JAMA-Journal of the American Medical Association -acclaims "MEDICAL EXPERT TESTIMONY." Calls his new book “Crowning achievement” and “Definitive text.

Washington, D.C., February 2, 2010 --"'MEDICAL EXPERT TESTIMONY' is The Definitive Text for physicians seeking to augment their income as medical expert witnesses or for clinicians forced to participate in the civil litigation arena," according to the Journal of the American Medical Association. The book review is published in JAMA. 2010; 303 (4): 369 by reviewer Alan G. Williams, JD, in the Book and Media Reviews of the Journal of the American Association. Perry Hookman MD, board certified in both Gastroenterology and Internal Medicine, is the author of the new Book II Medical Expert Testimony: Advanced Syllabus for Health Care Professionals (Hardcover) 33 chapters; 936 pages. Publisher: Potomac Press-CRC; ISBN: 978-0-9817570-0-1; ISBN: 10:0-9817570-0-6 - Price $289.95; including CD-ROM.

This recent JAMA review points out that:

"Although Perry Hookman has previously written a valuable reference manual regarding medical expert testimony in malpractice cases (Book I Medical Malpractice Expert Witnessing: Introductory Guide for Physicians and Medical Professionals),[his new Book II] -Medical Expert Testimony: Advanced Syllabus for Healthcare Professionals - represents his crowning achievement."

"The novice medical expert can greatly benefit from the keen observations and astute recommendations in the chapters regarding "Strategies and Tactics Designed to Trick the Expert"; "Questions to Make the Medical Expert Look Biased, Incompetent, Embarrassed"; and "How Attorneys Use Cross-Examination Mishaps, Errors, and Testimony Control for Impeachment of the Medical Expert Witness."

"Hookman begins by explaining what the particular strategic move by the attorney is and then follows with the recommended counter-move. The advice contained in these chapters alone makes the book well worth reading."

"The format of Medical Expert Testimony contributes to its appeal; each topic is clearly delineated and interspersed with text boxes of facts and examples. As opposed to page after page of text (the book totals nearly 1000 pages), Medical Expert Testimony succeeds as a reference manual owing in part to its staccato bursts presenting the identified problem, the recommended remedy, and the likely result. Each section is followed by a list of sources to aid the reader in exploring additional references or materials."

"'Medical Expert Testimony,' written by a veteran expert witness who obviously knows his subject, serves as a thorough explication of serving as an expert witness in a medical malpractice case. Other than omitting few superfluous sections, it is difficult to imagine a better way to meaningfully improve on this textbook. Medical expert witnesses would do well to heed the recommendations and advice presented in this unique and insightful reference."

CONTACT
Web: www.Hookman.com
Phone: 561.445.0486
E-Mail: hookman@hookman.com
Book Website: www.MedMalBook.com


Please remember, as with all our articles we provide information, not medical advice.
For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com

For more health info and links visit the author's web site www.hookman.com

5 Tips on Diverticular Disease

1. Diverticulosis is a condition with pouch-like protrusions in the colon:
• Rare before age 30
• Common after age 60
• Usually no symptoms

2. Complications of diverticulosis include:
• Bright red rectal bleeding with clots
• Diverticulitis

3. Ways to prevent and manage diverticular disease include:
• Increasing dietary fiber to keep bowel movements soft
• Avoiding stimulant laxatives

4. Diverticulitis is a serious complication in which pouches become inflamed or infected. Symptoms of diverticulitis include:
• Pain in left lower abdomen
• Fever
• Sudden change in bowel habit
See your doctor immediately if you have any of these symptoms.

5. Treatment of diverticulitis may include:
• Antibiotics
• Special feeding
• Surgery


Please remember, as with all our articles we provide information, not medical advice.
For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com

For more health info and links visit the author's web site www.hookman.com

ONE DRUG CAUSES LIFE EXTENSION BY 14%

The antitumor drug rapamycin targets TOR, a kinase that is part of the PI3K–AKT–mTOR cascade, involved in regulating protein translation, cell growth and autophagy. Reducing TOR function is known to extend the life of yeast, worms and flies.
Now experiments replicated in three different laboratories demonstrate that rapamycin, fed to male and female mice in a dose that substantially inhibits TOR signalling, can extend their median and maximal lifespan by up to 14%. This life extension was observed in mice fed rapamycin from 270 days of age and also at a late stage in their life, from age 600 days.

These findings point to the TOR pathway as a critical point in the control of ageing in mammals and in the pathogenesis of late-life illnesses. The small molecule rapamycin, already approved for clinical use for various human disorders, has been found to significantly increase lifespan in mice.

Is this a step towards an anti-ageing drug for people?
From Rapamycin fed late in life extends lifespan in genetically heterogeneous mice
David E. Harrison, et al.doi:10.1038/nature08221


Please remember, as with all our articles we provide information, not medical advice.
For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com

For more health info and links visit the author's web site www.hookman.com

Caution Not to Take Sertaline, Citalopram in Pregnancy Because of Link to Heart Defects in Offspring

Women who use the antidepressants sertraline (Zoloft) or citalopram (Celexa) early in pregnancy face increased risk for septal heart defects in their offspring, BMJ reports online.

Researchers examined data on more than 490,000 infants born in Denmark between 1996 and 2003. They found that women who filled prescriptions for sertraline and citalopram (but not other SSRIs) during their first trimester were significantly more likely to have children with septal heart defects (but not other malformations) than those who didn't use SSRIs (odds ratios: 3.2 and 2.5, respectively).

The authors and an editorialist (both with ties to SSRI manufacturers) note that the absolute risks for septal heart defects were low: 0.9% in children exposed to at least one SSRI and 2.1% in those exposed to more than one.

The editorialist concludes: "Clinicians and patients need to balance the small risks associated with SSRIs against those associated with under-treatment or no treatment."


Please remember, as with all our articles we provide information, not medical advice.
For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

*Tune in later for ONE DRUG CAUSES LIFE EXTENSION BY 14%.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com

For more health info and links visit the author's web site www.hookman.com

MAKE MEDICAL ERROR REPORTING COMPULSORY?

Few states have instituted compulsory medical error admissions. William M. Sage et al., The Relational Regulatory Gap: A Pragmatic Information Policy For Patient Safety and Medical Malpractice, 59 Vand. L. Rev. 1263 (2006) noted that four states recently passed legislation requiring patients to be informed when they were the victim of medical errors. One state that has is New Jersey, which, in 2004, enacted the Patient Safety Act, N.J.S.A. 26:2H-12.23 (PSA). This landmark legislation changed the way medical errors are dealt with in New Jersey by creating a legal duty to immediately disclose medical errors to patients who are harmed by them. N.J.S.A. 26:2H-12.25.

Should The Law in New Jersey be the Same in Other States?
Under the PSA, when the patient is a victim of a serious preventable adverse event, he or she must be informed no later than the end of the episode of care; or, if discovery occurs after the end of the episode of care, in a timely fashion. N.J.S.A. 26:2H-12.25(d). A "serious preventable adverse event" is any adverse event that is preventable and results in death, loss of a body part, or disability or loss of bodily function either lasting more than seven days, or that is still present at the time of discharge. N.J.S.A. 26:2H-12.25(a). In addition to requiring adverse events to be reported to the victims of medical malpractice, the PSA also requires health care providers to report medical errors to the New Jersey Department of Health and Human Services (the Department). N.J.S.A. 26:2H-12.25(c).

On Jan. 24, 2008, the Department enacted regulations that gave teeth to the notification and reporting requirements of the Act. As of March 3, 2008 (for hospitals), Aug. 30, 2008 (for ambulatory care facilities, home health care agencies and hospice providers), and March 3, 2009, (for nursing homes and assisted living facilities), health care providers have five business days after discovery of a serious preventable adverse event to notify the Department that a preventable adverse event has occurred. N.J.A.C. 8:43E-10.1, N.J.A.C. 8:43E-10.6(b). The notification requires the inclusion of specific categories of information, including: 1) the date and time the event occurred; 2) a brief description of the event; 3) a statement about the impact of the event on the health of the patient; 4) the date and time the facility became aware of the event; 5) how the event was discovered; 6) the immediate corrective actions the facility took to eliminate or reduce the adverse impact of the event on the patient; and 7) what steps were taken to prevent the occurrence of future similar events. N.J.A.C. 8:43E-10.6(c).

Failure to comply with these reporting requirements results in a fine of $1,000 a day. N.J.A.C. 8:43E-3.4(14).


Please remember, as with all our articles we provide information, not medical advice.
For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

*Tune in later for Caution Not to Take Sertaline, Citalopram in Pregnancy Because of Link to Heart Defects in Offspring.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com

For more health info and links visit the author's web site www.hookman.com

Hospitals And Medical Staffs Have Failed To Be Effective In Reducing Medical Errors

A recent Medicare policy change has brought into critical focus the fact that hospitals and medical staffs have failed to be effective in reducing medical errors. The Centers for Medicare and Medicaid Services (CMS) announced that it would no longer pay hospitals for the extra costs of treating injuries, infections, or other complications caused by preventable errors (never events). At the same time that hospitals are encountering this looming payment restriction from Medicare, they also are confronting the possibility of payment restrictions from commercial payors. Cigna, Aetna, Health Net, and Health Partners are among the payors that have indicated they are considering making nonpayment for “never events” a standard part of their provider contracts.

There are significant potential liability concerns that may arise from the new CMS payment plan and from similar state and commercial plans.

Not all of the qualifying "preventable" complications selected by CMS are comparable in terms of their preventability, nor are they entirely within the control of the hospital or its medical staff. It is without question that instruments or sponges left behind after surgery should be never events. However, current best efforts may not entirely prevent vascular infections from catheter use, for example. Similarly, the amount of effort and expense required to prevent the formation of pressure ulcers is far greater than that required to avoid retained instruments. This alone could lead hospitals to alter admission policies and practices. The aspect of the Medicare never event payment policy change requiring hospitals to report Present on Admission Indicators may make it inevitable.

This Heller article suspects that plaintiff’s attorneys may well argue that never events should be viewed as res ipsa occurrences or, at the least, that they should always be viewed as representing below standard care. This would appear to be an excellent example of the law of unintended consequences as "the mere designation of never events will likely result in both more numerous and more valuable plaintiffs’ verdicts nationwide."

Some sets of these never events, for example those recently approved by the Washington State Hospital Association and the Washington State Medical Association, employ the modifier "serious," penalizing hospitals only for "serious disability associated with a fall" or "serious disability from medication error," without, not surprisingly, offering criteria for defining the term "serious."

This may then be left for the legal system to define. It is not clear how far out in time from the never event the ban on hospital charges extends. On the one hand, says Heller, if a patient sustains a hip fracture from an in-hospital fall, it is clear that the hospital may not bill for the fracture repair. If, on the other hand, three months post-discharge, the patient develops what appears to be a nonhospital acquired infection at the hip repair wound site and the patient is readmitted, who pays the bill? What if a patient develops a deep pressure ulcer in the hospital (clearly, not reimbursable) and is discharged when the ulcer appears to be healed, but is readmitted after two weeks at home with an ulcer at precisely the same site. Who pays? It is possible to develop many confusing and confounding scenarios that may evolve from the new CMS rule and its progeny, and the end effects are not in sight.

Please remember, as with all our articles we provide information, not medical advice.
For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

*Tune in later for Reducing Medical Errors.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com

For more health info and links visit the author's web site www.hookman.com

A Balance Disorder Known As Vestibular Dysfunction

A Balance Disorder Known As Vestibular Dysfunction

Which Affects Up To 69 Million Americans Should Be Part Of The Routine Medical Checkup

Millions of people may suffer from inner-ear disorders that affect their balance but not be aware that they have a problem, a new study has found. Writing in The Archives of Internal Medicine, researchers noted the connection between balance problems and falls, especially among the elderly. The findings of the study, they said, suggest that doctors should make balance tests a routine part of checkups. This is especially true in nursing and assisted-living homes, they said.
“The big deal here really is falls,” the lead author, of Johns Hopkins, adding that a serious fall can be the beginning of the end for an older patient. The researchers drew on data from a federal study in which more than 5,000 people age 40 and over were surveyed about their history of falls and balance problems. They were then given examinations to determine how well they could maintain their balance in a variety of situations, including with their eyes closed.
More than a third of the subjects, the researchers found, had the balance disorder known as vestibular dysfunction — a figure that would translate to 69 million Americans. They also found that 32 percent of the volunteers who did not report problems with dizziness showed evidence of balance problems. Though they did not experience symptoms, they were still at higher risk for falls, the study said.
For doctors, detecting balance problems in a patient is not very complicated. And treatment is available, including exercises that help people compensate for inner-ear problems that lead to poor balance. The cost of the treatment, would most likely be less than medical costs associated with falls.

Please remember, as with all our articles we provide information, not medical advice.
For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

*Tune in later for Reducing Medical Errors.

Deepen your understanding of "medical malpractice"... www.MedMalBook.com

For more health info and links visit the author's web site www.hookman.com