|
|
Michles & Booth Blog
Bill protects ER against lawsuits
By Jim Saunders
3/4/2010 © Health News Florida
Reopening a political battle about medical malpractice, Florida senators are considering a bill that would limit the liability of hospitals, doctors and other workers for emergency-room errors.
The Senate Health Regulation Committee voted 5-2 this morning to approve the bill, which is sponsored by Sen. John Thrasher — an influential figure who also doubles as chairman of the Florida Republican Party — and is backed by groups such as the Florida Medical Association and Florida Hospital Association.
The bill would extend what is known as “sovereign immunity” to hospital emergency rooms. Sovereign immunity, which normally applies to government agencies, restricts payouts to injured people or their families to $100,000 or $200,000, depending on the circumstances.
Thrasher, a St. Augustine Republican, said he is concerned that hospitals have difficulty getting physicians in high-risk specialties, such as neurosurgery and orthopedic surgery, to work in emergency rooms. He said lawsuit protections would help.
“We need to have access to these folks,” Thrasher said.
But limiting medical-malpractice lawsuits has long been a divisive issue in the Capitol, with trial attorneys already vowing to fight Thrasher’s bill.
Republican Sen. Durell Peaden, a Crestview physician who is a top lawmaker on health issues, also said he has qualms about the proposal to limit damages.
“Mistakes are made. You can’t totally disregard what happens,” said Peaden, who does not serve on the Health Regulation Committee but is the Senate’s health-budget chairman. “You’ve got to be fair to everybody on that issue.”
Lawmakers filed similar proposals to extend sovereign immunity to emergency rooms the past three years, but none of the bills passed committees. The issue could gain momentum this year, however, because of the backing of Thrasher — who won election to the Senate in 2009 after a nasty campaign that included attack ads financed by trial lawyers.
The debate also comes as congressional Republicans call for including medical-malpractice limits in a federal health-reform bill.
The Legislature had a full-blown debate about medical malpractice in 2003 and passed a law that included some liability protections for emergency-room doctors. As an example, the law placed limits of $150,000 or $300,000, depending on the circumstances, on what are known as “non-economic damages” that compensate victims for pain and suffering.
Also, public hospitals already have sovereign-immunity protections in lawsuits.
But Thrasher’s bill would go much further, extending the sovereign-immunity limits to emergency rooms at all hospitals that provide emergency care. Along with doctors and hospitals, the bill would extend the limits to workers such as paramedics and nurses, Pensacola medical-malpractice attorney Marcus Michles said.
Michles agreed that getting specialists, such as neurosurgeons and orthopedic surgeons, to work in emergency rooms is a problem. But he disputed the contention that granting sovereign immunity would attract them.
He said doctors in the past needed hospital privileges and, as a result, would be on call for emergencies. But he said they now can operate at surgical centers without the inconveniece of getting called to the ER.
“Twenty years ago, there was no such thing as an outpatient surgery center,” said Michles, who is chairman of the medical-malpractice committee of the Florida Justice Association, a statewide trial lawyers group.
A report issued last year by the state Office of Insurance Regulation indicated emergency rooms are the third most-frequent source of medical-malpractice lawsuits. The report examined malpractice claims closed in 2008 and found 436 that stemmed from emergency rooms — trailing hospital-inpatient care and physicians’ offices.
Sovereign immunity is designed to shield government agencies from expensive lawsuits. By extending it to emergency rooms, lawmakers effectively would give the same liability limits — $100,000 per claim or $200,000 if there are multiple claims from an incident — to medical providers.
Thrasher, a former general counsel of the Florida Medical Association, said such limits also could help hold down health-care costs. He said emergency-room doctors take extra precautions and practice “defensive medicine” because of the threat of lawsuits, unnecessarily increasing costs.
“That cost is borne by all of us,” said Tallahassee physician Craig Butler, who represented the Florida Orthopaedic Society at this morning’s meeting.
But Senate Minority Leader Al Lawson, a Tallahassee Democrat who voted against the bill, questioned the need to extend sovereign immunity to emergency-room workers beyond physicians. He called the measure “just too broad.”
Capital Bureau Chief Jim Saunders can be reached at 850-228-0963 or by e-mail at jim.saunders@healthnewsflorida.org.
Posted in Blog | No Comments »
by Kel Murphy
As an injured worker, you may be entitled to receive lost wage payments to help offset reduced income while on “no work” or “light duty” status as a result of a workplace accident. The amount you are due is controlled by Section 440.14 of the Florida Statutes and is based on your Average Weekly Wage (AWW).
The primary method of determining your AWW is by taking an average of your weekly gross income for the thirteen weeks immediately before your work accident. If you worked two jobs during the thirteen week period, gross wages from both jobs are added together. The value of employer-paid fringe benefits, such as health insurance, will also be included in the AWW if your employer stops providing the benefit. This means your lost wage check should increase after your employer stops paying toward your health insurance.
If you didn’t work for the same employer for thirteen weeks before the accident (or if you worked significantly less hours than was customary for you), your pay rate may be based on the thirteen week wage average of a “similar employee” in the same employment. If there is no “similar employee” then your AWW may be based on your contract of hire—the stated pay rate multiplied by the amount of hours you were hired to work. Seasonal workers can often expand the thirteen week period to fifty-two weeks in order for the court to account for wages that vary greatly over the year.
The answers to the questions below may lead you to a higher AWW and increased lost wage payments:
- Before your injury, had you recently received, or been promised, a pay raise?
- Was your employer providing fringe benefits, such as health care or housing?
- Were you working two jobs before the injury, and do you have pay stubs for the second job?
- Were you injured on the job before you worked there for thirteen weeks?
- Did you work less than 75% of the total customary hours you were hired to work in the thirteen weeks before the accident?
- Are you a seasonal worker?
- Are you under 22 years of age?
You should know that the amount of lost wages owed is frequently miscalculated by the insurance company, and many injured workers find that they are owed additional past wages. If so, you may be entitled to an additional 20% penalty plus interest on late payments. Your attorney should review the payout history in your case to ensure you are receiving the amount you are rightfully due. You can help in this process by providing pay stubs for the thirteen weeks before the accident.
A $40 increase in your lost wage checks may not mean anything to the insurance companies, but it can make all the difference when bills are due and you are unable to work. Let one of our Worker’s Compensation attorneys determine whether you are receiving all the money you are entitled to.
Posted in Blog | No Comments »
Thursday, March 4th, 2010
Today’s Medical News From Newspapers, TV, Radio and the Journals Thursday, March 4, 2010
Leading the News
New guidelines say physicians should educate men on risks, benefits of PSA testing.
ABC World News (3/3, story 6, 2:00, Besser) reported that “there’s a big change in store” for prostate cancer screening. “Since1997, the American Cancer Society (ACS)…hasn’t routinely recommended the PSA test, but most doctors have done it. Now they’re saying you need to have a conversation between you and your doctor before that test is done.”
The Los Angeles Times (3/4, Maugh) reports, “New guidelines…issued Wednesday emphasize that physicians should better educate men about both the risks and benefits of using the PSA test for screening.” The group “also urged greater use of education specialists, pamphlets, videos, and other materials.”
The AP (3/3, Stobbe) reported that the ACS “wants doctors to talk to men and give them plenty of information before they have a PSA test to make sure they understand its limits.” The new guidelines follow recent findings that the “PSA test may lead to unnecessary treatment for many men,” because “the test can’t clearly indicate whether a cancer is aggressive or harmless.”
PSA blood tests can “lead to false readings that require additional tests and biopsies…said” lead author Andrew Wolf, a physician at the University of Virginia, Bloomberg News (3/4, Randall) reports. “If patients do choose to be screened with PSA blood tests, those with low levels can safely be screened every other year instead of every year as suggested previously, according to the new recommendations.”
The Houston Chronicle (3/4, Ackerman) reports that “the guidelines also urge doctors to…make the digital rectal exam an option rather than using it as a standard screening tool” and to “base the frequency of PSA testing on previous scores.” And, although the ACS does not “call for eliminating mass screening events,” the group recommends including “high-quality information upfront of screening’s potential risks.”
CNN (3/4, Falco), MedPage Today (3/3, Bankhead), Reuters (3/4, Steenhuysen), HealthDay (3/3, Gardner), and Medscape (3/3, Mulcahy) also covered the story.
Sanofi drug may boost prostate cancer survival. The New York Times (3/4, B10, Pollack) reports, “A new drug being developed by Sanofi-Aventis extended the lives of men with advanced prostate cancer in a clinical trial and could become a new last-ditch treatment,” according to research presented at the Genitourinary Cancers Symposium. Sanofi intends “to complete its application to the Food and Drug Administration for approval of” the new drug, cabazitaxel, “in the first half of this year.”
Bloomberg News (3/4, Randall) reports, “Cabazitaxel is the first drug shown to break down tumors and prolong life after patients have been treated with Paris- based Sanofi’s Taxotere [docetaxel], a standard chemotherapy for prostate cancer, according to…the study’s lead author” Oliver Sartor, the Piltz Professor for Cancer Research at Tulane Cancer Center. He added that “progression-free survival was better, response rate was better, and virtually every subgroup of patients did better.”
The New Orleans Times-Picayune (3/4, Pope) reports that the study showed an “increase of nearly 19 percent” in median survival time with cabazitaxel compared to mitoxantrone. Although cabazitaxel provides an “advantage of less than three months,” Dr. Nicholas Vogelzang, of the Comprehensive Cancer Centers of Nevada, who sits on the cancer-communications committee of the American Society of Clinical Oncology, noted that “advances in cancer therapy have always been incremental.”
WebMD (3/3, Laino) reported that Vogelzang also said that men with early stage prostate cancer may see greater benefits from the drug. Reuters (3/4), MedPage Today (3/3, Phend), and the AP (3/4, Marchione) also covered the story.
Dendreon says provenge boosts survival in patients with prostate cancer. Dow Jones Newswire (3/4, Shwiff) reports that Dendreon Corp. said that a Phase III study of its prostate cancer treatment Provenge (sipuleucel-T) showed that the drug boosted overall survival by 40% after three years compared to placebo. The company had previously reported a 38% increase in survival after 34 months. Dendreon is expected to present its data at the American Society of Clinical Oncology meeting Friday.
Pharma & Device Update
BPH may be best treated with combination of drugs.
The Los Angeles Times (3/3, Maugh) “Booster Shots” blog reported, “A combination of drugs is better than either one alone for treating benign prostatic hyperplasia or BPH.” After randomizing some 4,800 patients to either tamsulosin alone, dutasteride alone, or “a combination of the two drugs,” researchers at the University of Texas Southwestern Medical Center “found that patients taking the combination were 67% less likely to have acute urinary retention and 70% less likely to require surgery than those taking tamsulosin alone.” According to a study in European Urology, “patients taking the combination also reported fewer side effects and were less likely to drop out of the study.”
Reuters (3/3) and the Wall Street Journal (3/3, Becker) also covered the story.
Medical-Legal Landscape
Survey indicates growing incidence of medical identity theft.
McClatchy (3/4, Yip) reports, “The number of ID fraud victims jumped 12 percent in 2009, but consumers are becoming more educated and are filing more reports with law enforcement, according to Javelin Strategy & Research.” Experts “said the increase may be due to the economic downturn, when fraud rises historically.” Notably, “a budding area is medical ID theft, in which thieves use your personal and health insurance information to obtain medical treatment or drugs. Javelin’s survey found that the theft of medical records to commit ID fraud accounted for 7 percent of all instances of ID theft in 2009, up from 3 percent in 2008.”
Posted in Blog | No Comments »
Thursday, March 4th, 2010
In a front-page story, the New York Times (2/20, A1, Harris) reported, “Hundreds of people taking Avandia [rosiglitazone], a controversial diabetes medicine, needlessly suffer heart attacks and heart failure each month, according to confidential government reports.” A Senate Finance Committee review cites internal FDA documents that highlight a dispute among regulators that “has been brewing for years but has been brought to a head by disagreement over a new clinical trial.”
The Wall Street Journal (2/22, Mundy) reports that the Senate committee concluded that Glaxo was aware of the risks, but minimized the issue and attempted to suppress concerned physicians. The FDA’s documents also indicate that agency scientists said the drug should be pulled from the market in 2008, but FDA chiefs rejected the recommendations. Now, agency commissioner Margaret Hamburg is expected to meet “with FDA scientists and outside experts to gain a full understanding…of all of the data and issues involved,” a spokeswoman said.
The AP (2/21, Ortutay) reported that the Senate committee is asking the FDA “why it allowed a clinical trial of Avandia to continue even after the agency estimated that the drug caused 83,000 heart attacks between 1999 and 2007.” Glaxo agreed to an FDA request for “a six-year study between its drug and” the Pfizer diabetes drug Actos [pioglitazone] “to give a definitive picture of Avandia’s safety.”
But, the FDA’s internal documents showed that “safety officers…said that a medical trial comparing Avandia with Actos that was being planned would be ‘unethical and exploitive’ because it would expose patients to unwarranted risks,” Bloomberg News (2/21, Waters) reported. Sens. Max Baucus (D-MT) and Charles Grassley (R-IA) sent a letter to Hamburg “asking what steps the agency was taking to protect patients in the…trial and demanded a response to their concerns by March 4.”
CNN (2/21) reported, “The Senate committee investigation stems from concerns that Avandia and other high-profile drugs put ‘public safety at risk because the FDA has been too cozy with drugmakers and has been regularly outmaneuvered by companies that have a financial interest in downplaying or under-exploring potential safety risks,’ the report states.” HealthDay (2/20, Mundell) and Reuters (2/21, Richwine) also cover the story.
Posted in Blog | 1 Comment »
Wednesday, March 3rd, 2010
In the aftermath of the Haiti earthquake and subsequent tragedies, Michles & Booth felt compelled to help the victims by donating a sizeable monetary contribution. Here at Michles & Booth we believe in helping the victims so they can put their lives back together. Listed below are other local area organizations that we support.
Michles & Booth Annual Christmas Carolling Caravan
FavorHouse
Shelter House, Inc.
Michles & Booth, P.A. Family Freedom Foundation, Inc.
Military Order of the Purple Heart
Gulf Coast Kids House – Santa Rosa County
Emerald Coast Professional Firefighter’s Council
Escambia County Professional Firefighter Local Union 4131
Escambia County Sheriff’s Office
Gulf Breeze Rotary
Harvard Vineyard Mission, Inc.
Allen Rescue Foundation
Hodges Play Park
Movement for Change – Prison Books
Northwest Florida Legal Services
Elements of Praise
Rebuild Northwest Florida
PKD Foundation
American Cancer Society
Juvenile Diabetes
Autism Society of America – Safe & Sound Initiative
Breast Cancer Awareness
Covenant Hospice
Gulf Coast Wings of Hope
Kids Day America
Hallmark Elementary School – mentoring program
Ft. Walton Beach High School Drama Department
Navarre High School Mock Trial Team
Kenwood Elementary School
Baker High School US Army JROTC Program
University of Mobile Department of Music
Posted in Articles, Blog, Firm News, Law News | No Comments »
Wednesday, March 3rd, 2010
Marcus J. Michles II is the son of a 100% disabled Vietnam Veteran, and a veteran himself. Having served in the 82nd Airborne Division, 3rd Special Forces Group (Airborne) and the 1st Special Operations Command (Airborne), Mr. Michles has a strong and long-standing commitment to military families. Upon leaving active duty and locating to the Panhandle following Operation Dessert Storm, Mr. Michles has continued to serve the military and its families in the form of charitable donation of time, money, and services. His vision along with that of his wife Cindy (also raised in the military as the daughter of a retired Air Force Vietnam Veteran and graduate of Ft. Walton Beach high school) is to form a lasting Foundation funded by local charity and commitment to reach out to the military and municipal fire and law enforcement men and women who serve our community every day.
The mission of the Family Freedom Foundation is to provide financial assistance in the form of money and professional services (legal, accounting, and financial advice) to the families of servicemen, firemen and police killed or seriously injured in the line of duty, with an emphasis on providing funds to establish educational trust funds for the children of these families.
The Family Freedom Foundation hopes to raise sufficient collateral to fund an ongoing Trust Fund to manage independent funds for individual families. In addition, a support roster of available local businessmen and women in all aspects of local business will be available to provide assistance as diverse as Moving support, house cleaning, and child care, to professional services such as tax advice and asset protection.
Contact
Currently the Foundation offices are located as a courtesy of Michles and Booth, P.A in the Michles and Booth building at:
191 Brooks Street S.E.
Ft. Walton Beach, FL 32548
Phone: 850.864.4848
info@familyfreedomfoundation.org
Posted in Articles, Blog, Firm News, Law News | No Comments »
Wednesday, March 3rd, 2010
Each holiday season, Michles & Booth’s employees, family and friends take a day from work to sing traditional holiday songs to the community. They load up on decorated trolley cars with tractor trailers and, traveling a pre-arranged route through Downtown Pensacola and local Cordova Mall, they sing carols in exchange for donations to local charitable organizations. They are joined by “Scoop” and his team, The Pensacola Pelicans, The Pensacola Ice Flyers, for the day of fun and laughter. Gifts and monetary contributions are gathered from local businesses and individuals. Although it takes a lot of work to put the caravan together each year, the thought of the looks on the kids’ faces when the truckloads of toys are delivered the following day makes it something the firm would do every month if we could.
On December 21, 2009 we held our annual Michles & Booth Christmas Caroling Caravan. For the past 8 years we have gone door-to-door at various businesses in the area and at Cordova Mall to sing Christmas carols in exchange for monetary and toy donations to benefit Favor House of NW Florida and Family Freedom Foundation. This year we collected $1,118.00 in monetary donations and a van full of toys to support these local charities.
Posted in Articles, Blog, Firm News, Law News | No Comments »
Car insurance is mandatory in Florida, which is good news for anyone involved in a car accident. But just how much car insurance is required can be somewhat surprising. In Florida, if you are the victim of another driver’s negligence, your primary source of recovery is from that driver’s bodily injury insurance. Unfortunately, in Florida, drivers are only required to carry $10,000 in bodily injury insurance per person, or a total of $20,000 insurance for a single accident, regardless of how many people are injured. For some types of injuries, that might seem like more than enough insurance. But let’s take a look at some pretty simple medical bills. The average MRI costs $2,000, while the average ER visit is over $1,000. In an accident, if your injuries aren’t too serious, this may be enough to cover your medical bills.
So, what happens when you suffer a serious injury, and your bills exceed both your Personal Injury Protection $10,000, and the negligent parties $10,000 bodily injury limits? That’s where your Uninsured/Underinsured Motorist (UM) coverage comes into play. It provides you an avenue of compensation when the at-fault party has decided to carry only the minimal insurance. By law insurance companies have to give you the opportunity to select UM coverage when you first sign a policy, but so often we see people rejecting the coverage to save a few dollars. The problem is, you can’t pick when, where, and with who you get in an accident with… and you can’t predict how serious your injuries will be… but you can make sure you have your safety net in place.
So here it is in a nutshell: If you get seriously injured in a car accident, you are compensated by your PIP coverage first, the at-fault driver’s Bodily Injury insurance next, and finally by your UM coverage—but only if you have it. So when you get a moment, check your insurance policy to see whether or not you have UM coverage. If you don’t, we ask you to think long and hard about whether you want to get it, because although we recognize that times are tough right now, imagine trying to pay potentially thousands of dollars in medical bills when you’re trying to recover from injuries. You may decided you don’t need UM coverage, but at least you’ll understand what it is you’re giving up, and what the risks really are.
Posted in Blog | 1 Comment »
Wednesday, January 27th, 2010
Nipro recalls two million defective Huber needles.
The AP (1/27, Perrone) reports, “Federal health officials announced [a] recall of two million medical needles Tuesday because of a risk they can push bits of silicone into patients’ bodies.” The FDA “said Japanese manufacturer Nipro Medical Corp. has voluntarily recalled its Exel/Exelint Huber needles manufactured between January 2007 and August 2009.”
Bloomberg News (1/27, Peterson) reports that the “defect…might lead to fatal blockages of the main artery of the lung, the [FDA] said.” The needles, which are intended “to give food and medicine to chronically ill patients,” can “dislodge ‘cores,’ or slivers of silicon, from ‘ports’ under the skin and release the material into the bloodstream, FDA officials said.” Jon Casamento, deputy director of the Solid and Fluid Mechanics Division at the FDA’s Center for Devices and Radiological Health, said the “defective needles…may cause tissue damage and inadequate drug delivery.”
Regulators have not received reports that the needles released silicon or other foreign chemicals into patients, but the defect is difficult for doctors to detect, Dow Jones Newswire (1/27, Favole) reports.
CQ HealthBeat (1/27, Kim) reports that the “recall is categorized as Class I, which indicates the most serious risk to consumers among the FDA’s three recall categories.” Inspections revealed that the “problem occurred in 60 to 72 percent of tests” at “Nipro Medical Corporation’s facilities in Japan this past October,” and the defects “were caused by the design and manufacturing processes.”
CNN (1/27, Young) reports that the FDA “said anyone using the products should stop immediately and return any unused needles to Exelint.” The agency indicated that it is conducting investigations “of needles from 20 companies,” of which 10 have already been completed. “The FDA said it has sent letters to all Huber manufacturers asking them to address any design or manufacturing problems.” Reuters (1/27), Modern Healthcare (1/27, Rhea), MedPage Today (1/26, Smith), and Medscape (1/26, Hitt) also covered the story.
Posted in Articles, Blog, Firm News, Law News | No Comments »
Wednesday, January 27th, 2010
PARALEGAL CORNER
By Angela M. Bainter
GET ORGANIZED
One of the most important tasks for the Paralegal is to “Get Organized”. Your organization does not have to follow any particular model, but you must be able to find your files and/or your client’s information expeditiously. You also need to know where you are going and what you need to do to get there.
Set Goals:
What is the ultimate (bottom line) or destination?
Identify what is expected and where you are going.
Make sure that the task is completed as required.
Educate yourself.
If you do not know the answer, ask someone who does and/or
do the research yourself.
Increase your efficiency and productivity.
When you find the answer to a question, save it so you can find it
in the future because it will present itself again. Also, you will have
a starting point if a similar problem presents itself. Proofread
everything to minimize mistakes.
Make a Plan to implement your Goals:
Prioritize
Mark what is the most important on your “to do” list.
Know deadlines and give yourself enough time to complete each
task in a timely manner.
Ticklers
Prepare ticklers to remind you when things need to be done & mark
when “completed”.
Lists
Make as many as you need to make sure that you “get your job done”.
Interaction with Others:
Clients
Make sure that they know that you are working for them and that
their concerns will be addressed. Without clients, you do not have
a job.
The boss
Make sure that you understand what the boss wants you to
accomplish and then accomplish it. If you have a problem doing
so, let him/her know the problem before it gets to be unmanageable.
Co-workers
Do all you can to help your co-workers as you are all working for
the same goal – to serve the client. You don’t have to like someone
to work together for a common goal.
Stress Management:
Take Control
Get your job done on time to alleviate stress.
If you need help, ask sooner rather than later.
Keep Focused
If you get off track, take a break and then get back to the job
at hand. If you need to be alone to complete your task, speak up.
15% of success indicates actual skills
85% of success indicates interpersonal skills, managing stress, and getting along
with others.
Posted in Para Legal's Corner | No Comments »
|
