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Wrightsville Beach Medical Malpractice Law Blog

Ataxic cerebral palsy, a permanent birth injury

Parents in North Carolina should be aware of a type of injury that their baby may incur during birth or some time later. It is called ataxic cerebral palsy. Cerebral palsy refers to a disorder of the cerebellum, which controls muscle movements and balance, and ataxic CP is characterized by balance issues and by a jerky or unbalanced way of walking. Children with the condition may walk with their legs spread farther apart than other children.

As with other cases of CP, ataxic CP can result in various disabilities, including speech, vision, hearing, eating and learning disabilities. Children may even be unable to reach for things due to issues with muscle coordination. Seizures are another possible symptom.

Federal agency to reveal list of problematic nursing homes

Nursing home neglect and abuse can pose a major threat to the health and well-being of elderly or disabled residents in North Carolina. A report presented to the U.S. Senate in June revealed that the federal government knew that a number of nursing homes were severely troubled but did not release that information to the public. The Center for Medicare and Medicaid Services, or CMS, has come in for criticism due to allegations that it has not done enough to crack down or warn the public about nursing homes that could pose a danger to their loved ones, allowing them to continue to accept less-informed patients.

In April, the agency announced that it would conduct a thorough review of its practices toward nursing home regulation following a Government Accountability Office report saying that it needed to do more to improve nursing home regulations and federal oversight of investigations. It declared a five-point plan that would include higher oversight authority and greater enforcement of quality violations at homes. The federal agency also began requiring more details from nursing homes about whom they hire as well as strengthening the requirements. It also took greater note of care facilities with inadequate staffing numbers that could leave patients at risk of malnutrition or injuries.

North Carolina residents should be aware of nursing home abuse

Residents of North Carolina who are concerned about neglect and abuse in health care facilities should be aware of a disturbing case in which a vulnerable patient gave birth in an Arizona nursing home. A subsequent medical exam discovered that she had suffered sexual assault at the hands of a male employee. Her attorneys planned on going to court if an agreement on a settlement for the victim and her parents could not be reached, and a separate case was opened against the nurse who assaulted her. It was proven that he was the father of the baby after a paternity test.

The victim suffered a near drowning when she was 3 years old and has lived in a health care facility since. Documents from the health care facility the year before the birth state that the victim had been defensive when touched and was unable to smile or make eye contact with the employees. Another document suggests her family requested that only female staff be responsible for her personal care, such as bathing and dressing. They also requested that she be supervised at all times.

Healthcare fraud may constitute nursing home abuse

Healthcare fraud may not be what immediately comes to mind when people in North Carolina discuss nursing home abuse, but it is a serious and growing issue. Generally, the healthcare fraud engaged in by nursing homes involves illegal, inflated or improper medical billing. Residents in nursing homes who get funding from private insurance, Medicaid or Medicare are more vulnerable than others to fraud. When such fraud happens, it can have serious negative effects for the resident.

Some common healthcare fraud strategies include overbilling by including more supplies or services than the resident actually utilized, billing for services or items that the payor organization does not cover, and billing for things that are not medically necessary. Other common techniques include offering kickbacks for unused drugs and billing for unnecessary care or other services.

Lack of oxygen a top cause of birth injuries in premature babies

It is not always possible to control when a baby is born. According to the March of Dimes, nearly 10% of babies are born prematurely in North Carolina--a rate that is higher than many states'. And with how common premature babies are, it might make sense that doctors and hospitals nationwide understand how to keep both mother and child safe.

However, a high percentage of premature babies sustain severe birth injuries. And a new report connects long-term brain injuries to a significant lack of oxygen during and after birth.

Kentucky Enacts New Medical Malpractice Law After Medical Review Panels Ruled Unconstitutional

In 2017, Kentucky enacted a law that required any medical malpractice claim to be reviewed by a panel of experts and an attorney before the claimants could file their suit in court. This caused a mandatory delay, contradicting Kentucky's own constitution that states every person has access to the courts without delay. At the end of 2018, this law was declared unconstitutional. Cases in Kentucky can move forward much faster now.

However, a new medical malpractice law was passed after collaboration between plaintiff lawyers, nursing homes, hospitals, and doctors. Under this new law, victims of medical negligence will be required to file a "Certificate of Merit" from a medical expert before bringing a lawsuit.

Kentucky Medical Malpractice Review Panels Ruled Unconstitutional

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Kentucky enacted a Medical Review Panels Act in 2017 that required medical malpractice claimants, including in nursing home negligence cases, to submit their case to a panel of health care providers and an attorney for review before filing a lawsuit. In some cases this caused up to as much as a nine month wait for claimants before an injury or death victim could file suit.

In November of 2018, however, these medical review panels were ruled as unconstitutional by the Kentucky Supreme Court. The requirement that medical malpractice claimants (including in nursing home cases) get "approval" from these panels directly contradicted Kentucky's own constitution (Section 14), which states that every person has access to the courts "without... delay." People in Kentucky are supposed to have a right to "immediate access to courts," yet the law created a mandatory delay. It did allow claimants to bypass the review panel, but only if the defendants agreed to binding arbitration or bypassing the review panel process.

Nursing home fines drop significantly

Fines against nursing homes that were found to injure or endanger their residents were significantly reduced after the Trump administration changed its policy on the issue. Average fines dropped from $41,260 in 2016 under the Obama administration to $28,405 under Trump. The reason why fines decreased so much is due to a policy that changed the way nursing homes in North Carolina and other states were fined. It changed from the number of days they were out of compliance to a single fine for each reported violation.

This shift in policy was welcomed by the nursing home industry, but many health officials say that it could make life more dangerous for seniors. Since taking office, the Trump administration has heeded a wide range of suggestions made by nursing home lobbyists who believed that enforcement of regulations was overzealous. This included an 18-month moratorium on penalties related to several new health and safety regulations implemented by the Obama administration.

Induction of Labor and "High-Alert" Drug Pitocin/Oxytocin

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Oxytocin is a naturally-produced hormone that plays a role in social bonding, sexual reproduction, childbirth, and the period after childbirth. The synthetic version of oxytocin (brand name "Pitocin") is often used for the induction of labor, and in the labor and delivery process to cause or strengthen labor contractions.Using Pitocin interrupts the natural process of birth, and does not allow for spontaneous labor. Spontaneous labor is generally healthier for both the mother and the baby.

Despite its common use, oxytocin is considered a "high-alert" medication, which means that it has a higher risk of causing significant patient harm when used in error. When harm does occur with high-alert medications, the effects are more devastating to patients.

Quality of Care Regulations in Nursing Homes

Virtually all skilled nursing facilities accept taxpayer dollars via Medicare. As a condition of being able to get paid Medicare dollars, Medicare has regulations that set minimum standards for the quality of nursing care provided in nursing homes. The purpose of these regulations is in part to ensure proper care is given in order to avoid neglect, injury, and even death to nursing home patients. These regulations, 42 CFR 483.25, address some of the more common types of problems we see in nursing home cases, problems that can lead to injury, or even death.

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