There may be more to the complaint than meets the eye. There may be obvious issues, such as a failed component resulting in a fall, a skin breakdown that on the surface appears that it was as a result of overuse or a rough area within the prosthetic socket.
Foot and ankle injuries due to motor vehicle accidents (MVAs) present unique challenges to the astute foot and ankle physician. Even more challenging than the pathology, however, is ability to return to pre-injury level. Published medical literature provides strong evidence for risk of post-traumatic arthritis after a heel bone (calcaneus) fracture - this post-MVA condition can manifest as residual deformity and resulting arthritis, thus precluding the ability to rapidly return to pre-accident levels. Hence it is imperative that an erudite foot and ankle clinician ascertain the appropriate treatment and long-term prognosis of foot and ankle injuries due to MVAs.
Occipital neuralgia is characterized by severe pain, accompanied by tenderness and trigger points, in the distribution of the greater, lesser, and/or third occipital nerves. Occipital neuralgia is typi- cally idiopathic, but also is characterized as a common form of posttraumatic headache. Typical treatments include nerve blocks with local anesthetic, nerve stimulation, pulsed radiofrequency, and cryoablation. OnabotulinumtoxinA (ONA) has recently been utilized in nerve blocks to treat occipital neuralgia, with the potential for a longer duration of pain relief than local anesthetic.
Occipital neuralgia, while typically idiopathic in presentation, is a common form of posttraumatic headache. It is associated with severe pain in the greater, lesser, and/or third occipital nerves, and often accompanied by tenderness or trigger points in the surrounding musculature. OnabotulinumtoxinA (ONA) has been recently utilized in nerve blocks to treat occipital neuralgia, but current literature supporting such use is scarce. We describe a case of occipital neuralgia in a patient following C1 fracture and vertebral artery dissection due to gunshot injury. Successful treatment with bilateral ONA nerve blocks led to an 80% - 90% improvement in pain, with decreased Visual Analog Scale (VAS) pain scores immediately following treatment and upon follow-up 1 month later.
Plaintiff was admitted to a health care facility with ventricular tachycardia (VT). He had a normal coronary angiography with moderate left ventricular (LV) function and was referred for an implantable cardiac defibrillator (ICD) implant procedure. A diagnosis of right ventricular outflow tract tachycardia was made. He was then admitted for an ablation procedure in March 2005, which was successful. In April 2005, he was readmitted with a further occurrence of tachycardia which required emergency cardio version due to hemodynamic compromise and a temporary pacing wire was placed. There was a further attempt at ablation that was again successful and the LV function noted now to have deteriorated and was noted as having poor functioning. On this basis he was considered a candidate for an ICD implant. There was a further reoccurrence of an episode of ventricular tachycardia (VT) in March and April 2006 which was treated medically and he was discharged.
The Medtronic's Enpulse Model E2DR21P Serial number PMU411109 as well as the Atrial Lead (model #496525, SN: LBT042477R-Epicardial Unipolar and the Ventricular Lead (model #496525, SN: LEN036731R- Bipolar Epicardial had been used to continually pace patient in the DDD pacing mode during patient's lifetime. The expert referred to all Medtronic specifications; warnings; and advisories relevant to both the pacemaker and pacing leads used for pacing this completely pacemaker dependent patient).
1986: Crocket, Dolsky, Lack, Leventhal, Nathanson and Jackson visited London, France and Italy, observing surgeons using different modalities at that time and then brought back their information and openly taught liposuction in the United States under the auspices of the AACS. Other early teachers were Elam, Fenno, Tobin and others.
As part of their educational process, practitioners of manipulative procedures are made aware of the possible association between neck manipulation and cerebrovascular accidents[i] (CVAs) as well as what to do in the event a CVA occurs during treatment.[ii] For any litigation considered regarding a stroke that closely follows spinal manipulation, the starting point for retained counsel is to ask what else could have caused or contributed to the stroke. Screening issues to consider include the following:
Lawsuits pertaining to injuries from laser treatments gone awry or just not as expected are on the rise. Part of the issue is the lack of objective training protocols. There is relatively vague legal language across many state medical boards and often lax regulation of these procedures, who is allowed to perform them, and what training and supervision is required.
Following a neurological event such as a traumatic brain injury, cerebrovascular event, multiple sclerosis, etc., the medical needs of the person are of primary importance initially, for purposes of survival. As medical treatment proceeds and the survival needs of the person are met, the team of rehabilitation professionals will be established in an attempt to improve upon function performance in order to sustain quality of life. The rehabilitation team may be composed of a physician, physical therapist, occupational therapist, speech therapist, recreational therapist, vocational specialist, case manager, the psychologist, social worker, and nurse, to name several. It is often during this tim e that additional medical and rehabilitative needs are identified through diagnosis or observation by member s of the rehabilitation team.