Thursday, September 25, 2008

Anesthesiologist Settles Claim with Stroke Victim Who Lost Vision During Surgery.


The plaintiff was a resident of Lakehurst, New Jersey. He underwent a second spinal surgery on November 27, 2000. It was the plaintiff's contention that the defendant anesthesiologist utilized an anesthesia technique of induced hypotension, and that during the operative procedure the plaintiff's blood pressure was allowed to drop too low, causing an ischemic stroke to occur.

The plaintiff further contended that the defendant anesthesiologist failed to perform an appropriate preoperative evaluation, and failed to take into consideration in his anesthesia plan that the plaintiff suffered from hypertension, was obese, smoked and had other underlying cardiovascular problems that required his blood pressure to be higher during surgery. Further, the plaintiff took the position that he was not provided with adequate or timely blood replacement during the operative procedure, and that intraoperative monitoring of his condition was inadequate.

The defense denied that the induced hypotension was contraindicated, and took the position that the plaintiff suffered from only "white coat hypertension," and that his stroke was not due to negligence.

Lawyer John Ratkowitz (click here for bio) resolved the case while awaiting a trial date.

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Wednesday, September 24, 2008

Pediatrician Settles Traumatic Birth Injury Medical Malpractice Case for Defendant's $1 Million Insurance Liability Limits.


At 4:00 a.m. on May 24, 2001, the mother was admitted to Labor and Delivery. Initial fetal heart rate measurements were noted to be in the 100-110 beat per minute range. The defendant physician arrived at 4:30 a.m. Shortly afterward, at 4:35 a.m., the fetal monitoring strips became non-reassuring. Oxygen was applied to the mother, and position change was employed. An internal fetal scalp electrode was not applied, and a good portion of the fetal monitoring strips thereafter were uninterpretable.

At 5:05 a.m., due to continuing concerns about the fetal heart rate, the defendant applied a vacuum extractor while the baby was at +2 station, with the vertex in the occiput position. At 5:22 a.m., the baby was delivered with a midline episiotomy under local anesthesia, with Apgar scores of 2/2/5 at 1/3/10 minutes. When the plaintiff was born, resuscitation was necessary, and she was intubated.

The plaintiff was diagnosed with metabolic acidosis and persistent pulmonary hypertension while admitted at the hospital. Additionally, she demonstrated irritability though fisting, clonus and bicycling movements.

Following discharge from the hospital, an MRI of the brain demonstrated findings consistent with the chronic phase of profound asphyxia. The plaintiff suffered from aspiration pneumonia and gastroesophageal reflux and failure to thrive and required the insertion of a gastronomy tube. She then went on to develop a spastic quadriplegia and developmental delay.

The plaintiffs contended that the defendant's failure to employ an internal fetal scalp electrode was a breach of accepted standards of care, and prevented the defendant from knowing the true status of the baby's condition, and led to an inappropriate decision to move forward with operative vaginal delivery rather than taking further resuscitative measures during labor and potential cesarean section.

The defense contended that the fetal tracings were intermittently reassuring, that the mother was combative during labor and that the extremely rapid pace of labor made the defendant's anticipation of imminent vaginal delivery logical, and therefore his decision to forego a cesarean section was within accepted standards of medical care.

John Ratkowitz (click here for bio) settled the case after parties and witnesses were deposed and expert reports were exchanged.

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Tuesday, September 23, 2008

20-Year-Old Somerset, New Jersey, Resident Settles Auto-Accident Claim for $300,000.


On November 29, 2004, between 9:00 and 10:00 p.m., the defendant was traveling south on Middlebush Road in Franklin Township, New Jersey, when without warning, she veered into the northbound lane of Middlebush Road and struck the plaintiff's 1995 Toyota Corolla. The defendant advised the police that she fell asleep at the wheel and did not wake up again until after the accident occurred.

The plaintiff was removed from his vehicle with the "Jaws of Life." He was taken to Robert Wood Johnson University Hospital. Multiple radiographic studies were performed, which disclosed multiple broken bones. An x-ray of his right tibia and fibula demonstrated comminuted fractures of the distal tibia and fibula, with overriding of the fracture fragments and a lateral tilt of the distal fragments. A chest x-ray and x-ray of my left shoulder revealed a displaced fracture of the mid-shaft of the left clavicle, with inferior displacement of the distal fragment. Finally, a CT scan of the lumbar spine revealed a comminuted and displaced fracture of the left transverse process of the L3 vertebral body, and a non-displaced fracture of the left transverse process of the left vertebral body at L4. These fractures were accompanied by a diffuse disc bulge at L4-5 and a moderate diffuse disc bulge with a small central disc herniation at L5-S1.

The plaintiff underwent surgery which included intramedullary nailing with the insertion of a tibial traction pin to set and stabilize his leg fractures.

The plaintiff made a remarkable recovery, although his leg and back injuries have restricted his recreational and leisure activities. The plaintiff is currently an engineering student at college out of state.

Lawyer John Ratkowitz (click here for bio) was able to resolve the case following a settlement conference before the Honorable Victor Ashrafi.

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Tuesday, June 3, 2008

Newark Teenager Settles Negligent Security Case for $375,000 During Trial.


On October 9, 2003, at approximately 12:30 p.m., the plaintiff, who was a freshman in high school, was exiting a bathroom when two female students, who were seniors at the school, assaulted her by pinning her against the wall and inappropriately touching and fondling her. The plaintiff alleged that the assault took place in the vicinity of a security desk, and was witnessed by a security guard who failed to act to stop the attack. Additionally, the plaintiff alleged that defendants routinely failed to follow their own security policies and procedures, creating an environment in which individual security guards were largely unaccountable for their work performance.

Six days following the attack the plaintiff had to be hospitalized for anxiety attacks. She began psychiatric care on an outpatient basis following the hospitalization. She returned to school after being released from the hospital approximately one week later. At plaintiff's mother's request, the school assigned the plaintiff an aid to walk her back and forth from classes, and began bussing the plaintiff to and from school because she feared retaliation from her attackers for pressing criminal charges.

The plaintiff's condition throughout the remainder of the 2003-2004 school year ebbed and flowed in conjunction with run-ins with her attackers and alleged teasing about the attack from her peers at school. She remained under psychiatric care for medication monitoring and she received psychological counseling once a week.

Plaintiff alleged that when she returned to the high school for the 2004-2005 school year, the teasing about the October 9, 2003 sexual assault continued. Ultimately, the plaintiff was placed on a home schooling program after leaving the high school in November 2004. Shortly before her home schooling program was set to expire, she attempted suicide by overdosing on Paxil. A month later, she attempted suicide a second time by taking Paxil, this time consuming more pills. The plaintiff was then admitted into an intensive outpatient therapy program and completed her 2004-2005 school year there.

In addition to the negligent security claim, the plaintiffs alleged that the teasing she experienced at the Newark highschool denied her a harassment free school environment in violation of the New Jersey Law Against Discrimination, pursuant to L.W. v. Tom's River Regional Schools Bd. of Educ., 189 N.J. 381(2007).

At the recommendation of her social worker, the plaintiff was transferred into another school district after she was released from her outpatient treatment following her second suicide attempt. Although she remained under the care of a psychiatrist, the plaintiff excelled in her new educational environment. She was elected student body president at her new school and graduated valedictorian of her class.

Lawyer John Ratkowitz (click here for bio) represented the plaintiff. The case settled on the third day of trial.

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Friday, February 8, 2008

After Doctor Fails to Diagnose Endocarditis, 64-Year-Old Resident of Monroe Township, New Jersey Obtains Confidential Medical Malpractice Settlement

The plaintiff began to suffer flu-like symptoms in August 2002. When they persisted, he became concerned that he might be suffering from Lyme disease. Two weeks earlier he was bitten by an insect at a golf outing. When he reported this history to the defendant, his primary care physician, he was placed on prophylactic antibiotics and blood tests were ordered to rule-out the possibility of Lyme disease.

Three years before he began to suffer from flu-like symptoms, the plaintiff was found to have a heart murmur during an Executive Physical performed by another physician. The plaintiff advised the defendant of this diagnosis, and the defendant primary care doctor referred the plaintiff to a cardiologist for an echocardiogram. Investigation revealed that the defendant failed to follow-up on the echocardiogram he ordered, and never ascertained the results of that test and did not know that the plaintiff was suffering from a grade III/IV diastolic murmur and aortic regurgitation, a condition which made the plaintiff susceptible to bacterial endocarditis.

Although the plaintiff's lab studies were available on September 5, 2002, the defendant did not review them until September 16, 2002. Despite the fact that the test results came back negative for Lyme disease, the defendant continued to treat the plaintiff for that condition throughout the remainder of September and into October 2002. Ultimately, the plaintiff suffered a stroke on October 21, 2002. He was admitted to the hospital and found to have vegetations on his heart caused by bacterial endocarditis. The plaintiff underwent intravenous antibiotics to combat the infection. In early 2003 he was admitted to the hospital for aortic valve replacement surgery and repair of the mitral valve.

It was the plaintiffs' contention that accepted standards of medical care required the defendant physician to entertain Bacterial Endocarditis in his differential diagnosis, and that he failed to do so because he did not obtain the results of the echocardiogram he ordered and did not know that the plaintiff was susceptible to this disease. The defendant maintained that accepted standards of medical care did not require him to diagnose the plaintiff with Endocarditis because it is a rare disease.

Attorney John Ratkowitz represented the plaintiffs. The case was assigned to trial. Jury selection and opening statements took place. The plaintiffs called the defendant doctor as their first witness. The case settled prior to the conclusion of his testimony.

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