double check diagnosis or properly follow-up with the patient after a procedure or with test results. Proper monitoring and timely treatment could have led to very different results in each of these ten cases.
]]>The active ingredient in Darvon and Darvocet, propoxyphene, was found to lead to a potentially fatal, rapid heartbeat. In November 2010, the U.S. Food & Drug Administration (FDA) asked Xandodyne to remove the dangerous prescription drugs from the market after it determined that Darvon and Darvocet caused QT prolongation, which lengthens the time between electrical impulses that measure the regularity of a heartbeat.
]]> According to the complaint, the man died from sudden heart problems just prior to November's recall. He had been taking the painkillers since July 2010. The lawsuit alleges that Xanodyne failed to warn users about the increased risk of potentially lethal heart rhythm problems.Darvon was first placed on the market in 1957. According to the watchdog group Public Citizen, which has twice petitioned the FDA to ban propoxyphene, thousands of cardiac toxicity deaths have been linked to the drug since 1981. Fatalities were caused by repeated regular doses, due to a buildup of the drug in one's system, and inadvertent overdoses barely exceeding the recommended dose.
Propoxyphene was banned in the United Kingdom in 2005 and throughout Europe in 2009 for safety reasons, according to Public Citizen. An FDA advisory panel advised the drug be banned in the U.S. in 2009, but it is unclear why the FDA waited over a year to act.
Sources: Darvon, Darvocet Lawsuit Blames Painkillers for Sudden Death; Delayed FDA Removal of Painkiller Propoxyphene (Darvon, Darvocet) From U.S. Market Has Cost More Than 1,000 U.S. Lives
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