Imagine living in a Maine nursing home and having cancer or arthritis so severe that you cannot get out of bed by yourself. You rely on the nurses to make sure your pain patch is in place, but the nurses don’t check, and the nursing assistants steal your pain medication. Imagine that no one comes right away when you press your call light to go the bathroom, and no one comes to help you change your position. Imagine that you fall out of bed and break your arm trying to get to the bathroom on your own. And imagine that, because you aren’t positioned by nurses on schedule, you develop a large and excruciatingly painful bedsore that grows deep into your flesh and becomes infected.

All of these images are real examples of injuries caused by nursing home negligence in Maine. Nursing home negligence caused by understaffing, or poorly trained staff, may cause severe injuries and death to Maine’s most vulnerable population- the nursing home bound elderly.

Families need to know that that their elderly mother, father, aunt, uncle or dear, older friend is safe and well cared for. How do Mainers scratch the surface of a nursing home that appears clean and pleasant on an introductory tour? One starting point is to look at a nursing home’s “star rating”.

The federal government has a five-star rating system. A Maine nursing home can obtain up to five stars (much above average) in each of five areas: Health Inspections, Nursing Home Staffing, Quality Measures, Fire/Safety. The lowest ranking possible is one star (much below average).

In Maine, the good news is that 26% of our long term care facilities received the government’s best nursing home score. However, more than 7% of our nursing homes received the lowest “one star” ranking.

According to officials, the five star rating system is meant to be an accompanying tool for consumers to compare nursing homes, but should not take the place of visits and interviews at the actual facility. Here’s why:

A Nursing Home may receive five stars for staffing, three stars for inspections, three stars for fire safety, but only one star for quality measures, and still have an overall score of three stars. Even if a nursing home has an overall three star score, would you want your mother or father exposed to a higher risk of injury, including bedsores and urinary tract infections, than they would encounter at a different nursing home only a half mile away? When a nursing home tells the federal government that it has great staffing, but also has a high percentage of bedsores, urinary tract infections and depressed residents, the facts speak for themselves. Nursing homes are only as good as the care they deliver.

Mainers may see the rating system as a way to challenge nursing homes to improve the care they provide in the 112 facilities across the state. Maine families considering nursing homes for loved ones should weigh many factors when choosing a long term care facility. The number of stars a nursing home is assigned is just the tip of the iceberg.

Copyright 2009 Briggs & Counsel

Honesty is the basis of good science. Government agencies such as the Food and Drug Administration (the “FDA”) count on good, honest science used by the government to protect the public.

In a recent letter to President-Elect Obama, several FDA scientists allege that dishonesty is prevalent at the agency and that the “scientific review process for medical devices has been corrupted and distorted by current FDA managers, thereby placing the American people at risk.”

Among the charges: scientists and doctors have been threatened and told, on occasion, to ignore FDA regulations; devices have not been properly labeled; managers without appropriate experience have been given authority to make final decisions about device regulation and have done so while ignoring serious safety and effectiveness concerns; FDA experts have been excluded from product meetings because manufacturers felt that they were “biased”; and manufacturers have been allowed to market their products without FDA approval.

An internal investigation of the charges, according to the scientists, has resulted in absolutely nothing. “No one was held accountable, no appropriate or effective actions have been taken, and the same managers who engaged in the wrongdoing remain in place and have been rewarded and promoted.”

With the transition to President-Elect Obama’s administration will come changes to the leadership of both the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC).

According to a recent statement from the FDA, “We have been working very closely with members of the transition team and any concerns or questions they have on any issue, we will address directly with the team. Separately, the agency is actively engaged in a process to explore the staff members’ concerns and take appropriate action.”

By: Eliza Stoll for Briggs & Counsel

Copyright 2009 Briggs&Counsel

Maine residents who have been prescribed antipsychotic medications by their psychiatrist or physician should be aware that there is a low to moderate risk of sudden cardiac death when taking such medications.

According to a recent study among patients taking high doses of antipsychotics, there are about 3.3 cases per 1,000 that result in sudden cardiac death. Patients who have been prescribed antipsychotics need to be fully aware of all potential side effects before beginning a medication regime. Doctors need to fully disclose all potential risks to patients.

New research published recently in the New England Journal of Medicine shows that antipsychotic drugs are not risk free, the authors of the study urging more caution in fact in their use. The drugs are associated with a risk of sudden cardiac death, especially at higher doses.

Doctors prescribe antipsychotic medications for a variety of reasons these days, although they were originally intended to treat schizophrenia. They are now being used to treat anything from conduct disorder in children to aggressive behaviors in Alzheimer’s patients. Three particular antipsychotics; olanzepine, risperidone, and quetiapine; are in fact among the top ten drugs sold worldwide.

Antipsychotics are broken down into two categories: typical and atypical. The typical antipsychotics are older medications that have been used for many years to treat schizophrenia. The risk of sudden cardiac death with the use of typical antipsychotics is about 1.99 times greater than in patients who are not using antipsychotic medications. Atypical antipsychotics are newer medications used to treat a variety of behavioral and mental health problems and are considered to have a lesser risk of side effects than typical antipsychotics. According to the article, the risk of sudden cardiac death in patients taking atypical antipsychotics is 2.26 times greater than in patients who are not using antipsychotic medications.

Well, it’s official.  Here in Maine it is perfectly alright for a doctor to hide the fact that you have a possibly cancerous tumor from you.  He can violate his duty to disclose the existence of a “dark spot” on an x-ray  until the cancer has progressed to a point when the treatment is horrific, or even to the point where no amount of treatment will work and you face certain death. 

In a recent Maine Supreme Court case  the Court referred to Maine’s Health Security Act that sets the statute of limitations for suing a doctor or hospital at three years.  In  Dickey v. Vermette, Mrs. Maetta Dickey was a regular dental patient of  Dr. Vermette.  In March 2000 she had an x-ray that showed a “dark spot” .  Her dentists didn’t tell Mrs. Dickey about the dark spot, or ask her if she wanted any follow-up.  Instead, they kept the information to themselves, and decided that they would just “keep an eye on it.”  The dentists kept an eye on it for FIVE YEARS.  Then the dentist referred Mrs. Dickey to an oral surgeon who diagnosed the oral cancer.  But, because the cancer had progressed so far, a big piece of Mrs. Dickey’s face had to be cut out to make sure the tumor was removed. 

Not every Justice on Maine’s high court thinks that “Don’t Warn, Don’t Treat” is legal in Maine.  Justice Alexander thinks that the Court’s opinion is “contrary to good law, good medicine, and good common sense.”  Justice Alexander points to the fact that Mrs. Dickey had a special, confidential, doctor/patient relationship with her dentist.  Justice Alexander stated the plain fact that, in medicine, “when a suspicious dark spot appears on an x-ray, and cannot be otherwise explained, there should be disclosure and warning to the patient, further investigation, and forensic testing for the possibility of cancer.” And while one Maine law says that medical malpractice cases must be filed within three years of the negligent act, another Maine law says that the three years is “tolled” where a plaintiff has failed to learn of a negligent act as a result of defendant’s fraud.  And “fraud” doesn’t just mean hiding an important fact on purpose, or lying.  Fraud in Maine also means not telling someone you have a “special relationship” with information that there is a duty to disclose.  Like a doctor’s duty to disclose that you might have cancer. 

Justice Silver also thought Mrs. Dickey should have been able to base her claim on facts that related back to the 2000 failure to tell about the dark spot. 

But Justice Alexander and Justice Silver are in the minority.  All of Maine’s other Justices say their hands are tied by the law that says doctors are only responsible for their mistakes going three years back.  

So, if your doctor finds a possibly cancerous tumor on your x-ray, and waits until three years and one day to let you know about it, you cannot do anything about it.  Even if you have huge medical bills that were caused by the three year delay, even if you are going to die and leave your family without a bread-winner, even if the three year delay ruins everything you built your life on, too bad for you. 

Maine-TheWay Life Should Be…

…For Doctors Who Sit On Critical Patient Information For Three Years!!!

Copyright 2009 Briggs & Counsel

Is it fair that Maine citizens who count every penny trying to save money on the monthly food budget have to sacrifice physical health to financial concerns?

As part of recent healthy eating initiatives, many states, including Maine, have requested that nutritional information be posted on boards behind the counters of fast food restaurants.

It should be just as easy for Mainers to find information about the food they purchase at fast food restaurants as it is to buy food at the supermarket. Why does it matter? It matters because Maine families are as affected by the nutritional content of the food they consume as they are by the cost of that food. Maine residents are justified in fighting food content misinformation and fraud that is linked to diabetes, heart disease and the nation’s obesity epidemic.

How can legislators in Augusta, and civil lawyers for justice throughout the state, help Maine citizens obtain the information they deserve to make correct choices on the healthiest food to buy in tough economic times? One way is through legislation that requires the information be made available. The other way is for Maine’s lawyers who specialize in consumer justice to take on powerful food industries make inadequate or deceptive disclosures of potential health risks involved in consuming certain foods. Food industries that mislead Maine consumers through advertisements that omit important nutritional information do so at their own risk.

In other states, McDonald’s Corporation has been called to answer for deceptive practices, negligence, and a failure to warn consumers of the harms of ingesting food at McDonald’s restaurants, particularly where minors are involved.

Maine consumers have a right to make an informed choice about what they spend money on for food. They also have a right to know the nutritional value of the food they put into their bodies and their children’s bodies.

If you are concerned about this issue, call or email your state legislator in Augusta, or send your comments to our Maine personal injury lawyers.

By Eliza Stoll and Alison Mynick

Copyright 2009 Briggs & Counsel

In 20 cold weather states, including Maine, Nissan Motor Company is recalling more than 240,000 trucks. Nissan plans to fix the problem that could prevent the front air bags from deploying.

The recalls affect the Xterra, Frontier and Pathfinder models of Nissan trucks, ranging from 2005-2009 model years.

The problem was discovered through a series of warranty claims. In states where road salt is used on icy roads, it was found that a mixture of salt and snow could enter a crash zone sensor area and rust, thereby interrupting the signal and potentially preventing the front air bags from deploying in a crash.

So far, there have been no reports of crashes or injuries related to this issue. If you own a Nissan truck that is one of the above mentioned models and in the year range noted, see your Nissan dealer immediately.

If you have been injured in a vehicle accident as a result of the air bags failing in your Nissan truck, you may wish to speak to an experienced personal injury lawyer at Briggs and Counsel.

By: Eliza Stoll

Copyright 2009 Briggs& Counsel

It is extremely stressful watching our grandparents and parents grow older. With advancing age comes many new concerns about health, long term care, and losing our loved ones. When they are no longer able to live on their own or be cared for by loved ones, many of us turn to an assisted living facility or nursing home to provide thoughtful and conscientious care.

Many of these facilities can provide great care for our loved ones. Unfortunately, there are many as well that do not. Many are often understaffed with underpaid and poorly trained employees. Many nursing homes push the bottom line so far that they endanger the lives of their patients.

Neglected, abused, and threatened, nursing home residents may suffer physically and emotionally. Painful bedsores, broken bones, or even premature death can result from neglectful and outright abusive treatment.

Visible injuries are the type that you will pick up on right away. Examples are broken bones, cuts, scars, and bed sores.

Neglect type injuries are more subtle and more difficult to see. These include insufficient food, water, and bathing opportunities, failure to change the resident’s underclothes in a timely manner if using the toilet is an issue, failure to supply adequate bathing supplies such as shampoo and soap, failure to properly assist the resident who needs help bathing, eating, walking, and verbal abuse.

If your loved one has fallen victim to abuse or neglect in a nursing home setting, you may wish to seek the legal counsel of Briggs and Counsel. We have a successfully prosecuted nursing homes that have caused injury to residents through neglectful care.

Computed tomographic (CT) colonography is a new, noninvasive screening option for the detection of colorectal cancer. A federal study of this alternative to the dreaded colonoscopy confirms that it is an effective tool in detecting cancer, however, it’s accuracy had not been well-defined.

With Medicare already considering paying for the procedure, experts are predicting a boost in screening due to it’s noninvasive nature. The new study identified nine out of ten people who had cancers and large growths seen by regular colonoscopies.

The New England Journal of Medicine suggests that the CT colonography’s real value may be in showing who really needs a regular colonoscopy. The test was found to be more accurate at ruling cancer out than it was at detecting it.

There are risks of false alarms with the new alternative screening tool. The colonographies showed large growths in about one in six people, although some were not confirmed by colonoscopy. Of the patients with growths verified by colonoscopy, 90 percent were flagged through the CT colonographies.Only one in four of those patients diagnosed with a growth actually had one.

CT colonographies, currently recommended every five years, expose people to repeated doses of radiation. It’s half the dose of a standard CT exam, but the cumulative effects are not known at this time. Colonoscopy is only recommended every 10 years. These concerns do not rule out CT colonography as a screening tool, but they should be considered.

Colorectal cancer is the second largest killer in the United States, claiming about 50,000 lives per year. Screening for colorectal cancer is recommended once a person reaches the age of 50.

The Journal of Injury Prevention announced that overweight children are more likely to sustain arm and leg fractures than thinner children when involved in a car crash according to researchers at Johns Hopkins Bloomberg School of Public Health.

There is evidence that overweight children’s bones may be more likely to fracture. Also, by being larger, heavier children’s bodies are closer to the inside of the car, putting them in danger of a more forceful impact. These findings mirror what occurs for adults involved in car crashes who are overweight.

Heavier children are more than twice as likely as their thinner friends to sustain arm and leg fractures. Thinner children are more likely to sustain injury to the pelvis, thigh bone and collar bone.

Evidence shows that overweight children may have lesser levels of vitamin D, which could lead to weaker long bones in the arms and legs.

Above all else, researchers suggest that children always be properly restrained when riding in vehicles. Children under the age of 13 should always ride in the back seat.

Copyright 2009 Briggs & Counsel

Maine physicians have a duty to direct patients to seek a second opinion when appropriate. There are enough gray areas in medicine that it is often worth asking for a second opinion, but alarmingly, only three percent of patients ask for a second opinion! What is the reason for this?

Could it be that Maine patients are simply lackadaisical about following a doctors clear statement that a second opinion is warranted? Or, given the insurance disincentive to provide more costly care, is it the case that doctors feel pressure to minimize second opinion referrals?

Medical test results can give conflicting information to a primary care physician, and in many cases, another physician’s opinion—perhaps even a specialist’s opinion- is warranted. Though patients may worry about what their primary care physician will think and how they will be treated in future visits if they do seek a second medical opinion, a physician’s attitude can reverse that fear. It is medical malpractice for a Maine physician to fail to refer a patient for a second opinion in appropriate circumstances.

Maine doctors should encourage patients who are unclear or uncomfortable about the management of a particular course of medical or surgical treatment to obtain another opinion. Maine physicians should be interested in how another doctor can approach the same clinical situation, but are they?

Elective surgery and diagnoses of cancer are two instances where second opinions could be very helpful. This is particularly important in Maine for this reason: If, for example, a doctor negligently overlooks a tumor on an imaging study, and three years go by before the medical mistake is caught, the patient cannot recover against the negligent doctor for the increased risk of death, payment of bills for costly treatments caused by the delay in treatment, or lost wages related to the delay in treatment.

Knowing how vulnerable Maine patients are to physical, emotional and financial injury caused by medical malpractice is reason enough to give second opinions a second look.

Copyright 2009, Briggs & Counsel