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New York City Medical Malpractice Law Blog

Treatment for Erb's Palsy

New York mothers should know that Erb's Palsy, or brachial plexus birth palsy, is a birth injury that causes the arm of a baby to grow weak and leads to loss of motion. Erb's Palsy often develops after a difficult delivery when the neck of a baby is moved to the side during a tumultuous delivery.

Infants with Erb's Palsy tend to suffer from a weakened arm during the first two years of their life. A child suffering from this condition not able to move the afflicted arm, but a physical therapist may be able to teach the parents exercises to stimulate the appendage. These therapy exercises should ideally be done when the baby is around three weeks old so that the affected arm does not become too stiff and cause contracture of the joints.

What is informed consent?

New York patients know that decisions concerning their health care are rightfully theirs to make. To accomplish this, a patient must be given adequate and clearly presented information. This allows for combined participation by the patient and his or her doctor. If the patient is incapable of understanding and participating in their care, his or her legal representative may give permission. Informed consent may not be required in emergencies.

Informed consent is a structured, thorough explanation of a patient's health status and condition provided by a physician. It also offers information concerning possible treatment or procedures, the risks and probability of success that these might render, as well as other available options. The format may be written or verbal, and the patient must understand what is being said to them. It is the physician's responsibility to ascertain that the patient comprehends this information. It is a patient's right to accept or refuse the proposed care.

Types of brachial plexus injuries

Statistically speaking, newborn children in New York will encounter brachial plexus injuries only rarely. However, when such birth injuries occur, they tend to fall into one of three types, which are stretch, rupture, and avulsion. These injuries are further designated by the site at which they occurred.

A stretch injury is the least serious. The nerves are pulled too far, often during the process of birth, and the sheath surrounding the nerve is strained. Stretch injuries often make a full recovery. A rupture is the second degree of severity. Nerves are torn and the nerve sheath is disrupted. Although the body will attempt to heal, there will be scarring and a loss of function.

How is nursing home abuse or neglect defined?

Nursing home abuse and neglect are widely defined. The Administration on Aging, a federal agency that oversees the welfare of elderly people in New York and around the country, offers a clear definition of abuse. According to the AOA, abuse is characterized as the willful infliction of injury, unreasonable confinement, intimidation or cruel punishment with resulting physical harm, pain, or mental anguish or deprivation by a person, including a caregiver, of goods or services that are necessary to avoid physical harm, mental anguish, or mental illness.

While most people associate physical abuse with pushing, hitting, or using an object to strike an individual, nursing home abuse extends further to include rape, indecent exposure and other unwanted sexual contact with a resident. Physical abuse also involves improperly restraining residents physically or by the use of a chemical substance. Nursing home abuse may include that which is done psychosocially and verbally. This type of abuse includes intimidating, humiliating, harassing or threatening the person and is done through nonverbal or verbal acts intentionally to inflict distress, pain or anguish on the elderly person.

Prevention measures for wrong-site surgeries

Research has shown that doctors in New York and across the nation are not infallible. One clear example of this is wrong-site surgeries. Whether the surgeries are performed on the wrong part or side of the body, the results for the patient can be devastating. It is estimated that these types of errors are very rare, and that the typical hospital might only have such an incident once every 10 years, but the goal for medical professionals should be to eliminate these types of preventable errors completely.

To that end, efforts are under way to protect patients by putting an end to these surgical errors. One preventive measure is preoperative site marking where the patient is actively engaged in marking and initialing the site to be operated on. The work to be performed is also reviewed before the patient is given any anesthesia or other drugs that might impair the ability to comprehend and engage in the conversation. Another measure is the timeout procedure. Designed to improve communication among the surgical staff, a checklist is reviewed before the surgery begins. The goal is to confirm that all members of the operating team are aware of the surgery to be performed and the surgical site.

What constitutes medical misconduct by a physician

Medical misconduct takes on many forms in New York. It may be reported to the Office of Professional Medical Conduct of the New York State Department of Health and, if the complaint has substance, an investigation may ensue. State residents may be interested in knowing specifically what constitutes medical misconduct and what steps need to be taken if it is suspected.

Numerous actions may be construed to be misconduct by a health care provider. Practicing while impaired by drugs or alcohol or having been criminally convicted are examples. However, telling a patient that treatment will be curative without clarification may also be considered medical misconduct. Filing reports that are false, providing fraudulent information to the patient or a third party or not treating a patient due to religion, color or nationality are all considered wrongdoing by a medical provider.

Medical malpractice and cerebral palsy

Cerebral palsy is a series of conditions that affects a child's brain and nervous system. Cerebral palsy is often the result of head trauma or oxygen deprivation at birth. Cerebral palsy is a long-term condition that requires continuing care. States with higher rates of low-weight and premature births, like New York, experience more frequent instances of cerebral palsy.

The symptoms of cerebral palsy vary greatly. The effects can range from mild physical impairments to severe crippling that requires constant care. Cerebral palsy sufferers can also experience cognitive challenges that result in reasoning, communication and behavioral impairments. The severity of the condition depends on the parts of the brain that are affected.

Family claims elderly relative was neglected at nursing home

The family of an elderly woman in New York has filed a Notice of Claim alleging that two caregivers neglected to provide their loved one with adequate daily care. The 79-year-old woman suffers from dementia and Alzheimer's disease and relies on the staff at Terrace View Long Term Care Facility in Buffalo for 24-hour care.

According to the state attorney general, a hidden camera that was placed in the patient's room captured footage of two certified nursing aides neglecting to provide the non-ambulatory woman with proper care. The 48-year-old woman and 35-year-old woman were observed failing to employ a mechanical lift to move the patient and failing to perform incontinence care with at least two people. The women are also accused of concealing the neglect with falsified documents. A lawyer for the elderly woman's family commented that the case was representative of many other elder neglect cases where the nursing facility does not employ enough staff.

Understanding birth injuries and implications

Two of the most common birth injuries are Erb's palsy and cerebral palsy. New York parents may be aware that these can result from complications that occur as a child is born. There may be a concern about the actions of medical staff during child birth when such conditions are diagnosed.

Cerebral palsy actually refers to a variety of disorders that can impact the brain function and physical activity of a baby. Commonly believed to be a result of poor oxygen supply during birth, CP can also occur due to a brain injury that takes place before labor and delivery. Tt can also occur at some point after a baby is born as well. A baby born very prematurely may have a high risk of CP. Head trauma after delivery can also cause brain injury and CP. Some prescription medications used by a mother during the pregnancy can result in CP. An obstetrician's failure to ensure a proper oxygen supply in a timely manner through Caesarean section or other means could facilitate a CP-causing brain injury as well.

How instances of wrong-site surgery can be prevented

With less than 600 wrong-site surgeries reported nationwide in 2007, a New York resident might figure that the probability of experiencing such an incident is unlikely. However, specialization of a medical professional may cause a slightly different view as approximately one-fourth of orthopedic surgeons with 25 years of experience and one-fifth of hand surgeons are reportedly involved in wrong-site incidents during their careers.

In order to establish better reporting and preventive standards, the issue has been studied and addressed on a national level. Major goals have been adopted that focus on prevention through better patient-identification procedures. Additionally, efforts to include family members in the process have been important. A pre-operative process is integral to limiting the risk of a wrong-site event.

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