Brien Roche Law http://www.brienrochelaw.com Sat, 12 Apr 2014 02:11:58 +0000 en-US hourly 1 Pediatric Heart Defects http://www.brienrochelaw.com/blog/pediatric-heart-defects/ http://www.brienrochelaw.com/blog/pediatric-heart-defects/#comments Fri, 11 Apr 2014 18:19:48 +0000 http://www.brienrochelaw.com/?p=9184 Pediatric Heart Defects from Brien Roche Law

A DC-Metro woman who is also a physician with the FDA gave birth to her third child in 2009; a seemingly healthy baby girl who nursed well and had gained weight before her very first pediatrician’s appointment. When the baby … Continue reading

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Pediatric Heart Defects from Brien Roche Law

A DC-Metro woman who is also a physician with the FDA gave birth to her third child in 2009; a seemingly healthy baby girl who nursed well and had gained weight before her very first pediatrician’s appointment.

When the baby was about 6 weeks old she began vomiting, had difficulty nursing and appeared to be in pain; symptoms of which her doctor thought could be reflux.  The doctor suggested to the mother that she change the baby’s diet.

A few days had passed with no apparent improvement in the baby’s condition so the mother made another appointment with the pediatrician.  That day when the baby went down for a nap, she cried a bit and then went silent.  When the mother went in to check on her, she discovered her baby lying motionless on her stomach and not breathing.  Her child was dead.

Pediatric Heart Defects-Diagnosable

The medical examiner said the baby died of total anomalous pulmonary venous connection (TAPVC) which is a heart defect related to critical congenital heart disease and that the child lived longer than would have been expected.  It turned out that this was a condition that could have been remedied if the hospital had only performed an extremely low-cost test that could have detected a congenital heart defect in less than 60 seconds.  The device used in this test is called a pulse oximeter which is a hand-held device that measures oxygen saturation in the blood through a sensor connected to the fleshy part of a baby’s hand or foot.  Abnormally low levels of blood oxygen are associated with congenital heart defects.  Once something is picked up in this low-cost and non-invasive test, further testing can be done to isolate and treat the problem.  If treated quickly enough, 98% – 100% of those children can be saved.

Pediatric Heart Defects- Metro DC

With one in every 100 live births being affected by congenital heart defects, it is surprising that this simple test that can cost less than $1 per baby isn’t mandatory in all 50 states.  Maryland hospitals have been required to administer this test to all newborns since 2011 and Virginia now has mandated that hospitals with maternity wards screen for this after previously allowing it to be done on a voluntary basis since 2010.  In the District all hospitals use pulse oximetry screening as part of a screening program recommended by Children’s Hospital.  As of the beginning of 2014, 35 states have passed legislation that require this testing.  There currently is no legislation covering the 5 to 6 percent of babies who are delivered by midwives.

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Uterine Fibroids http://www.brienrochelaw.com/blog/uterine-fibroids/ http://www.brienrochelaw.com/blog/uterine-fibroids/#comments Thu, 03 Apr 2014 18:00:58 +0000 http://www.brienrochelaw.com/?p=9182 Uterine Fibroids from Brien Roche Law

Uterine fibroids are noncancerous tumors or growths in the muscles of the uterus.  These fibroids can get quite sizeable and as a result of their size cause heavy bleeding, urinary frequency, constipation, bloating, pain and interference with the ability to … Continue reading

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Uterine Fibroids from Brien Roche Law

Uterine fibroids are noncancerous tumors or growths in the muscles of the uterus.  These fibroids can get quite sizeable and as a result of their size cause heavy bleeding, urinary frequency, constipation, bloating, pain and interference with the ability to become pregnant or carry a pregnancy.

Uterine Fibroids-Unspoken Problem

The unspoken problem with uterine fibroids is that many women ignore them and wait many years before seeking any help from a medical practitioner.  

The traditional treatment over the years has been a hysterectomy.  That however frequently can be avoided through the use of what is called a myomectomy, which involves cutting out the fibroids.  

These fibroids can be on the exterior of the uterus or they can be internal to the uterus.  The ones that are external tend to be less problematic.  The ones that are growing in the lining of the uterus frequently are problematic.

In terms of the cause of these fibroids, there is no clear answer.  A woman’s hormones can certainly play a role in fibroid growth but in large measure fibroids are thought to be genetic.  There is some evidence that diets that are heavy in red meat and low in green vegetables and citrus fruit increase risk of fibroid growth.  

Uterine Fibroids-Treatment

The traditional treatment of hysterectomy, although it obviously eliminates the fibroid, carries with it several potential risks including infection, bowel and bladder problems, increased risk of osteoporosis and heart disease.  

The other alternatives aside from myomectomy are that of hormonal treatments and various radiological procedures to shrink the fibroids.  Another alternative is simply watchful waiting i.e., to wait and see if the fibroids shrink over time.

The hormonal therapies are temporary measures and do not eliminate the fibroids.  

The radiology procedure tends to cut off the blood flow to the fibroids and thereby kills them in that fashion.  

The surgical treatment of fibroids frequently involves medical malpractice issues.  If you or a loved one has been exposed to such a surgical procedure that has gone awry, contact medical malpractice attorney Brien Roche.

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Eye Malpractice http://www.brienrochelaw.com/blog/eye-malpractice/ http://www.brienrochelaw.com/blog/eye-malpractice/#comments Mon, 10 Mar 2014 18:00:18 +0000 http://www.brienrochelaw.com/?p=9169 Eye Malpractice from Brien Roche Law

Laser surgery has become popular in the last many years.  Most eye malpractice claims arise from this type of surgery.   Eye Malpractice Caused by Laser Surgery There are two main types of such surgery.  One type is the traditional … Continue reading

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Eye Malpractice from Brien Roche Law

Laser surgery has become popular in the last many years.  Most eye malpractice claims arise from this type of surgery.  

Eye Malpractice Caused by Laser Surgery

There are two main types of such surgery.  One type is the traditional Lasik surgery which involves cutting a flap on the surface of the cornea.  The cornea is the circular portion of the eye that is at the front of the eye.  Once this flap has been cut, then a laser is used to reshape the underlying cornea.

The other type of laser surgery is one that involves scraping very thin layers of tissue off the cornea’s outermost layer.  This does not involve making a flap in the cornea.  

These forms of surgery have the ability to correct nearsightedness, farsightedness and astigmatism.  

The downside of these surgeries is that there is some inherent risk in the surgical procedure going awry.  In addition this surgery cannot correct or prevent the natural loss of focusing power for close-up objects that happens with age.

In fact there is some evidence that laser surgery actually hastens the development of this condition especially in people who are already nearsighted.

Another frequent topic in regards to eye care is that of diet and food supplements.  Being overweight clearly increases the risk of developing Type 2 diabetes which can then result in damage to the blood vessels in the retina in the back of the eye.  As such weight control certainly is important.   Food supplements are a matter of significant debate.  Probably all that can safely be said about that is that the consumption of carrots not only have the benefit of potentially improving eye health but also have the general benefit that is associated with any vegetable.  

Eye Malpractice-Call Brien Roche

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Bicycle Accident Cases http://www.brienrochelaw.com/blog/bicycle-accident/ http://www.brienrochelaw.com/blog/bicycle-accident/#comments Sat, 15 Feb 2014 18:00:52 +0000 http://www.brienrochelaw.com/?p=9167 Bicycle Accident Cases from Brien Roche Law

For the year 2011, the National Highway Traffic Safety Administration reported that there were 677 deaths  from bicycle accident and 48,000 injuries from such accidents with motor vehicles. Bicycle Accident Factors In looking at bicycle accident cases there are a number of … Continue reading

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Bicycle Accident Cases from Brien Roche Law

For the year 2011, the National Highway Traffic Safety Administration reported that there were 677 deaths  from bicycle accident and 48,000 injuries from such accidents with motor vehicles.

Bicycle Accident Factors

In looking at bicycle accident cases there are a number of factors that need to be considered:

  • There are certain biases that exist with many motorists that bicycle riders are risk takers and rule breakers and therefore are not entitled to equal rights.
  • The use of helmets is mandated in most states and therefore the lack of use of a helmet by a bike rider may defeat or minimize the chance of recovery.
  • Some states have developed what are called “vulnerable user” laws which protect bicyclists and also pedestrians from motor vehicles on the theory that the person operating the heaviest vehicle is responsible to operate that vehicle in such a way to avoid contact with the vulnerable user.  Even if this law does not apply in your state, that theory may be of some value.
  • Preservation of the actual bicycle that is involved in the collision is critical as is thorough documenting of the conditions that existed at the scene of the accident.  This can be done both through video and still photos.
  • There may be publicly or privately operated cameras that may actually show the collision.
  • It is important to visit the scene of the collision with the victim so that all of the details of the collision can be recounted.
  • The client should write out a detailed memo reconstructing the events as best as he/she can.
  • Any safety courses that have been taken by the client may be of relevance in terms of showing the overall safety tendencies of the client along with whether or not the vehicle had reflective tape, reflectors, lights and other safety gear.
  • Whether or not the motorist knew of the use of this area or roadway as an area frequented by bicyclists may be of significance.
  • Whether the motorist worked for a large company that has some special training dealing with bicycle safety and how to be on the lookout for bicyclists may be of some importance.

All of these factors are significant ones to consider in terms of bicycle accident cases.

Bicycle Accident-Vehicle Accidents

For more information on vehicle accidents, see the other pages on this site.

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Sovereign Immunity http://www.brienrochelaw.com/blog/sovereign-immunity/ http://www.brienrochelaw.com/blog/sovereign-immunity/#comments Mon, 03 Feb 2014 18:00:03 +0000 http://www.brienrochelaw.com/?p=9160 Sovereign Immunity from Brien Roche Law

Sovereign immunity is a difficult concept to comprehend in Virginia.  The cases from the Virginia Supreme Court appear to be inconsistent. Sovereign Immunity-Ministerial and Discretionary A recent trial court decision from the Chesapeake Circuit Court however somewhat clarifies the law. … Continue reading

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Sovereign Immunity from Brien Roche Law

Sovereign immunity is a difficult concept to comprehend in Virginia.  The cases from the Virginia Supreme Court appear to be inconsistent.

Sovereign Immunity-Ministerial and Discretionary

A recent trial court decision from the Chesapeake Circuit Court however somewhat clarifies the law.  The case involved a sheriff that was transporting prisoners in a motor vehicle and rear-ended another driver.

In that context the test of immunity is whether or not the sheriff was using judgment and/or discretion.  The sheriff argued that he was using judgment and discretion since he had to consider his own safety and that of the public in that he had to be aware of any unusual or threatening behavior by the inmates that were in the vehicle he was driving.  

In this particular case there was no evidence that the inmates were exhibiting any threatening or unusual behavior.

Sovereign Immunity-Motor Vehicle Operation

The trial court concluded that the conduct of the sheriff was simply ministerial involving the operation of the vehicle and therefore there was no basis for sovereign immunity.

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Colonoscopy http://www.brienrochelaw.com/blog/colonoscopy/ http://www.brienrochelaw.com/blog/colonoscopy/#comments Sun, 02 Feb 2014 18:00:04 +0000 http://www.brienrochelaw.com/?p=9157 Colonoscopy from Brien Roche Law

A Washington Post article of December 24, 2013 addresses the issue of colonoscopy and how effective they are.  The evidence is fairly clear that they are highly effective in preventing colorectal cancer.  Colorectal cancer is the second deadliest type of cancer.  The … Continue reading

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Colonoscopy from Brien Roche Law

Washington Post article of December 24, 2013 addresses the issue of colonoscopy and how effective they are.  The evidence is fairly clear that they are highly effective in preventing colorectal cancer.  Colorectal cancer is the second deadliest type of cancer.  The colonoscopy allows a doctor to detect precancerous growths in the colon and remove them on the spot.  The article indicates that 15,000 to 20,000 lives could be saved per year with the increased use of colonoscopy.

Colonoscopy-Colorectal Cancer

Colorectal cancer is a slow growing type of cancer and typically takes 10 to 15 years to develop.  As such early screening increases the likelihood of long-term survival. 

In preparation for a colonoscopy you are required to limit yourself to a clear liquid diet for 24 hours and you may have to consume a large quantity of laxative solution.

Colonoscopy-Risks

There is some small risk of bowel perforation during the course of the procedure.  In addition the drugs that are used during the procedure have a rare but potentially serious risk such as difficulty with breathing.

Medicare and most private insurers are required to cover this type of procedure.

For more information on medical malpractice, see the other pages on this site.

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Proximate Causation http://www.brienrochelaw.com/blog/proximate-causation/ http://www.brienrochelaw.com/blog/proximate-causation/#comments Sat, 01 Feb 2014 18:00:07 +0000 http://www.brienrochelaw.com/?p=9159 Proximate Causation from Brien Roche Law

The concept of proximate causation is always a difficult one.  The word “proximate” literally means “near”.  It can be juxtaposed to the word “approximate” which literally means “not near”.  A near cause of any event is one that is a … Continue reading

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Proximate Causation from Brien Roche Law

The concept of proximate causation is always a difficult one.  The word “proximate” literally means “near”.  It can be juxtaposed to the word “approximate” which literally means “not near”.  A near cause of any event is one that is a sufficient cause to actually cause the event.  

Proximate Causation-Sufficient Cause

In a recent decision from the Virginia Supreme Court, the Court dealt with these conflicting definitions of proximate causation.    The particular case involved asbestosis.  The trial court in this case gave an instruction indicating that the jury could find against the defendants if the defendants’ products were a substantial contributing factor in causing harm to the victims.  The Supreme Court rejected that substantial contributing factor test and the so-called “but for” standard.  The proper test the court said is that the product exposure must have been “a” sufficient cause of the injury.

Proximate Causation-More Than One

Conceivably there could be more than one sufficient cause of an injury.  If that is the case however then each of those sufficient causes by themselves must have been sufficient to cause the injury.  

For more information on proximate causation and other personal injury issues see the other pages on this site.

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Hospital Infections http://www.brienrochelaw.com/blog/hospital-infections/ http://www.brienrochelaw.com/blog/hospital-infections/#comments Fri, 31 Jan 2014 18:00:18 +0000 http://www.brienrochelaw.com/?p=9158 Hospital Infections from Brien Roche Law

Hospital infections are fairly common.  Hospitals take extra measures to decrease the likelihood of infection.  The fact is that hospitals can be dangerous places.  This likewise applies that doctors’ offices, clinics and other health care settings.  A particular type of … Continue reading

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Hospital Infections from Brien Roche Law

Hospital infections are fairly common.  Hospitals take extra measures to decrease the likelihood of infection.  The fact is that hospitals can be dangerous places.  This likewise applies that doctors’ offices, clinics and other health care settings.  A particular type of bacteria that has been found to be on the rise in these environments is called Clostridium difficile also known as C. diff.  The infection can cause chronic diarrhea, abdominal pain and intestinal inflammation.

Hospital Infections-Antibiotic Resistant

The people most at risk are those who are in a hospital setting that are being treated with antibiotics.  Antibiotics not only kill the harmful bacteria but they also destroy protective bacteria that exist within our system.  This allows the C. diff to gain a foothold. 

A Washington Post article of December 17, 2013 addressed this issue.

This particular bacterium has been evolving into an increasingly aggressive strain that can resist drug treatment.  

Within our intestinal system there are a multitude of different types of bacterium, many of which are helpful and necessary in order to properly digest food.  The growth of these types of bacteria can be promoted by what are called probiotics.  Probiotics consist of such things as yogurt which promote the growth of this helpful bacteria.

Doctors believe that our increasingly sterile environment may be actually weakening our ability to develop these helpful bacteria.  Antibiotics in particular can be dangerous because they not only kill the harmful bacteria but they also kill the helpful bacteria.  

Hospital Infections-Medical Malpractice

For more information on infections, see the other pages on this site.

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Chiropractic Malpractice http://www.brienrochelaw.com/blog/chiropractic-malpractice/ http://www.brienrochelaw.com/blog/chiropractic-malpractice/#comments Thu, 30 Jan 2014 18:00:27 +0000 http://www.brienrochelaw.com/?p=9156 Chiropractic Malpractice from Brien Roche Law

Although chiropractic malpractice may come in many forms, one of the more devastating forms arises from a manipulation called “cracking the neck”.  This cervical procedure involves a sharp manipulation to the neck. Chiropractic Malpractice-Cervical Manipulations Some patients have experienced immediate … Continue reading

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Chiropractic Malpractice from Brien Roche Law

Although chiropractic malpractice may come in many forms, one of the more devastating forms arises from a manipulation called “cracking the neck”.  This cervical procedure involves a sharp manipulation to the neck.

Chiropractic Malpractice-Cervical Manipulations

Some patients have experienced immediate dizziness, blurred vision and a sense of the world going dark on them after these manipulations.  

The evidence is inconclusive as to the effectiveness of these types of cervical manipulations.  The lack of evidence is due in large part to a lack of any large rigorously-designed study.  

The possibility does exist however that these types of manipulations that involve sudden powerful thrusts do carry with them the possibility of tearing the carotid or vertebral artery leading to the brain.  Such a tear can cause a blood clot that travels to the brain causing a stroke.  

A 2010 study, as reported in a Washington Post article of January 7, 2014, reports 33 deaths after spinal manipulation mostly due to a tear or dissection of the vertebral artery.  This study suggested that there were many more such cases unreported.  

Although the evidence is unclear as to whether or not the manipulations are in fact causing this so-called “chiropractic stroke”, it is clear that many chiropractors do not warn patients of the risks associated with such manipulations.  

Chiropractic Malpractice-Failure To Warn

This failure to warn may be a basis for liability for resulting injuries from cervical manipulations.

For more information on medical malpractice, see the other pages on this site.

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Economic Loss Rule-Negligent Representation http://www.brienrochelaw.com/blog/economic-loss-rule/ http://www.brienrochelaw.com/blog/economic-loss-rule/#comments Wed, 29 Jan 2014 18:00:17 +0000 http://www.brienrochelaw.com/?p=9155 Economic Loss Rule-Negligent Representation from Brien Roche Law

The economic loss rule in its original form was designed to prevent a commercial buyer of defective goods from suing either in negligence or strict liability when the only injury consisted of damage to the goods themselves.  The rule attempts … Continue reading

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Economic Loss Rule-Negligent Representation from Brien Roche Law

The economic loss rule in its original form was designed to prevent a commercial buyer of defective goods from suing either in negligence or strict liability when the only injury consisted of damage to the goods themselves.  The rule attempts to preserve the distinction between contract and tort claims by keeping contract issues solely within the contract realm.

A second purpose of the rule was to restrict potential liability exposure to commercial users downstream from the manufacturer.  

Economic Loss Rule-Split Decisions

Two recent decisions from the Kansas and Nevada Supreme Courts take different views of this issue.  

In the Kansas case the issue was whether the doctrine applied to actions for negligent misrepresentation arising from construction contracts.  

The Kansas court held that negligent misrepresentation claims are not subject to the economic loss rule.  They held that the tort of negligent misrepresentation is sufficiently confined that it can be limited to those to whom the defendant supplied the allegedly false information.

The Nevada court took a somewhat different view of a similar issue.  The Nevada court ruled that the economic loss rule barred a claim for negligent misrepresentation brought by a general contractor against a developer.

These differing decisions from two different State Supreme Courts highlight the continuing ambiguity as to the scope of the economic loss rule.

Economic Loss Rule-Personal Injury

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