Tuesday, July 28, 2009

The Rights of Patients in Nursing Homes

The decision to utilize a Nursing Home for a loved one is often a difficult one for family members to make. It is important that relatives and the prospective resident are aware of their rights once moved into the home. The following is a printable list of rights that are declared in Michigan Compiled Laws Annotated, 333.20201 (1998)3.

* receive appropriate care regardless of race, religion, color, national origin, sex, age, handicap, marital status, sexual preference, or source of payment.

* to receive treatment for your physical and mental problems.

* to receive complete information about your medical condition and care plan.

* to be free from physical or drug induced restraints which are not required to treat your medical symptoms.

* to refuse treatment and be told of the possible consequences if you refuse.

* to issue instructions about your future medical treatment or to appoint a "patient advocate" to make such decisions for you.

* to receive meals that meet your needs.

* to live in a clean place.

* to meet privately with your spouse.

* to regular, private use of a telephone.

* to privacy during treatment or when attending to your personal needs.

* to see visitors you want to see.

* to participate in social, religious, and community activities.

* to a safe place to keep your valuable possessions.

* to keep and manage your own money.

* to return to your facility following a hospital stay.

* to advance notice before your room or roommate is changed.

* to have information about you kept private.

* to inspect and copy your personal and medical records.

* to be informed of your rights and responsibilities.

* to information from the nursing home on how you can get help to pay for your care.

* to written notice of all services available in the home and their cost.

* to receive a copy of your nursing home’s rules about resident care and conduct.

* to review the most recent state and federal inspection reports of your nursing home and the home’s plan of correction.

* to meet with other residents and residents’ families in the home to discuss nursing home issues.

* to send and receive personal mail unopened the day the nursing home receives it.

* to the same constitutional and civil rights given to all citizens.

If you, a relative or friend have suffered an injury while in a nursing home, or have any questions, please call or visit:


5510 Woodward Avenue

Detroit, Michigan 48202

Phone: (313) 875-8080 or (800) 247-5974

Fax: (313) 875-8522

Website: www.c2law.com

E-Mail: lawyers1@c2law.com

Monday, July 27, 2009

Breast Cancer Facts & Risk Factors

Cancers of the breast present complex medical and personal issues. With the modern diagnostic techniques of mammography, ultrasound and biopsy, more cancers are being detected at an earlier stage. Because early detection and treatment are believed to provide better survival rates, more women are undergoing breast screening and suspicious lump explorations. In spite of improved diagnostic techniques, however, many physicians still wrongfully believe that they can distinguish the cancerous from non-cancerous lumps "by feel."

Obstetrician-gynecologists are in general agreement that a suspicious lump should not be followed for more than one menstrual period. A lump may be followed for a menstrual period to see if it shrinks or disappears with the passing of the cycle. Where the lump continues beyond the cycle, even though it may prove to be cystic and non-malignant, there is general agreement that such lumps must be aggressively explored and presumed malignant until proven otherwise.

Mammography and ultrasound are useful in identifying the existence and location of lumps (cysts or tumors). However, only a biopsy of the lump can determine whether a lump is cancerous or merely cystic.


  • Most frequent cancer in women, but it also occurs in men.

  • The odds that a woman will get breast cancer are:

    • 1 in 50 by age 50

    • 1 in 17 by age 65

    • 1 in 8 over a lifetime

  • Breast cancers constitute 32% of all cancers.

  • Breast cancers cause 18% of cancer deaths in women in USA annually.


  • Factors increasing risk of breast cancer (role of hormones) unclear.

  • Personal history factors suggesting risk of breast cancer are:

    • Nipple discharge

    • Trauma

    • Fever

    • Present or previous cancer lesions in the breast

    • A maternal history of breast cancer

    • A lump that doesn't go away after a period, or a lump that has pain or increases in size.

In spite of improved technologies, physician failure to diagnose breast cancer is one of the most common claims of medical malpractice faced by obstetricians/gynecologists. The suspicious lump that is "followed too long" (more than two months); the "suspicious lump" that is determined to be cystic and non-cancerous by feel alone (and not biopsied); the "suspicious lump" accompanied by nipple discharge, or pain; or the "suspicious lump" that increases in size, in the face of physician complacency, are all situations, if a cancer is later found, that warrant a medical-legal investigation to determine whether medical malpractice occurred.

Because the medical/scientific literature shows improved chances of survival with early diagnosis and treatment (surgical, chemical and/or radiation) a physician’s failure to aggressively investigate "suspicious lumps" may result in the patient having to undergo more extensive surgery or treatment, or indeed, suffer a loss of life. Because breast cancer is treatable, a physician’s failure to timely diagnose and treat the "suspicious lump" may result in a successful malpractice claim.

In cases were the failure to diagnose breast cancer occurs, the 1995 Physician Insurers Association of America (PIAA) Breast Cancer Study shows that:

  • The patient discovered the "suspicious lump" in 60% of cases

  • The most common presenting symptom: painless mass (46.5%)

  • No suspicious symptoms were reported (16.6%)

  • No physical finding in 1/5 of cases (21.4%)

  • 80% of the mammograms were negative or equivocal

  • Most "suspicious lumps" were discovered by the woman during self examination.

The most common reasons for delay in diagnosis were:

  • The physician was unimpressed by "suspicious lump" (35%)

  • The patient failed to follow up with the physician after the discovery of symptoms (e.g. "suspicious lump" or nipple discharge)

  • A falsely negative mammogram (25.8%)

  • A misread mammogram (27.7%)

  • The failure of the physician to biopsy (27.7%)

  • The delay or failure of the physician to request a surgical consult

From the findings of the 1995 PIAA Breast Cancer Study, it is apparent that a significant number of cases involving the failure to diagnose, or a delay in diagnosing breast cancer, are the result of physician error. In any case where there has been a delay or failure to diagnose breast cancer and subsequent treatment provides evidence of spread to the lymph nodes, a medical-legal investigation is warranted. <back