Bangor Medical Malpractice Lawyers Standing Up for Clients Hurt After a Medical Error
Whether you work construction, drive a truck or are in food services, there are rules and procedures you are, most likely, required to follow to do your job safely.
The practice of medicine should be no different.
Doctors and hospitals are required to have rules, procedures and ways of delivering medicine that keep patients safe. For examples, doctors are required to wash their hands between patients, so that they do not transmit an infection from one patient to another. Providers are required to document accurately in the medical chart. They are required to communicate with one another, especially at the beginning and end of a shift so that incoming providers will have the information they need to care for a patient. Providers are required to spend the time necessary to obtain a complete patient history and to order testing and follow up studies when necessary to ensure the patient’s safety.
When medical providers violate these common-sense rules, or when hospitals have no rules or procedures, or fail to hire, train and supervise personnel on how to follow their own policies, then there may be a strong claim of malpractice. The malpractice may be the negligence of a single provider, or it may be a “system failure,” in which the entire system of care (within a hospital, for example) failed to deliver reasonable medical care.
The lawyers at Gideon Asen have a long track record and specialized expertise in handling medical malpractice cases.
WHAT ARE THE 11 MOST COMMON TYPES OF MEDICAL MALPRACTICE CASE?
- Birth Injury.
These are cases that arise out of treatment provided throughout the pregnancy (prenatal), during the process of labor and delivery (perinatal), or immediately after the birth (neonatal). The “classic” birth injury case involves oxygen deprivation to the fetus that results in a brain damage to the baby called hypoxic ischemic encephalopathy; other cases arising out of prenatal, labor and delivery or post-natal period include maternal or neonatal death. Oxygen deprivation of an unborn child can result from a number of factors, including, among others, placental insufficiency, compression of the umbilical cord, placental abruption, infection, intra-uterine growth deficiency, and genetic factors.
- Spinal Cord/Nerve Injuries.
We see many cases involving spinal cord injuries, where negligence in identifying or treating a disease or condition that effects the spinal cord causes permanent paralysis of our clients. These cases tend to fall into one of three categories: (a) spinal infection/epidural abscess, (b) spinal epidural hematoma, and (c) mechanical compression or traumatic injury.
(a) Spinal Infection/Epidural Abscess. When bacteria or other type of infection invades the bones, discs, soft tissues, or space surrounding the spinal cord, pus or abscess can form and expand to compress the spinal cord or nerve roots. Typically, cases relating to spinal infection arise from a medical provider failing to order appropriate diagnostic imaging in a timely manner, or, having diagnosed the abscess, failing to prescribe antibiotics and surgically drain the abscess before it causes permanent paraplegia or quadriplegia.
(b) Spinal Epidural Hematoma. Similar to abscess cases, spinal hematoma cases involve compression of the cord or spinal nerves by an accumulation of blood (hematoma). Those who have had recent spinal surgery or an epidural catheter are most at risk for bleeding around the spine, but spontaneous hematomas can also form in patients who are on long-term anticoagulation medication.
(c) Mechanical Compression/Cauda Equina Syndrome. The spinal cord or nerves can be damaged by mechanical compression from an expanding osteophyte, herniated disc or traumatic injury. Where such processes cause a deterioration in the patient’s neurological function, medical providers must investigate and act rapidly before the patient becomes permanently paralyzed.
Sepsis is a leading cause of death in America, and there are well-established treatment guidelines and algorithms that should be followed to ensure that the diagnosis is not missed. Unfortunately, we frequently see cases involving patients sent home from a primary care providers or walk-in clinics with alarming signs and symptoms of sepsis, including dangerously low oxygen saturation levels, tachycardia, hypotension, increased respiratory rate, and/or high fever. When sepsis is missed, the patient often goes on to die from an infectious process that was treatable with timely intervention. Of course, there are many other types of missed infections—including bacterial endocarditis (infection of the heart valves) and bacterial, viral or fungal meningitis—all of which can form the basis of a medical malpractice claim.
- Cardiac Care.
Heart attack, or myocardial infarction, is another leading cause of death in America. Yet, despite frequent public service announcements advising people to see their doctor with non-specific pain symptoms (such as jaw pain, heartburn, arm pain) that are consistent with heart attack, we regularly see cases where patients with these types of symptoms are discharged by family doctors, clinics, or emergency departments without cardiac workup. Unfortunately, these patients frequently go on to die of preventable heart attacks, or else suffer permanent and debilitating damage to their hearts.
- Delayed Diagnosis of Cancer.
We routinely see and evaluate cases involving claims of delayed or missed cancer diagnoses. Typically, these claims concern either patients whose symptoms merited workup for cancer, or patients who were worked up for cancer but whose tests and imaging were misinterpreted or not followed up appropriately (for example, by more advanced testing or a biopsy to confirm or rule out the cancer diagnosis). As will be discussed in detail in a future article, these cases can be difficult, because the plaintiff has the burden of proving that earlier diagnosis and treatment would have changed the patient’s treatment options and long-term survival. Likewise, some or all of the missed cancer findings may have occurred beyond the three-year statute of limitations for bringing medical malpractice claims, and unlike most states, Maine has no discovery rule for medical malpractice claims.
- Pulmonary Embolism.
A pulmonary embolism is a blood clot that forms in the body (usually the deep veins of the legs) and then migrates to the lungs. Once there, it disrupts the normal oxygen exchange and can cause serious injury or death. We regularly see cases in which providers fail to have an appropriate index of suspicion for this disease in high-risk patients who present with signs and symptoms suggestive of pulmonary embolism (coughing, low oxygen saturation, history of deep vein thrombosis, etc.).
- Acute or Chronic Limb Ischemia.
Another common fact pattern that we see involves patients who suffer limb amputations as a result of a lack of blood flow (ischemia). Typically, this happens because a blood clot develops in a critical artery supplying blood to the effected limb. This can be an acute event where a previously patent artery becomes suddenly blocked by an embolism or thrombosis of the vessel, and the limb turns cold, blue and pulseless. Or the vessel can become occluded gradually over time. Either way, if the condition is properly diagnosed and blood flow to the limb is restored (using anticoagulants, thrombolysis, or vascular grafting) before the limb becomes necrotic and gangrenous, the limb can most often be saved.
- Intra-Abdominal Process/Surgery.
Over the years, we have seen many cases involving intra-abdominal processes, often following abdominal-area surgery, including gall bladder surgery (cholecystectomy), bariatric surgery, pancreatic or liver surgery, prostate surgery, hernia surgery and aneurism surgery. Typically, the cases involve post-surgical complications, such as damage to the biliary system or bowel causing bile or fecal leakage into the abdominal cavity (peritoneum). If such complications are not identified and addressed right away, bacteria enter the peritoneum and can cause peritonitis, sepsis, and death. Similar complications may occur with any type of surgery.
- Retained Objects and Wrong-Sided Surgery.
We occasionally see cases involving so-called “never events,” such as retained foreign objects (surgical sponges or other equipment used in the surgery) or surgery to the wrong body part or limb.
- Medication Errors.
We regularly see cases involving patients who have been administered an incorrect dose or the wrong medication. Particularly if the patient has a medication allergy; if the patient suffers the synergistic effect of multiple medications; or if the patient becomes overdosed on a dangerous drug, like opioids, the effect of such a medication error can be catastrophic. Sometimes, the negligent party is a provider or hospital; on other occasions, the negligence party is a pharmacy.
- Eye-Related Injuries.
We see cases involving eye injuries causing severe vision loss or blindness. Perhaps the most common fact pattern involves a failure to monitor patients who take Plaquenil (Hydroxychloroquine), which is used to treat the autoimmune disease, Lupus. If unmonitored, this medication can cause toxicity in the eyes that leads to permanent blindness. al malpractice cases.
HOW DO I PROVE A MAINE MEDICAL MALPRACTICE CASE?
Access to Highly-Qualified Experts
In Maine, as in most states, proving a medical malpractice case requires expert testimony. If you accuse a doctor in a particular medical specialty of negligence, you must have an expert in the same specialty willing to testified that the defendant doctor acted unreasonably and thereby breached the standard of care for doctors who practice in the same specialty.
Because expert testimony of a practitioner in the same specialty is required, medical malpractice cases often require multiple medical experts in order for the plaintiff to meet her burden of proof. For example, in a case involving the failure of a hospital to diagnose a heart attack in the emergency department and after admission to the hospital, the plaintiff may need to present the testimony of an expert in emergency medicine (an ER doc), hospital-based medicine (a hospitalist) and a cardiologist.
In most cases, both sides have opposing experts in each medical specialty. Because so much turns on the experts, having access to the highest quality experts with the best qualifications and most credibility is paramount. At Gideon Asen, we regularly work with the most elite, highly qualified doctors from the best hospitals in the U.S., including Massachusetts General Hospital, Brigham & Women’s, Beth Israel Deaconess, Leahy Clinic (all in and around Boston), Columbia Presbyterian and NYC Langone Medical Center (in New York City), Yale New Haven Medical Center (New Haven, CT), Johns Hopkins (Baltimore), Cleveland Clinic, University of Pittsburgh Medical Center, University of Chicago Medical Center, and many more. We search long and hard in each case to find the best, most highly qualified experts to testify for our clients and help us win the case.
Use of Technology, Video and Animations in the Courtroom
When we present a medical malpractice case at a panel hearing or trial, we use the latest, cutting edge trial presentation technology that allows us to project any one of hundreds (or thousands) of pages of documents and exhibits on a large video screen in front of the jury with the touch of a button. Once on the screen, we can highlight, enlarge, rotate or compare images to enable the jury to see and understand our case.
Our personal injury attorneys in Portland also pioneered the practice of videotaping every deposition, so that we are able to capture not only a witness’s verbal testimony, but also his or her non-verbal communication, body language, facial expressions and demeanor. A case can be one of lost on a single witness’s shifting eyes, pregnant pauses or other non-verbal cues that most lawyers do not capture in a paper transcript.
Once we have the video, we use it extensively in the courtroom. If a witness testifies to something at trial that is different from what he said under oath during the deposition, we don’t just point to the paper transcript. We pull up the videotape and play the clip of the witness contradicting himself. It is powerful in a courtroom and is just one more important tool to give our clients an edge.
Finally, we believe strongly that anything important we want to communicate to a jury should be communicated not just orally, but also visually. Most people are visual learners. Without visuals, many jurors may struggle with some of the complex medical concepts involved in a malpractice trial. We regularly work with some of the most sophisticated trial animation and graphics companies in the U.S. to develop animated exhibits which we use to help present our case to the jury.
HOW DO MEDICAL MALPRACTICE CLAIMS WORK IN MAINE?
Maine has a special judicial process just for medical malpractice claims. For most other types of civil cases, the case is commenced by filing a complaint in one of Maine’s county courthouses (the Superior courts). For medical malpractice cases, the case is commenced by filing a notice of claim in Superior court. The notice of claim triggers a pre-litigation screening panel process, which must be completed before the complaint can be filed. Typically, the pre-litigation process lasts approximately 10 – 12 months.
Here is some additional information about Maine’s medical malpractice screening panel process:
Maine’s Medical Malpractice Screening Panel Process
- State-law medical malpractice claims must be screened through the pre-litigating screening panel process before the action can be commenced by filing a complaint in superior court (unless the parties agree to waive the panel process).
- The panel action is commenced through the filing of a notice of claim in superior court. The notice of claim is signed by the client under oath. The court then appoints a panel chair to preside over the case.
- The panel chair issues a scheduling order, and the parties conduct discovery, including depositions of fact witnesses and experts.
- The panel chair empanels a lawyer and a medical provider in the same or similar subspeciality as the respondent provider to sit on the panel for the case.
- After competition of discovery, the parties submit detailed panel briefs, medical records, and depositions transcripts to the panelists.
- The panel chair convenes a panel hearing, at which the parties present live evidence to the panelists.
- The panel issues a decree. Each panelist has one vote on each of the following questions:
1. Whether the acts or omissions complained of constitute a deviation from the applicable standard of care by the health care practitioner
2. Whether the acts or omissions complained of proximately caused the injury complained of
3. If negligence on the part of the health care practitioner or health care provider is found, whether any negligence on the part of the patient was equal to or greater than the negligence on the part of the practitioner.
- If the panelists are unanimous in support of claimant or respondent, then the party with unanimous findings may present the panel decree (subject to a carefully crafted jury instruction) to the jury at trial. The jury may (but is not required to) consider the panel decree as one piece of the evidence submitted at trial.
HOW LONG DOES IT TAKE FOR MY SETTLEMENT TO BE AWARDED?
Unlike other types of cases, medical malpractice cases are not subject to Maine’s mandatory alternative dispute resolution (ADR) rule, because they go through the panel process instead. However, if a claimant wins a unanimous decree before the panel, it is common for the medical provider and his or her insurer to request the opportunity to mediate the case on a voluntary basis, and to make an effort to settle the case soon after the panel hearing. This means that some cases will be in a good position to settle approximately a year after the notice of claim is filed. Even when a claimant does not win a unanimous decree, there may be an opportunity to settle the case if the claimant’s evidence before the panel was strong and would be the kind of evidence that might provide the claimant with good chance to win the case at trial before jury.
Special Insurance Considerations In Medical Malpractice Cases
In Maine, a large majority of the private (non-governmental) health care companies, hospitals and individual providers are insured by the same medical insurance company called Medical Mutual of Maine. This is a mutual insurance company formed and managed by the health care providers themselves, so it subscribes to special rules that do not apply with other types of insurance companies.
The most important of these special rules is that medical providers must provide consent before the insurance company is permitted to settle any case. In other words, insured doctors can veto any settlement by refusing to grant consent. This protects doctors who prefer to fight the case all the way to the courthouse and have the jury decide.
WHY SHOULD I HIRE A MEDICAL MALPRACTICE ATTORNEY FOR MY CASE?
As you can see, to succeed with a medical malpractice case requires an enormous amount of experience, expertise, skill and resources. Personal injury Attorneys in Bangor who do not regularly handle medical cases can quickly before overwhelmed or out of place in a process they do not understand. The skilled medical malpractice lawyers at Gideon Asen are best positioned to provide you with the advice and representation you will need to prosecute and win your medical malpractice case.
WHAT CAN I DO NOW?
If you trusted a healthcare professional or facility and they failed you, you need to have a skilled legal team on your side who can aggressively represent you and stand up for your rights. Gideon Asen LLC focuses on medical malpractice cases in Bangor and all over Maine, Vermont, and New Hampshire. We serve every customer with individualized attention, professionalism, and compassion. Our legal team will build the strongest case possible on your behalf, and we don’t shy away from courtroom battles if that is what it takes to secure the fair compensation you deserve. If you have been injured due to a preventable medical error or negligence, contact us at (207) 206-8982 to learn your options.