Cleveland, Ohio Medical Malpractice Blog

Nearly 450,000 people in the United States live with severe spinal cord injuries and almost 10,000 people suffer from serious spinal cord injuries each year. Generally, a spinal cord injury is an injury of the spinal cord that results in loss of body functionality (i.e., mobility or feeling).

Complete vs. Incomplete Spinal Cord Injuries

When a person suffers a spinal cord injury, it may be classified as either complete or incomplete.

The characteristics of a complete spinal cord injury are the following:

• Complete paralysis below the level of the injury
• May result in no feeling or movement in the legs, bowel and bladder
• May result in no feeling or movement in the arms and hands
• May require a ventilator for breathing

The characteristics of an incomplete spinal cord injury are the following:

• An injury that does not eliminate all feeling and movement below the damaged area
• The degree of injury is usually evaluated six to eight weeks after the onset of the injury

Incomplete spinal cord injuries are generally  more common than complete spinal cord injuries.

A pulmonary embolism is a blockage that develops in an artery in the lungs. It occurs when a blood clot moves through the blood stream and eventually becomes lodged in an artery. In normal cases, embolisms are easily diagnosed and treated with anti-clotting medicine. However, a recent studies indicate that mismanagement of pulmonary embolism diagnoses is much more common than it should be.

The studies - published in the Annals of Internal Medicine - found that physicians often withhold anti-coagulant treatment of suspected pulmonary embolisms when initial tests rule it out. However, even if initial tests are negative, guidelines call for additional testing or treatment because false negatives are fairly common. One study indicated that 43 percent of pulmonary embolism cases were mismanaged according to these guidelines. Misdiagnosis of a pulmonary embolism led to a six-times-higher risk of a thromboembolic event.

Glenda Christian was 30 years old when she noticed a pea sized lump in her left breast. Concerned about the lump, she had a mammogram but the test revealed nothing. Shortly after, she became pregnant and following the birth of a son, nursed him for 13 months. She then came to find that the pea sized lump had grown to the size of a small pickle. This prompted Glenda to have an ultrasound and a second mammogram but again nothing was revealed.

A Year Later

After two mammograms and an ultrasound, Glenda was still without a diagnosis. The lump she had felt grow from pea size to the size of a small pickle had now morphed into cottage cheese-like lumps that covered half of her left breast. She was also experiencing intense pain stretching from her arm pit to her breast.

The Diagnosis

It was not until the lump had changed shapes and started to cause Glenda great pain that she was diagnosed as having stage 3B estrogen-receptor-negative breast cancer. She underwent a mastectomy of her left breast and had chemotherapy. Glenda had now lived for over three years with undiagnosed breast cancer and was lucky to be alive.

Recommendations regarding the frequency with which women should receive mammograms have been swirling for the last decade. Conflicting reports and studies have led to confusion and frustration by women who simply want to do what is best for their health. A new study authored by Dr. John Schousboe, professor at the University of Minnesota, has added a new twist to the debate.

Previous recommendations regarding mammogram scheduling have been mostly aged-based up until now. The American Cancer Society recommends women start annual screening at the age of 40. The U.S. Preventive Services Task force suggests biennial screening from ages 50 to 74. It also recommends women discuss with their doctor the possibility of screening before the age of 50.

Analysis of Risk Factors Rather Than an Age-Based Approach

The result of a new study led by Dr. Schousboe challenges the age-based approach and proposes that a woman's mammography schedule be customized and unique based upon certain risk factors. Dr. Schousboe argues that one schedule for all women, simply based upon age, is not the best method for breast cancer screening. Factors such as breast density, breast biopsy history, family history of breast cancer and the woman's views pertaining to the risks and benefits of screening, as well as the woman's age, should determine the screening schedule.

Evidence suggests that women who give birth to a child via cesarean section are at higher risk for injury to the birth organs in subsequent vaginal deliveries.

Uterine scars from a cesarean section can essentially function as fault lines in the organ's structural integrity. In some cases, the pressure caused by vaginal delivery can cause the scar to break open, leading to birth injuries such as uterine rupture.

According to a study published in the New England Journal of Medicine, women who delivered their first child via cesarean section and then delivered a second via vaginal delivery were approximately three times more likely to suffer a uterine rupture than women who delivered both children vaginally. The risk is even higher for women whose labor is induced during the second delivery.

The danger is further compounded for older women and those who begin their pregnancies obese or overweight. Exceptionally large babies - especially those weighing over 8 pounds, 13 ounces - also decrease the chance that women will have a successful vaginal birth after c-section.

Although the risk of uterine rupture is present, it is relatively small. Still, the consequences of a uterine rupture are catastrophic - the injury usually means death for both mother and baby.

This year, the March of Dimes' premature birth report card shows that the United States is improving but has a long way to go. The report, which analyzes data from 2009, gives the U.S. a "C" grade - the same grade that Ohio earned. The year before, the U.S. received a "D."

One in eight babies is born before full term in the U.S. This number is higher than in most developed countries.

Risks for Premature Babies

A baby is born prematurely if it arrives during or before the 36th week of pregnancy. The reason it is so important that babies are born at full term is the health problems that can plague "preemies." These include:

• Low birth weight
• Cerebral palsy
• Intellectual disabilities
• Underdeveloped organs, especially the lungs
• Respiratory problems and breathing difficulties
• Death

"Never events" is a term that was coined by Kenneth Kizer - formerly of the National Quality Forum - to describe surgical events in a hospital that should, as the name suggests, never occur. These events range in severity from operating on the wrong body part to performing an operation on the wrong person entirely.

While this may sound like some gruesome anomaly that you'd only hear about on the evening news, surgical errors are becoming ever more common. According to the Joint Commission - an organization that is responsible for accrediting hospitals around the country - 40 operations on the wrong body part occur in hospitals and clinics on a weekly basis. And those are just the never events that the Joint Commission knows about: Since half of the states in the country do not require medical facilities to report these surgical accidents, the true amount of never events is unknown.

Medication errors - where a patient is given the wrong medication or the wrong dosage of the correct medication - are among some of the deadliest mistakes in the medical field. According to the Agency for Healthcare Research and Quality, 1.9 million people were injured as the result of some kind of medical mistake in 2008 - up from 1.2 million injuries in 2004.

A recent study by Consumer Reports may illustrate the role that pharmacies play in these types of injuries: After visiting consumer pharmacies in a number of chain stores - CVS, Target, Walgreens, Costco and Walmart - the magazine's researchers found that four out of five of the pharmacies did not provide medication guides to patients that are required by the federal government. In addition, the study found that for some chains, the information provided to customers about the medications ordered varied from one store to the next - with some stores not giving out any information at all.