A few weeks ago, a dear friend and close relative of my wife woke up one morning to find herself becoming paralyzed below the waist.  Her husband took her to the hospital where doctors struggled to figure out what was going on.  Almost all of the diagnoses they entertained involved some component of autoimmunity.  In autoimmune diseases, the body’s immune system goes haywire and attacks healthy organs or systems.  The final working diagnosis was Neuromyelitis Optica,  an autoimmune disease with a spectrum of presentations.  Her immune system was attacking her spin ..read more

Most people pray that they remain healthy.  Since we know it is unlikely we will always remain healthy, may I suggest a more practical prayer?  Pray you only get common diseases. Before a doctor can treat you, she needs to figure out what ails you.  This involves the art of diagnosis, and it is an art.  Misdiagnosis, either the failure to accurately diagnose an illness or the failure to reach a diagnosis at all, is one of the leading causes of injuries due to malpractice that I see in my work. When a doctor is confronted with a sick patient, she must create a differential ..read more

Last week I wrote about medication mistakes in hospitals and the factors that make them so common and so deadly.  This week I want to write about the Tennessee nurse whose medication error killed a patient and who ended up being prosecuted and convicted in the death. RaDonda Vaught was only two years into her nursing career in 2017 when she made a mistake that will haunt her for the rest of her life.  She was assigned to administer a sedative, Versed, to an elderly patient who was about to undergo an MRI scan and who was anxious about the procedure.  Instead of Versed, she mist ..read more

Over the years, I have suggested a number of strategies to prevent or at least reduce the risk that you will be the victim of medical malpractice.  There is one form of malpractice, however, that is very difficult to prevent.  It is the risk of a medication error while you are in the hospital. Hospitals are complicated places.  Patients are constantly coming in and leaving.  Nurses are constantly coming on and off shift.  Many medical specialists may play a role in the care of a single patient.  All of these health care providers must communicate with each other ..read more

More and more eligible Americans are signing up for Medicare Advantage plans.  And why not?  Celebrity spokespeople promise low to no premiums and benefits not available under traditional Medicare.  It sounds almost too good to be true.  “Get the benefits you are entitled to.  Call now and an insurance specialist will take your call and explain this wonderful offer to you.”  Of course, as you should know by now, there is no such thing as a free lunch. First, just a quick reminder of how Medicare Advantage works.  The companies that participate in the Medicar ..read more

Superbugs!  That is the name given to antibiotic resistant bacteria.  Because of our indiscriminate use of antibiotics, more and more bacteria are developing resistance to them and posing an ever greater threat that we will be forced back to the bad old days before antibiotics when bacteria killed wide swaths of the population, especially the young and the infirm.  Already it is estimated that superbugs kill 5 million people a year and that this number will increase to 10 million by the year 2050.  10 million a year is one person every three seconds. The rise of the antibi ..read more

Arizona has inherited the ancient common law doctrine of sovereign immunity.  Without its permission, you cannot sue it or any other state.  Like the other states, Arizona has waived its immunity, but it has done so with some limitations.  One of these is that, before you can bring an action against the state or a subdivision of the state or a state employee, you must first serve a Notice of Claim.  Arizona’s Notice of Claim statute, A.R.S. Section 12-821.01, sets forth the requirements of the notice.  It is a highly technical statute and, if its requirements are not f ..read more

Doctors are only human.  They are prey to the same frailties that plague the rest of us.  Like the rest of us, some of them become addicted to alcohol or use narcotics or other substances that can affect their judgment and performance.  Unfortunately, when this happens, their human frailty can affect the health of those of us who are or who become their patients. If you think you are unlikely to encounter an impaired physician, you are wrong.  Current estimates are that 10 to 15% of physicians will experience impairment due to alcohol or drugs at some point during their ca ..read more

As you can probably guess, medical tourism is the name given to the practice of going to a foreign country for medical treatment, usually because it is cheaper there.  One of the most common treatments sought by medical tourists is cosmetic surgery and one of the most common places American medical tourists go is Mexico.  There are always risks associated with cosmetic surgery but they are much higher in Mexico. Americans are nothing if not cost conscious.  Look at this advertisement.  Who could resist?  Affordable health care with a nearby beach and margaritas to boo ..read more

I have been writing lately about medical ethics, which are sometimes more ignored than followed.  The following are instances of doctors being greedy and trying to steal from insurance companies or from Medicare and Medicaid.  It doesn’t matter who you are or what you earn or what is your level of education.  Money can be tempting and some doctors, for a variety of reasons, find the temptation to be irresistible.  And remember, this is only the tip of the iceberg. A Michigan doctor has been charged in a scheme along with a pharmacist to create fake prescriptions for speci ..read more