medical malpractice

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medical malpractice

Postby trumpadoo » Sat Mar 12, 2005 8:02 am

Is anyone aware of a successful medical malpractice action against a neurologist for failure to timely diagnose and treat multiple sclerosis?
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Postby OddDuck » Sat Mar 12, 2005 10:24 am

Well, I'm not personally. Besides, how could you prove what "timely" is regarding an MS diagnosis? Is there even enough solid or concrete information or belief with regard to MS as a disease itself whereby you could allege that diagnosis was "untimely"?

I've been waiting 48 years for a solid neurological diagnosis. Many people are in what they call "limboland" for many years until they finally receive a diagnosis of MS. When I finally get one (IF I ever do), would I then be able to go back on previous doctors who were not able to diagnose it previously? This isn't a legal opinion by any means, but I'd personally sincerely doubt it.

And as far as bringing in an expert witness for a medical malpractice case? Every physician's opinion could and probably would be different, based on the majority of experiences I have read and heard about from other people with MS, etc. So, again, how could such a thing be proven or alleged?

Sorry, I can't help but personally think that this would not be a very successful path to follow (again, not expressing any legal opinion or advice here - you'd have to consult with an attorney for that).

Deb
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malpractice

Postby texas_jim » Sun Mar 13, 2005 1:59 am

MS is usually was is called an exclusion disgnosis. they have to rule out a big list of other stuff and then they say you have MS. not all physicians have the time, expertise and diagnositic equipment to rule out all of these but this is a list i found under : differential diagnosis of MS


Encephalomyelitis

CNS Vasculitis

Lyme Disease

Lupus Erythematosus

Spastic Paraparesis

Behçet Syndrome

Sarcoidosis and Sjogren's Syndrome

Vitamin B-12 Deficiency and Syphilis

Leukodystrophies

Hereditary Degenerative Disorders

Multifocal Leukoencephalopathy
Acute disseminated encephalomyelitis - Follows infections or vaccination in children, fever, headaches, and meningism common
• Lyme disease - Antibodies to Borrelia species antigens in serum and CSF
• HIVassociated myelopathy - HIV antibodies present
• HTLVI myelopathy - HTLVI antibodies present in serum/CSF
• Neurosyphllis - Syphilis antibodies present in serum/CSF
• Progressive multifocal leukoencephalopathy - Immunosuppressed patients; biopsy of lesions demonstrates virus by electron microscopy
• Systemic lupus erythematosus - NonCNS manifestations of lupus; antinuclear antibodies, antidsDNA
• Polyarteritis nodosa - Systemic signs; angiography shows microaneurysms; biopsy of involved areas shows vasculitis
• Sjogren's syndrome - Dry eyes and mouth; antiRo and antiLa antibodies; lower lip biopsy helpful
• Behcet's disease - Oral/genital ulcers; antibodies to oral mucosa
• Sarcoidosis - NonCNS signs; increased protein in CSF; biopsy shows granuloma
• Paraneoplastic syndromes - Older agegroup; antiYo antibodies; identify neoplasm
• Subacute combined degeneration of cord - Peripheral neuropathy; vitamin B12 levels
• Subacute myeloopticoneuropathy - Mainly in Japanese; adverse reaction to chlorhydroxyquinoline
• Adrenomyeloneuropathy - Adrenal dysfunction; neuropathy; plasma very long chain fatty acids increased
• Spinocerebellar syndromes - Familial; pes cavus; scoliosis; absent reflexes; normal CSF IgG and no bands
• Hereditary spastic paraparesis/ primary lateral sclerosis - Normal CSF, MRI, and visual evoked potential studies
• Miscellaneous - Strokes, tumors, arteriovenous malformations, arachnoid cysts, ArnoldChiari malformations, and cervical spondylosis all may lead to diagnostic dilemmas on occasion. These conditions may coexist differentiation based on history, clinical followup, and MRI features.
• Complicated Migraine
• Tumour or other Cord compression (eg. Spinal Stenosis)
• Stroke
• Acute Transverse Myelitis
• Acute Disseminated EncephaloMyelitis (ADEM) - also known as Post-Infectious Encephalitis
• Herpes Simplex Encephalitis (HSE)
• Sub-Acute Sclerosing Panencephalitis
• other Encephalitis
• Progressive Multifocal Leukoencephalopathy
• HTLV-1 Associated Myelopathy (HAM)
• Tropical Spastic Paresis(TSP)
• HIV Associated Myelopathy
• Adrenomyeloneuropathy (AMN)
• Hypothyroidism
• Myasthenia Gravis
• Diabetes
• Lyme disease
• Systemic Lupus Erythematosus
• Cerebral Arteritis
• Polyarteritis nodosa
• Sjogren syndrome
• Behcet's syndrome
• Sarcoidosis
• Paraneoplastic syndromes
• Neuromyelitis Optica (Devic's syndrome)
• Spinocerebellar syndromes
• Neurosyphilis
• Hereditary Spastic Paraparesis
• Guillian Barre Syndrome
• Polymyositis
• Benign Paroxysmal Positional Vertigo
• Parkinson's Disease
• Cerebral Haemorrhage
• Amyotrophic Lateral Sclerosis (ALS)
• Mononeuritis


ive been a paramedic for 12 years and had never heard of a good 20% of these conditions. as for me i was ruled out of having:
stroke, brain cancer, secondary syphillis, lyme disease and syringomyelia
that i can remember.

jim
paramedic with MS
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Postby OddDuck » Sun Mar 13, 2005 5:27 am

As I believe has been recommended to you before, in other posts on other websites, Jim, you really should get all the facts straight and receive an actual opinion from someone with a "license" in law, such as an attorney.

If you want to attempt such a lawsuit, go right ahead. And if you believe you already know the answers to your own questions, why are you posing questions to any of us?

I have a feeling that you have already obtained the same type of recommendation from others that I have just given you.

What you are dealing with is extremely complex "under the LAW" and I again reiterate. BOTH of you need to consult with an attorney.

If either of you wants to file something pro per, you are entitled to do that.

My personal opinion (I have been in law for over 30 years) is still "good luck".

Deb

EDIT:
MS is usually was is called an exclusion disgnosis. they have to rule out a big list of other stuff and then they say you have MS. not all physicians have the time, expertise and diagnositic equipment to rule out all of these...


Also, as everyone knows, just like actual "legal advice" should not be provided on a message board or provided at ALL by someone other than an attorney, neither should "medical advice", Jim, be provided by anyone other than an actual physician. Those are pretty definitive "statements", which may or may not hold true, as I'm certain many of us here on this website already recognize.

SECOND EDIT: Oh, and Jim? I realize what I'm saying here probably sounds somewhat "stern" or something, but truly that is not my intent, nor am I attempting any type of personal attack on you at all. Believe me, my total understanding and empathy goes out to you regarding your struggles. I can relate.
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Postby trumpadoo » Sun Mar 13, 2005 6:59 am

I only want to know if anyone is aware (has knowledge of) a successful malpractice action. I am well aware of the difficulties entailed in successfully carrying the burden of proof.
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Postby OddDuck » Sun Mar 13, 2005 8:40 am

Hi, Trump.

You're right. My apologies to you.

I do have a habit of becoming overly concerned at times regarding people taking the law in their own hands without the proper guidance of an attorney, and I believe I do often expound, perhaps needlessly at times, outside of the precise question asked.

I truly meant no harm nor disrespect. I have that irrepressible desire to "inform, protect and serve", I guess. :wink:

My personal bottom line answer to you would simply be as I started out (and should have just ended at, I see), is "No, unfortunately I am not aware of any, but there may be some legal websites that you can visit that may provide you with more information."

Deb
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Postby trumpadoo » Sun Mar 13, 2005 9:31 am

Deb:
No harm incurred and no disrespect taken. I have reviewed a number of your posts, and you obviously are greatly concerned for the welfare of others. For this I thank you.

trump
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medical advice

Postby texas_jim » Sun Mar 13, 2005 11:39 am

i was not giving medical advice. i just posted a list of stuff that's r/o before a MS dx is made.
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med mal

Postby Cathy » Thu Mar 17, 2005 12:27 pm

I am a registered nurse who works for plaintiff med/mal attorneys-You can not sue a MD for not making a timely diagnosis unless you can prove the injury you suffer as a result of the delay in diagnosis would not be present if he had diagnosed you timely. Unfortunately, with MS, I don't think you can prove that because of the nature ofthis disease. Everytime I get a MS case, I recommend to the attorney not to take it. Its unfortunate, because there are no reprocussions for them not to accurately diagnose. Sometimes I think if there were, we would not have had to wait so long, and would not have been put through the psychological trauma just because they don't listen or pay attention to abnormalities on physical exam.
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Postby OddDuck » Thu Mar 17, 2005 1:54 pm

Cathy,

Sometimes I think if there were, we would not have had to wait so long, and would not have been put through the psychological trauma just because they don't listen or pay attention to abnormalities on physical exam.
[emphasis added]

Amen!!! Can I take you to my next doctor's appointment, Cathy, as a witness to what I actually tell them is what they should put in the chart, and not their "misinterpretations"? :roll:

Deb

EDIT: Just for further clarification as to my remarks above, I just recently received copies of all my medical records from three different physicians. Only ONE even comes CLOSE to what I have actually told them, etc. etc. etc. I've never in my life seen such a mish-mash of misquotes, misinterpretations, and just plain "misses"! It's like "did they mix me up with some other patient or something"? For example, did you know that I complained about bladder problems at EVERY appointment? Uh........not! I haven't had any problems like that in 20 years! I was shocked!!! (Plus, I gave them everything in writing, and even in my notes to them it says that (i.e. that I haven't had any bladder problems.) Do they think we patients won't eventually read their notes? And it was conveniently forgotten to be noted that one of them literally scared the crap out of me for a long time with his dire predictions of ALS! Not ONE notation is anywhere regarding THAT whole stressful event that it caused me! hmmmmmmmm....... Or wait, yes it is. It is noted that patient "is having anxiety". But it doesn't say that that's because the doctor keeps telling patient he thinks she has ALS! GAWD!! And that's not the half of it! Ok............sorry........I just had to vent for a second. :wink:
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Postby Cathy » Thu Mar 17, 2005 2:29 pm

I now ask for a copy of each and every office visit note, and if I find an error, I write an addendum to the note. No more bullshit in my medical records. Due to the privacy laws (HIPPA), you have the right to review all of your medical records any time you want to review them, and write an addendum if they are wrong.

I too was amazed at the stuff my doctors wrote in my medical records, which will follow me around for the rest of my life. I actually had one neurologist, who told me he would be able to help me (probably the 5th I had seen that year) wrote in my medical record I did not have MS, but rather obsessive compulsive disorder. I found this out when my insurance company denied copaxone. When I call the insurance company they said it was because of something my Doctor wrote in my record. Next appointment I asked to see my record, and the Doc was furious-through my chart at me. I had to go to yet another Doc who had to write a letter to the inurance company explaining I had clinically definate MS. What a night mare. If you knew me, you would laugh at the DX of obsessive compulsive disorder.

Since we are on the subject, I believe everyone should be very careful of what they tell Doctors, because your medical records really do follow you around for the rest of your life, and you can be denied certain things, such as life insurance, depending on what is in your medical records. Your records do not belong to you, they belong to the Doctor or hospital, and here in the US they do not need your permission to give your records to other Doctors, facilities, or insurance companies. You do have the right to request your own copies, which you will have to pay for, and you have the right to review your records and add an addendum. Utilize your rights.
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Postby OddDuck » Thu Mar 17, 2005 2:45 pm

Ditto, Cathy!!! Wow.......I'm so glad to hear I'm not alone! (Although, doesn't that just take the cake?)

Well, I basically "gagged" them (legally speaking). Under HIPAA, you can withdraw any and ALL authorization for them to share your medical records with ANYONE, including speaking verbally with anyone regarding your medical records (and I also invoked the Federal Privacy Act, too, not to mention here in Tennessee, there are a few additional ones to protect medical privacy), and you're right. After this, I am going to ask to read what the doctor writes down after each visit also. They are all paid up by the insurance (we're self-insured here anyway), and I have all the copies of the records for any purposes needed.

And I also thought about writing a correction via addendum, etc., but you know what? I'm taking all three sets in total to the next physician, and I'm not saying a word. Once anybody with half a brain reads the drastic differences between all three doctors in one sitting, they'll see it all in all of its glaring detail. I mean, which physician will the new doctor believe? I'm going to remain "mum", as they say. If the new physician suggests we start from scratch, then that will tell me that I've got a physician who can see what I see. It's all a mish-mash and some of it verges on actual medical mal.

If they (the medical industry) thought I was hard to deal with before (that's why they were writing all that crap in the first place, I think........because of my legal background, so they wanted to damage my credibility just a hair - just in case), just wait NOW! Talk about breach of trust!

But, how can you prove it, ya know? Besides, the way they have some things written, if I protest too much (as the saying goes), it will only make me look worse and in some cases, might even play into their hands.

So...........nope. I'm not that dumb.

Cathy, with your legal background also, I think we "scare" them somewhat, so they start the good ole "CYA" (cover the butt) before they are even threatened or need to! That's my theory anyway, because I'd hate to believe that they really ARE that dumb.

Yep.........utilize your rights!! (Just be prepared for physicians to hate you doing so........ :lol: )

Cathy, where have you been all these past months? I could have used your support here for the past year! :wink:

Deb

EDIT: Cathy.........just as further explanation. You're right. The physical records don't belong to you, but the "information" in them DOES belong to the patient! hehe........ I researched until I found what I knew had to be there.

SECOND EDIT: Oh, and the above particularly appears to apply to physicians you have discharged and whom are no longer treating you (which I did do....I discharged them and gagged them at the same time.) AND any notes specifically referring to anything psychological at all is doubley protected! :wink:
Last edited by OddDuck on Thu Mar 17, 2005 3:17 pm, edited 1 time in total.
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Postby Cathy » Thu Mar 17, 2005 3:04 pm

I check this site all the time, but usually when I am at work, so I don't always have a lot of time. This is my absolute favorite site for MS. Its amazing how much you learn from people who live with this disease on a daily basis.

I know what you mean, if they write you are crazy (in so many words), then you do get crazy (which at this point I can) then it looks like you were crazy to begin with. I know the 6th neuro was appalled at my previous Doc's innaccuracies, and he did his best to get me what I needed. He was in Orlando and I am in the West Palm Beach area-it became too far for me because I could not drive at one point, and the trip by bus was exaughsting. (sorry-can't spell anymore) So you do need to be diplomatic and hope the new Doc is smart enough to know the previous ones were clueless.

Doctors hate lawyers and everyone who works for them. I had to leave clinical nursing because of this disease, although had not been diagnosed at the time. Came to work for lawyers because I could not find a job with a MD office that would even pay my bills. Worked as a nurse in this area for 20 years, and once I cam to work here, many of them would not treat me because of where I work. I know have a good group of doctors though, and they are not intimidated by me, nor am I intimidated by them.

I think Doctor shopping is necessary with MS. So many of them just don't get it and have no desire to get it. I was reading something about MS recently and it said the way Doc's used to deal with this was "diagnosis and addios". Meaning since there was no treatment, get lost. I think the good thing about drugs like Tysabri was not only was this drug supposed to help MS, it was going to be a money maker for the office with infusion nurses, equipment, ect..These Doctors want money makers. Not that I blame them for that, but that is what medicine has become. This is a whole new subject I don't want to get started with.

Good luck with your new Doc. Keep well.
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Postby OddDuck » Thu Mar 17, 2005 3:11 pm

Thank you, Cathy.

The same to you!! You take care, and if there is ANYTHING at all that I can do for you (or anyone, as always) please do not hesitate to ask.

I know this disease takes such a toll on a person not only physically, but emotionally.

Many hugs, Cathy!! You hang in there! I'm in your corner, if that helps at all. (It may make you feel worse! :wink: )

Keep well.....

Deb
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Postby OddDuck » Thu Mar 17, 2005 3:31 pm

In case anyone is interested, here is some good information, written with less legal terminology, regarding HIPAA and your medical privacy rights:

http://www.hhs.gov/ocr/hipaa/

Deb

EDIT: Ok, I'm on a roll. Here's another tidbit I found a while ago that substantiates some of what I'm referring to above (regarding privacy of your records by physicians no longer treating you). Note carefully below:

http://www.hhs.gov/news/facts/privacy.html

....Limits on Use of Personal Medical Information.

The privacy rule sets limits on how health plans and covered providers may use individually identifiable health information. To promote the best quality care for patients, the rule does not restrict the ability of doctors, nurses and other providers to share information needed to treat their patients. In other situations, though, personal health information generally may not be used for purposes not related to health care, and covered entities may use or share only the minimum amount of protected information needed for a particular purpose. In addition, patients would have to sign a specific authorization before a covered entity could release their medical information to a life insurer, a bank, a marketing firm or another outside business for purposes not related to their health care.
[emphasis added]

That above is what I call "gotcha"! :wink:
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