Boston Scientific agrees to pay $22 million to resolve dispute over alleged kickbacks.

The AP (12/24, Seaman) reported that "heart device maker Boston Scientific will pay $22 million to resolve allegations its Guidant division paid kickbacks to doctors to get them to use its heart devices" according to US attorneys. The physicians received between $1,000 and $1,500 "each in 2003 and 2004 to participate in four studies, called RaCE, RaCE II, RaCE III, and MERITS," the Justice Department said.
Bloomberg News (12/24, O'Reilly) reported that the studies were "designed to assess the performance of pacemakers and defibrillators, the US Department of Justice said...in a statement." But, the company was really "paying doctors to select Guidant devices over competing products, the government said." In a statement, US Attorney Carmen Ortiz wrote, "Although medical-device and pharmaceutical companies can use post-market studies legitimately to obtain information about how their products work in the field, they cannot use those studies, and the honoraria associated with them, to induce physicians to use their products."
Dow Jones Newswire (12/24, Kell) reported that in addition to paying the $22 million, Boston Scientific has also said it would adhere to a corporate integrity agreement with the Department of Health and Human Services.

NO HEALTH INSURANCE = 40% HIGHER DEATH RATE

Featured in Journal Watch: Mortality and Lack of Health Insurance
In a 12-year study, adults without health insurance had a 40% higher relative risk for death than did insured adults.
Journal Watch General Medicine summary

Advocate seeks to eliminate "discretionary" clauses in Texas health insurance plans.

The Dallas Morning News (12/17, Stutz) reports that "the state's insurance consumer advocate is seeking to eliminate the blanket authority of health and disability insurers to decide what their policies cover, a shift that could have a major impact on health insurance in Texas." Mike Geeslin, Texas' insurance commissioner, has been asked by "Public Insurance Counsel Deeia Beck...to end long-standing provisions in most health plans, called 'discretionary' clauses, that give insurers the right to interpret their policies and decide what benefits must be paid." So far, "twenty-two states have banned the practice, either through state law or new regulations."

GAO report finds FDA lacking in development of drug surveillance office.

The AP (12/9, Perrone) reports the Food and Drug Administration "still hasn't restructured its staff to better monitor drug safety, more than three years after experts recommended key changes in the wake of the Vioxx scandal." According to a report by the Government Accountability Office that will be released on Wednesday, FDA officials "have made some changes to drug oversight," although the agency "continues to give the bulk of its decision-making power to scientists who approve new drugs, rather than those who monitor the side effects of drugs on the market." The GAO "calls on the FDA to set a timetable for transferring new responsibilities to the surveillance office." In response, the FDA "said major decisions about drug safety are delegated to the new drugs division because that is 'where staff with the broadest expertise and experience' on product safety issues reside."

FDA Investigating Excess Radiation During CT Brain Scans

Physician's First Watch for December 8, 2009
David G. Fairchild, MD, MPH, Editor-in-Chief
The FDA has identified nearly 260 patients who were exposed to up to eight times the expected level of radiation during CT perfusion scans of the brain, the agency announced on Monday.
The problem was first noted in October, when it was discovered that 206 patients had radiation overexposure at Cedars-Sinai Medical Center in Los Angeles during an 18-month period. Since then, the FDA has learned of "at least 50" additional cases involving more than one scanner manufacturer and is investigating cases in other states. Some patients have reported hair loss and skin redness after their scans.
To prevent additional problems, the FDA has issued interim recommendations for imaging facilities, such as reviewing whether patients have had excess radiation exposure and reexamining radiation dosing protocols.
FDA news release (Free)
Associated Press story (Free)

Toyota extends scope of runaway-acceleration recall.

The Los Angeles Times (11/29, Bensinger, Vartabedian) reported, "Amid widening concern over acceleration events, Toyota has cited "floor mat entrapment.'" Reports, however, are pointing "to another potential cause: the electronic throttles that have replaced mechanical systems." The automaker "says the gas pedal design" in "more than 4 million...Toyota and Lexus vehicles makes them vulnerable to being trapped open by floor mats." Last week, Toyota "announced a costly recall to fix the problem." The article noted that "accounts from motorists...interviews with auto safety experts and a Times review of thousands of federal traffic safety incident reports all point to another potential cause: the electronic throttles that have replaced mechanical systems in recent years."
The AP (11/25, Thomas) reported, "As a temporary step, Toyota will have dealers shorten the length of the gas pedals beginning in January while the company develops replacement pedals for their vehicles," stated the US Transportation Department, adding that "new pedals will be available beginning in April, and some vehicles will have brake override systems installed as a precaution." According to the Chicago Tribune (11/26, Zimmerman), "the announcement dramatically expands the scope and likely expense of the recall, which was announced Sept. 29. Toyota initially had focused on the possibility that improperly installed floor mats might be causing the unintended acceleration problems, and it urged owners of affected vehicles to remove the mats until they could be replaced."
The Detroit Free Press (11/26, Gardner) reported, "It's unclear whether these steps will contain or reduce Toyota's legal exposure from lawsuits already filed. 'It helps in that it looks like they're trying to do something,' said Carl Tobias, a University of Richmond law professor specializing in product liability law. 'In the end, it comes down to: When did the company know about the issue and did it take action voluntarily?'"
On the front page of its business section, the New York Times (11/26, B1, Vlasic, Bunkley) reported, "Several lawsuits have been filed against Toyota, including a class-action suit in California. 'We feel that Toyota has known about this problem for a long time,' said David Wright, whose firm filed the class-action case on Nov. 5 in Los Angeles." The Wall Street Journal (11/27, B2, Linebaugh) also reported the story.

Nine Percent of Surgeons Have Made ‘Major’ Errors Recently

WALL STREET JOURNAL 11-24-09
By Jacob Goldstein
A survey to measure burnout and quality of life among surgeons turned up a detail that caught our eye: Nine percent of surgeons said they were concerned they had made a “major medical error” in the past three months.
The authors of the paper, published by the Annals of Surgery, point to why this is noteworthy.
Although surgeons do not appear more likely to make errors than physicians in other disciplines, errors made by surgeons may have more severe consequences for patients due to the interventional nature of surgical practice.
Those who said they had made an error also showed more signs of depression and emotional exhaustion, the authors found. It wasn’t clear whether the distress made errors more likely, errors made distress more likely, or both.
The survey was commissioned by the American College of Surgeons, and some of the results relating to burnout and career satisfaction were published earlier this year. Overall, 40% of those who responded were “burned out,” according to the authors, and 30% showed symptoms of depression.
Surveys were sent to nearly 25,000 surgeons, and just under 8,000 responded. Response bias is always a concern in interpreting survey results — do those who respond differ in some important way from those who don’t? But it’s unclear which way response bias cuts in this case. Burned-out surgeons could be apathetic and less likely to respond than others, or particularly interested in quality-of-life issues and more likely to respond, the authors write.
WSJ's blog on health and the business of health.

ACOG Releases New Cervical Screening Guidelines into Politically Charged Environment

New clinical management guidelines for cervical cytology screening advise that screening should begin at age 21, not at the age of first sexual intercourse.
The guidelines, released in the American College of Obstetricians and Gynecologists' ACOG Practice Bulletin, say the change is "based on the potential for adverse effects associated with follow-up of young women."
Initially, screening is recommended every 2 years. For women over 30 who have had three consecutive negative screenings, screening may occur at 3-year intervals. Women with certain risk factors may require more frequent screenings: those infected with HIV, the immunosuppressed, those with in utero exposure to DES, women with a history of cancer or cervical intraepithelial neoplasia.
Screening can be discontinued for most women between 65 and 70, or who have had a hysterectomy for benign indications and no history of high-grade CIN.
The guidelines also give recommendations on HPV screening.
Both the New York Times and the Washington Post report that release of the cervical screening guidelines and those on mammography within the same week was a coincidence. Both recognized that the ACOG guidelines would add fuel to the political firestorm over health care reform.
ACOG Practice Bulletin (Free PDF)
New York Times story (Free)
Washington Post story (Free)

80% Uninsured Trauma Patients Die vs Insured Patients!

Legally, it’s not supposed to matter whether emergency room patients have insurance or not. The Emergency Medical Treatment and Active Labor Act, passed by Congress in 1986, guarantees that all people brought to the emergency room receive all the treatment they require, independent of their ability to pay.
And yet, a study just published in the Archives of Surgery found that patients lacking insurance are 80% more likely to die from traumatic injuries than those with private insurance, including commercial health plans, health maintenance organizations, and Medicaid.
Trauma physicians said they were surprised by the findings, even though a slew of studies had previously documented the ill effects of going without health coverage. Uninsured patients are less likely to be screened for certain cancers or to be admitted to specialty hospitals for procedures such as heart bypass surgery. Overall, about 18,000 deaths each year have been traced to a lack of health insurance. –LA Times
While the researchers from Harvard University and Brigham and Women's Hospital in Boston were expecting to find some disparity in risk between insured and uninsured trauma patients, they were shocked at just how large the disparity was.
The researchers offered several possible explanations for the findings. Despite the federal law, uninsured patients often wait longer to see doctors in emergency rooms and sometimes visit ERs at several hospitals before finding one that will treat them. Other studies show that, once they're admitted, uninsured patients receive fewer services, such as CT and MRI scans, and are less likely to be transferred to a rehabilitation facility. –LA Times

CHILDREN ARE VICTIMS AS WELL:
11-19-09 Featured in Journal Watch:
Mortality and Insurance Status — The Safety Net Has Holes
Uninsured children with blunt or penetrating trauma have higher mortality rates than their privately insured counterparts.Journal Watch Pediatrics and Adolescent Medicine summary

INSURANCE COMPANY PROFIT VS DEATH?

The insurance industry recently reported that $80 Billion is paid each year for Mammogram screening for Breast Cancer and PSA screening for Prostate Cancer. According to their financial reports the costs don't justify the return, meaning- by the number of lives saved by early detection of Cancer.
Is it "OK" for the Insurance Industry take away our individual right to obtain preventative screening for cancer? Is it "Ok" for the Insurance Industry to use the medical studies for justification of these "new restrictions" so they can pay less for preventative screenings and increase their profit margins even further? Lord help you if you are diagnosed with Cancer. You can be assured that your insurance company will also Deny life saving treatment under ambiguous exclusion clauses such as; "Investigational or Experimental Treatment."

At what point do we say, "NO" to Insurance companies who only see human beings a profit margins and expendable for the sake of their bottom line.

What do you think? I welcome your comments on this very hot topic.

USPSTF Recommends Against Routine Mammography for Women in Their 40s
The U.S. Preventive Services Task Force now recommends against routine screening mammography for average-risk women aged 40 to 49. This represents a change from the USPSTF's 2002 recommendation statement, which advocated for routine screening starting at age 40.
Among the task force's other updates, published in Annals of Internal Medicine:
Screening mammography should be performed every 2 years for average-risk women aged 50 to 74.
Evidence is insufficient to recommend for or against screening in women 75 or older.
Clinicians should not teach women how to perform breast self-exams.
Evidence is insufficient to make recommendations on using clinical breast exams in addition to mammography.
Evidence is insufficient to recommend for or against using digital mammography or MRI instead of film mammography.
In Journal Watch Women's Health, Dr. Andrew Kaunitz says that because the updated guidelines recommend less screening, women may be confused or even outraged. He calls for consistent "frank discussions" with patients about the benefits and risks of screening mammography.
(The American College of Radiology has spoken out against these guideline changes.)
Annals of Internal Medicine article (Free)
Annals of Internal Medicine editorial (Subscription required)
Journal Watch Women's Health clinical practice guideline watch (Free)
American College of Radiology statement opposing USPSTF's changes (Free)

Can we protect teenage drivers from motor vehicle accidents & death?

Few rules set by parents and teens' access to their own cars might increase the risk for a car accident.
Many parents fear the day that their teenagers drive for the first time. Investigators examined the relation between access to a car and parenting style and risk for car crashes in a nationally representative survey of about 5000 students in the 9th, 10th, and 11th grades. General parenting style was determined based on adolescent reports and was categorized as authoritative (high support and high control), authoritarian (low support and high control), permissive (high support and low control), and uninvolved (low support and low control).
Teenagers who reported that they were the main drivers of a vehicle (primary access) were twice as likely to report that they had been involved in a crash during the past 12 months as teenage drivers who reported shared access to a car. Teenagers whose parents were categorized as authoritative were significantly less likely to report involvement in crashes as the driver or passenger during the past 12 months than teenagers of parents who were categorized as uninvolved, (odds ratio, 0.47 and 0.73, respectively). Teenagers with authoritarian or authoritative parents were significantly more likely than those with uninvolved parents to use seat belts as drivers and passengers.
Comment: As a father of two teenage boys who began driving during the past 3 years, I read these reports with great interest. The results suggest that parents who set few rules and give their children ready access to a car might increase the likelihood that their teenagers will have a car accident and reduce the likelihood that they will use a seat belt. My wife has been telling me that for years! Raising adolescents is fraught with challenges, some of which are to establish rules, be consistent, and not acquiesce to all requests despite protests.
— Howard Bauchner, MD
Published in Journal Watch Pediatrics and Adolescent Medicine October 28, 2009

Exhibits & Admissibility: When in Doubt, Hire a Pro

Debunking the Myths of Litigation Exhibits & Presentations

I recently attended a legal conference where I discussed the services of our company – Med Art & Legal Graphics – with attorneys from across the country. It was good to see many old friends who have used our demonstrative evidence exhibits & trial presentations with much success. Still, I ran into a fair number who said, “I don’t use that kind of stuff.”

Granted, not all cases require exhibits. However, I feel I should address some…um…myths (for lack of a better term) I have heard from attorneys regarding the use of “that kind of stuff.”

This is the third in a 5-part series of the most common myths regarding the use of demonstrative exhibits and litigation presentation tools.

MYTH 3: Graphic exhibits won’t be admissible.

When exhibits are prepared by Certified Medical Illustrators, then reviewed and approved by the treating physician or other expert to be true, fair and accurate, they are always accepted into evidence.

A skilled attorney will have her/his exhibits prepared by a professional – like Med Art & Legal Graphics -- who works with experts to get the necessary approval every step of the way. This applies equally to crime scene exhibits, accident orientation depictions and all other illustrative mediums.

For those of you DIY folks, take note of what Ed Josiah of GREYHAWK North America has to say in his treatise, “Demonstrative Evidence Evidentiary Issues & Laying a Proper Foundation:”

“When casually measured and hastily prepared diagrams are used to pinpoint specific placement of crucial evidence, or to verify eyewitness visibility, they step over the boundary of their original intent and may create a false picture of the evidence.”

Don’t risk exhibit inadmissibility: Contact the professionals at Med Art & Legal Graphics Company – 888-715-0784. Or, visit our website at www.med-art.com.

Note: For statutory guidelines, see Federal Rules of Evidence 901, 902, and 1001-1004.evidence.

Day 2: Exhibits That Don't Cost an Arm & a Leg

Debunking the Myths of Litigation Exhibits & Presentations

I recently attended a legal conference in sunny Arizona where I discussed the services of our company – Med Art & Legal Graphics – with attorneys from across the country. It was good to see many old friends who have used our demonstrative evidence exhibits & trial presentations with much success. Still, I ran into a few who told me, “I don’t use that kind of stuff.”

Granted, not all cases require exhibits. However, I feel I should address these misconceptions I have heard from attorneys regarding the use of “that kind of stuff.”

This week, I will debunk the 5 most common myths. I will also provide hints to help you to clarify the facts & fortify your case through the use of demonstrative exhibits and litigation presentation tools…for all budgets.

MYTH 2: My case doesn’t warrant the expense.

Winning is the object, right? But if the jury (or settlement panel) can’t visualize the damages, why bother?

A picture’s worth a thousand words. The complexities of human anatomy escape most people – jurors & judges alike – unless they have a visual aid to guide them. A medically accurate drawing created by a Certified Medical Illustrator (CMI) and placed within the jury’s view throughout trial will have a dramatic impact… and generally for less than $1,000.

To see examples of exhibits depicting all types on anatomy, visit the “Gallery” section of our website – www.med-art.com.

Who Needs Litigation Exhibits? YOU do!!!

Debunking the Myths of Litigation Exhibits & Presentations

I recently attended a legal conference in sunny Arizona where I discussed the services of our company – Med Art & Legal Graphics – with attorneys from across the country. It was good to see many old friends who have used our demonstrative evidence exhibits & trial presentations with much success. Still, I ran into a few who told me, “I don’t use that kind of stuff.”

Granted, not all cases require exhibits. However, I feel I should address some…um…myths (for lack of a better term) I have heard from attorneys regarding the use of “that kind of stuff.”

Over the next 5 days, I will debunk the 5 most common myths. I will also provide hints to help you to clarify the facts & fortify your case through the use of demonstrative exhibits and litigation presentation tools…for all budgets.

MYTH 1: We don’t go to trial, so we don’t need big, splashy graphics.

Splashy graphics? Probably not. However, you still need to present your case in a concise & compelling manner. Fumbling around with boxes of documents and MRI films in a manila folder is a red flag to opposing counsel: You might as well go to Kinkos & buy a banner saying “I am sooo not ready to go to trial!”

We offer many options that communicate the facts of the case in mediation/settlement while sending the clear message, “We’re ready, bring it on!” Briefly, in order of expense…

o Illustration (or “board”): We can take stock art and make minimal modifications, or enhance xrays/MRI films, to present a clear picture of the injury(s) in your case at a very modest price.

o Interactive PDF Presentation: These incorporate all case facts – depo clips, accident scene photos, before/after pix, photos, enhanced films, EFM strips, comprehensive depiction of injuries – in easy-to-use file that you can email, burn to disc or simply pull up with no special software. The PDFs are so easy to work with, they make TrialDirector look like quantum physics! And they’re surprisingly affordable.

o Day-In-the-Life/Wrongful Death Video: We take photos, video footage, family interviews, depo clips, medical records and all other relevant information… and put it together into a well-scripted, compelling presentation for display via video screen or laptop. And the price would surprise you: The benefits far outweigh the cost.

Many other options exist that fall in between these there basic levels of communication in terms of simplicity and cost. Med Art & Legal Graphics provides free, no-obligation quotes to determine the appropriate medium given your case facts and budget.

To see an example of an Interactive PDF Presentation, email me at lauraquine@med-art.com.

Photos & Admissability in the Courtroom

The following article, courtesy of Caught.net, discusses the use of photos in the courtroom and issues surrounding admissibility.

Med Art & Legal Graphics Co. are experts in the preparation of demonstrative evidence exhibits and creation of compelling presentations for trial, mediation and settlement. With more than 20 years in the legal arena, producing everything from basic boards & medical illustrations to state-of-the-art interactive trial presentations, we know what works!

For a free consultation on your next case, contact us at 888-715-0784 or visit us on the web at www.med-art.com.

Photographs

A trial attorney holding a photograph in his hand and approaching a witness with it will undoubtedly catch the attention of the jury, opposing counsel, and the judge. All present will tend to lean forward as the lawyer shows the photograph to the witness. Photographs tend to be extremely powerful pieces of evidence. After all, "one photograph is worth a thousand words." Before a photograph may be used at trial, it must first be admitted in evidence.

Photographs are admissible in civil trials if they are relevant. For a photograph to be deemed relevant, a trial attorney must argue that the photograph tends to prove or disprove a material fact in the case. See, Fla.R.Civ.Pro. Rule 90.401 and Fla.R.Evid. §90.401. Nevertheless, before a photograph is admitted into evidence, it must first be authenticated; thus, the proper foundation must be established.

Contrary to the belief of many practicing attorneys, the photographer does not need to be called as a witness before a photograph may be allowed into evidence. All that is necessary, is that a witness with knowledge, testify that the photograph fairly and accurately represents the condition, product, person or scene that it depicts. City of Miami v. McKorkle, 199 So.2d 575 (Fla. 1940). Once the witness authenticating the photograph establishes that the photograph correctly and accurately depicts what the witness has previously seen, then the photograph is admissible. If more than one photograph is shown to the witness for purposes of authentication, the lawyer must ask the witness to identify and authenticate each photograph before showing the photographs to the jury.

If the photograph was taken long after the incident in question, this does not mean that the photograph is inadmissible; however, the witness must establish that the conditions depicted in the photograph did not change from how they appeared at the time at issue. If the conditions in the photograph depict something different than what appeared at the time in question, then the photograph may be declared inadmissible if it lacks probative value as a result of the changes, or if the probative value is out-weighed by prejudice to the jury. Pensacola Inn, Ltd. v. Tuthill, 404 So.2d 1173 (Fla. 1st DCA 1981).Questions regarding who took the photograph, how it was taken, from what angle it was shot, what the lighting was like, the film quality and other matters do not go towards the admissibility of the photograph. Those matters are directed towards the weight and credibility of the evidence offered. Those types of questions are proper subjects for cross-examination. Channewacker v. City of Jacksonville Beach, et al., 419 So.2d 308 (Fla. 1982).

Gruesome photographs showing grotesque scenes, severely injured and bloody people, and other potentially offensive depictions are generally admissible on the same grounds as photographs depicting other matters if they are relevant. See Wilson v. State, 436 So.2d 908 (Fla. 1983). Gruesome photographs are admissible if they truly and accurately depict a material fact in question at the trial. Id. For example, the cause of death, the type of injury, the location of injury, the extent of injury, and the intent of the defendant among other related things. See Lewis v. State, 566 So.2d 270 (Fla. 2d DCA 1990).

Nevertheless, pursuant to Fla.R.Civ.Pro. Rule 90.403 and Fla.R.Evid. 403, a defendant may move to exclude a gruesome photograph on the basis that its probative value is greatly out- weighed by prejudice to the defendant. If it appears that the only reason the photograph is being used is to inflame, shock, or excite the jury, then the photograph should be excluded as more prejudicial than probative. Lewis, 566 So.2d at 272; Also See, Gore v. State, 475 So.2d 1205 (Fla. 1985).

Evidentiary photographs are extremely effective tools that will greatly assist the trial attorney in presenting his case. In order to ensure the admission of the desired photographs in evidence, the lawyer should decide early in the legal proceedings what photographs he intends to use during the trial, what order he intends on introducing them, and what witnesses will authenticate the photographs. The trial practitioner should also review all photographs that may be introduced at trial against him and, if possible, prepare a written motion in limine on the basis of prejudice to prevent the damaging photographs from being introduced at trial.

More from the Tort Reform Debate

Med Art & Legal Graphics Co. keeps up-to-date on the tort reform debate.

Health Care - Tort Reform Is Not The Answer

Written On August 26, 2009 By Bob Kraft, of Kraft & Associates
In a column in the Baltimore Sun today Jay Hancock discusses some of the myths about health care reform. One is that tort reform would significantly cut the costs of medical care in the United States. His conclusion is that it would make little difference. Here are the relevant paragraphs from his article:
“Why is it … in this grand health care debate we hear not a word about one of the worst sources of waste in American medicine: the insane cost and arbitrary rewards of our malpractice system?” syndicated columnist Charles Krauthammer asked last month.
Actually we hear plenty about tort reform - fixing the laws pertaining to medical malpractice and other personal injury. Talk radio is full of it. Krauthammer wrote about it again this month. I get reader e-mails all the time asking the same question.
There’s lots to talk about. Malpractice awards and “defensive medicine,” in which doctors over-scan and over-treat patients to fend off lawsuits, cost tens of billions a year.
Trial lawyers bring dubious cases along with deserving ones. Juries deliver nonsensical verdicts. Every few years, malpractice insurance costs drive neurosurgeons or obstetricians to retire, move to other states or otherwise withhold badly needed care.
There is nothing about tort reform in the Democrats’ health care legislation. No accident there. Trial lawyers give millions to Dems and hardly anything to Republicans.

But tort reform is not the solution to the health care crisis. The absence of tort reform is not a reason to reject what’s going on in Washington.

“Tort reform as discussed in the United States would probably have very little impact,” says Gerard
Anderson, a professor at the Johns Hopkins Bloomberg School of Public Health. “The states that have enforced tort reform have about the same amount of litigation - and the awards are comparable - as states that don’t.”
A more drastic malpractice makeover would deliver substantial gains - but only once. New Zealand has a no-fault medical injury system in which lawsuits are essentially banned and experts decide how much to award victims. But even such a system, which nobody is talking about in the United States, would cut health care costs by maybe 7 percent at the most, Anderson said.
That includes costs from defensive medicine. At a time when employers and patients often see medical costs rise by double-digit percentages every year, 7 percent is a footnote.

The nonpartisan Congressional Budget Office, as usual the best source for this kind of analysis, says
malpractice costs make up only 2 percent of health care spending. “The evidence available to date does not make a strong case that restricting malpractice liability would have a significant effect,” the CBO says.

Even WellPoint, the insurance giant whose CEO likes to complain about malpractice lawsuits, says
litigation and defensive medicine “are not considered a recent significant factor in the overall growth of health care spending.”
Kraft & Associates 2777 Stemmons Freeway Suite 1300 Dallas, Texas 75207 Toll Free: (800) 989-9999 FAX: (214) 637-2118 E-mail: info@kraftlaw.com

Med Art Honored as GTLA Preferred Partner!

Med Art is honored to be invited to become a "Preferred Partner" with the Georgia Trial Lawyers Association! We have been proud to serve the trial lawyers of Georgia for the past 5 years!

In July, 2004, Med Art opened a full service production office in the Atlanta area, providing case review and presentation stragedies, the creation of exhibits, animations and interactive presentations. Additionally we provide trial presentation services for medication or trial.

Contact Southeast Office: ShelleyWatts@med-art.com

Contact Northeast Office: PatMurphy@med-art.com

Farewell Mr. Kennedy

Sen. Kennedy was a friend of the same individuals our country’s trial attorneys are fighting for: the victims. He was committed to protecting our nation’s legal system and was dedicated to social justice. He fought for those injured in the workplace or by unsafe products. He staunchly supported health care reform for all Americans. Sen. Kennedy’s distinguished career in the U.S. Senate will stand forever as a model of compassionate leadership.

“For all those whose cares have been our concern, the work goes on, the cause endures, the hope still lives, and the dream shall never die.” – Sen. Edward M. Kennedy

Malpractice suits not to blame for high health care costs

As attorneys, you are needed to speak for the thousands of Americans who die or are injured due to medical negligence. Med Art & Legal Graphics Co. can help you get justices for your clients with our compelling exhibits and persuasive trial presentations. To learn more about our full range of services, visit www.med-art.com.

Published: August 19, 2009 3:00 a.m.

Letter (Web version): Malpractice suits not to blame for health care costs

Sen. Mitch McConnell calls them “junk lawsuits.” Rep Mike Pence calls them “runaway jury awards.” Either way, Republicans pin colossal hopes for health care reform on the bugaboo – tort reform.

Four of 10 medical malpractice cases are groundless, thus dismissed in court. That means six of 10 involve plaintiffs, lives unalterably changed, who deserve an opportunity to be made whole.

According to the Institute of Medicine, between 44,000 and 98,000 Americans die yearly of avoidable errors. Yet fewer than 11,000 were compensated in 2008, down from 15,000 in 1999.

The National Practitioner Data Bank found the average U.S. malpractice payment for 2008 was $326,000, “the smallest on record”– hardly a runaway jury award. Eighty percent of that money went to those with significant permanent injuries such as quadriplegia and brain damage, needing health care the remainder of their lives and having enormous medical expenses. These are junk lawsuits?

Medicare’s administrator told Congress in 2005, that malpractice litigation accounts for only 0.6 percent of U.S. health care costs, and medical liability accounts for less than 1 percent of the country’s health care costs with “the vast majority of victims receiving no compensation whatsoever.”

Recently, Americans for Insurance Reform found that medical malpractice premiums amount to one-half of 1 percent of health care costs and medical malpractice claims, one-fifth of 1 percent of health care costs.

Tort reform, without a public option to compete with for-profit private insurers, is a toothless GOP health care reform component.

JULIA K. GOUVEIA Muncie

Copyright © 2009 The Journal Gazette.

INSTANT Case Presentation!!

One of the electronic tools attorneys seem to have no problem embracing in a trial setting are PowerPoint presentations. A tool like Trial Director seems to be so scary. But scary no more! A tool like Presentation Scripts allows for PowerPoint-like functionality in the court room, only with all Trial Director's bells and whistles! This function allows you to organize your exhibits in the order you wish to present them, save them, then display them one-by-one in the courtroom with a single-click of the space bar! Here's how you do it:

Create a workbook and populate it with the exhibits you wish to present, then organize them in the order you want to present them in. Right-click on the workbook and find Send Workbook Contents to Presentation Script. You only have two options: 1) Give it a name and/or 2) have each slide advance automatically every [x] amount of seconds. Click OK. Remember what you called it, as there is no indication anywhere that you just did this. Go to presentation mode. Type in the name of your presentation script (just like you would any exhibit) and hit enter. Voila! Your first exhibit is displayed, and advances every time you hit the space bar (except where you've entered a number of seconds for an automatic slide advance). Note: This functionality works in both 4.x and 5.x versions. In 4.x, you work with Folders rather than Workbooks, but the process is the same.

Withholding Abnormal Test Results?

Abnormal results weren't shared 6% of the time.

How often are patients not informed about abnormal test results? To find out, researchers retrospectively reviewed records for more than 5400 outpatients (age range, 50–69) who were treated at 23 U.S. primary care practices. Randomly selected records were examined for results of 11 blood tests and 3 screening tests (e.g., abnormal mammogram finding, serum potassium level <3.0>5.5 mEq/L). Physicians were given the opportunity to state whether they actually had notified patients but had failed to document that notification.

A total of 1889 abnormal test results were identified; in 117 instances (6%), patients were not notified. Practices with established processes for handling test results (i.e., all results are routed to the responsible physician; physician signs off on all results) had lower failure-to-inform rates than those without such processes, but rates were not lower in clinics with electronic medical record (EMR) systems than in those without such systems.

Comment: In this retrospective study, 6% of the time, patients were not notified about markedly abnormal test results. Notably, practices with established processes for handling test results had lower failure-to-inform rates; the presence of an EMR did not lower this rate.

Jamaluddin Moloo, MD, MPH

Published in Journal Watch General Medicine July 23, 2009Citation(s):Casalino LP et al. Frequency of failure to inform patients of clinically significant outpatient test results.Arch Intern Med 2009 Jun 22; 169:1123.

How Do You Highlight This FAILURE in Your Case?

Med Art & Legal Graphics would use their 40+ years of combined years of graphically representing complex medical situations to create a Timeline which would clearly represent a "What is Told to the Patient" section and a "What is Withheld from the Patient" section. This is a very concise way for the audience to see what was left out of the story. For more information on how to best "Illustrate" your case click here to see Med art's web site.

Vertebroplasty No Better Than Sham Procedure in Osteoporotic Fractures

Two placebo-controlled trials of vertebroplasty find no added benefit in pain relief or quality of life. The studies appear in theNew England Journal of Medicine.

In both studies, patients with painful osteoporotic vertebral fractures underwent randomization to either vertebroplasty or a sham procedure.

Among some 80 Australian patients in the first study, there were no differences between the groups in overall pain improvement at the 3-month mark, the primary outcome measure.

Similarly, in the second study, some 130 patients from the U.S., U.K., and Australia underwent randomization and subsequent follow-up for clinical improvement at the 1-month mark. Again, no significant differences were found.

An editorialist says the results may consign vertebroplasty to being considered "no better than placebo." And in Journal Watch General Medicine, Dr. Allan S. Brett writes that unless studies can identify a subgroup of patients who benefit from it, the procedure "should be viewed skeptically." http://firstwatch.jwatch.org/cgi/content/full/2009/806/1

How Do You Highlight This?

Med Art & Legal Graphics would use their 40+ years of combined years of illustrating medical procedures to create "Normal" anatomy to educate the viewer, then illustrate the surgical procedure in question. After the viewer is educated the results of the study are easy to understand. For more information on how to best "Illustrate" your case click here to see Med art's web site.

Pharmaceutical Company Paid Ghostwriters to Draft Journal Articles Supporting Hormone Therapy

The New York Times reports that Wyeth paid ghostwriters to draft 26 journal articles emphasizing the benefits of hormone replacement therapy — and de-emphasizing the risks. The articles, published from 1998 to 2005 in 18 medical journals, were mainly review articles, and they did not fully disclose the ghostwriters' extensive contributions. For the entire article.

How Do You Highlight This?

Med Art and Legal Graphics would use a Trial Presentation software and project the ghostwriter's articles on a large screen (4x6 foot large). Then Visually compare the article's Fraudulent statements to the FDA's List of Risk Factors with Hormone Replacement Therapy. For more information on how make your case crystal clear to your audience contact us. Med Art & Legal Graphics Co.

South Carolina Association for Justice

South Carolina Association of Justice Annual Convention - 8/6/2009

Med Art & Legal Graphics will have an awesome Raffle Item for the SCTLA Members to win! Come by our booth and see our NEW Interactive PDF presentations!!! THEY ARE COST EFFECTIVE- EXTREMELY EASY TO USE!

Hilton Head, South Carolina

Med Art's Medical Expertise includes being up-to-date on the most recent medical data for patient care, the risks and the standards of care. While consulting on Gastric Bypass cases we found the following:
Perioperative Complications with Bariatric Surgery
Patients need to balance benefits and risks associated with each type of weight-loss surgery. Patients who are considering bariatric surgery must weigh short-term risks of surgery against long-term benefits of weight loss. Comment: These results are consistent with other published data. Patients face several trade-offs when they choose among bariatric procedures: In a recent systematic review, Roux-en-Y gastric bypass conferred greater long-term weight loss than did laparoscopic adjustable gastric banding, at the expense of higher perioperative complication rates; however, beyond 30 days, complication rates (e.g., obstruction or reoperation) actually became higher with adjustable banding than with Roux-en-Y
(JW Gen Med Nov 13 2008).
— Allan S. Brett, MD
Published in Journal Watch General Medicine July 30, 2009
To see more Medical Illustrations of Gastric Bypass and other types of Abdominal Surgeries Click Here.

What Do Colors Really Mean?

Below is an article by Susan Gunelius on color branding, it applies to the use of color on exhibits. Think about what the color you use in exhibits, because color can Help and Hinder.

Color Branding: The Meanings Behind Colors

August 14, 2007 by Susan Gunelius

Blue: Cool blue is perceived as trustworthy, dependable, fiscally responsible and secure. Strongly associated with the sky and sea, blue is serene and universally well-liked. Blue is an especially popular color with financial institutions, as its message of stability inspires trust.

Red: Red activates your pituitary gland, increasing your heart rate and causing you to breathe more rapidly. This visceral response makes red aggressive, energetic, provocative and attention-grabbing. Count on red to evoke a passionate response, albeit not always a favorable one. For example, red can represent danger or indebtedness.

Green: In general, green connotes health, freshness and serenity. However, green’s meaning varies with its many shades. Deeper greens are associated with wealth or prestige, while light greens are calming.

Yellow: In every society, yellow is associated with the sun. Thus, it communicates optimism, positivism, light and warmth. Certain shades seem to motivate and stimulate creative thought and energy. The eye sees bright yellows before any other color, making them great for point-of-purchase displays.

Purple: Purple is a color favored by creative types. With its blend of passionate red and tranquil blue, it evokes mystery, sophistication, spirituality and royalty. Lavender evokes nostalgia and sentimentality.

Pink: Pink’s message varies by intensity. Hot pinks convey energy, youthfulness, fun and excitement and are recommended for less expensive or trendy products for women or girls. Dusty pinks appear sentimental. Lighter pinks are more romantic.

Orange: Cheerful orange evokes exuberance, fun and vitality. With the drama of red plus the cheer of yellow, orange is viewed as gregarious and often childlike. Research indicates its lighter shades appeal to an upscale market. Peach tones work well with healthcare, restaurants and beauty salons.

Brown: This earthy color conveys simplicity, durability and stability. It can also elicit a negative response from consumers who relate to it as dirty. Certain shades of brown, like terracotta, can convey an upscale look. From a functional perspective, brown tends to hide dirt, making it a logical choice for some trucking and industrial companies.

Black: Black is serious, bold, powerful and classic. It creates drama and connotes sophistication. Black works well for expensive products, but can also make a product look heavy.

White: White connotes simplicity, cleanliness and purity. The human eye views white as a brilliant color, so it immediately catches the eye in signage. White is often used with infant and health-related products.

http://www.bizzia.com/brandcurve/color-branding-the-meanings-behind-colors/

Med Art is Exhibiting at Georgia Trial Lawyers Association Auto Torts Seminar

Georgia Trial Lawyers Association
GTLA 2009 Auto Torts Workshop
Please stop by our booth and see our NEW Interactive PDF presentations!!! THEY ARE COST EFFECTIVE- EXTREMELY EASY TO USE!
Amelia Island, FL
7/30/2009
2 Days
Representatives:
Shelley Watts, President;
Fran Twelkemeier, Sales and Business Manager

Monday, July 27, 2009

"The Bright Ideas Company" has done it again with our Interactive PDF Presentations!! These PDF presentations are a "No Brainer". They are easy to use, require no learning and ALWAYS Work!! Imagine having ALL your case trial exhibits, photographs, documents, video deposition clips, timelines, graphics and more in ONE PDF file. Just click on the PDF file and it will automatically open with Adobe Reader. Additionally, the PDF file can be emailed or added to a CD-ROM or uploaded to the internet to be viewed by judges, insurance adjusters, experts or co-counsel.

The example shown above is a demand package presentation created for a personal injury case (for the full animated version click here). The PDF file was designed to be easily navigated simply by clicking on the images you want to see. All types of files can be viewed in our PDF presentations including 3D models, (just like the rotating male figure seen above), medical illustrations, medical animations, video clips, CT, MRI or X-Ray images or movies can also be displayed. How about including video clips of the Treating Physician's testimony or IME's testimony regarding your client's damages and future prognosis?? These powerful presentations work extremely well for settling cases or for use in mediation. We should know, Med Art has been helping our clients successfully present their cases for over 20 years!

$2.5 Million Jury Verdict on Alabama Wrongful Death Case!!

Tuesday, July 28, 2009

$2.5 Million Jury Verdict on Alabama Wrongful Death Case!!

"We recently had the pleasure of working with ALAJ-Fellows member, Shelley Watts, president of Med Art & Legal Graphics Co. Med Art was hired to help us create visuals we could use during the trial of a Nursing Home Negligence/Wrongful Death case.

Shelley is a real professional to work with. She designed compelling exhibits to visually educate the jury to the facts and key issues in this case. We relied upon Med Art’s Medical Illustrations and Timeline throughout trial and found them to be tremendously useful to the jury. The end result was a $2.5 Million verdict for our clients! We were very pleased with our experience with Med Art & Legal Graphics Co., and would recommend them to others who are in need of these types of services."

Susan Silvernail, Managing Partner

Derrick Mills, Associate

Marsh, Rickard & Bryan, P.C.

Birmingham, AL