Posted On: December 29, 2010

Chicago Attorney Robert Kreisman Explains Reasons for Chicago Judge's Dismissal of Whistleblower Lawsuit - Goldberg v. Rush University Medical Center and Midwest Orthopaedics at Rush, LLC

Northern District of Illinois Federal Judge Ruben Castillo dismissed the whistle-blower lawsuit brought by Robert S. Goldberg, M.D. against Rush University Medical Center, Midwest Orthopaedics at Rush, LLC and other named orthopedic surgeons under the provisions of the False Claims Act, 31 U.S.C. §3727 et seq. The lawsuit,Robert S. Goldberg, M.D. and June Beecham v. Rush University Medical Center, et al., 04-CV-04584, was brought in the federal court by Dr. Goldberg claiming that Rush University Medical Center, along with the orthopedic surgeons and their physicians group, had been overbilling Medicare.

whistle%201.jpgChicago medical malpractice attorney Robert Kreisman was interviewed by The Chicago Tribune's Melissa Harris in an attempt to shed some light on the judge's decision in Goldberg. While Illinois lawsuits involving doctors and hospitals typically are regarding medical negligence that has occurred, in the case of Goldberg, the Illinois lawsuit involved accusations made by one of Rush's orthopedic surgeons of fraudulent activities committed against the government. These types of case, where a plaintiff brings forth an action because he or she believes that the government has been defrauded, are called whistleblower cases.

The fraud at issue in Goldberg was that a group of orthopedic surgeons at Rush University Medical Center were violating Medicare billing requirements when they overbooked surgeries and through their heavy reliance on residents to perform parts or all of the surgeries. Rush is a teaching hospital and is compensated for training its residents, not for allowing its residents to perform unsupervised surgical procedures.

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Posted On: January 25, 2010

Radiation Therapy Treatment for Cancer Patients at All-Time High

For many years, radiation therapy has been considered one of the standard treatments given for cancer patients with more than half of all cancer patients receiving some type of radiation therapy. And while radiation does help save many lives, it also presents serious risks for patients and may cause life-threatening injuries or result in potential Illinois medical malpractice.

Medical%20Symbol%204.jpgTherefore, when radiation is used, safety rules must be strictly adhered to because sometimes even the most powerful and technicologically complex machines go awry. And while new technology allows doctors to more accurately attack tumors and reduce certain mistakes, its complexity has created new possibiliities for error through software flaws, faulty programming, poor safety procedures or inadequate staffing and training. When those errors and medical negligence do occur they can be devastating.

Hospitals and doctors trust computer systems and software to apply radiation in many cancer victims. However, there is no single agency that oversees medical radiation and no central clearing house of cases. Furthermore, radiation accidents are chronically underreported, and some states, including Illinois, radiation accidents are not required to be reported at all.

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Posted On: December 23, 2009

New Risk Calculator Available For Bone Fractures To Women

Osteoporosis poses a serious health risk for women both in Chicago and nationwide. According to the National Osteoporosis Foundation, one out of every two women will experience an osteoporosis-related incident during their lifetime, compared to one in every five men.

Spine%20xray%202.jpgOsteoporosis is a condition characterized by thinning bones as people age. More fragile bones means that even low-trauma, seemingly minor falls can be debilitating and costly for those who suffer from osteoporosis. An estimated $17 billion is spent nationwide for treatment of fractures connected to fractures to those afflicted with osteoporosis.

Common treatment for osteoporosis involves placing the patient on medications that attempt to slow the disease's progression. However, there is some question as to at what point patients should be started on medications. For example, should patients whose bones are being to weaken be placed on medications even if they are not yet osteoporotic? Or how about those who have no history of any episode or prior fractures due to osteoporosis, but has osteopenia, a state of lower bone density that may or may not lead to osteoporosis?

To help answer these questions, the World Health Organization (WHO) devised a controversial tool called FRAX, an online risk calculator to help doctors and patients analyze the likelihood of future osteoporotic fractures and determine whether drug therapy might prevent them.

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Posted On: December 11, 2009

Cancer Patient Saved by 43 Hour Ex Vivo Resection Surgery

A 59 year-old man with a large tumor on his liver recently underwent a grueling 43 hour surgery to remove the tumor and give him a new lease on life. The lengthy surgery was performed by a team of physicians at New York Presbyterian Hospital and Columbia University Medical Center.

Scrubs%202.gifThis particular surgery is unique in that it was an ex vivo resection, which essentially involves removing the organs and operating on them outside the body. This type of procedure is done when tumors cannot be treated or removed in any other way. Once the tumor is removed, the organs are returned to the body and sewn back in.

Ex vivo resections are highly complicated and can require the work of dozens of surgeons and anesthesiologists, which is in turn reflected in the high cost of the procedure. However, according to one of the surgeons in the present case, Tomoaki Kato, MD, "If you don't do it, the patient would have no chance to live." Dr. Kato has been the lead surgeon in about 16 ex vivo operations and assisted in half a dozen others.

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Posted On: December 9, 2009

High Blood Pressure Could Be Better Controlled By Applying Teamwork Approach

High blood pressure is a fairly common complaint among Americans. A new study has shown that many Illinois and American patients with high blood pressure have a difficult time keeping their blood pressure under control. Generally, fewer than 40% of Americans with high blood pressure have their hypertension under control.

Pills%20C%202.bmpThe Midwest study was conducted by researchers at the University of Iowa. The clinical trial involved over 400 patients with uncontrolled hypertension, i.e. high blood pressure, who were treated at six different clinics around the Midwestern state. While all of the clinics employed clinical pharmacists, only three of those clinics had the pharmacists teamed with physicians.

The outcome of the new study suggests that results can improve if the physician and pharmacist work together as a team to help lower blood pressure. After six months, 53.9% of the patients who were being cared for by a doctor/pharmacist team had gotten their blood pressure under control, compared to 29.9% of the patients of the regular care group.

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Posted On: November 30, 2009

Diabetes on the Rise Could Lead to Higher Insurance Costs

It is predicted that the number of Americans with diabetes would nearly double over the next 25 years. At the same time, the cost of care would almost triple as patients live longer and develop more of the disease's long-term complications.

Med%20Money%203.gifA University of Chicago researcher, Dr. Elbert S. Huang, the lead author of a recent paper says that, "In 25 years, there is going to be this convergence of the population getting older but also many people having had diabetes for a long period of time, and that would lead to higher costs".

The projections estimate that the population of diabetic individuals will rise to 44.1 million by the year 2034. At the present time there are approximately 23.7 million persons afflicted with diabetes with medical spending increasing to $336 billion from $113 billion.

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Posted On: October 28, 2009

Heart Valve Replacement Surgery To Be Made Safer

Leading heart valve manufacturers Edwards Lifesciences and Medtronic are racing each other to perfect new heart valves that could revolutionize heart valve replacement surgery. The new heart valves would result in a less-invasive surgery because they can be inserted via catheters without the requirement for an open heart procedure. And because the procedure is less invasive, more people would be candidates to receive valve replacements. Currently there is a significant population of critically ill or elderly patients who are considered too frail to undergo open heart surgery and therefore are not able to receive new heart valves.

Heart%20Anatomy%202.jpgThe new heart valves have been available in Europe for 18 months and have thus far yielded positive results. Medical trials of the valves are being conducted in the U.S. amongst older, critically ill patients who are not candidates for open heart surgery. Medical experts predict that if the devices live up to their makers’ claims they could revolutionize heart valve replacement, a common heart operation, and extend the lives of thousands of frail patients who are not now considered candidates for the open heart surgery.

An estimated 20,000 people die annually from heart valve-related diseases, including those too sick to withstand the open-heart surgery. The new valves would be meant to enable more such patients to have life-saving valve replacements. Furthermore, a less risky surgery lessens the possibility of transplant errors from occurring.

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Posted On: August 31, 2009

Arthritis Pain Can Be Eased By Certain Foods Found in Mediterranean Diet According to Several Studies

Arthritis is becoming more and more of a common problem with research showing that as many as one in four Illinois residents suffering from some form of arthritis. Oftentimes there is no cure for arthritis so scientists are constantly searching for methods of alleviating arthritis pain.

Elderly%20Hands%202.jpgA recent diet analysis involving various types of arthritis examined data from more than 800 patients taken from 15 studies. The analysis focused on several diets that were popular among arthritis patients.

A Mediterranean-style diet was found to be the most effective and emphasized eating fruits, vegetables, grains, fish, and olive oil while also limiting red meat consumption. Over a 12 weeks those on this diet reported about a 15% reduction in joint pain, but showed no improvement in morning stiffness or physical function.

The study showed that similar results could be achieved through a vegetarian diet that included eggs and dairy. Other research has suggested that consuming daily capsules of fish oil along with antirheumatic medications yielded greater benefits for tender and swollen joints than when the medications were taken on their own. These results are suspected to be due to the anti-inflammatory properties of oils.

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Posted On: August 17, 2009

Asperger’s Syndrome Draws Attention As Subject of Three New Movies

Over 20 years have passed since we were introduced to Dustin Hoffman's portrayal of an autistic man in "Rainman". Since then there has been little or no film portraits of Asperger’s syndrome, a complex and mysterious neurological disorder linked to autism, but that will all change this year as three upcoming films offer a broader view of autism disorder.

movie-reel%201.jpgThe first of these films, "Adam", has already been released and has garnished significant attention, including receipt of the Alfred P. Sloan Prize at the Sundance Film Festival for outstanding feature films focusing on science and technology. The film centers on the life of an adult male with Asperger's syndrome and a passion for astronomy and his romance with a neighbor.

Adam is portrayed as a young man with Asperger’s who is left to defend for himself after his father dies. Adam is about life, not his disability. It uses Asperger’s as the lens that views his life. The movie is about relationships, love and family. It is now playing at the Evanston Theater on Maple Street in Evanston, Illinois.

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Posted On: August 12, 2009

Chemotherapy Patients Acknowledge Memory Loss

Two years ago The New York Times published an article dealing with chemo brain, a type of mental fog experienced by cancer patients. Recent research has indicated that this phenomenon might be more widespread than previously believed.

Stethoscope%202.jpgWhile memory and concentration problems are common among chemotherapy patients, for most these effects are short-term and their cognitive function returns to normal. However, for about 15 percent of these patients the memory impairment is prolonged. It is these patients who are suffering from chemotherapy-induced cognitive impairment, or "chemo brain".

Many studies are being done to try and pin down the cause of chemo brain. Some researchers are exploring whether there is a connection between hormonal changes from chemotherapy and chemo brain, while others are examining which drugs have the strongest links to chemo brain. Yet there are some therapists who argue that chemo brain is the result of the psychological strain of cancer and can be attributed to anxiety, depression, stress, fatigue and fear rather than direct effects of chemotherapy on the brain.

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Posted On: August 7, 2009

Child Birth Injuries And Maternal Deaths On The Rise In Poor Countries

A recent New York Times editorial caught my eye about a woman in Pakistan who lost her baby after a long, difficult labor and delivery. Her experience was used to demonstrate the lack of emphasis placed on medical practices that we in America take for granted, such as giving birth to your child at a hospital, and the effect that this has on maternal and child birth injuries in impoverished countries.

Pregnant%20Woman%201.jpgRecent research suggests that worldwide perhaps as many as one woman dies every minute from complications of pregnancy or childbirth, which is about 20 times greater than the number who have suffered childbirth injuries. As a firm we have taken on several Illinois birth injury cases and there are no words you can offer the family for their loss and pain. What is so striking about The New York Times article is that it suggests that these startling statistics could improve if more emphasis was placed on maternal well being.

For example, while Sri Lanka is an impoverished country it has succeeded in saving more mothers because it simply has tried to do so. And while this sounds like an oversimple solution in our country where a great deal of emphasis is placed on prenatal care and delivery, in impoverished countries this is not the case. The girl portrayed in the article was not taken to a hospital until after she had already been in labor for over 24 hours. By the time a c-section was performed her baby was already too weak to survive. If she had been taken to the hospital and followed by medical professionals from the start of her labor then the outcome might have been different. Yet this is not the standard in her native Pakistan, where one in 74 woman die from pregnancy complications.

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Posted On: July 8, 2009

Medical Advances Expand Kidney Transplants

The number of Americans and Chicagoans suffering from chronic kidney disease has drastically increased in recent years, driven by high rates of hypertension and diabetes. Likewise the reported cases of patients with end stage renal disease has risen, which can only be treated with dialysis or a kidney transplant. And despite improvements in dialysis technology and the possibility of transplant errors, the transplant remains the most effective and preferred treatment due to its better long term outcomes and quality of life.

Kidneys%201.jpgAccording to the National Kidney Foundation, almost 80,000 Americans are currently on a waiting list for a new kidney. However, not everyone is considered a prime candidate for transplant surgery.

Consider the case of a stunned patient suffering from kidney failure who was informed by a group of physicians that her mother's attempts to donate one of her own kidneys was out of the question. Like 3 out of 10 kidney-transplant candidates, this patient had tested positive on a panel reactive antibody (PRA) blood test, which revealed that the patient had high levels of PRAs, or proteins that attack foreign tissue. So even though her mother's kidney would have been a good match based on its blood type and tissue, the patient's body would have attacked it.

Until recently patients with high PRA levels had little chance of success for transplantation and were oftentimes forced to remain on dialysis. In fact, as recently as 10 years ago a kidney transplant was absolutely contradicted for patients with high PRA levels. Increased PRA levels can be caused by blood transfusions, pregnancy, or a previous transplant.

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Posted On: July 1, 2009

Birth Injury Reduction Unlikely to Occur Under Revised Fetal Monitoring Strip Guidelines for Doctors in the Delivery Room

The current standard for labor and delivery practices is to use electric fetal monitoring (EFM) to evaluate a baby's status. Physicians and nurses will review the EFM readings in order to reduce the risks of a birth injury, such as erb's palsy or cerebral palsy (CP), and death as a result of inadequate oxygen to the fetal brain. However, there is some concern regarding whether the EFM does more harm than good due to inconsistent interpretations of the EFM strips by both physicians and nurses.

Fetal%20Monitoring%20Strips%201.gifEFM has been used in the labor and delivery setting since the early 1970s. Essentially the EFM monitors the fetal heart rate and reproduces the fetal heart tracings on both a screen and paper to enable the medical staff to determine when a baby is distressed. The readings are ultimately used to determine if the baby needs to be delivered surgically by Cesarean section or can be delivered vaginally.

However, unlike a basic medical marker like temperature or blood pressure which is not subject to interpretation, the EFM tracings can be interpreted differently by different doctors. Depending how the individual physician interprets a monitoring strip there can be a difference in opinion about the proper course of action. Recent information has show an increase in the number of c-section deliveries. For example, in Chicago almost 40 percent of deliveries are done via Cesarean.

Some critics say that this rise in c-section deliveries is the result of an increased fear among labor and delivery physicians of potential medical malpractice litigation. While a Cesarean is not necessarily a dangerous option, it still carries risks for both the mother and infant and is much more expensive than a simple vaginal delivery.

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Posted On: May 22, 2009

Medical Industry Gifts To Doctors To Be Made Public

Vermont recently enacted a law (S.48) requiring doctors to publicly disclose any and all medical industry payments they receive. Under the law 'medical industry payments' includes any money and/or gifts made to healthcare providers. The healthcare providers are required to specify the names of the gift givers and the corresponding dollar amounts. The new law goes a step beyond just making all gift exchanges a matter of public record and bans nearly all industry gifts to doctors, nurses, medical staff, pharmacists, health plan administrators and healthcare facilities.

Gift%20Box%201.jpgAfter the new law goes into effect on July 1, 2009, state citizens can learn which doctors have been paid by manufacturers of brand-named drugs that they have been prescribing their patients, or how much money surgeons have received from the makers of stents, pacemakers, artificial knees, and other implant devices. The law is designed to provide a window into the considerable efforts and spending by device and drug makers to influence doctors.

This law, and others like it, is in response to concerns that drug and medical device manufacturers exert too much influence over doctors and their practice. For more information on this debate, please see our March 2009 blog "Do Drug Companies Really Influence Doctor’s Decisions Regarding Dispensing Drugs to Illinois’ Residents?".

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Posted On: May 21, 2009

Cancer Patients Sue Over Gene Patents

Advances in the field of genetics has made for some exciting medical advances in the past few years. For example, the sequencing of the human genome has led to many medical breakthroughs. Furthermore the availability of more genes and sequences has increased research in the use of gene patterns to silence human tumors and allowed for better classification of tumors and disease. Genetics can also be used to predict a client's prognosis and potential response to various anti-cancer treatments.

Genes%202.jpgRecently a lawsuit was filed against Myriad Genetics, a gene company that owns a patent on BRCA1 and BRCA2, two genes closely associated with increased risk for breast cancer and ovarian cancer. The patent system gives companies like Myriad the ability to exclusively promote its innovations and allows for substantial research and development investments. The result is that the patent restrictions allows Myriad to restrict others from measuring the risk the gene poses for closely associated cancers.

The New York lawsuit against Myriad was brought by the American Civil Liberties Union (ACLU) on behalf of the plaintiffs. The case blends medical science, patent law, breast cancer, activism and an unusual civil liberties argument that could make this case a landmark.

While Myriad Genetics is the defendant in the lawsuit, the plaintiffs claim that they have a bigger bone to pick with the U.S. patent office than they do with the company holding the gene patent, i.e. Myriad.

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