Articles Tagged with “medical malpractice”

young surgery team in the operating room .As The Boston Globe continues to report on the unsafe practice of concurrent surgeries, we want to remind patients and health care consumers that you have legal rights when you seek medical treatment.

In 2015, The Boston Globe Spotlight Team reported on the practice of concurrent, overlapping surgeries at hospitals in Massachusetts and across the country. Concurrent surgery occurs when a surgeon has one patient still in surgery and starts a procedure on another patient. Patients were not informed of the practice.

This month, the U.S. Senate Finance Committee urged hospitals to clearly prohibit the practice.

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Poor communication between doctors and hospital staff hurts patients and causes many deaths, a new study reports. Electronic medical records should improve communication, but doctors are not always reading results.

Communication failures played a role in 30 percent of the medical malpractice cases examined by CRISCO Strategies of Boston. The study was released Monday.

The study reports on roughly a third of all paid medical malpractice claims nationwide, nearly 24,000 cases from 2009 to 2013. Over 7,000 cases involved communication failures which injured patients, including 1,744 resulting in wrongful death.

“Good communication in the medical record or in verbal reports is the hallmark of good medical care. We have seen many preventable deaths and serious injury cases that were the result of communication breakdowns,” Attorney Marc L. Breakstone said.

When Medical Mistakes May Happen

Electronic medical records may get doctors test results more promptly, but the study shows some are not reading them:

  • One woman’s cancer diagnosis was delayed for a full year. Her primary care doctor never read the lab result in her electronic medical record.
  • A patient was rushed to the emergency room and died after his lungs filled with blood. Less than two weeks earlier, his primary care doctor had referred him to a lung doctor. The two doctors failed to communicate about the lab results on the patient’s electronic medical record, which showed possible early congestive heart failure.

Many mistakes – 80 percent – happen as a result of miscommunication when doctors and medical staff transfer patient cases, according to the Joint Commission Center for Transforming Healthcare.

Across the country, 32 hospitals are trying to improve communication by adopting the I-PASS approach for how doctors and nurses communicate during shift changes, according to the medical publication STAT. One of these hospitals is Brigham and Women’s Hospital in Boston.

What Patients Can Take Away from This Study

Monitor Your Medical Records. If you have the option, monitor your medical records online. You will gain a better understanding of how your doctor and the medical practice approach your care. If you find a mistake, ask for a correction. On the other hand, if you do not have electronic access, remember you have the right to make a written request for medical records at any time.


When Shifts Change. Before the day of a surgery, ask when the surgeons and nurses change shifts. Ask what to expect if your procedure is delayed.


Patient Advocate. Bring someone you trust to your pre-operation appointment and to your procedure. Our article about the Massachusetts Patient’s Bill of Rights may be a helpful resource.


Research Online. Research if your doctor or surgeon has been disciplined or has paid medical malpractice claims in the Massachusetts Board of Registration database. You can also search Medicare’s Hospital Compare database for hospital information, ratings and practices.


Make Your Own Decision. Online databases and electronic medical records are important but make your own decision about your doctor’s communication. Observe their practices firsthand, ask questions and choose another doctor if you are concerned.

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20160127-rising-health-care-costs-300.jpgState officials have not lived up to mandates to maintain a website for consumers to compare pricing for medical procedures and doctor’s visits.

The Boston Globe detailed the problems with the website development this week. Meanwhile, the state’s Health Policy Commission recently released its “2015 Cost Trends Report.” The report noted less competition is driving rising health care costs, not higher quality care or other common measures of value.

Attorney David White, consumer advocate, said, “It is unfortunate that the Commonwealth is failing to get basic information to consumers. Health care costs vary so significantly from provider to provider. Consumers need every bit of help they can get to reduce the costs of care.”

White also said, “A very serious issue is how steeply costs vary between facilities for the same procedures. The report demonstrates that the fancy, expensive hospitals do not, on average, deliver significantly better care.”

The Website
The state’s health care reform law of 2006 required a website be established to inform the public about health care cost and quality of care. The website was also included in 2012 legislation. While there have been websites launched, no website is currently available.

As a result, consumers have no central resource to research the costs of a medical procedure or a doctor’s visit at different medical facilities. Pricing cannot be a factor in their decision-making process. The state’s Center for Health Information and Analysis is still deciding what information to include in the website, The Globe reported.

What Consumers Can Do
Many consumers can access some pricing information through websites developed by their health care plans. Contact your health insurance company by telephone if you cannot find your plan’s site. Insurers were required to launch websites by the state, but only members can access these databases, which may be limited. Even the Massachusetts Association of Health Plans supports a state-run website to validate the information.

Consumers should also be able to contact a hospital or doctor’s office and request pricing in advance. This will take longer than simply searching a website, but it may be worth your time if you are scheduling a medical procedure or tests. Prices and the quality of care vary widely. For example, maternity care for low-risk pregnancies can cost $9,722 some hospitals compared to $18,500 at Massachusetts General Hospital in Boston.

“You have the right to find out what your procedures will cost,” Attorney White said. “Be an advocate for yourself: Ask to see the price list that the doctors and hospitals are required to provide.”

Read more in the “2015 Cost Trends Report” and The Boston Globe.

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medicalerrors.jpgThe American College of Surgeons will consider new guidelines for the practice of concurrent or “double-booked” surgeries after a Boston Globe Spotlight Team report this fall.

The Spotlight Team found many surgeons in Boston and across the country are performing in two operations that overlap in part or their entirety, without the patient’s knowledge or consent. In some cases, doctors have even traveled back and forth to surgeries at different hospitals, leaving patients to wait under anesthesia.

“Patient safety is paramount,” said attorney Marc Breakstone, who has represented clients injured by medical malpractice for 30 years. “It is fundamental that patients have a right to be informed who is performing their surgery. If surgeons are overlapping their schedules, patients must be informed, without exception.”

The Boston Globe Spotlight Team surveyed 47 hospitals nationwide, reporting that 15 percent of surgeries at Massachusetts General Hospital are concurrent (of 37,000 surgeries per year). Of these, 1,000 surgeries involve at least one patient with an open incision. At UMass Memorial Medical Center in Worcester, 5 to 10 percent of surgeries are concurrent. The report also included double-booked procedures at other hospitals.

Patients and family members told the Spotlight Team they had no warning that their surgeon may leave during the procedure.

Among them was former Red Sox pitcher Bobby Jenks, who had spinal decompression surgery at MGH in December 2011. Jenks was critical of his care, and in February 2012, told the media his MGH surgical team made an error. As a result, he said he had to undergo another surgery 18 days later in Arizona.

When interviewed this year, Jenks said he had recently learned his surgeon was double-booked during his entire three-hour procedure. In response, MGH told the Spotlight Team the surgeon had been in the operating room during the entire operation and performed properly.

Other Boston Cases
The Spotlight Team reported on cases of concurrent surgeries at hospitals across the country. Two local cases involved Beth Israel Deaconess Medical Center and Brigham and Women’s Hospital.

In 2005, a hand surgeon left Beth Israel during a break from an operation and went to Children’s Hospital, where he was on staff. His lawyer said the doctor experienced difficulties with a medical device involved in his procedure and went to Children’s Hospital to obtain a replacement. While there, he removed a cast for a young patient who wanted to take a trip with his family, the lawyer said.

The Brigham and Women’s Hospital case involves a thoracic surgeon who allowed other surgeons to perform a lung surgery, which led to the patient suffering complications. During testimony, the doctor acknowledged that the surgery overlapped with that of another patient. Though the jury sided with the doctor, the federal appeals court ordered a new trial, saying the judge erred by excluding testimony from expert witnesses.

From Our Experience
The Spotlight report reminds us of surgery that was performed on one of our clients at the Mount Auburn Hospital in Cambridge in 2002. The surgeon, Dr. David Arndt, left the operating room during complex back surgery. His mission was solely a private one–he needed to cash a check. As a result, he immediately lost his medical privileges and his medical license was revoked. For more details about the $1.25 million recovery we obtained for our client, click here.

Read the Boston Globe Spotlight Team coverage.
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44783989_s.jpgPatient beware: A new report says most of us will leave a doctor’s office with a diagnosis which is either late or wrong at least once in our lives. This can be life-changing for some, leading to serious injury, handicap or even death.

The report, “Improving Diagnosis in Health Care,” was released this week by the Institute of Medicine, which also published the landmark report, “To Err is Human” in 1999. The 1999 report exposed the fact that approximately 44,000 to 98,000 people were dying in U.S. hospitals each year as a result of medical errors.

The current report focuses on how doctors diagnose patients. The report shared the story of Carolyn, who believed she was suffering a heart attack and visited a hospital emergency room. When she asked her doctor questions, a nurse told her the doctor “doesn’t like to be questioned.” Told she was suffering acid influx, she was released a few hours later. But she was not better; she returned to the ER two weeks later. As she suspected, she had suffered a heart attack and needed surgery to unblock her artery.

The authors say they do not know how many Carolyns are out there. But some estimates are at least 12 million people are being incorrectly diagnosed like this year, or roughly 5 percent of adults who seek outpatient care each year.

They predict more bad news for patients too: Errors will likely increase because of the processes behind how patients are diagnosed, and how health care is being delivered today. The Institute of Medicine recommends health care organizations set up systems to identify diagnostic errors, adopt a non-punitive culture and work as a team.

A few highlights from the report:

  • There are many causes to diagnostic errors, including poor collaboration among physicians, patients and their families.
  • Physicians often receive limited feedback when they make a diagnostic error. In some cases, they never even learn about their error.
  • The medical culture continues to discourage transparency and disclosure of errors.
  • Doctors may still be struggling to learn electronic medical record systems which have been implemented to help eliminate medical mistakes. This may actually be contributing to mistakes.

Read more from the report and its recommendations.

Patient Resource:
Our attorneys have also written an article called “Preventing Medical Errors at Hospitals” which discusses how patients can advocate for themselves and explains the Massachusetts Patients’ Bill of Rights.

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doctor-patient-2014.jpgDespite years of patient safety initiatives, reports of serious medical errors at Massachusetts hospitals are rising rapidly.

In 2013, Massachusetts acute-care hospitals reported 753 serious medical errors and other patient injuries, according to The Boston Globe. This was an alarming 70 percent increase from the previous year. Other hospitals, including those providing psychiatric and rehabilitative care, saw a 60 percent increase from 2012.

Some say the reason may be broader reporting requirements from the state. Since 2008, hospitals have been required to notify the state Department of Public Health about serious reportable events. In addition, the Department of Public Health now has a computerized system for reporting, a change from when medical errors were reported by fax.

In the past, hospitals had to report incidents which left a patient with a “serious disability.”
In 2012, the term became “serious injury” and it has new categories, including if a patient dies or suffers serious injury if a medical professional fails to communicate test results.

State officials say the new requirements have been fully implemented. That means the conversation should move on to safety and preventing medical malpractice.

There were very serious injuries reported in 2013 and these are the areas which saw the largest increases:

  • Patients who underwent a procedure on the wrong body part
  • Patients who were burned in an operative room fire or by a heating pack
  • Patients who were exposed to contaminated drugs or improperly sterilized equipment

Massachusetts is working to reform medical malpractice along with many other states and the federal government. In 2012, the state passed a health care cost containment bill. The goal of the bill was to save the state $200 billion in health care costs over the next 15 years. Measures included $135 million in grants to help community hospitals adopt electronic medical records and a 182-day cooling off period for injured patients to negotiate out-of-court with hospitals and physicians.

A few months earlier, some Massachusetts hospitals had also joined a plan which would allow doctors to apologize to patients for medical errors and work to settle malpractice claims out of court. It was based on a model developed by the University of Michigan Health System which was credited with reducing the number of lawsuits.

Our Resources for Patients
Our lawyers have over 100 years combined experience handling medical malpractice and personal injury claims. Please view our patient safety resources.

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medicalerrors.jpgIn 2013, the amount paid out in medical malpractice lawsuits increased by $168 million, or 4.7 percent, nationwide. It was the first increase in 10 years. Of these, 96 percent of payments came by settlement, not a jury verdict.

These figures come from an analysis by Diederich Healthcare. The company reviewed 2013 medical malpractice payouts as recorded by the National Practitioner Data Bank. Other highlights:

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In 1999, the Institute of Medicine reported a stunning figure: Each year, up to 98,000 people were dying in U.S. hospitals. These people were not dying from the illness that brought them to a hospital, but from medical mistakes which happened during treatment there.

Over the years, there have been signs the number may be greater. One came in 2010, when the Office of Inspector General for Health and Human Services reported that hospital mistakes contributed to the deaths of 180,000 Medicare patients in just one year.

Now, a new study published in the Journal of Patient Safety reports between 210,000 and 440,000 patients each year suffer some type of preventable harm that contributes to their death. These harms may include patients getting the wrong medicine, surgical errors, or infections resulting when safety procedures are not followed. That makes medical malpractice the third leading cause of deaths in the U.S., following heart disease and cancer.

marcbreakstone_125.jpgMassachusetts Lawyers Weekly writes this week about the divide among lawyers on monitoring social media use and Internet activities by jurors. It is a common practice, especially in Massachusetts, which does not allow attorney-conducted voir dire. There have been no ethical opinions on the subject issued in Massachusetts. Not all attorneys are comfortable with it, but some consider it fair.

“I see no ethical issue. It’s in the public domain,” says Marc L. Breakstone, a Boston personal injury and medical malpractice lawyer with over 25 years of experience. “The public domain is the public domain. There’s certainly nothing wrong with checking the Internet. There would be a lot wrong with interacting with jurors or doing anything on the Internet to influence jurors with respect to the case.”

Breakstone later adds, “Trial lawyers are starving for information about jurors. The Internet is a potential treasure trove of information. Why wouldn’t a diligent trial lawyer inquire of that source? I would rather have voir dire, but without voir dire, this is all I can do.”

Read the full article online or view the PDF version.


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A man who was injured by a driver who suffered a seizure due to his brain tumor could not sue the driver’s neurologist for allegedly failing to warn him not to drive, or for otherwise failing to control his driving.

On December 21, 2001, the plaintiff suffered serious personal injury when he was struck by a car operated by the defendant driver. The driver had been diagnosed with a brain tumor in September 2000 after he had suffered a grand mal seizure. The tumor was malignant and inoperable.

The driver waited six months before he began driving again, as required by Massachusetts law. His treating neurologist, Frederick Hochberg, M.D. of Massachusetts General Hospital, allegedly did not attempt to prevent his patient from driving again and did not warn him not to drive. 

After he was hurt, the plaintiff sued the driver’s estate (the driver had passed away). He also brought a medical negligence claim against Dr. Hochberg. The plaintiff claimed that Dr. Hochberg owed a general duty to the public who might be injured due to the nature of the underlying medical condition that he was treating. The plaintiff argued that the duty rose from the special relationship between a physician and a patient. The plaintiff argued that general negligence principles created a duty in Dr. Hochberg to warn his patient of the dangers of driving while suffering from the brain tumor. The Supreme Judicial Court rejected both arguments.

The court found that this doctor-patient relationship was not a “special relationship” which would give rise to a duty to prevent harm to a third person. Absent such a special relationship, the court said, “there is no duty to control another person’s conduct to prevent that person from causing harm to a third party.”

In 2007, the court had found, in Coombes v. Florio, 450 Mass 182 (2007), that a physician may have a duty to warn his or her patient about the side effects of medication being prescribed. The court ruled that this duty extended to third parties who might be injured if the warning had not been given. But the court refused to extend that ruling to include medical conditions under treatment.

The Coombes case was seen by the court as a very narrow exception to the general rule that a physician owes no duty to third parties who might be injured by a patient. The court stated that the duty sought by the plaintiff would “impose on physicians an affirmative duty … to nonpatients to warn patient of the risks of driving due to any underlying medical condition. We conclude this is an unwarranted and ill-advised expansion of liability for several reasons.”

The main concern of the court was that the physician did not do anything to increase the likelihood of harm by the patient, compared to the physician who might be liable for prescribing medication and thus creating additional risk. The court also believed that further imposition of duty would intrude on the doctor-patient relationship and might increase collateral costs. 

This case represents the second time the court has stated that it will not be expanding the duty recognized in the Coombes case.  At least that narrow exception survived.

The case is Medina v. Hochberg, SJC-11178 (May 13, 2013).

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