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Miami Medical Malpractice Law Blog

Doctors mixed on effectiveness of new lung cancer test

Florida residents may be interested to learn that while Medicare will pay for a new lung cancer test for individuals within a certain high-risk population, not all doctors think the test is a good idea. Although a study in 2011 showed that the test might reduce lung cancer deaths by 20 percent, some physicians caution that it must be balanced against the potentially high rate of false positives and the subsequent tests that may have dangerous complications. For example, a lung biopsy could lead to a collapsed lung.

Physicians are not questioning the study itself, and a panel of independent experts have argued that the tests, called spiral CT scans, are more likely to do good than harm. The concern that some doctors have is about how the tests will be conducted outside the strictures of the study. Physicians point out that in the study, participants fully understood the parameters of the test and the potential dangers of follow-up testing.

Emergency room physicians more likely to be sued

Florida doctors recognize the importance of careful diagnostics and treatment when dealing with their patients. However, those involved in emergency care may find it necessary to be even more cautious in these efforts due to the fact that this area of practice is particularly prone to malpractice claims. A recent study notes that the failure to diagnose is a leading issue contributing to injuries to emergency care patients.

More than half of the cases studied were closed medical claims involving physician negligence through diagnostic errors. Another 13 percent of cases involved incorrect management of treatment, especially in trauma cases. Some cases related to inappropriate procedure execution, and others were connected to medication errors. As other contributing factors to patient injuries are considered, inadequate equipment for dealing with special situations such as obesity are cited. A lack of communication among providers can also result in poor patient outcomes.

Diagnostic errors in radiology

Florida residents may know the role of diagnosis in the treatment of disease cannot be minimized. A 2009 report in the Journal of the American Medical Association indicated that 40,000 to 80,000 hospital deaths are due to diagnostic error in the United States. Radiographic studies play an important part in the diagnostic process, and the report emphasized that failure to recognize radiographic evidence of a disease occurs frequently.

Radiology error is involved in about 4 percent of all such interpretations. In addition, 30 percent of abnormalities are not reported, and this might result in less effective treatment. In one group, chest nodules measuring 16 millimeters across and related to lung cancer were missed by radiologists 19 percent of the time. Since early treatment may lead to an improved prognosis, this sort of mistake may have a deleterious effect.

Study shows most breast cancer biopsies are misdiagnosed

A surprising new study shows that pathologists in Florida and across the United States may be misdiagnosing up to 75 percent of all breast cancer biopsies. The research was recently published by the American Medical Association. In the study, researchers asked three leading breast cancer specialists to review the biopsy diagnoses of 100 pathologists and compare them with their own medical opinions. The specialists noted significant discrepancies between their findings and the findings of the pathologists. The results indicate that a significant number of the 1.6 million women who undergo breast cancer biopsies annually are being misdiagnosed.

Approximately 20 percent of women who have breast cancer biopsies are told they have breast cancer. Another 60,000 find out they have atypia, which means abnormal cells have been found in the milk duct. If they have been misdiagnosed, they may be over-treated for benign conditions or under-treated for life-threatening conditions. Those with atypia are at particular risk of over-treatment, because medical experts disagree whether the condition is actually a precursor to cancer.

Safety risks of problematic childbirths

Expecting parents in Florida may be interested in information on how childbirths may be affected by the quality of the safety programs in place at local hospitals. Some reports contend that the fatalities and injuries associated with problematic childbirths is one of the most significant health care issues in the country. However, a recently report reviews some of the ways four institutions dramatically improved childbirth safety over the past 15 years.

Studies attribute poor communication to approximately 65 percent of the catastrophic outcomes that can occur from a problematic childbirth. Improving training in communication, emergency childbirth response, compliance during high-risk procedures and cesarean section assessment were the common focal points in the safety initiatives. One organization lowered the neonatal fatality rate at over 40 of its hospitals by almost 50 percent, despite it being 62 percent below the country's average at the onset of the campaign.

The occurrence and results of anesthesia mistakes

It is a complex task to calculate general anesthesia for a patient, which is why proper training is required to administer anesthetics. A mistake in the type of anesthetics or the dosage could have debilitating effects or even cause death. It is often used on patients who are undergoing some type of painful medical procedure, such as surgery. However, many Florida residents might not know that it is used in more places than an operating room.

Anesthesia could be used prior to operations and surgeries as well as during recovery, and mistakes could happen at either of those times. Many nurses also administer anesthetics during labor and delivery. This means that there is a chance that an error in the combination or dose causes injuries to the mother, baby or both during birth.

What Florida parents should know about neonatal bone injuries

Bone injuries are among the most common birth traumas sustained by newborn babies in Florida and nationwide. Certain risk factors such as birth weight, breech delivery, shoulder dystocia and use of forceps during delivery are all associated with the possibility of bone injury. The prognosis for these is generally good, if identified properly and treated correctly, but may lead to more severe problems if not dealt with adequately and quickly.

Clavicular fracture is a very common type of neonatal birth injury, resulting in a fracture of the collarbone. This type of bone fracture is often considered unavoidable, but it may be exacerbated by other risk factors as described above. Healing with this type of fracture usually takes seven to 10 days, if treated properly. Long bone fractures, those relating to the arms or legs, may result from mishandling during labor and birth. If the bone is not displaced, typically splinting and restriction of movement are adequate treatments. Complete recovery takes two to four weeks, with the splint generally able to be removed after eight to 10 days.

The causes of laryngeal nerve birth injuries

A laryngeal nerve injury involves damage that occurs to one or both of the nerves attached to the voice box. Since this type of injury could happen during the delivery of infants, Florida parents might want to familiarize themselves with how it happens and its symptoms and treatment.

The main cause of this birth injury is the lateral rotation and flexing of the newborn's head while it is in the uterus. Injury to the laryngeal nerve during birth causes about 10 percent of paralyzed vocal cord cases. Due to the injury, an infant may exhibit high-pitched breathing or have a hoarse cry, often resulting from unilateral nerve paralysis. The newborn might also have trouble swallowing if the superior branch of the voice box is damaged. Bilateral paralysis could occur if both nerves are damaged or if the infant suffers an injury to the central nervous system, such as a hemorrhage or hypoxia involving the stem of the brain. The symptoms are usually asphyxia or severe respiratory distress.

Prevention of surgical errors

Florida residents may have heard stories about surgical errors like sponges being left behind in people. Although incidents such as these are rare, they do happen sometimes. However, surgeons and hospitals have taken a number of steps to help prevent these types of mistakes. Some of those measures are simple ones. Surgical teams count sponges before and after surgery, use ink to mark surgical spots and employ checklists as well as enforcing time-outs during surgery to ensure that they have the right records, the right plans and the right patient.

Contrary to the perception that these types of errors are common to surgeons at the beginning or end of their career, most mistakes are made by mid-career surgeons. Such errors also seem to cluster around surgeons who have made mistakes in the past. Statistics show that two-thirds of surgeons who make a mistake have also been mentioned in multiple malpractice suits prior to the surgical error.

Thyroid disease can affect one's mental health

Seeking help from a Florida physician for mental health issues could result in a surprising diagnosis: thyroid disease. Untreated hyperthyroidism can lead to issues such as depression because of the depletion of certain hormones. Low thyroid function can lead to slower thinking and motor responses, also causing an affected individual to deal with fatigue and sleepiness. Mood changes can result from untreated thyroid disease as well, and individuals could deal with a higher risk of Alzheimer's disease.

In cases involving a physician's failure to diagnose thyroid disease, conditions can worsen over time. Additionally, a physician may attempt to treat the wrong disease or condition by not recognizing a thyroid problem. In addressing a patient's complaints, a physician could overlook thyroid disease because of the general nature of the symptoms, which can often be indicators for various other medical conditions.