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Category: Medical Malpractice

Over Radiation In The Treatment Of Cancer


The use of radiation therapy for cancer treatment is designed to kill cancer cells and stop the cancer from spreading. It is a specific and exact therapy where an external beam is directed to the site of the cancer by a machine called a linear accelerator. The beam is precise in terms of the amount of dose sent to specific areas on the human body for treatment.

Over radiation occurs when the patient gets more than the prescribed dose of radiation over a period of time. The results for over radiated patients even in seemingly small doses weakens and kills healthy tissue causing skin and organ damage.

In a remarkable article by Josh Goldstein of the Philadelphia Inquirer it was reported last week that the Hospital of the University of Pennsylvania (HUP) has publicly revealed that on January 21, 2010 a man being treated for prostate cancer received radioactive seeds, a similar therapy to that of a linear accelerator, which were incorrectly implanted outside of the intended target site. Similarly, the Department of Veterans Affairs in December 2009 apologized for a prostate-cancer program where veterans were over radiated for six years at its main Philadelphia VA Hospital via the same method as in the HUP case.

These are not isolated events. In a lawsuit against the Melbourne Internal Medicine Associates, a cancer clinic in Melbourne, Florida, it is alleged that doctors put patients at risk through poor safety procedures as well as lack of oversight of technicians, and then tried to cover up their mistakes. Not only that, but the lawsuit further alleges that the clinic fraudulently over billed Medicare from 2003 through 2008 for the over use of the high tech and highly reimbursed radiation treatments. The Florida suit was started by a “whistle blower,” a Fred Fangman, the cancer center’s former director of radiation oncology. Federal prosecutors joined in the suit.

Walt Bogdanich of the New York Times has been following this issue. His article dated January 26, 2010 entitled “The Radiation Boom-As Technology Surges, Radiation Safeguards Lag” reports the following.

In New Jersey, 36 cancer patients at a veterans hospital in East Orange were overradiated — and 20 more received substandard treatment — by a medical team that lacked experience in using a machine that generated high-powered beams of radiation. The mistakes, which have not been publicly reported, continued for months because the hospital had no system in place to catch the errors.

Lorraine Raymond, a radiation therapist, raised concerns about overradiation in the treatment of Frederick Stein at a Veterans Affairs hospital in New Jersey in 2006.
In Louisiana, Landreaux A. Donaldson received 38 straight overdoses of radiation, each nearly twice the prescribed amount, while undergoing treatment for prostate cancer. He was treated with a machine so new that the hospital made a miscalculation even with training instructors still on site.

In Texas, George Garst now wears two external bags — one for urine and one for fecal matter — because of severe radiation injuries he suffered after a medical physicist who said he was overworked failed to detect a mistake. The overdose was never reported to the authorities because rules did not require it.

These mistakes and the failure of hospitals to quickly identify them offer a rare look into the vulnerability of patient safeguards at a time when increasingly complex, computer-controlled devices are fundamentally changing medical radiation, delivering higher doses in less time with greater precision than ever before.


Was Your Doctor Mistaken? Cases of Misdiagnosis Highlight the Importance of Getting a Second Opinion


On Tuesday, January 17, 2012, The Wall Street Journal’s Laura Landro reported that seeking second opinions from doctors can lead to drastic changes in diagnoses. It is not unheard of for mistakes to occur during the process of diagnosing an illness. It is possible for the reading of radiology slides and biopsies to be entirely incorrect or just false enough to leave a patient seeking the wrong treatment.

Second opinions have, for example, revealed malignant tumors to be benign; and, in some cases, what was initially thought to be asthma has later been diagnosed as chronic obstructive pulmonary disease. To say the least, seeking a second opinion can be an effective safeguard against misdiagnoses.

Misdiagnosis is one of the leading reasons for medical malpractice lawsuits as patients can waste valuable time seeking treatment they do not need, or undergoing surgery which proved to be useless to their condition. Some of the most common misdiagnoses involve:

Breast cancer
Lymphoma
Thyroid cancer
Salivary gland cancer
Chronic obstructive pulmonary disease
Alzheimer’s disease
Coronary artery
It is good to remember that doctors are human and, as a consequence, are not perfect. They can occasionally become entrenched in a diagnosis, unintentionally overlooking evidence which would either disprove their diagnosis or indicate a different diagnosis. A fresh set of eyes, as it were, can be vital to getting to the core of your ailment. Remember, you are entitled to take slides, pathology reports, and other information to another doctor for your second opinion.

Of course, we know you can’t always afford to obtain a second opinion for your diagnosis or treatment plan. Sometimes you simply have to accept what your medical professional has told you. This why it is important that your primary care physician is someone whom you trust and respect.

If you decide to seek a second opinion for your diagnosis, here are some questions to ask so you can get the most out of your second opinion:

“Are the test results contestable? Could a second round of testing prove useful?”
“Are you positive that this is the disease I have? Is it possible that there are other explanations for my symptoms?”
“Do you agree with the original diagnosis? If so, are you able to suggest any alterations or modifications to my treatment plan?”
“Have we explored all possible options?”
When it comes to your health you should try to be as informed as possible. The more you know about yourself and your condition, the more you can help your doctors treat you. Read “Top 5 Common Misdiagnoses” and “Most Common Types of Medical Malpractice,” and other articles located in our Medical Malpractice Law Articles section of our website.


The Unanticipated Problems For Doctors With The Passage Of The Fair Share Act


The new Fair Share Act passed earlier this year eliminates joint and several liability. Joint liability now only applies when a defendant is found at fault for not less than 60 percent of the total liability apportioned to all parties. Under the predecessor statute of joint and several liability, a legal doctrine that had ruled Pennsylvania since the Colonial era, a successful plaintiff could pursue a judgment against any one party as if it were jointly liable; it then became the responsibility of the defendants to sort out their respective proportions of liability and payment. Now, collection of the judgment is based on a defendant’s actual level of responsibility for an injury so long as that defendant is not found by the jury to be 60 per cent or more negligent vis a vis the other defendants.

But, in the medical malpractice context, the abolition of joint and several liability in fact exposes individual doctors to the risk of greater jeopardy to personal assets. Why? Typically the defendant doctor is sued as a corporation and as an individual actor. Under the old law, a total payment of the verdict (or settlement) would be made on behalf of the doctor and his corporate entity and paid by the defendant doctor’s corporate medical malpractice insurer. Case over. Under the current law, if that doctor is found less than 60 per cent negligent, the plaintiff can only collect on a pro rata portion of the verdict of that doctor’s negligence. In other words, with the enactment of the Fair Share Act, plaintiffs’ counsel clearly have a greater incentive, and legal obligation, for suing physicians individually and keeping those judgments on file in the courts indefinitely where excess verdicts, over and above the carrier’s policy limits, are obtained. Additionally, the Fair Share Act’s intent was to reduce exposure to medical defendants. But consider the likelihood that more defendants will have to be sued in order for plaintiffs’ counsel to try to identify the individual or corporate entity who may ultimately be the defendant who is 60 percent or more responsible for plaintiff’s injuries. That information is simply not known pre-suit, and can only accurately be determined after litigation is commenced and in the discovery portion of the case. More defendants will undoubtedly be sued than they otherwise would have been before the abolition of joint and several liability.

Who may these defendants be? They will be nurses, hospitals policy makers, administrators, and peripheral physicians who would otherwise not have been the focus of the lawsuit, but now will be, under the Fair Share Act.

The stated purpose of the Hospital and Health System Association of Pennsylvania was to get more doctors into the clutches of hospital employment equating to the consolidation and control of medical care by the large hospital corporations. And why wouldn’t a doctor want that? Clearly he or she would because as an employee of the hospital corporation the doctor not only does not have to worry about liability coverage, but the hospital corporation can purchase greater amount of coverage than the individual doctor could have or would have otherwise chosen.

The unrealized and unanticipated effects of the Fair Share Act will be played out in the Commonwealth’s courts for years to come, and unfortunately some physicians may find they do not like the results.