Tuesday, March 17, 2009

Supreme Court Rulings Effect Consumer Lawsuits

Recent rulings by the United States Supreme Court may effect every consumer’s ability to raise claims against medical device manufacturers and drug manufacturers for injuries resulting from product defects.

Medical Devices
In February 2008, the U.S. Supreme Court ruled eight to one that FDA review and approval of medical devices, such as pacemakers, protects manufacturers from state lawsuits even if the devices do not work properly. The ruling applies to Class III medical devices, which are devices that receive the highest level of FDA scrutiny prior to approval. The FDA notes that “Class III devices are usually those that support or sustain human life, are of substantial importance in preventing impairment of human health, or which present a potential, unreasonable risk of illness or injury.”

In this case, Charles Riegel died in 1996, after a balloon catheter inserted during an angioplasty burst. The catheter was a Class III medical device, which had been approved by the FDA after extensive testing, and was made by Medtronic.

The effect of U.S. Supreme Court decision is still being determined. The decision will likely limit the options of legal recourse available for consumers injured by medical devices approved by the FDA. The decision also appears to fall in line with existing federal law governing the FDA. Federal law prevents state law from pre-empting the FDA’s approval process for medical devices.

Drug Warning Labels
The U.S. Supreme Court, in March 2009, determined in a six to three decision that even if a drug undergoes FDA review, patients injured by that drug may still pursue state liability lawsuits against drug companies.

In this case, Diana Levine (a former guitarist) lost her arm in April 2000 after she went to a Vermont health clinic for treatment of a migraine. Wyeth's Phenergan drug (an anti-nausea drug) was injected into Ms. Levine by a physician’s assistant. For this particular drug, medical personnel have several options for injecting the drug, including:

  • The "IV-push" (drug is injected into a vein and is the most risky injection method)
  • Intramuscular injection
  • A slow intravenous drip into a vein

Unfortunately, the injection in this case was made using the “IV-push” method and was directly injected into Ms. Levine’s vein. This course of action allowed the drug to reach an artery and immediately caused gangrene. A jury in Vermont originally found that Wyeth's label had inadequate warnings regarding the dangers of the injecting the drug through the “IV-push” method and Ms. Levine was awarded $6.7 million. The Vermont Supreme Court upheld the jury’s ruling in 2006, prior to the U.S. Supreme Court upholding the jury’s determination. Wyeth had argued that the warning on the drug was sufficient because it had been approved by the FDA, which the U.S. Supreme Court rejected.

The effect of this ruling is not yet known. One possible effect is that drug companies, like Wyeth, will likely fail in arguing that a case raised by an injured patient should be dismissed, simply because the FDA approved of the warnings placed on the drug’s packaging.

Medical Malpractice Representation from Paulsen & Armitage. Thank you for reading our blog. If you suspect that you or a loved one have been injured by a defective medical device or drug, please contact us for immediate assistance. Please note that our postings do not constitute legal advice and your comments will not be treated as confidential. If you wish to discuss your legal matter with us, please contact our office for a consultation.

Thursday, March 5, 2009

Anesthesia Awareness

Imagine undergoing surgery after being given general anesthesia. However, instead of being unconscious during the procedure, you feel the unthinkable physical pain of surgery. But, because of the paralytic drugs you had received prior to surgery, you are unable to move or shout to express what you are experiencing.

The frightening experience described above is a condition called, anesthesia awareness, or unintended intra-operative awareness. It is a condition where patients undergoing surgery are aware of parts or all of the surgical procedure.

Effects of Anesthesia Awareness
Typically, when a patient is given general anesthesia, the patient receives a combination of drugs: sleep agents that make the patient unconscious and have no memory of the surgery, painkillers, and paralytics that prevent the patient from moving. If a patient does not receive enough doses of any of these drugs, then the patient may be conscious of events during surgery or feel pain, and worse, feel pain but be unable to tell doctors.

Of those patients who experienced anesthesia awareness, 42 percent felt the pain of the operation, 94 percent experienced anxiety, and 70 percent had lasting psychological problems, such as post-traumatic stress disorder. The experience is so traumatic for some patients that some have flashbacks and panic attacks whenever they experience anything that reminds them of their ordeal.

Causes of Anesthesia Awareness
Anesthesia awareness can occur due to the anesthetist’s error. An anesthetist may provide an inadequate amount of drugs to the patient or inadequately monitor the patient. Anesthesiologists should monitor patients by checking their vital signs to make sure the patient is unconscious and not experiencing pain. Another possible cause can be an anesthesiologist’s improper use of machines. Other times, the anesthesia is lightened too soon towards the end of surgery, so that the operating room can be used for the next patient, or the anesthesia is too light because the patient is a trauma patient who could die if given too much anesthesia.

Patient’s Experience with Anesthesia Awareness
In 2002, Sidney L. Williams was undergoing open-heart surgery when he awoke and heard the bone saw cutting into his sternum. Williams could hear the doctors discussing his diseased heart, and later he felt sharp, excruciating jolts when the doctor tried to shock his heart. Williams was unable to indicate what he was feeling to doctors at the time, because he was paralyzed due to the paralytic agent and because he was intubated.

Recommendations by JCAHO
Although anesthesia awareness is a rare condition where approximately 20,000 to 40,000 patients of 21 million patients who undergo general anesthesia, become conscious during surgery, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), a quasi-governmental organization that certifies hospitals, issued an alert, trying to reduce the occurrence of anesthesia awareness. The JCAHO made several recommendations to healthcare organizations, which included the following:

  • Educating clinical staff about the condition and how to manage patients who experience the condition
  • Identifying patients who are at higher risk of anesthesia awareness
  • Having anesthesia monitoring techniques
  • Maintaining anesthesia equipment
  • Providing patients with access to mental health treatments

Thank you for reading this blog. If you or a loved one has suffered an anesthesia-related complication due to medical malpractice, or experienced serious injury due to medical malpractice, contact us for a confidential consultation. If you have a question or comment, please reply to this blog or send us an e-mail.