Thursday, May 18, 2017

What happens when the hospital fails to manage your labor & delivery?

$1,500,000.00 Settled at ADR mediation Baby decedent died at six days of age secondary to hypoxic ischemic encephalopathy. His labor and delivery was managed at defendant hospital by a midwife, an obstetrician/gynecologist and nursing staff. Objective evidence on fetal monitoring strips revealed a baby that was not tolerating labor during his last hours in utero. Adding insult to injury, pitocin was administered during this intolerance period, augmenting contractions. The pitocin was turned off shortly thereafter, but not without inflicting additional damage. Baby decedent was born blue, floppy and without respirations. Resuscitation and intubation was accomplished and the baby was transferred to another hospital for neonatal interim care and attention. Baby decedent succumbed to the severity of his brain injury at six days post-birth. The prenatal course was uneventful. The mother presented to defendant hospital. A fetal monitor was placed. The fetal monitor is the best tool available to monitor fetal well-being. Initially, the fetal monitor strips were categorized as a Category I, which means normal heart rate, accelerations and variability. Category II means there are some abnormalities, decreased variability or evidence of decelerations or dips in the heart rate below baseline. Category II tracings need to be monitored closely for the very reason of what happened in this case. The idea is to intervene before the strips progress to a Category III level, which requires immediate emergent intervention. The fetal heart rate monitor revealed variable decelerations which were appropriately designated early in the labor, and the baby responded to resuscitative measures appropriately taken by the nursing staff. What began to occur is the decelerations became more frequent and baby decedent lost his ability to compensate. He did not respond to resuscitative measures in utero. Adding insult to injury during this time of intolerance, pitocin, a contraction augmentation drug, was administered. Recognizing the instant intolerance of the fetus, the pitocin was turned off 4 minutes later and a cesarean section was called. Baby decedent was born by cesarean section approximately 21 minutes later, meconium-stained with tight nuchal cord times 1. He was limp and blue with no respiratory effort. He was administered chest compressions for 20 minutes, epinephrine given, intubated, and cord gases were performed. His APGARs were 2 at 1 minute, 1 at 5 minutes, 10 minutes and 15 minutes respectively. At delivery, meconium was noted. Meconium is, in essence, the baby’s first bowel movement. The amniotic fluid at time of the rupture of membranes earlier in the labor was clear. Meconium presence is generally secondary to stressors on the baby. The cord was also noted around the neck. This is a common finding, the significance being that a cord, whether wrapped around the neck or a body part, can easily be compressed while in utero. Variable decelerations noted were related to cord compression. Pediatricians were present at the time of delivery and initiated resuscitation. Baby decedent was successfully intubated at approximately 20 minutes of life and was transferred to another hospital for neonate intensive care attention. At the second hospital, Phenobarbital was given as a seizure preventative as well as cool-capping, which is hypothermic treatment. MRIs of the brain confirmed the diagnosis of HIE. Ultimately, baby decedent expired secondary to severe hypoxic ischemic encephalopathy. Pathology was performed, which was consistent with said diagnosis. Plaintiff brought the action of medical malpractice in the failure to properly manage the labor and delivery, resulting in the death of baby decedent. Plaintiff relied on the expertise of numerous specialists, including obstetrics/gynecology, midwifery, maternal-fetal medicine, nursing, pediatric neurology, neuroradiology and placental pathology. The hospital’s defense was that fetal monitoring strips were appropriately interpreted and labor was appropriately managed. After the death of baby decedent, the relationship of the parents unraveled. As a result of this death, their lives were changed forever. They were parents for a moment. Submitted by: Co-Counsel: CHARFOOS & CHRISTENSEN, P.C. DAVID W. CHRISTENSEN P11863 MARY PAT ROSEN P34992 26622 Woodward Avenue, Suite 100 Royal Oak, MI 48067 (248) 399-0350 or (313) 875-8080 Fax: (248) 399-0351 CONYBEARE LAW OFFICE, P.C. MICHAEL D. MARRS P25117 519 Main Street Saint Joseph, MI 49085 (269) 983-0561 Fax: (269) 983-5327

Thursday, May 4, 2017

Wife & Mother Meets Girlfriend for a Drink and is Shot! Bar Staff Could Have Prevented Her Death if They Called The Police Instead of Breaking the Shooters Jaw Before He Had The Gun!

Estate of Plaintiff’s Decedent vs. Defendant Bar Owner, Defendant Bar Operator/LLC, Defendant Security Companies, Defendant Bouncers and Defendant Bar Customer State of Michigan, County Circuit Court Regarding settlement $250,000.00 with Bar Owner and Settlement $3,500.00 with Defendant Security Companies Case Evaluation: $129,500.00 Settled following facilitation Facts: This is a case of a bar out of control with foreseeable tragic results. The defendant bar operator/LLC, operating under a lease and agreement with defendant bar owner who held the liquor license, should not have been operating on the night that Plaintiff’s decedent was fatally shot. It remained in operation even after the city police, who believed the bar was a menace to the safety of citizens and patrons, notified defendant bar owner that operations should be terminated immediately. The defendant owner insisted on abiding by a 10-day notice provision in the operating agreement with the defendant bar operators/LLC, which was the only reason the bar was allowed to remain in operation. Four days after police said the operating agreement should end immediately, altercations and threats involving defendant bouncers/security and customers led to gunfire which killed Plaintiff’s decedent. Plaintiff’s decedent died from a bullet wound to her head. She was married and the mother of a minor son, enjoying an evening with female friends at the defendant bar. It was Plaintiff’s decedent’s first visit to the bar and she was unaware of the bar’s notorious history among city police detectives. Police had documented numerous violent incidents including shootings, assaults and drug dealing at the venue. The defendant bar was owned and operated by the defendant owner and bouncers were provided by other defendant security companies. Defendant owner owned the building and liquor license which it licensed to defendant bar operator/LLC under an unusual arrangement that was not approved by the Michigan Liquor Control Commission (“MLCC”). Earlier, the defendant bar owner was informed by the city police department of ongoing problems at defendant bar, and several meetings were held in an attempt to remedy the problems. During the next three months, the problems involving assaults, thefts, overcrowding, and use of controlled substances, among other problems at the bar increased in frequency and severity. The Michigan Liquor Control Commission suspended defendant owner’s liquor license for failure to provide proof of financial responsibility and police reported the bar for various violations. Suspension notice was received by the city police. Days before the tragic death, the city police held a meeting with defendant bar owner. Following that meeting, defendant owner sent an e-mail to city police advising them that defendant bar operator/LLC would be notified that defendant bar owner was revoking defendant bar operator/LLC’s use of defendant bar owner’s liquor license. However, two days later defendant bar owner notified city police that he had been informed by an attorney that an agreement between defendant bar owner and defendant bar operator/LLC provided for a 10-day notice period before termination, and therefore, defendant bar would be operating with the liquor license for 10 more days. City police responded to defendant bar owner informing him that the 10-day notice period applied to the lease and the liquor license could be revoked immediately. According to the agreement, defendant bar owner as licensee was responsible for the conduct of the operation of the licensed business and the actions of the manager in the conduct of the licensed business, in the same manner as he would be with respect to his own employees. This agreement was never approved by the MLCC and should have been deemed nonbinding. Despite this knowledge, defendant bar owner did not revoke the rights of defendant bar operator/LLC to operate under its liquor license but instead allowed it to continue to use the license. Two days later, Plaintiff’s decedent was seated with her friends inside the defendant bar. On the other side of the bar, its bouncers staffed by defendant security companies, some of whom were armed, had an altercation with three male customers. One of the male customers, also a defendant, threatened to get a gun and “shoot the m*** f*** club up” after being punched by a defendant bouncer. None of the defendants called police at this time. Defendant bouncers removed the customers to the bar’s parking lot where defendant bouncers beat the defendant customer a second time, causing him to spit up blood, and another removed customer suffered a broken jaw at the hands of defendant bouncers. The defendant customer returned to his car, bloodied and humiliated. Still, none of the defendants called police at this time. Defendant bouncers retreated inside the bar’s locked glass doors. The defendant customer sat in the front seat of his car. He wiped the blood from his face, changed his bloodied shirt and got his gun. His friend, seated in the passenger seat, saw the gun and tried to counsel defendant customer against using the gun. About five minutes later, defendant customer and his friend returned to the bar’s entrance, calling for the bouncers to come out. The defendant bouncers brandished their guns from inside the glass doors. But the police were still not called. About 25 seconds later, defendant customer fired several shots at the building. One bullet went through a glass window, striking Plaintiff’s decedent. The first call to city police was logged 24 minutes after the altercations between bouncers and defendant customer. Police and emergency medical technicians attempted to treat Plaintiff’s decedent at the scene. She was pronounced dead upon arrival at the hospital. Plaintiff’s decedent died as a result of breaches of duty by all the defendant participants, who had a duty to maintain a safe premises. Plaintiff’s decedent was 33 years of age, a wife, a mother and was gainfully employed. Settlement was achieved with the defendant bar owner, with minimal contribution from the defendant security companies. Defendant bar operator/LLC claimed they were operating under the operating agreement. Defendant bar owner and security companies claimed if city police had been called the death would not have been prevented.

Wednesday, May 3, 2017

Apprentice Tradesman Burned to Death at Industrial Company

Personal Representative of the Estate of a 21-year old Deceased vs Defendant Industrial Corporation and Defendant Trades. Settlement: $4.25 Million Dollars, February 2012. Plaintiff’s Decedent was an apprentice tradesman working at Defendant Industrial Company, as were Defendant Trades. All parties were present at Defendant Industrial Company for the purposes of unblocking a gas washer. Defendant Industrial Company developed a plan and sequence utilizing all of Defendant Trades and Plaintiff’s Decedent’s Trade to unblock the gas washer. At the date and times these events were to take place, Defendant Industrial Corporation eliminated the safest access to address the blockage. Defendant Industrial Corporation altered the plan so that Defendant Trades would attempt to unblock the gas washer by attempting to vacuum or water jet out the clean out lines and/or replace a 40-inch clean out pipe at the bottom of the clogged gas washer. If these attempts were unsuccessful, Plaintiff’s Decedent’s Trade would remove a flange attached to the bottom of the gas washer. Defendant Trades were unsuccessful in their attempts at unclogging the gas washer. All Defendants were aware that any material in the gas washer was known to be super heated. After Defendant Trades were unable to unclog the gas washer, Defendant Industrial Corporation advised Plaintiff’s Decedent to proceed in removing the flange. The flange was located at the bottom of the gas washer in an area that subsequently was defined as a confined closed space, meaning there was limited ingress and egress. Plaintiff’s Decedent was standing in front of the flange removing every other bolt as instructed by Defendant Industrial Corporation in preparation for its removal. After completing the task of removing every other bolt, Plaintiff’s Decedent was instructed to begin removing the rest of the bolts. With one bolt left, the flange opened, engulfing Plaintiff’s Decedent in hot steam water and mud. Plaintiff’s Decedent was burned over 95 per cent of his body. Plaintiff’s Decedent expired the following morning.

Hospital & OB-GYN fail to order a c-section; Cerebral Palsy

Case Name: Baby Girl v Hospital and OB/GYN. Settlement: $3.25 Million with the assistance of facilitation. This is a claim of medical negligence in the management of the birth and delivery of Baby Girl at Defendant-Hospital. At 40 weeks gestation, mom presented to the hospital with spontaneous rupture of membranes. Amniotic fluid was ample and clear. Pre-natal management was unremarkable. A physician examined the patient. Fetal heart tones on fetal monitor were noted as good and reassuring. At approximately eight hours later, a pattern began to emerge on the fetal monitoring strip of one of minimal to absent variability and prolonged and late decelerations. There was an under appreciation by the Defendants, including the OB/GYN and the Hospital nursing staff that changes were occurring. The ominous pattern continued to progress, yet, no action was taken towards delivery or discussions regarding Cesarean section. Approximately another hour and a half later, the infant was born without spontaneous respiration. Resuscitative personnel had to be called into the delivery room, at which time the baby was intubated for a short period of time. The baby remained floppy, pale and limp with a cord blood gas of 6.82. Blood cultures were drawn, which later revealed negative findings. Blood work at the time revealed normal white blood count. Also at the time, the baby had a normal temperature. The baby was transferred to another hospital for intensive care management, at which time during that hospital stay, the baby developed rhythmic movements potentially a seizure. A CT scan at approximately 38 hours of age revealed cerebral edema, consistent with hypoxic ischemic encephalopathy. Claims against the Defendants were: in failing to recognize and appreciate the signs and symptoms of a non-reassuring fetal heart tone and to order timely Cesarean section. That the labor and delivery nursing staff failed to appreciate the signs and symptoms of fetal distress and to call this to the attention of the Defendant-OB/GYN in a timely manner. Given testimony provided by the Defendant-OB/GYN at the time of deposition, the Defendant, too, did and would have failed to appreciate the signs and symptoms of fetal distress and, therefore, the nursing staff would have had the responsibility to go up the chain of command to see that the interests of the infant were being met within the standard of care. Plaintiffs relied on the expertise of physicians in various specialties: obstetrics and gynecology, neonatology, neuro radiology, pediatric neurology, placental pathologist, life-care planning and an economist. The Defendants set forth a defense that the fetal monitoring strips did not reveal ominous signs and symptoms of fetal distress (although testimony was inconsistent between their own experts). The main defense was one of placental and fetal infection, in which they engaged two placental pathologists, one that had been disqualified as an expert on causation in the State of Michigan, in another case. The Defendants’ pediatric neurologist and neonatologist relied on the opinions of their placental pathologist, opining that the most likely cause of the child’s brain damage was infection and in doing so, they merely played a game of statistics, totally disregarding the evidence of fetal distress and hypoxic injury. The Defendants did not have a neuro radiologist to refute Plaintiffs’ neuro radiologist’s opinions. This baby has been diagnosed with cerebral palsy, is spastic, is quadriplegic, precocious puberty, blind, is fed by a feeding tube, is in need of 24-hour care and is being taken care with unconditional love by her mom, dad and younger sister. The settlement was reached through the assistance of a facilitator with a non-disclosure agreement.

Hospital let patient sit in chair 18 hours after abdominal surgery!!

Plaintiff vs. Defendant Hospital Regarding Settlement $175,000.00 Settled following case evaluation, days before trial Facts: This is a medical malpractice action where Plaintiff, after abdominal surgery, was allowed to sit in a chair in his room from approximately 6:00 p.m. on the day of surgery until the following day at approximately noon, approximately 18 hours in a chair while on pain medication with an epidural in place. There was no indication in the notes that he was moved, shifted or whether skin integrity was assessed. Further, the nurses admitted this was the timing of the duration which he was sitting in the chair. As a result, Plaintiff developed severe and painful decubitus ulcers on his buttocks and feet, experienced numbness in his toes and impaired paresis of both lower extremities resulting in the need for extensive physical therapy, the need to wear braces and utilize a cane. Plaintiff was a vibrant 72-year-old at the time of this elective surgery for the resection of a benign gastrointestinal mass. He was working part-time in law enforcement, a job which required both agility and mobility on his feet. The defense was based on the testimony of the day and night shift nurses that Plaintiff refused to go to bed. The nurses indicated there was nothing more they could do. The nurse supervisor, however, indicated that the nurses could follow the chain of command and seek assistance to mobilize Plaintiff and return him to bed. The Plaintiff does not remember the events after surgery until he was lifted from the chair around noon – feeling skin ripping from his buttock. Plaintiff relied on the expertise of a registered nurse and a neurologist, who testified that it was below the standard of care to allow a patient to sit in a chair for over 17 hours, and that clearly the ulcerations and the nerve damages experienced was secondary to allowing him to remain in the chair without pressure relief. Plaintiff’s expert neurologist performed an IME examination and testified that as a direct result between the damages inflicted and the patient’s positioning, the Plaintiff sustained bilateral sciatic neuropathies as a result of being in the chair for a prolonged time. This resulted in direct damage to the sciatic nerve fibers and their blood supply, resulting in permanent neurologic impairment. Defendant claimed that Plaintiff had neurologic impairment to his lower extremities due to his diabetes prior to his admission, that Plaintiff had a history of refusing treatment a couple of times, and that on this day he refused to go to bed. At the time of the incident, Plaintiff was working part-time as indicated, living at home with his wife. He was extremely independent, an avid photographer and artist, and enjoyed his law enforcement work. He had been married 53 years. His wife had developed Alzheimer’s, and as a result of his neurologic impairment he was unable to care for his wife, who then needed to be placed in a senior care nursing home. Rehab consisted of learning to walk again. Plaintiff’s right ankle would flex out to the right and make it difficult to walk. There was and is no feeling. Plaintiff has fallen and stumbles frequently due to inability to feel pressure of stepping on his foot and has a constant sense of losing his balance. The nerve damage is permanent.

Tuesday, May 2, 2017

Motorcycle does not see tow truck cable, passenger dies. Who is at fault?

On May 30, 2011, Plaintiff, age 29, died a tragic and untimely death as a result of the negligence of the Defendants in the execution of their acts and towing responsibilities. The Plaintiff sustained injuries when the motor bike on which she was a passenger collided with a tow truck cable that was attached to a vehicle 70 or more feet away. This incident occurred in the Edison (or ITT) Corridor. On this particular day, a pickup and trailer were stuck in the mud and Defendant Towing Company was called to assist. As the Towing Company entered the property, a tow truck employee noticed a motorbike with a passenger making passes in the corridor. The tow truck operators proceeded to let out the cable and attached it to the front of the pickup. This cable was 3/4 inch in diameter and was twisted and oiled covered steel. Everyone agrees there were no markings on the expanse of the cable. The supervising tow truck operator testified he was not aware of the motorbike and had he known and been made aware, he would have taken the time of notify them of the potential hazard. The cable was pulled taut. The driver and The deceased Plaintiff, as his passenger, were heading toward the cable. The driver thought he could make a safe pass avoiding vehicles in the path. What he did not know and did not see was the dark wench cable stretched across the field. The only obstacle the experienced driver, could not negotiate was that which was not anticipated to be there, one he could not readily see. No markers, no cones, no flags, no reflector. The driver said that at a brief moment before he collided with the cable, he saw a tow truck operator waving his hands and then he hit. the driver would not have been able to stop in time to avoid the cable. It was only a matter of seconds. The bike struck the cable and threw them from the bike. The passenger (plaintiff) survived the hit and was talking, complaining of pain. The Plaintiff (passenger) died at the hospital approximately a half hour after the incident. Autopsy revealed that she had sustained multiple blunt injuries, amputation of a digit, impacted injuries to her torso, pulmonary contusions, lacerated liver and spleen, numerous rib fractures and fractures of the lumbar spine, secondary to injuries sustained by impact. The Towing Company failed to ensure site safety. It was not reasonable and prudent to stretch cable over 70-80 feet without demarcation. The Towing Company was negligent in the performance of their duties by failing to alert bystanders of this danger. Defendants created the peril and failed to warn. As a result of their negligence, a person died of injuries sustained as a result of traumatic impact. The award against Defendant Towing Company through binding arbitration ordered by the Court was $900,000.

Family Doctor Fails to Notice Limp Limb in Infant. Hip Dysplasia

Minor Plaintiff vs. Defendant Family Practitioner State of Michigan $127,500.00 settlement. This is a medical malpractice action based on defendant family practitioner’s failure to timely diagnose congenital hip dysplasia in minor Plaintiff. Minor Plaintiff was born with congenital hip dysplasia (“CHD”) that was not diagnosed until 14 months of age. Surgery ensued, casting, immobility and medical attention followed. As a result of the delay, minor Plaintiff was subjected to additional and more invasive surgeries, required additional medical follow-up and experiences disfiguration, has an abnormal gait, has increased risk of avascular necrosis and will likely need hip replacement when older. Defendant pediatrician saw minor Plaintiff routinely during her first year for well visits. During these visits defendant should have diagnosed hip dysplasia and did not. Congenital hip dysplasia occurs when a child is born with an unstable hip due to abnormal formation of the hip joint during the early stages of fetal development. Another name for this condition is developmental dysplasia of the hip. The ball and socket joint in the hip may sometimes dislocate. Statistics show one out of every 1,000 infants is born with a dislocated hip. The cause is unknown. The standard of care is to screen for congenital hip dysplasia from birth and throughout the first year of the child’s life. The most common screening method is a physical examination where the pediatrician will gently maneuver the child’s hips and legs while listening for clicking or clunking sounds that may indicate a dislocation. These tests are generally utilized for children up to three months of age. The instability worsens with age. Older babies’ findings that indicate CHD include limping, limited abduction and a difference in leg lengths if they have a single hip affected. Imaging tests can confirm a CHD diagnosis. If detected early enough, a child may be placed in a harness which abducts the hip by securing their legs in a frog-leg position. The baby may wear this harness for 6 to 12 weeks depending on their age and the severity of the condition. Also, the baby may need to wear the harness full time or part time. If the harness application is unsuccessful, surgery is generally indicated. After the baby’s hip is placed into position, their hips and legs will be casted for at least 1-2 months in a SPICA cast. In this case, minor Plaintiff was not afforded treatment at an early age, and therefore extensive open reduction surgery was necessitated. It is estimated that between 80 and 95 percent of cases identified early receive successful treatment, depending on the severity of the condition. The complicated and more invasive treatment is less likely to be necessary when the doctor identifies the CHD early and provides appropriate treatment. Once treated, the child will likely continue regular visits with an orthopedic specialist to insure the hip is growing normally. In this case, defendant pediatrician examined minor Plaintiff at 9 days, 14 days, 8 weeks, 4 months and 6 months. By the age of six months, the minor’s parents observed asymmetrical folds in her right thigh and buttocks area and informed defendant doctor of the same at the six month visit. There is no mention by defendant physician of the concerns conveyed to her. The abnormalities in skin folds were still present again at the nine month visit, and then the 12 month visit. Again, no mention was made in the record. Shortly thereafter, minor Plaintiff began to walk and had an obvious limp, was walking like she had one high heel on and noticed one leg was longer than the other. Plaintiff mother knew an orthopedic doctor and discussed the minor’s condition with him. An x-ray revealed “suggestive of congenital right hip dysplasia.” A physical examination revealed that the right leg was externally rotated with a mild limp. The note indicates that the parents noted asymmetric thigh folds approximately six months ago, and that this was brought to the attention of the pediatrician, who told them there was nothing to be concerned about. Surgical consultation was recommended. The procedure performed was a femoral shortening, right abductor tenotomy with right hip open reduction. Minor remained in a SPICA cast for the next 6 weeks and underwent physical therapy thereafter. At 18 months, minor could stand but not walk. Minor presented again with hip dislocation and further surgery was recommended, with a Salter or Dega osteotomy to obtain better coverage for the right femoral head. Minor underwent therapy and today continues to exhibit a limp when walking and gallops when running. Plaintiff relied on experts in family practice medicine, and a treating orthopedic surgeon. Defendant violated the applicable standards of care by failing to carefully evaluate the range of motion and flexibility of minor Plaintiff’s hips and legs during her well visits. Defendant failed to recognize that asymmetrical folds in the buttocks and/or thigh of the minor were suggestive of hip dysplasia and warranted further evaluation, early diagnosis of hip dysplasia and treatment. Had defendant performed the appropriate evaluation with careful detail as per the standard of care towards hip range of motion and flexibility, performing certain maneuvers, congenital hip dysplasia would have been diagnosed, an ultrasound or x-rays should have been performed, and a referral to a pediatric orthopedic surgeon should have been made. Defendant claimed that thorough examinations were done within the standard of care, and that the condition only presented itself at 6 month of age or later and surgery at that point would have been the same, with the same outcome. As a direct and proximate result of defendant’s negligence, minor Plaintiff had an undiagnosed and untreated hip dysplasia which worsened significantly as she got older. Her risk of avascular necrosis, additional surgeries, abnormal growth of the femoral head, future delayed socket development and leg length discrepancy are all continued risks. Hip replacement surgery is most likely in the future, with revisions as she ages.