Articles Posted in Medical Malpractice

lung-cancerWith November being Lung Cancer Awareness Month and the 20th being designated as the Great American Smokeout, a day on which smokers are encouraged to make a plan to quit, we were especially interested to learn that South Carolina ranks third worst in the nation for combating lung cancer, according to a survey by Wallet Hub.

Wallet Hub, whose goal is to help consumers and small business owners make better financial decisions and save money, analyzed data from the U.S. Census Bureau, the CDC, the EPA, the American Cancer Society, and other sources. They looked at such things as air quality, price of cigarettes, cigarette taxes, number of smokers, lung cancer rates, and smoking bans, among other factors. Here are some of the other rankings for the Palmetto State when it comes to lung cancer:

  • South Carolina ranked 42nd in cigarette taxes,
  • 39th in lung cancer mortality,
  • 51st in cigarette prices,
  • 32nd in the percentage of smokers who attempt to quit,
  • 43rd in new lung cancer cases per capita,
  • 45th for smoking bans,
  • 46th for top-rated hospitals for cancer,
  • 15th for lung cancer mortality,
  • offering residents a 16.6 percent chance of surviving lung cancer.

In terms of making better financial decisions, I guess this data could say South Carolina is a good state for smokers to live in because cigarettes are cheap here and smoking is tolerated in most places. It could indicate this is a good state in which to set up a pulmonary medical practice, since there are lots of potential patients. But for employers concerned about productivity, this survey confirms what American Lung Association statistics say about the real cost of smoking in South Carolina: The annual cost of smoking to the state in direct healthcare expenditures is $1.6 billion, more than $1 billion in workplace productivity losses and $2.3 billion for premature deaths, for a total cost to the state’s economy of nearly $5 billion per year.

Lung cancer accounts for about a third of all cancer deaths, killing more people than breast cancer, colon cancer and prostate cancer combined, according to the American Cancer Society. In South Carolina, 3,480 cases of lung cancer were diagnosed in 2010 and 2,712 people died from the disease.

Those of us who represent victims of medical malpractice are concerned about the potential for misdiagnosis of lung cancer, either by a doctor’s diagnosing it as something else or by overlooking it altogether on X-rays or scans, either of which can lead to a deadly delay in timely treatment. Some studies have shown that as many as 25% of lung cancers are missed by radiologists when first looking at X-rays. Sometimes lung cancer is misdiagnosed as tuberculosis or a fungal infection. Another error is to note an abnormality but then fail to track it or to do further diagnostic testing. It is also possible for a pathologist to misread a biopsy sample by identifying the wrong cancer type or stage of progression.

About 230,000 new cases of lung cancer are diagnosed annually in the United States. The percentage of people who survive at least one year after lung cancer is detected is 43% and the five-year survival rate is 17%. But the sooner it is detected and appropriate treatment begun, the better the odds for the patient.

The United States Preventive Services Task Force recommends that people age 55 to 80 who have smoked a pack a day for 30 years or more, or 2 packs a day for 15 years, or who have quit within the past 15 years should receive screening for lung cancer with low-dose CT scans every year. That screening should be done until the person has not smoked for 15 years or develops a health problem that would shorten their life or prevent them from being able to have surgery for lung cancer. If you’re a long-time smoker, has your physician been following these guidelines?

According to the American College of Chest Physicians (ACCP) and the American Society of Clinical Oncology (ASCO), ”If you are considering lung cancer screening, it’s important that it is done at a cancer center that can provide the complete support and resources needed for the screening, as well as evaluating the images, managing the results, and diagnosing and treating cancer.” This should be troubling for South Carolinians, since our state ranked 46 for top-rated cancer hospitals.

If you are a smoker, the American Cancer Society has lots of information about resources to help you stop. On November 20, join the Great American Smokeout. If you or your loved one has been the victim of a misdiagnosis or medical error which led to a wrong or delayed diagnosis of lung cancer, call the Louthian Law Firm at 1-888-440-3211 or go to our website for more information.

beatlesWhen I get older, losing my hair, many years from now
Will you still be sending me a valentine, birthday greetings, bottle of wine?
If I’d been out ’til quarter to three, would you lock the door?
Will you still need me, will you still feed me when I’m sixty-four?

This Beatles tune became familiar to most Baby Boomers back in 1967. Some may still be asking these questions, but others are more worried that in their later years their medical symptoms will be misread by their physicians, attributed to normal aging instead of disease or treatable conditions.

“If you believe that your family doctor or specialist is ready to successfully handle your increasingly complex health care needs as you age, you are very likely wrong,” writes Bruce Brittain, a geriatric care consultant. Geriatrics is the medical specialty focusing on the health care needs of “the elderly” (frequently defined as those over the age of 64). The Baby Boomer generation began turning 65 in 2011, a slow-motion explosion which Brittain warns will create “77 million cranky old sex addicts with multiple medical complaints, worn out body parts but less hair.” His characterization may be debatable, but his conclusion isn’t: “There won’t be nearly enough trained geriatricians–and I’m talking about a huge gap because the number of geriatricians is shrinking–to provide appropriate care. The end result will be millions of misdiagnoses, over-medication (already a troubling problem), unnecessary and expensive procedures (likewise) and a reduced quality of life for millions of Boomers who would otherwise do quite nicely with correct care.”

There are currently about 7,600 certified geriatricians in the United States, representing just 1.2% of physicians in the country. That’s somewhere around one for every 2,600 Americans age 75 and older, according to the American Geriatrics Society. Ideally, there should be one for every 300.

Question #1: Why don’t more doctors in training become specialists in this field where the number of patients is growing exponentially?

First, it is not an especially lucrative specialty. A geriatric physician can expect to make about $200,000 per year, while other specialists average $400,000. Medicare and private insurers have established reimbursement caps, so many general practitioners briskly churn through a large caseload each day to maximize their income. To properly diagnose an elderly patient who presents with multiple complaints, a physician needs to spend time questioning and listening, something that many health care professionals avoid because it cuts down on their billable opportunities. In America, doctors are rewarded for procedures, not conversations.

Second, the curriculum at most U.S. medical schools treats geriatrics as an elective, not a required field of training. And, according to the U.S. Department of Health and Human Services, out of the 145 medical schools in the U.S., only 11 have a geriatric department. In Great Britain, every medical school has a department of geriatrics, as do one half of Japanese medical schools.

Medical school curricula have been slow to adapt and offer specialized instruction in the diagnosis and treatment of the aged. Dr. Adam Gordon, a consultant and lecturer in geriatrics at England’s Nottingham University Hospital, said, “Most medical school curriculums evolved in the last century, when the type of medicine we practiced was very different. And the way to teach doctors of old was to teach them about the heart, lung and liver and hope that they’ll somehow learn to join up the dots.” Yikes!

Question #2: What’s so different about treating older patients?

Would you take your two-year-old to your own physician? More than likely you would seek the expertise of a pediatrician. Advocates for the elderly say that geriatric medicine is as different from routine medicine as pediatrics is.

To begin with, older patients are likely to have multiple chronic conditions that overlap. A doctor may be challenged to assess which condition is implicated by a newly reported symptom. Elderly people often have multiple underlying disorders, such as hypertension or diabetes, that increase the potential for harm if a complaint is misdiagnosed. Even when a proper diagnosis has been made, the appropriate treatment of an elderly patient is likely to be different because older bodies absorb drugs more slowly and respond differently to certain protocols than younger bodies.

General physicians may dismiss some symptoms, regarding them as normal signs of aging. Things like confusion, unsteadiness, muscle weakness or gait oddities may be assumed to be typical characteristics of the elderly rather than signs of depression, nutrition or hygiene problems, or a urinary tract infection. Certain diseases are much more common among the elderly (diastolic heart failure, Alzheimer’s disease, normal pressure hydrocephalus) and may be more readily recognized by a geriatric specialist.

Conversely, doctors should take into account the natural effects of aging and not mistake pure aging for disease. For example, slow information retrieval is not dementia.

If a rose is a rose is a rose, isn’t a doctor a doctor? In a word, no. Dr. Joseph G. Ouslander, Founding Director of the Boca Institute for Quality Aging in Boca Raton, Florida, said, “I’ve worked with some truly outstanding physicians during my career but I’ve seen cases where they poison or misdiagnose their elderly patients due to ignorance of geriatric medicine.”

Question #3: Are there any solutions to the problem of the shortage of geriatric specialists?

Actually, South Carolina established an innovative program to attract more doctors with specialized training in geriatric medicine to our state. In 2005, the South Carolina General Assembly approved the first Geriatric Loan Forgiveness Program in the country. It offers up to $35,000 per year in loan forgiveness for those receiving training in an accredited geriatric fellowship, in exchange for their establishing and maintaining a geriatric or geropsychiatric practice in South Carolina for five consecutive years immediately following completion of fellowship training. With the average medical resident carrying a debt of $170,000, according to the Association of American Medical Colleges, this is a powerful incentive. Since 2006, 23 physicians have received loan forgiveness awards to establish practices in South Carolina, increasing the number of geriatricians in the state by over 50%.

Navigating safely through our later years is a challenge, and that includes finding a physician who correctly diagnoses and treats the physical and mental afflictions encountered in those years – one who takes the time necessary and who has the training and skills required and who doesn’t misread us when we’re 64 . . . or 74 . . . or 84 . . .

If you or your elderly loved one has been the victim of medical negligence or misdiagnosis, contact the Louthian Law Firm at 1-888-440-3211. We will help you seek truth and find justice.

If you’re young and single, you may think I’m talking about those little glasses of vodka or whiskey meant to be downed in one quick swallow. If you’re a parent of school-aged children, you know I’m talking about back-to-school vaccinations, which are not nearly so enticing.

Way back in 1905, the U.S. Supreme Court upheld the authority of the states to enforce compulsory vaccination laws (Jacobson v. Massachusetts, 197 U.S. 11). Childhood immunizations protect children from diseases which can have serious complications:

Measles – About one out of 10 children with measles also gets an ear infection, and up to one out of 20 gets pneumonia. For every 1,000 children who get measles, one or two will die.

Mumps – This disease can cause acquired sensorineural hearing loss in children. More rare are cases of mumps-associated encephalitis, which can be fatal.

Diphtheria/tetanus/pertussis – Diphtheria was once a major cause of illness and death among children, fatal in up to half of cases, but is no longer a problem in the U.S. due to vaccines. Caused by bacteria entering through a cut in the skin, tetanus can cause muscle contractions and seizures, pneumonia and pulmonary embolisms, with a fatality rate of 10-20%. Pertussis (whooping cough) is highly contagious and can be fatal in infants. In 2012, there were 48,277 reported cases in the U.S.

Polio – Polio is a crippling and potentially fatal infectious disease which has no cure. It spreads from person to person invading the brain and spinal cord and causing paralysis.

These are just some of the common childhood diseases for which vaccines have been developed and for which children must be immunized before attending school or a daycare facility. South Carolina’s immunization program is under the direction of the Department of Health and Environmental Control, and you can see the entire schedule of required vaccines for the 2014-15 school year.

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Columbia’s newspaper, The State, has reported that seven – and maybe more – people suffered serious infections after they were treated at University Specialty Clinics for orthopedic problems. University Specialty Clinics is staffed by doctors from the University of South Carolina School of Medicine in Columbia and has nearly 200 doctors in 35 specialties.

Although the infected patients were treated in 2012 or 2013, the S.C. Department of Health and Environmental Control has stonewalled, refusing to release information about the problem.

The problem was mycobacteria, some forms of which cause tuberculosis and leprosy. But the particular form in question at the University Specialty Clinics is mycobacterium abscessus, in a group of environmental mycobacteria found in water, soil, and dust. It can also contaminate medications and products such as medical devices and syringes. According to the National Institutes of Health, the prevalence of nontuberculous mycobacteria has increased, and so it is no surprise that we are hearing increasingly about instances of infections acquired in a healthcare setting.

How did the USC infections occur? The State tells us that one woman’s infection developed after she had a cortisone shot for a knee problem. It was so severe that she wound up being hospitalized 10 times and having seven surgeries. According to the Centers for Disease Control and Prevention, people “who receive injections without appropriate skin disinfection may be at risk for infection by M. abscessus.” As this victim’s experience illustrates, the mycobacterium abscessus organism is resistant to commonly used antibiotics. For patients with pre-existing respiratory conditions, a mycobacterial infection can lead to chronic lung diseases.

Some mycobacterium abscessus infections have been associated with the use of alternative therapies. In the mid ‘90s, an injectable product claiming to contain adrenal cortex extract (ACE) infected 87 people because one distributor’s medication had been contaminated when manufactured under non-sterile conditions in a Florida lab. Some patients required drainage of the infected site, surgical excision and plastic surgery.

A study done after the ACE outbreak reported mycobacterium infections resulting from cardiac surgery, cosmetic surgery, podiatric procedures, invasive procedures to improve hearing, and dialysis. It also cited a large outbreak in Colombia (not Columbia) when 350 patients were infected by injections of lidocaine from multi-dose vials. A cluster of infections also occurred in a Texas clinic when nurses giving allergy shots did not properly prepare the skin before injection.

Patients who develop any of the following symptoms after receiving an injection should see their doctor immediately:

  • Site of injection becomes red, warm, and tender to the touch
  • Tissue is swollen and/or painful
  • Area develops boils or pus-filled blisters
  • Patient has fever, chills, muscle aches, and a general feeling of illness.

To make a definite diagnosis, the doctor must take a sample of the discharge or biopsy the infected area and send it to a lab for analysis.

Because many bacterial abscesses occur as a result of improper procedures in healthcare settings, a patient who has been the victim of a medical provider’s negligence may wish to file a lawsuit to recover damages which can help pay for the pain they suffer and lengthy treatment they may require. As Columbia medical malpractice lawyers, we at The Louthian Law Firm know where to start and how to proceed in order to arrive at a just conclusion for patients who were harmed by those they trusted to help them become well. Call us at 1-888-440-3211.

Laparoscopic Surgery ComplicationsLaparoscopic surgeries – those done “robotically” through small incisions – have become preferred by doctors and patients in many instances, because they mean less time in the hospital, quicker recovery and minimal scarring. On April 14, 2014, however, the FDA issued a Safety Communication about the device used to accomplish some of these surgeries, specifically hysterectomies and surgeries to remove fibroid tumors in women.

The surgical device is called a morcellator, and it is produced by five companies, including Johnson & Johnson. The surgeon inserts the morcellator into the uterus through a small incision. Its blades chop up the tissue so it can be removed through the same tiny incision. What they are finding, however, is that when women have an undiagnosed cancer, a uterine sarcoma, the cancerous tissue also gets divided and may spread malignant cells throughout the abdomen and pelvis, “significantly worsening the patient’s likelihood of long-term survival.”

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back-pain-injectionsOn April 23, 2014, the FDA issued a Drug Safety Communication about corticosteroids administered through epidural injection.  Commonly used for back and neck pain, the injections may cause permanent blindness, stroke, paralysis, and death, according to the FDA’s warning.  Other serious adverse events have included spinal cord infarction, seizures, nerve injury, and brain edema.  The reactions may occur within minutes or up to 48 hours after the epidural corticosteroid injection.

The drugs’ labels will now have to carry a warning that these serious consequences can follow when the steroid is administered by spinal injection.  Injectable corticosteroids include methylprednisolone, hydrocortisone, triamcinolone, betamethasone, and dexamethasone.

The FDA never approved corticosteroids for injection into the epidural space of the spine.  For decades, however, doctors have been using them in this “off-label” fashion for treatment of chronic pain.  They are, in fact, a common form of pain intervention.  In 2011, nearly 9 million Americans received epidural steroid injections.

It was only a couple of years ago that corticosteroids were in the news after 64 people died of meningitis from contaminated supplies produced by the New England Compounding Center.  The current warning is completely unrelated to that outbreak, however.  Two other factors have prompted the FDA’s concern and latest announcement:  (1) Steroid injections via the transforaminal approach bring a needle within millimeters of critical arteries feeding the spinal cord; and (2) Particulate steroids are slow to dissolve and may create blockages that trigger strokes if accidentally injected into arteries.

The Safe Use Initiative is a program of the FDA which solicits input from medical practitioners about the use of various medications.  In 2012, they convened a group of experts from anesthesiology, orthopedics, neurology/stroke neuro-radiology, pain medicine, and physical medicine and rehabilitation to create guidelines for best practices for steroid injections administered close to the spinal arteries.  They continue to investigate the issue, and the FDA may take further actions in the future.

For the many Americans who suffer with back and neck pain, the FDA urges a discussion with healthcare professionals about alternative treatments.  A patient who has received an epidural steroid injection (ESI) should seek emergency medical attention immediately if they experience vision changes, tingling in the arms or legs, sudden weakness or numbness, dizziness, severe headache or seizures.

People who suffer from back and neck pain and are considering epidural steroid injections for pain management should seek out a highly qualified, experienced doctor who has superior training in the technique, and injections should be given in the appropriate setting, such as an ambulatory surgery center or hospital.  A 2013 investigative report on DrOz.com states:

[T]oday, general practitioners, physician assistants – even some dentists and chiropractors – have started offering ESIs. Some doctors spend just one weekend learning the delicate procedure at training centers that teach cosmetic injections like Botox and fillers, but also teach doctors how to poke around people’s spines. One weekend training center advertises epidural steroid injections as “lucrative specialty options” that “create dramatic earnings for your practice.”

Several multimillion-dollar jury verdicts have attempted to compensate men and women who sought treatment for their pain and wound up with life-long disabilities after being given corticosteroids by spinal injection.  In 2010, a Florida woman and her husband won a $36 million malpractice verdict when she was partially paralyzed by a botched steroid injection for back pain.  A Texas man is nearly blind and in a wheelchair after his treatment; he settled for a confidential sum.  A Texas teacher suffered permanent nerve injury and has difficulty with balance, pain and numbness in her legs and feet; her case is still pending in court.

If you or someone you love has been harmed by a medical practitioner who administered or prescribed a drug in an off-label use, call the South Carolina medical malpractice lawyers at the Louthian Law Firm at 888-440-3211.  When life goes wrong, we fight for what is right.

Two recent court rulings are of interest to us as a law firm which represents the rights of whistleblowers who bring to light fraudulent activity.

The first is a decision of the U.S. Supreme Court in Lawson v. FMR, a case in which the whistleblowers worked for a contractor hired by Fidelity Investments to provide advisory and management services. The two employees were dismissed after they raised concerns about what they claimed were misrepresentations in the fees charged to shareholders and the disclosures made to the SEC.

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Valentine’s Day is rapidly approaching and a new study says we should be paying as much attention to our sweet tooth as we do to our sweetheart.

South Carolina Heart Health

A new study, the biggest one so far, warns that eating too much sugar can greatly increase the risk of cardiovascular disease (CVD), which includes heart attacks, strokes and artery disease. In the past, we were encouraged to limit our sugar intake so that we wouldn’t become obese, or so that our teeth wouldn’t rot. Now the research shows, as Dr. Laura A. Schmidt states in a February 3, 2014, article for JAMA Internal Medicine, “Too much sugar does not just make us fat; it can also make us sick.”

Researchers from the Centers for Disease Control and Prevention (CDC) analyzed data from more than 31,000 people, gathered from 1988 to 2010. They found that people who consumed more than the recommended amount of calories from added sugar were more likely to die of heart disease. (Added sugars are those incorporated into food during processing and preparation, as opposed to sugars naturally occurring in fruits and vegetables.)

Different organizations make different recommendations about the amount of added sugars a person should consume: The Institute of Medicine recommends added sugars make up less than 25 percent of a person’s daily calories; the World Health Organization suggests 10 percent; and the American Heart Association says women should limit daily consumption to 5 percent and men to 7.5 percent.

This is a situation where a little means a lot. The risk of CVD doesn’t just go up as a person’s level of added sugar consumption rises – it goes up exponentially. The study shows that the risk of dying from heart disease increases when added sugar intake is more than 15% of calories consumed daily; but if you consume 33% or more, the risk is four times as great.

Heart disease is the leading cause of death worldwide and kills more than 600,000 Americans each year, according to the CDC. With February being American Heart Month, this latest announcement about the dangers of added sugar is especially timely. The most common sources of added sugar are sugar-sweetened beverages, grain-based desserts, fruit drinks, dairy desserts and candy.

Here are some products from your grocery shelves that are surprisingly high in added sugar:

  • Baked beans
  • Dried, sweetened cranberries
  • Ketchup
  • Powdered cream substitutes
  • BBQ sauce
  • Reduced calorie salad dressing
  • Powdered lemonade mix
  • Granola bars
  • Flavored yogurt
  • Sports drinks
  • Chocolate milk
  • Jelly and jam.

And about that other sweet event this month . . . Sorry, dear, you won’t be getting a heart-shaped box of chocolates. How about some string cheese?

Medical mistakes can change the entire course of a person’s life . . . and the lives of his or her family members as well. Unfortunately, misdiagnosis is one of the most common types of medical mistakes, affecting thousands of persons each year. According to the Journal of the American Medical Association, almost 40 percent of patients who unexpectedly had to return to their primary care doctor—for whatever malady–did so because they had initially been misdiagnosed.

women-cancer-misdiagnosis

A missed diagnosis or misdiagnosis can run the gamut, from mistaking a heart attack for heartburn to misreading an ultrasound. Both men and women are vulnerable, trusting that their medical caregivers will hold to the highest standards of the profession but sometimes being the victim of negligence and malpractice. This being said, however, it is true that women have unique health issues: reproductive difficulties; childbirth injuries; cervical and ovarian cancer; breast cancer.

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Any surgery has risks, even those we think of as routine. We often don’t think twice about scheduling some procedures for our children because they are so common they seem to be harmless; and, of course, the vast majority of us would never knowingly subject our children to harm. But even “routine” surgeries can have complications, as these recent news reports show.

South Carolina Surgery Mistakes

A 13-year-old girl in California was declared brain dead three days after undergoing a routine tonsil removal surgery in December 2013. The child’s physician recommended the surgery because she suffered from sleep apnea. During the patient’s recovery, she experienced excessive bleeding and trouble breathing, went into cardiac arrest and was declared brain dead. Whether or not she will remain on life support is a continuing issue before the courts.

Tonsillectomy is the most common surgical procedure in children. More than half a million tonsillectomies are performed in the United States each year. According to The Journal of Family Practice, mortality rates for the operation range from 1 in 10,000 to 1 in 35,000. The most common complication is postoperative bleeding, which usually occurs within the first 24 hours after surgery. About 1 in 200 patients is returned to the OR so that bleeding can be controlled. Other complications can include pain, nausea and vomiting. Many tonsillectomies are performed on an outpatient basis, but the Journal recommends that patients with sleep apnea, coagulation disorders, or other underlying diseases, and anyone younger than 4 years of age or living a long distance from the hospital should be admitted for overnight observation.

Earlier this year, in February, another teenaged patient died after a routine tonsillectomy at a surgical center. After the surgery, she was given Fentanyl, a strong narcotic pain reliever known to depress respiration. Her failing respiratory condition went unnoticed and she sustained significant brain damage due to oxygen deprivation. She died 15 days later. The family filed a medical malpractice case against the surgical center and received $6 million in settlement.

Another common surgical procedure for children and young adults is the removal of wisdom teeth. In March of 2013, a 24-year-old California man died unexpectedly after undergoing this routine oral procedure in a doctor’s office. A former football player, he had no known health problems. During the procedure, the patient woke up coughing, so he was given more anesthesia. (The medical records later showed he received five kinds of sedative medications, including propofol.) He went into cardiac arrest. Responding EMTs took him to a hospital, where he died three days later.

Another death from the administration of propofol during wisdom tooth surgery occurred in 2011, when a 13-year-old girl from Ohio died of brain damage. She never awoke from the sedation given in the doctor’s office. The girl was taken to a hospital, where she died two weeks later. The parents won a $1 million settlement in a personal injury lawsuit.

In April 2012, a 17-year-old Maryland girl went to her doctor for removal of her wisdom teeth. Just 15 minutes after the procedure began, she experienced respiratory complications. Her brain was severely damaged and she died 10 days later. The oral surgeon and the anesthesiologist were named in a lawsuit, which was settled for a confidential sum.

Although these kinds of tragic outcomes are rare, there are some important questions to ask your doctor or dentist before you or your child has a “routine” surgical procedure:

• Is the office the right setting for the procedure, or are there medical issues that might make it safer to go to the hospital?
• Who will be giving sedation or anesthesia?
• What type of sedation or anesthesia will be used?
• Will someone other than the surgeon be monitoring blood pressure, heart rate and breathing? (The answer should be yes.)
• Is equipment available if the patient stops breathing?
• Is someone on staff certified in Advanced Cardiac Life Support?
• What is the doctor’s plan in case of emergency?
• Who will monitor the patient’s recovery and supervise their discharge?

If you or someone you care about has suffered complications from a “routine” procedure, contact the Louthian Law Firm today by using our online form or call toll free at 888-662-0434 or locally at 803-454-1200. We have been helping injured people find justice since 1959.