Pulmonary embolism is a condition that occurs when a blockage occurs in one or both of the branches of the pulmonary artery that carry blood to the lungs.

Pulmonary embolism is most often caused by Deep Vein Thrombosis (DVT), a condition where a blood clot (thrombus) forms in the deep veins of the legs. The most common cause of DVT is trauma to the hip or leg. In addition, certain medical conditions create an increased risk of DVT, including paralysis, pregnancy, cancer, Irritable Bowel Syndrome, and certain rare blood conditions. DVT may also result from being confined to bed or sitting for a prolonged period of time. A pulmonary embolism occurs when a piece of the clot breaks off and travels (embolizes) to the heart.

A pulmonary embolism may result from failure to timely diagnose and treat DVT. There are many ways in which DVT can be diagnosed, the most common being an ultrasound. DVT”s are treated most often by administering anticoagulants (blood thinners) intravenously in the hospital and continuing orally once the patient is stabilized.

There are many recognizable signs of a pulmonary embolism. These include shortness of breath, sharp chest pain, rapid pulse, profuse sweating, and anxiety. It is important that the symptoms be treated immediately as death may occur within a very short period of time if left untreated. There are three common tests used to diagnose a pulmonary embolism, including pulmonary angiography, a lung perfusion scan (also known as a V/Q scan), and a lung ventilation scan.

The most effective means of preventing pulmonary embolism is by identifying those patients at greatest risk for DVT and providing appropriate prophylactic (preventive) measures to minimize the possibility of forming blood clots. Some common methods of DVT prophylaxis include elastic stockings, sequential compression devices, and subcutaneous (under the skin) low dose heparin. These patients must be closely monitored for signs and symptoms of DVT or pulmonary embolism so that therapeutic treatment can be promptly instituted.

Many of the wrongful death cases that we handle at Zucker and Ballen involve the failure to prescribe appropriate DVT prophylaxis as well as delayed diagnosis and treatment of DVT and pulmonary embolism. Please contact one of our medical malpractice attorneys if a loved one has suffered a wrongful death due to pulmonary embolism.

We at Zucker and Ballen handle many types of cancer cases. Cancer includes any of more than 100 diseases characterized by excessive, uncontrolled growth of abnormal cells that invade and destroy other tissues. Survival rates depend on the type of cancer and the timeliness of diagnosis. Many, but not all, cancers have a high cure rate when diagnosed early and a very low cure rate when diagnosed late. Unfortunately, some cancers have a low cure rate even when detected at the earliest possible time. Examples of cancers that are highly curable when caught and treated early and rarely curable when the diagnosis or proper treatment is delayed are melanoma, colon cancer, bladder cancer, breast cancer, cervical cancer, prostate cancer, lung cancer, kidney cancer, thyroid cancer, and testicular cancer.

Some cancers, such as breast cancer, cervical cancer, and colon cancer, can be detected before the patient experiences any symptoms by performing routine screenings, such as mammograms, pap smears, HPV tests, and colonoscopies. In evaluating cases such as these, we review the medical records to determine if the patient was advised to have appropriate screening tests performed, whether the tests were performed properly, and whether the results of the tests were correctly interpreted. It is important to consider the individual patient when determining when and how often these routine tests must be done. For example, certain patients are at increased risk of developing colon cancer, including patients who suffer from ulcerative colitis or have a family history of colon cancer, or have a history of polyps. Therefore, those patients must have more frequent colonoscopies.

Although the majority of cancers are not tested for routinely, certain symptoms should cause a physician to have a high index of suspicion for the presence of cancer. When a patient presents with non-specific symptoms, doctors are trained to formulate a differential diagnosis by first ruling out any condition that could potentially pose an immediate threat to the patient’s life and then, by process of elimination, identify the etiology (cause) of the patient’s symptoms.

Examples of cases we have handled include misread mammograms and x-rays, failure to biopsy a suspicious lesion for melanoma, failure to thoroughly evaluate the colon and perform a sufficient number of biopsies during a colonoscopy, failure to inspect the bladder and ureters when investigating the cause of hematuria (blood in urine), taking inadequate tissue samples for biopsies to rule out laryngeal cancer, failure to properly read a PAP smear, and causing severe burns due to excessive radiation.

As the old saying goes, “If you repeat something often enough people will assume it must be true.” Americans have repeatedly been told by no less a source than the President of the United States that the courts are flooded with frivolous medical malpractice cases that have driven up the cost of medical care and health insurance. The typical uninformed citizen might be justified in assuming that this must be true. After all, we have heard this message frequently during political campaigns and in each of the president’s State of the Union addresses. However, a January 2007 report by Public Citizen Congress Watch found that the overwhelming majority of medical malpractice cases are not frivolous, that insurance companies continue to reap huge profits, that the number of medical malpractice cases has decreased over the past several years, that the largest payments have been made to those who have suffered the most serious injuries, that most medical errors do not result in lawsuits, and that a small percentage of physicians account for the majority of cases where payments are made. To those of us who represent clients in the field of medical malpractice, this comes as no surprise. At Zucker & Ballen, we consult with appropriate medical specialists before commencing a lawsuit. We provide these specialists with all of the relevant medical records and obtain an opinion as to whether the treatment conformed with accepted standards of care. This allows us to identify the responsible parties before the lawsuit is commenced and, importantly, provides our attorneys with a clear understanding of the relevant medical issues. If you believe that you or a loved one have been injured as a result of medical malpractice, call our attorneys at Zucker & Ballen or go to our website at www.zuckerballen.com.

One of the most common medical malpractice cases at Zucker & Ballen involves injury to the common bile duct during surgical removal of the gallbladder. Since 1990, when laparoscopic cholecystectomy was approved, it has grown in popularity and is currently the most common surgery performed in the United States for removal of the gallbladder. This surgery has obvious advantages over the open surgery where a large incision is made and the abdomen opened. Laparoscopic surgery entails four very small incisions through which instruments and a camera are placed and allows the surgeon to view the gallbladder and surrounding structures on a television monitor which magnifies the image to 12 times its normal size. Surgical clips are then placed on the cystic duct which connects the gallbladder to the common bile duct. One clip is placed at the base of the gallbladder where it connects to the cystic duct and a second clip is placed at the other end of the cystic duct where it connects to the common bile duct. A cut is made between the two clips and the gallbladder is removed through the umbilicus (the belly button). Foremost among the concerns of the surgeon is to avoid mistakenly cutting the common bile duct rather than the cystic duct. It is this surgical error that has been the basis of many malpractice claims that we have successfully handled at Zucker & Ballen. In truth, there is no excuse for this error. Surgeons are taught in their training that if there is any doubt as to whether they have correctly identified the cystic duct, they should cease doing the surgery laparoscopically and convert to an open surgery. The surgeon can only be certain that he has identified the cystic duct if he can clearly see the connection between the end of the duct and the base of the gallbladder. This requires that the surgeon dissect (cut away) the gallbladder from the surrounding tissue. However, because of variations in anatomy (only 25% of patients have the classic anatomy) and because of inflammation that frequently occurs in acute flareups, it may be difficult to clearly visualize this junction. Thus, all surgeons routinely obtain consent from the patient preoperatively to convert to an open procedure in the event there is difficulty identifying the junction between the cystic duct and the gallbladder. In its March 12, 2007 issue, Newsweek reports that 1 in 200 patients undergoing this surgery sustain serious injury due to the surgeon’s error in cutting the common bile duct rather than the cystic duct. Even more alarmingly, many patients sustain further injury due to inadequate repair of the common bile duct after the initial injury occurs. Whereas it was previously common to perform a repair by simply sewing the severed bile duct back together (a primary repair), it has been found that this frequently causes stenosis (narrowing) of the bile duct with a resultant blockage of bile flow to the intestine and a backup of bile into the liver which, in turn, can lead to liver failure and death. Thus, a Roux-en-Y repair is now preferred whereby a new connection is made in order to circumvent the blockage. Many surgeons who are untrained or unskilled in this repair nevertheless attempt to perform the repair themselves rather than call in an appropriately trained specialist. If you or a family member have been injured during laparoscopic gallbladder removal surgery, please call our medical malpractice lawyers at Zucker & Ballen for a free consultation or contact us through our website at www.zuckerballen.com.

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