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The wife of an active duty serviceman elected to have breast augmentation in 2009 while living in Nevada.  She specifically requested 300cc implants.  At the time of the surgery, there were no 300 cc implants available so the surgeon placed 250cc implants and overfilled them to 270cc each.  She is unsatisfied with the outcome and is seeking $150,000 in damages for pain and suffering, mental anguish and travel related expenses.

The couple now live in Virginia and the story was seen in the Virginian Pilot.  The repeat surgery is said to cost her $6,500 if done in Virginia.  It is reported that settlement talks failed so the suit was filed.

Certainly if the surgeon agreed to place 300 cc implants and didn’t, he does have some explaining to do, however, the difference in implant size is only 30 ccs.  This is the equivalent of two tablespoons.  Is it really worth going through additional surgery for two tablespoons?  According to my research, assuming the woman had no natural breast tissue at all, 330 ccs would equate to a full C cup.  I would be hard pressed to undergo surgery for two tablespoons myself.  She should be compensated, perhaps a refund of the fees paid for the original surgery, but $150,000?  Wouldn’t any “mental anguish” she might have from feeling inadequate in size have been improved with the 270 cc implants she did receive?

What do you think?

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Tenants at Elsie Mason Manor and Ligutti Towers in Des Moines filed suit against the apartment managers and owners secondary to what they claim is bedbug infestation.  The tenants complained that they’d been repeatedly bitten, forced to discard infested furniture and shunned by relatives and by other landlords now too afraid to rent to them.

The Des Moines Register has reported that court papers have been filed in Polk County, Iowa claiming that apartment managers/owners knew about the infestation, but failed to warn tenants or to properly treat the problem until after they had been sued.  They are seeking class action status for the lawsuit on behalf of around 300 current/former tenants.  The suit claims that this infestation began as early as October 2007!

The group’s attorney, Jeff Lipman is seeking money for back rent, lost property and other hardships suffered because of the bedbug problem.

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A class-action lawsuit has been filed against DePuy Orthopaedics, Inc. a subsidiary of Johnson & Johnson over a hip replacement implant that was recalled earlier this year due to a high failure rate. According to a study published in Britain, 13 percent of patients that received the ASR XL Acetabular System hip replacement had to have revision surgery within five years.   This recall of the faulty hip replacement devices has affected around 93,000 people. The suit claims the company, DePuy Orthopaedics, misled patients to believe they were going to be reimbursed for the costs of their “revision surgeries.” Patients released their medical records to DePuy under that assumption, the lawsuit states.  The lawsuit contends that the company should have known the device was defective prior its sale to patients. The suit will potentially cover any patient who received a DePuy hip replacement in the last seven years.

DePuy is owned by Johnson and Johnson, whose slogan is:  “A family company.”  Reading these articles makes one wonder if any of the Johnson family was ever implanted with one of these faulty hip replacements.  Guessing the answer would be no.

We are talking 93,000 possible patients affected, worldwide.  Most of these individuals are older folks, who are more affected by anesthesia, less tolerant of the excruciating pain involved in hip replacement surgery, have longer duration of physical therapy treatment and are most likely have other conditions that affected the need for the surgery, which will further complicate matters.  In addition, for many of these patients, nursing home care will be required, with the attendant risks for the patient of being in that environment.

According to one of the law firms involved:

“Hip replacement surgery is among the most painful and disruptive surgeries an individual may have to endure. Once is certainly enough, but to undergo the procedure twice, and as a result of a defective implant is almost unimaginable,” said Seth A. Katz, Burg Simpson shareholder, and one of several attorneys working on this case.

Mr. Katz continues, “When medical devices such as DePuy’s ASR XL Acetabular System fail, the impact on a patient’s life can be devastating. Given the large number of devices recalled, it is conceivable that thousands of individuals across the United States may unknowingly need revision surgery, even if they are currently not experiencing any pain or discomfort…”

Added to that is the duplicity of DePuy in giving the impression that by the patients’ sending their medical records, the company would cover the expense of revision surgery, when it appears that the primary purpose of that request was to get their “ducks in a row” for the lawsuits they saw looming over them.

As a Nurse Life Care Planner, there are any number of considerations that will need to be evaluated in order to assess the ongoing damages to these patients:

• Overall status of these patient’s general health both for patients who have had revision surgery and those who will have to undergo the surgery again.  Including co-morbidities brought about by additional surgery and the resultant hospitalizations.
• What will be required for them to return to work and activities of daily living?  Physical therapy, assistive devices, nursing home care, home health care, etc.
• They could require a pain management specialist as this surgery and recovery is painful.  The effects of these medications should be reviewed.
• Particularly for the elderly patients, the services of a Case Manager will be needed to ensure continuity of care.

Related articles

• DePuy Hip Replacement Recall Prompted by Recurring Hip Dislocations and Serious Pain in Patients (prweb.com)
• Important Hip Replacement Recall Information from DePuy Hip Recall Lawyers (prweb.com)
• Rottenstein Law Group Recommends DePuy Hip Replacement Recipients Consult New Doctors About Revision Surgery (prweb.com)
• Recall for Hip Replacement Devices Required (first4lawyers.com)

A Michigan woman has filed a lawsuit against the Waldorf-Astoria hotel in New York City, claiming the room she and her husband stayed in was infested with bedbugs. The couple stayed in the hotel in May and said they were bitten constantly by the bedbugs and also carried them back to their Michigan home, infecting their two daughters. The suit is seeking unspecified damages to cover emotional distress as well as the cost of fumigating their home.  Reuters

Honestly, I have never seen a bed bug, and I have never been to the Waldorf-Astoria, but I do know that this bed bug infestation is growing and growing.  I have written about this several times before; here and here.  Allegedly this couple spent $4,500 to exterminate the little creatures. New York seems to have really been hit hard.  I wonder how @TakeTwo is handling this.

I travel a lot which means I stay in many hotels.  I am beginning to think that perhaps I should order that sleep sack I keep eying in the Sky Mall magazine!

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• Video: Bedbug Lawsuits Growing (cbsnews.com)
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As discussed on a recent blog post regarding patients who do not speak English well, it is never appropriate for a family member to interpret.  Medical interpretation requires that interpreters be a separate non-party as to ensure that the information being transmitted is the complete information and without bias.

I have a friend who is a sign language interpreter and has accompanied me on several visits with deaf clients.  In fact, I wouldn’t dream of visiting a deaf or hard of hearing client without an ASL interpreter.  Not only would that create unnecessary stress for the patient, but leaves a huge possibility for errors and liability.

If those reasons aren’t enough, it is the law to provide an ASL interpreter for these individuals.

I must say that I have a great deal of respect for the affected patients—they aren’t asking for millions in damages or for anything other than Baptist Hospital in Jacksonville be forced to provide ASL interpretive services.

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A Virginia man has filed a $1 million lawsuit against a local PetSmart, claiming he slipped and fell on a pile of feces in the store. Robert Holloway accuses the manager and store employees of failing to create a safe environment for customers in the store. He claims in his lawsuit that the fall injured his back and head and knocked out four of his teeth.  Staff Report, The Washington Post 04/01/2010 Read Article: The Washington Post

I am not sure how one falls onto their back and knocks out four teeth at the same time, but it makes for an interesting headline!

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Let me say right off the bat that my heart goes out to these parents and their child.  As those of you who read my blog know, I have grown kids of my own and am expecting two new grandbabies this summer.

At the same time, this is an opportunity to remind parents, grandparents and others who have children under their protection to please, please never use items that are not specifically intended for children.  Unless an item specifically states that it is for the use of children don’t buy it—no matter how cute it would look in “little Sally’s room.”

As a Nurse Life Care Planner, these types of cases are especially heartbreaking, because without even putting pen to paper, I have a good idea of the millions of dollars in future medical costs and sacrifices this family will have to make over the course of this little girl’s lifetime.  That misery will be heaped onto the guilt the parents must surely feel as well as the devastation of what might have been this little girl’s life.

Have you been involved in the litigation of a personal injury or medical malpractice case?  Are you pursuing compensation through our legal system for an injury you sustained?  If the answer is yes, this post is for you.  

So, what exactly is a deposition?  A deposition is a process of interviews that allows both sides of the case to “discover” what will likely affect the case based on the testimony of the witnesses, including potential experts.  Depositions will usually take place in an attorney’s office, in the conference room with a court reporter that will dictate the proceedings.  As an expert witness I have been involved in several depositions.  Most take place in a conference or other meeting room and are attended by both plaintiff and defense attorneys as well as the court reporter.

Instructions will be given to speak clearly and to avoid ‘umms’, ‘uh’s’, and ‘huh’s’ due to the fact that it makes reading the deposition difficult and distracting.   Instructions will also be given to avoid answering questions with nonverbal means, like nodding of the head or shrugging of the shoulders.  The court reporter has a difficult time translating the information if it is nonverbal in nature.  Be careful to wait until the complete question was asked before answering or the court reporter will have to interject your answer in mid question. 

The following are additional recommendations to keep in mind when you are in the deposition position:

1.  Listen to the instructions carefully.  If there is something you don’t understand, ask!
2. Take your time to answer the question.
3. Answer the question only.  Do not elaborate.  Keep it short!
4. If your attorney objects to a question, stop talking immediately.  Your attorney knows what is best for your case.
5. Don’t make jokes, use sarcasim or try to be cute!  That only implies that you are nervous and uncertain of your case.
6. Silence is golden!  Don’t fill the air with rambling or jokes….make them sweat it out for you.
7. Maintain eye contact.  It will show you are confident and that you cannot be intimidated.
8. Avoid getting angry!  If a question upsets you, don’t react from your gut.  Take a break!
9. Take a break!  This cannot be said enough.  You have a right to request a break at any point during the deposition.
10.  Attorney-client privilege.  What you say to your attorney stays with your attorney.  Don’t volunteer information.

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A few days ago, news broke out that several individuals had suffered from hair loss after having CT scans of the brain.  The majority of cases were reported at hospitals in Los Angeles and Glendale, California.  Then, yesterday, news broke of a young lady who had a CT scan of her brain after experiencing seizures.  Shortly thereafter, she began to lose her hair, and the doctors were dumbfounded as to the reason why.  That was until she received a letter from the CEO of the hospital.  He wanted to notify her that she was exposed to high levels of radiation.  The following link is the story from the local news station in Huntsville, Alabama.

Yesterday, a lawsuit was filed against GE Healthcare, the maker of the CT scanner that allegedly delivered 8 times the amount of necessary radiation.  The class action lawsuit, naming 16 plaintiffs, was filed in Huntsville, AL in the amount of $5 million dollars to cover future medical costs associated with the exposure.  The lawsuit  “claims GE Healthcare carelessly researched the design and failed to adequately test” its products, and that the scanners lacked safety features to warn of overdoses.” (http://www.newsinferno.com/archives/17531 ) 

 However, it is important to note that the FDA’s investigation of the CT scanners included more than one brand of scanner.  The initial report in October 2009 by the FDA, stated that this occurred at one facility.  However, there are more instances of occurring across the country.  Common immediate symptoms of excessive radiation include hair loss and a skin rash.  If you have concerns, you can contact MedWatch, the FDA’s voluntary reporting program. This can be done on-line by filing a voluntary report, by phone at 1-800-FDA-1088, or obtain the fillable form online, print it and fax to 1-800-FDA-0178 or mail to MedWatch, 5600 Fishers Lane, Rockville, MD 20852-9787.

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When people find out I am a nurse the first question is always, “What hospital do you work for?”  After I tell them I do not work for a hospital, it is usually followed by “Oh, what doctor do you work for?”  I then explain that I don’t work for a doctor, clinic or hospital, but rather I own a consulting firm.  “But I thought you were a nurse.”  Yes, I am STILL a nurse.

So you may be asking, “What exactly is a nurse consultant and what do they do?”  There are a variety of nurse consultants.  In my business we provide a variety of consulting services such as legal work, life care planning, case management and more.  I will address some of these different types of consulting in the coming posts, but first we will discuss legal nurse consulting.

The practice of legal nurse consulting began about 20 years ago as a way to assist others in understanding medical events within the legal practice.  Attorneys had previously used experts from various disciplines to support their cases.  Attorneys began to learn the value of what the nurse brought to the table.  The contributions to case development that nurses provide is a result of their collaborative experiences in healthcare. The legal nurse consultant is not a paralegal.  A legal nurse consultant’s value does not comes from a legal education but from his or her experience as a nurse and member of the healthcare team.  In certain practices a legal nurse might assume some of the duties of a paralegal.  Most importantly, the legal nurse consultant has been designated as a specialty area of nursing practice.  Those with the LNCC designation have met the rigorous requirements for certification and provide valuable information and insight to the beginning LNC. Also seek consultants who are associated with the American Association of Legal Nurse Consultants (AALNC); the professional association of legal nurses.

*The role of the legal nurse consultant in practice includes many facets – and multiple benefits to the client. These include, but may not be limited to:

• Letters to request medical records
• Tracking for accurate medical record keeping
• Define missing medical records
• Review any case where injury is at question
• Define the medical issues in a case
• Create a list of all parties involved in the case
• Generate research based reports
• Analyze and Define future medical needs of the injured client
• Analyze and Define medical issues in the case
• Analyze and Project future medical cost needs of a client
• Prepare the expert witness
• Recommend cost saving techniques for the attorney and client
• Define cost savings
• Work within a budget provided
• Identify testifying experts needed in a medical case
• Find and interview expert witnesses
• Research like-cases for the attorney client
• Attend Independent Medical Exams
• Provide recommendations for client safety questions
• Paginate and tab the medical file
• Provide demonstrative evidence in timelines and pictures for the client
• Generate a detailed chronology of the case
• Generate a meritorious based report
• Generate timelines of events
• Define the medical issues
• Educate the attorney client in the disease or the disease process
• Assess issues of causation · Assess issues of medical damages
• Create a medication list and their potential side effects
• Provide attorney support during depositions, discovery,trial and mediation
• Build the attorney client library with meritorious research
• Provide medical research regarding the disease and the disease process
• Assist in the production of interrogatories
• Assist the attorney in the development of case strategy
• Prepare the medical case for trial proceedings
• Provide current standards of care, policies and procedures in medical issues and define the appropriate testifying expert to speak to the issues
• Recommend Medicare Set Aside Allocations when appropriate, and Life Care Planning when appropriate
• Reviews a case for merit and provides recommendations to the attorney (in no way does this include the practice of law- the attorney client provides the final decision)
• The legal nurse consultant can explain and teach the medical record. She is a medical record expert. She can define and teach the client the meaning of all abbreviations within the medical case and provide explanation of the meaning of all acronyms
• Teaches the administration procedures and structure of the hospital, medical facility, nursing home, or other clinic setting to the attorney
• Consults with external persons to obtain a deeper understanding of the possible needs of the case i.e.; billing and coding,diagnosis and treatment needs, testifying expert needs
• Understands and keeps complete confidentiality with all cases in compliance with HIPAA
• The legal nurse consultant may provide testifying expert work, be a fact witness to the event, or complete work as an attorney product under confidentiality

The skills of the nurse as educator are among the most valuable in possession of the LNC. The LNC finds his or herself entrenched in the education of the attorney, legal support staff, and jury to assist in finding the truth and guiding them through the processes of discovery, mediation, and trial. I greatly enjoy my business as legal nurse consultant probably because I do greatly enjoy the education portion of my job as a nurse.  I work with both plaintiff and defense firms on all sorts of cases in which medical issues are of a concern.

*List created by The J.E.R.K. LNC (Juris Educational Resource Knowledge)