Articles Posted in Hospital procedure

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An old woman, 95 years of age, is a patient at a certain Staten island hospital. On 9 June 1998, she became comatose, cyanotic and unresponsive after she became disconnected from her ventilator machine. An employee of the hospital heard the old woman’s room alarm sound but the alarm at the nurses’ station failed to sound. Hence, it could not be determined as to how long the old woman remained disconnected from the ventilator. Respirator assistance was then provided to the old woman by the medical staff of the hospital. Thereafter, she was immediately transferred back to the cardiac care unit, which is where she had been prior to the ventilator incident, and there she received intensive therapeutic care and massive blood transfusions. From 10 June 1998 through 11 June 1998, the consulting neurologist indicated in his progress notes that the old woman had a guarded prognosis and was not receptive to outside stimuli. From 12 June 1998 through 17 June 1998, the progress notes indicated that the old woman was improving. The old woman’s neurologist then noted that she was at baseline, neurologically stable. In other words, the old woman’s neurological condition returned to the state that it had been prior to the ventilator disconnection. Thereafter, the hospital took several remedial measures to prevent any future incidents of this type. The hospital’s Code 15 committee reviewed the old woman’s case to decide whether or not it warranted Code 15 treatment, which consists of reporting to the Agency for Health Care Administration or AHCA within fifteen days of the incident, but later voted against such Code 15 treatment, believing that since the old woman recovered to her neurological baseline, no brain damage or brain injury had occurred. Instead of filing the incident as a Code 15, the hospital reported the occurrence as an adverse incident in its Annual Report of Incidents.

Consequently, the AHCA filed an administrative complaint against the hospital and contends that the hospital violated the law by reason of their failure to report a hypoxic event that caused brain damage to a patient as a Code 15 occurrence.

Sometime in December 2000, a formal hearing was held. After that, the administrative Law Judge or ALJ concluded that the old woman did in fact suffer from a brain damage, a transient or temporary brain damage, and the hospital should have reported the incident as a Code 15; and recommended that AHCA had justification to levy a $5,000.00 administrative fine against the hospital.

The hospital now appeals the aforesaid order.

The first issue is whether or not the hospital was required to report the incident to the AHCA.
Under the law, the hospital, as a licensed hospital facility, is required to report to AHCA within fifteen days of occurrence, any adverse or untoward incident that results in a brain or spinal injury to a patient. The standard of review of an agency decision based upon an issue of law is whether the agency erroneously interpreted the law and, if so, whether a correct interpretation compels a particular action. An agency’s interpretation of the statute it is charged with enforcing is entitled to great deference. However, a court need not defer to an agency’s construction or application of a statute if special agency expertise is not required, or if the agency’s interpretation conflicts with the plain and ordinary meaning of the statute. If the language of the statute is clear and unambiguous and conveys a clear and definite meaning, the statute should be given its plain meaning. When necessary, the plain and ordinary meaning of words in a statute can be ascertained by reference to a dictionary.

Here, the subject statute provides for the term “brain damage”, which exists under the list of every potential personal injury enumerated therein, separate and apart from any condition that results in a limitation of neurological, physical, or sensory function which continues after discharge from the facility. Thus, it is irrelevant under the injury or adverse or untoward incident, whether any brain damage in fact continues after discharge from the facility. Upon a reading of the subject statute, the words clearly mandate that whenever a brain or spinal injury to a patient result, it needs to be reported as a Code 15 occurrence. There is no word permanent before the word brain injury. In fact, the only term in the list of injuries enumerated, that the Legislature described as permanent, is that of disfigurement. No such other term modifies brain damage. Thus, since the Legislature did not modify the term brain damage with any word such as permanent or temporary, this intentional legislative omission cannot be lightly disregarded. The rule is, courts are not at liberty to add words to statutes that were not placed there by the Legislature. Thus, the Queens court finds that the plain meaning of the term is clear and unambiguous.

Moreover, under the Webster’s Third New International Dictionary, the word “damage” is defined as a loss due to injury; injury or harm to a person, property or reputation; while under the Black’s Law Dictionary, it is defined as a loss or injury to person or property. Obviously, this dictionary definition does not confine the term to only permanent injury. Thus, based upon the plain meaning of the subject statute, the court finds that brain damage can result even if a patient, such as the old woman, returns to a neurological baseline.

The second issue is whether or not the requirement of reporting any incident of brain damage to AHCA is indeed a logical interpretation of the applicable statute.

As a rule, once an enumerated incident occurs, a licensed facility must report to the agency within fifteen days. If a facility does not have to report an incident caused by a ventilator disconnection until the facility learns whether or not the incident is of a permanent nature, then in many cases it would be impossible for the facility to report to the agency within fifteen days.

Here, while the old woman did begin to return to a neurological baseline within three to four days, it is also quite possible that the old woman could have remained comatose for months before returning to baseline. If the court would rule that he hospital was not required to report the incident because the old woman later recovered, this outcome is not reasonable and would render the fifteen-day reporting requirement period dependent upon the length of the personal injury instead of its severity. Thus, the court finds that the hospital is certainly required to make the report. This interpretation of the subject statute renders a more logical outcome.

Lastly, the third issue is whether or not AHCA’s construction and interpretation of the term “brain damage” were vague and unconstitutional as applied to appellant, but AHCA argues that appellant waived this constitutional challenge by failing to raise this issue timely.
Under the rules, constitutional challenges can be raised for the first time on appeal. Administrative agencies lack the power to consider or determine constitutional issues. Courts have ruled that the administrative process cannot resolve a constitutional attack on a statute, rule or regulation; and that a party is not required to argue the facial constitutionality of a statute before an administrative agency because the agency lacks the power to declare a statute unconstitutional.

Here, since the order appealed from was decided by an administrative agency, the hospital can challenge the constitutionality of AHCA’s action for the first time in appeal. Nonetheless, the subject statute is clear and unambiguous; and, the rule is, if the record demonstrates that a party engaged in some conduct that is clearly proscribed by the plain and ordinary meaning of the statute, then that party cannot successfully challenge it for vagueness. The AHCA’s construction and interpretation of the statute are not vague and were not unconstitutionally applied to the hospital. Thus, by not reporting the ventilator incident as a Code 15 occurrence, the hospital undoubtedly violated the statute.
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The 38-year-olf father of a 9-week-old Grand Island girl was charged with two felony counts of child abuse last Thursday morning after the infant suffered a “severe brain injury.”

The county attorney asked for a “substantial bond” of 10% of $100,000 citing the infant’s injuries. She has retinal hemorrhaging, fluid on her brain and blood on her brain.
The baby’s long-term prognosis is unclear.

“According to reports,” a source says, “the events happened on at least three different days.

The defendant even admits to hitting the child in the head, which is the primary cause of the brain injury.

The County Judge set the bond above the attorney’s asking limit, at 10 percent of $250,000.

The judge looked at two women who were seated in the courtroom watching the father’s arraignment and pointed out the severity of the charges. “This is a pretty serious deal, understand?”

The defendant was seen wiping his eyes several times during the court appearance which was held via video conference from the county jail.

He was arrested the day before his charges were read after a Nebraska State Patrol investigation was instigated because his infant suffered a “severe brain injury” and was being treated at Children’s Hospital in Omaha.

The baby girl, who was born on Feb. 11, was being treated in the intensive care unit. She was transferred to the Omaha specialty hospital from a smaller, local hospital Tuesday night.
The incidents reportedly happened in Grand Island.

If convicted, this father faces up to 20 years in prison and a $25,000 fine for each count. His preliminary hearing was set for June. As part of his bond, he was ordered not to have any contact with the baby.

Legal restitution is guaranteed by law and can be granted through the expert legal aid obtained through Attorneys. Should you or your child in Nassau and Sufolk be harmed by others and need a strong voice to tell your story, contact a rep as soon as possible.
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An alleged overdose of post-operative pain medications led a patient to file a law suit against his nurse and her employers. The man suffered and anoxic brain injury after the overdose led him to code. He had been recovering after arthroscopic surgery. The judgment awarded him $126,500.

The man and his wife sued the Registered Nurse, Interim Health Care Staffing of North Louisiana, and Glenwood Regional Medical Center in West Monroe, Louisiana. The plaintiffs alleged that the nurse did not meet standards of care in her treatment of the post-op patient.
As the man recovered from rotator cuff surgery at Glenwood Medical Center in June of 2001, he received a dosage of IV Demerol. He was then transferred from the operation room to a recovery room and assigned to the above mentioned RN, a contract nurse employed by Interim.

The doctor’s orders, visible on the patient’s chart, called for the nurse to monitor, for 30 minutes, the patient’s vital signs and to look for any signs of respiration depression. The orders also outlined the dosage of additional pain relievers.

A Lawyer reports that the family’s allegations against the nurse said that she gave the man too much medicine too soon, not in compliance with the doctor’s orders. The overdose was evidenced when he coded, lost his pulse and respirations ceased. CPR was immediately started along with intubation. The patient had to be moved to ICU where he was placed on a ventilator. His hospital stay was lengthened to 5 days.

The report says that when the man returned home, he noticed memory loss, which is reported to his family doctor. The family physician ordered EEG and MRI tests which ended up showing that the man had suffered an anoxic brain injury. The patient and his wife blame the post-op overmedication for the brain injury.

The plaintiff was awarded $116,000 for “pain, suffering, mental anguish, emotional trauma and medical expenses,” almost 10 years after the negligence, April 2010. The plaintiff’s wife was awarded an additional $10,000 for loss of consortium. In Manhattan and Brooklyn, hospitals are aware of this outcome.
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Back in 1986, the U.S. Congress created the Vaccine Injury Compensation Program (VICP) under the National Childhood Vaccine Injury Act.  The original jurisdiction of this Program covered children’s claims of injury resulting from vaccines. 

With the necessity of vaccinations and because most children receive several vaccinations for daycare and school, it is of utmost importance that the VICP provide its services and compensations in fairness, due process, and transparency.

A study was recently conducted in both Long Island and New York City to empirically investigate the Program. In the study, claims that the VICP compensated for vaccine-induced encephalopathy and seizuredisorder were examined. According to a report, the VICP has compensated roughly 2,500 claims of vaccine injury since its beginning.  83 cases of “acknowledged vaccine-induced brain damage” that include autism, a severe disorder that affects speech, social communication, and behavior.  21 of these cases brought before the Court of Federal Claims, which administers the VICP, the Court ruled that the petitioners had autism, or described autism.  In the 62 remaining cases, the study found settlement agreements where Health and Human Services (HHS) compensated children with vaccine-induced brain damage, who also have autism or an autism spectrum disorder.

To be compensated by VICP, parents must have reported the existence of autism in a telephone interview and have supplied supplemental materials, including medical diagnoses, school records, and a completed standard autism screening questionnaire in order to verify their reports.  In 47% of the cases (39 of 83) of vaccine injury reviewed, there is a definite confirmation of autism, or autism spectrum disorder. 

This finding is significant, an expert reveals, because the U.S. government has been asserting that there is no vaccine-autism link, and they have been doing this for more than a decade.  Perusing publicly available information, the investigative study unveiled the fact that the VICP has compensated numerous vaccine-induced brain damage claims – claims that are closely associated with autism. And this compensation has been happening for more than 20 years!
Ultimately, the purpose of the study’s findings is to spur Congress to action; a thorough look at the VICP is asked for. What are the true possible side effects or outcomes of vaccinations? Are those risks properly revealed to patients and their parents?
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A woman who claims to have suffered brain damage from a hospital procedure performed shortly after her honeymoon has gotten a settlement after her case was taken to the Irish High Court.
The 46-year-old victim from Loughlinstown, Ireland, was described as “bubbly and vivacious” before her injury. She was employed as receptionist then, but now her injury requires her to have care 24 hours a day.
It was the victim’s husband who brought the suit before the court, on behalf of his wife. The charges alleged the hospital system and the surgeon who performed the operation were negligent and acted in breach of duty at St. Michael’s Hospital, where the victim was treated.
The defendants never actually admitted liability, except to say they did not provide a nutritionist at the hospital. The case was about to resume, but the judge was told the case had been settled. No one has revealed any details regarding the settlement.
According to court records, the victim became ill in June 2005, while on her honeymoon in the Dominican Republic. When she returned on July 18th, she was sent to St. Michael’s, where she a laparotomy was performed to treat a number of abdominal adhesions.
Only ten days after her discharge from the hospital, she was readmitted, due to continuing difficulties. Part of her small bowel was removed at that point, and she required emergency intravenous feeding known as total parenteral nutrition (TPN). Hospitals in The Bronx and Manhattan are always attentive to these problems.
The attorneys for the victim claim the intravenous feeding lacked an essential nutrient – the vitamin thiamine. As a result, she was afflicted with a condition known as Winicke Korsakoff psychosis. It is alleged the defendants did not do their duty to monitor, test, and review what their patient needed as a part of her TPN management.
The victim’s attorney told New York Brain Injury Lawyers his client became confused and disoriented, and soon developed problems with her memory. Her executive function also suffered a great deal, as did her linguistic ability. Even her overall IQ dropped, as a result.
She continues to suffer from unsteadiness and dizziness, as well as periods of heavy fatigue and depression, sources told New York Brain Injury Lawyers
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In 1986, Congress mandated the creation of the Vaccine Injury Compensation Program (VICP) which was to operate under the National Childhood Vaccine Injury Act. The VICP was to oversee all children’s claims of injury that had resulted from vaccines. The program’s implementation was highly important because of the widespread use of and necessity of several series of vaccinations for daycare and school.
A recent investigative study was conducted on the Program. In the study, many claims were examined, primarily vaccine-induced encephalopathy and seizure disorder claims. A Manhattan Brain Injury Attorney says that the study found the VICP has compensated about 2,500 claims since its inception. In 83 cases, compensation was given to “acknowledged vaccine-induced brain damage” including autism, the disorder that severely affects speech, social communication, and even behavior. 21 of these cases saw the Court of Federal Claims ruling that the child petitioners had autism. In the other 62 cases, the study found that the HHS (Health and Human Services) has paid settlement amounts to children with vaccine-induced brain damage such as autism or an autism spectrum disorder.
In order for their children to be compensated by VICP, parents must report the existence of autism via a telephone interview. They must also supply supplemental diagnostic materials, such as official medical diagnoses, school records, and autism screening questionnaires. All of these requirements are to validate the parents’ claims.
A Manhattan Brain Injury Attorney says this finding is highly significant. He reveals that it contradicts the U.S. government’s 10-year argument that there is no link between vaccines and autism.
The study’s investigators perused public files and found that over the last 20 years, the VICP has compensated many damage claims for vaccine-induced brain damage – claims closely associated with autism. With these findings recently published, the authors intend to prod Congress into thoroughly examining the VICP and their findings. They want Congress to evaluate the obvious link between vaccines and autism and litigate the necessity to warn patients and parents of patients about the possible side effect. Our youngest patients should not unknowingly be put at risk for a serious ailment, should they? These findings should be helpful to doctors in New York City and Nassau County.
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Severe closed head injuries are generally investigated by computed tomography (CT), which can give a visual representation of injuries that require surgery, New York Brain Injury Lawyershave learned. Medical professionals also monitor pressure inside the head and other details of the brain, so they know when to use artificial ventilation and other forms of therapy. A clinical examination plays in important role in the management of head injuries, especially severe head injuries.
The initial clinical evaluation is just as important here as it is in any other case. It is used in triage to assess the immediate need for care and as a baseline to see how far the patient has come in recovery. This initial evaluation also does a great deal to form the prognosis. The first neurological examination is often performed at the accident site or the emergency room, often by someone with no special experience or training in neurology. Thus, it is vital that paramedics, intensivists, and emergency physicians all know how to perform a neurological examination before other measures are enacted. These steps are followed closely by all hospitals in Brooklyn and The Bronx.
It isn’t necessary for everyone who might treat an unconscious patient to know everything about medical neurology, New York Brain Injury Lawyers have discovered. All that’s necessary is to learn a few basic neurological observations and making an accurate record of them. The care of a head injury patient should not be compartmentalized. The evaluation needs to be a continuous process, with the early findings always remaining important, no matter what the later outcome.
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