12/21/2010· Medical Malpractice
By: Paul B. Hofmann, DrPH, FACHE
Progress has been made on improving patient safety and reducing clinical mistakes, but errors happen and, in spite of everything, patients are still harmed.
By: Dr. Kent Sasse, MD,MPH, FACS, FASCRS, FASMBS
Email Dr. Sasse
Telephone: 707-597-2999
Mesh is used to support the tissues in most hernia repairs in the U.S. This practice stems from research showing that without reinforcement material, hernias tend to recur frequently over the long term when the repairs are performed using suture repairs alone. Surgical mesh, made from polypropylene and similar materials formed into screens, was designed to add a supportive layer and reduce the rate of recurrence of hernias. And, broadly speaking, inguinal, ventral, and incisional hernia repairs with mesh do recur less often and have less problems than those historical comparisons using suture repair alone.
But hernia repair is a surgical procedure with potential complications, and the mesh material may play a role in some types of complications, such as erosion, sepsis, mesh contracture, and other phenomena. When litigation arises after such complications, an expert witness is called upon to identify the root cause of the complications and determine whether a breach of standard of care has occurred. The hernia surgeon expert witness is called upon to testify on standard of care, determine if there was a breach of standard of care, and assess causation of damages. One of the primary issues for the bariatric surgery expert witness is determining whether complications suffered were a result of a breach of the applicable standard of care.
Hernia repair is performed with a wide variety of techniques today, including open repairs, laparoscopic repairs and robotic repairs. In some cases, the technique of repair may be the subject of discussion at trial. Additionally, the mesh graft products exhibit different characteristics and properties, and some have been recalled. If you are wondering about a particular type of mesh and whether it has been subject to a recall, you can check the FDA website here: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfRES/res.cfm.
Like all medical procedures, hernia repair surgery with mesh may result in complications and allegations of product defect or medical malpractice against the treating providers and the facility. In such lawsuits the parties may find an experienced hernia surgeon expert witness valuable to assist the trier of fact in fully understanding the evidence in the case.
Dr. Kent Sasse, MD,MPH, FACS, FASCRS, FASMBS, is a Bariatric surgery thought leader. He has performed over 5,000 primary bariatric surgical procedures and 500 revisional bariatric procedures. He is a Medical Director of a nationally accredited bariatric surgery center and an award-winning teacher. Dr. Sasse is a widely published scientist and author of nine books as well as an inventor and patent holder of a bariatric surgical device. His clinical experience includes bariatric surgery and endoscopy, sleeve gastrectomy, gastric bypass, duodenal switch, reoperative surgery, revisional surgery, hiatal hernia, wound care, Barrett's esophagus, hernia mesh, hernia mesh explantation, endoscopic stenting, leaks, Ambulatory Surgery Centers, and solving complications. Dr. Sasse is a prolific public speaker and he serves on the University of Nevada School of Medicine faculty. He is an experienced expert witness at both deposition and trial. Dr. Sasse can be contacted at 707.597.2999 or drsasse@sassesurgical.com.
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12/21/2010· Medical Malpractice
By: Paul B. Hofmann, DrPH, FACHE
Progress has been made on improving patient safety and reducing clinical mistakes, but errors happen and, in spite of everything, patients are still harmed.
11/5/2016· Medical Malpractice
Physician Assistant and Nurse Practitioner Malpractice Trends
Trends in malpractice awards and adverse actions (e.g., revocation of provider license) following an act or omission constituting medical error or negligence were examined. The National Practitioner Data Bank was used to compare rates of malpractice reports and adverse actions for physicians, physician assistants (PAs), and nurse practitioners (NPs). During 2005 through 2014, there ranged from 11.2 to 19.0 malpractice payment reports per 1,000 physicians, 1.4 to 2.4 per 1,000 PAs, and 1.1 to 1.4 per 1,000 NPs. Physician median payments ranged from 1.3 to 2.3 times higher than PAs or NPs. Diagnosis-related malpractice allegations varied by provider type, with physicians having significantly fewer reports (31.9%) than PAs (52.8%) or NPs (40.6%) over the observation period. Trends in malpractice payment reports may reflect policy enactments to decrease liability.
1/27/2023· Medical Malpractice
Defense Support - Paralysis Following An Epidural Injection
By: Joel L. Kent, MD
In this case I was asked to assist in the defense of a physician who had performed a T5/6 epidural on a patient who subsequently developed an epidural hematoma and resultant spinal cord injury with paralysis. The suit contended that the injuries sustained by the patient were the result of negligent..