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In this blog, I’ll be addressing personal injury cases, specifically motor vehicle accidents, one of the seven types of cases Barber Medical Legal Nurse Consulting, LLC can review. In the event of a personal injury case involving a motor vehicle accident (MVA), the plaintiff has a history of ankylosing spondylitis (AS). The plaintiff has a 5-year history of low back and bilateral hip pain.  Status post MVA, the plaintiff reports worsening mid to low back and left hip pain with a new onset of left leg pain radiating down the full length of extremity associated with numbness and tingling making it difficult to stand or walk for long periods of time.

 Is this a non-meritorious case secondary to a pre-existing medical condition?  Or, is this a meritorious case secondary to exacerbation of a pre-existing medical condition as a result of the MVA?

Per Patient Safety in Surgery, cited in Pitfalls and complications in the treatment of cervical spine fractures in patients with ankylosing spondylitis, (AS) is:

• A chronic system wide inflammatory rheumatic disorder primarily affecting the axial skeleton (sacroiliac joints and spine)
• Characterized by remissions (reduction in severity of disease symptoms), and exacerbation (acute increase in severity of disease symptoms).  Exacerbation’s can be triggered by traumatic incidences, such as an MVA.  Exacerbation’s should be distinguished from traumatic lesions which have been reported to occur in rigid AS spines (which usually resolve within two weeks.) 

>The defense is likely to argue that the damages were unavoidable and were due to a pre-existing condition of AS.

The below links are useful resources specific to AS with a great case study in the first link provided:

Handle with care: the dangers of cervical spine fracture in patients with ankylosing spondylitis. (Cases in Point). https://link.gale.com/apps/doc/A97295577/HRCA?u=nysl_ca_sal&sid=bookmark-HRCA&xid=f46a940f   

Pitfalls and complications in the treatment of cervical spine fractures in patients with ankylosing spondylitis. https://link.gale.com/apps/doc/A181172821/HRCA?u=nysl_ca_sal&sid=bookmark-HRCA&xid=35390642

P.S. Comment and share what your thoughts are about the merits of the case based on the limited information provided

P.P.S. Comment and share if you have experience with a personal injury case involving a plaintiff with a history of AS. How did this medical history impact the outcome of the case?

In this blog, I’ll be discussing toxic tort, one of the seven types of cases Barber Medical Legal Nurse Consulting, LLC can assist plaintiff and defense attorneys with.  The medical knowledge, combined with the ability to review large volumes of records and integrate learned knowledge into case analysis, assists clients with successful outcomes.

MOVE TO FEDERALLY REGULATE PFAS (“FOREVER CHEMICALS”)

On October 18, 2021 the Washington Post published an article announcing that the Biden administration will be moving to Federally regulate PFAS (“forever chemicals”).  These long-lasting, human-made chemicals pose many environmental and health risks.  These “forever chemicals” remain unregulated by the federal government.

The State of New Jersey was the first state to publish drinking water standards for Perfluorooctanoic acid (PFOA) and Perfluorooctane sulfonic acid (PFOS) (both collectively known as PFASs) in 2020 in the absence of federal regulations.  The State of New York adopted drinking water standards that went into effect in 2019. 

APPLICATION AND HEALTH CONSEQUENCES 

“Forever chemicals,” continue to be used in an array of products such as cosmetics, dental floss, food packaging, clothing and cleaning supplies.

According to the U.S. Department of Health and Human Services, Toxicological Profile for Perfluoroalkyls, PFAS has a long half-life in the human body causing bio-accumulation.  PFOA and PFAS are resistant to degradation by natural processes such as metabolism and are persistent in the environment because of their durability.  Over a period of time, the chemicals make their way into soil, water, food and even blood, potentially harming public health.   

Multiple peer reviewed studies demonstrate that exposure to PFAS at certain levels can lead to infertility risks, thyroid disease, certain types of cancers, gestational hypertension, and developmental problems in children.

CONSEQUENCES OF FEDERAL REGULATION

 Once mandatory Federal standards come into effect, it is believed that local water utilities will face penalties if they fail to meet them.  Additionally, if the Environmental Protection Agency (EPA) classifies some of the PFAS chemicals as hazardous, this would strengthen the ability to hold polluters accountable.

Click on the link below to view the article from the Washington Post:

https://www.washingtonpost.com/climate-environment/2021/10/18/epa-regulate-forever-chemicals-pfas/

Click on the link below to view content from the U.S. Dept. of Health and Human Services, Toxicological Profile for Perfluoroalkyls:

https://www.atsdr.cdc.gov/toxprofiles/tp200.pdf

P.S. Comment and Share your experience with toxic tort cases, or PFAS

In this blog I’ll be reviewing the NYS maternal mortality statistics as well what type of lawsuit would support maternal mortality cases. Additionally, I will be briefly addressing the new 2020 Joint Commission Maternal Safety Standards.

The NYS maternal mortality rate is 18.9 deaths/100,000 live births. This is 1.7 times the Healthy People 2020 target of 11.4/100,000 live births. Of the pregnancy-related deaths the CDC reviewed, 27.2% were considered preventable.

The NYS Maternal Mortality Review Report identified 33 pregnancy-related deaths in 2014.
The leading causes of pregnancy-related deaths were:
Infection: (21.2%)
Hemorrhage: (15.2%)
Cardiomyopathy, embolism, pulmonary problems: (12.1%)

According to the CDC, nine cases (27.2%) among the pregnancy-related deaths were considered preventable based on the reviewer’s determination that there was at least some chance of death being averted by changes to patient, family, provider, facility, system and/or community factors.

To address maternal morbidity, as of July 1, 2020 there are new Joint Commission (JC) Maternal Safety Standards required of JC accredited hospitals.

Medical malpractice, and wrongful death are types of lawsuits that can be filed to support maternal death cases. Recovery involves compensation for economic and non-economic damages. Having an understanding of current statistics, current standards of care, Joint Commission standards, available sources of evidence, and an awareness of how to interpret the medical records will help to ensure that your clients achieve the greatest possible outcome with the support of their legal team.

I welcome you to collaborate with Barber Medical Legal Nurse Consulting, LLC to learn more about the new Joint Commission Maternal Safety Standards.

To learn more about the NYS Maternal Mortality Review Report, visit link below: https://health.ny.gov/community/adults/women/docs/maternal_mortality_review_2014.pdf

In this blog, I’ll be referring to one of the seven types of cases a CLNC® has the expertise to analyze. Additionally, I’ll be providing an ongoing environmental issue that exists in the U.S. that is grounds for filing this particular type of lawsuit.

There are 7 types of cases a CLNC® has the expertise to review. Toxic tort, or environmental exposures is one of them. This type of claim is a specific type of personal injury lawsuit in which the plaintiff claims that exposure to a dangerous substance, or chemical, caused the plaintiff’s injury or disease.

Did you know that paraquat is one of the only two herbicides still being used in the U.S.? Paraquat has been banned in Switzerland and the European Union countries secondary to its high toxicity.

Breathing in paraquat can cause long term, irreversible lung damage and can lead to a disease called paraquat lung. Long-term exposure to paraquat may cause scarring of the lungs called pulmonary fibrosis. This makes it hard to breathe.

If paraquat touches the lining of the mouth, stomach, or intestines, it can cause damage to the body. Paraquat may also damage the kidneys, liver, and esophagus (the tube that food goes down from your mouth to your stomach).

If paraquat is swallowed, death can quickly occur. Death may occur from a hole in the esophagus, or from severe inflammation of the area that surrounds the major blood vessels.

To learn more about the long-term damages associated with paraquat, visit the U.S. National Library of Medicine, Medline Plus and the Centers for Disease Control and Prevention at the below links.

https://medlineplus.gov/ency/article/001085.htm

https://emergency.cdc.gov/agent/paraquat/basics/facts.asp

I look forward to learning about your experience with toxic tort cases. If you have been involved, or are involved in a medical case specific to paraquat, please respond, “yes.”

Breast cancer is the most commonly diagnosed cancer in women in the United States and the second leading cause of cancer death in American women.

Breast cancer mortality can be reduced through screening performed in accordance to current standards of care.

There are 12 million medical misdiagnoses each year, half of those being cancer-related. A quarter of all malpractice lawsuits are related to either a misdiagnosis or a missed diagnosis in the US. As many as 1 in 70 patients are diagnosed with cancer when they do not actually have cancer, leading to unnecessary treatment, and/or surgery. Many are misdiagnosed when they do in fact have cancer. This can lead to delays in treatment, and increased mortality rates.

It’s crucial to be aware of best practice recommendations specific to breast cancer screening, while remaining current with new screening modalities.
Breast cancer screening guidelines come from ACOG, U.S. Preventive Services Task Force, American Cancer Society, and the National Comprehensive Cancer Network.
Recommendations refer to breast cancer risk assessment, self and clinical breast examination, mammography, and MRI.

Historically, the screening recommendations have not considered racial differences in breast cancer epidemiology, treatment, and survival. According to a study published in the October Annals of Internal Medicine, in Black versus White women, initiating biennial screening 10 years earlier (at age 40) reduced Black-White mortality disparities by 57 percent.

To learn more about the study specific to reduction in racial disparities surrounding breast cancer screening, view the below link:
https://www.acpjournals.org/doi/10.7326/M20-6506

P.S. comment and share if you have experience in missed diagnosis or misdiagnosis cases