Chondrolysis is the disappearance of articular cartilage resulting in the disintegration of cartilage matrix and cells. This condition is often characterized by progressive destruction which ultimately causes narrowing and stiffness of the shoulder. There are numerous conditions which may cause chondrolysis to develop such as paralysis, disuse, or rheumatoid arthritis but recently it has been directed linked to post operative pain pumps.

In 2006, the American Academy of Orthopedic Surgeons met to discuss the link between a post operative shoulder surgery condition known as PAGCL and the use of pain pumps. The meeting was prompted because of a sudden surge of patients with strange complications after having arthoscopic shoulder surgery. “All the sudden we started seeing these patients come in with this mysterious and rare condition,” says Dr. Charles Beck, a well respected orthopedic surgeon and senior author of PAGCL study. “So, we decided to look back and see what they all had in common and what had changed. That’s when we started looking closer at the pain pumps and found that 63% of the patients who used one after surgery had all developed this horrible complication. Of course we stopped using them right away, but we felt obligated to do everything we could to help spread the word throughout the medical community.”

Post Arthoscopic Glenohumeral Chondrolysis (PAGCL) affects the glenohumeral joint which is located at the end of the shoulder comprised of the socket of the shoulder blade and the ball of the arm bone. PAGCL is the most common complication after shoulder surgery. Typically PAGCL will occur 3-12 months after the shoulder surgery.  The condition causes the cartilage to deteriorate resulting in numerous painful and permanent complications such as:

•·         Shoulder  Pain (both in motion and at rest)

•·         Shoulder Stiffness

•·         Shoulder Weakness

•·         Clicking, Popping, or Grinding

•·         Decreased Range of Motion

Studies suggest pain pumps may deliver too much medicine which in turn destroys valuable cartilage within the shoulder.  For years surgeons have routinely used intra-articular pain pumps as a way to assist patients in their recovery after shoulder surgery. The shoulder pain pumps became popular because they often reduced recovery time as well as offered an alternative to narcotic pain medications.  Unfortunately there is no consistently successful treatment of PAGCL and its effects can result in permanent shoulder pain and loss of movement. 

Lawsuits are now pending against companies that make these shoulder pain pumps.  Pain Pump manufacturers allegedly failed to warn doctors and patients that continuous injection of commonly used anesthetics may cause permanent damage or that the products general safety had yet to be established. Some of the shoulder pain pump manufacturers are the following:

• Stryker®
• Stryker® PainPump 1®
• Stryker® PainPump 2®
• PainPump® Blockaid®
• I-Flow®
• On-Q® Painbuster®
• Donjoy®
• Donjoy® Pain Control Device
• Accufuser® Plus Pain Pump

If you or someone you know has been injured by one of these pain pumps or if you have symptoms of  post -operative chondrolysis (PAGCL), you may have a claim or be entitled to legal compensation against one of the shoulder pain pump manufacturers. Call the experienced team of attorneys at the Orange County law firm Hodes Milman, LLP today for a consultation of your potential case.

Malpractice is always preventable and unacceptable under any condition. Concerns have been raised about the settings in Veteran Administration (VA) hospitals. United States veterans are eligible to receive healthcare in Veteran Administration (VA) hospitals around the country. Unfortunately, the poor conditions in VA hospitals have been the creator for much worry, especially in the last several years. Due to severity of these situations, it is very important to pick the right lawyer regarding VA medical malpractice lawsuits.

Poor cleaning routines could potentially spread infection and have been found in some VA hospitals. Supervisors have been discovered absent when they were presumed to be working, and supervisors have been incriminated for giving their computer passwords to resident physicians and furthermore even allowing them to cosign their own reports without supervision. Investigators have found that some staff members are not correctly supervised. Veteran Administration medical malpractice is on the rise, leading to many cases of serious injury and death to patients.

The two most common reasons are lack of stability of care and lack of strength of care. Patients often have very serious conditions and they will quick get disregarded yet they could have minor or major conditions. It is, of course, the duty of the doctor to determine the difference between urgent and moderate conditions. The typical situation is that the doctor, or assistant, assumes it is the minor condition without ruling out the major conditions. As time goes on, a simple stomach ache can turn into a problem as life threatening as cancer. Another frequent problem is that patients often don’t see the same doctors on return visits. This allows any signs or symptoms of chronic disease to go unnoticed.

Ordinarily, it is necessary for a veteran to affirm medical malpractice in order to acquire benefits. Military medical malpractice claims can be made by anyone not on active duty who has suffered from deficient care or negligence at a military health care facility in the United States. Military dependents which are defined as the family members of military personnel may file a negligence or malpractice lawsuit for injuries they have suffered. In time of war there is a big jump in veterans, yet there has been a decrease in people seeking care. There are many pitfalls in the process of bringing a claim against the government so having an attorney handle your claim is preferable. You can do it yourself and sometimes the government will pay a smaller claim amount but the problem is that some of the risks can be fatal. On top of it all, the government doesn’t make the process very user friendly. A lot of times cases presented from a person making a claim without an attorney will have their case go ignored or otherwise find extreme complications regarding their claim.

Obtaining an attorney will help you find the correct forms along with the right people. An attorney will also provide an expert witness and distinctly present the claim in a way that is more likely to get attention from the adjustor. A law firm representing a vet is much more likely to push the adjustor in your case. The first thing a client can do to help the attorney is to acquire all of the relevant medical records. Finding a single specific case generally increases your likelihood of winning a case.

If you are a veteran or military dependent and have been injured by a medical error at a military facility, you need a lawyer who understands the military system of medical care and the unique characteristics of military medical malpractice cases. To find out if you or your family members are qualified to file a military medical malpractice or veterans’ hospital negligence claim, please contact our experienced attorneys in Southern California attorneys at Hodes Milman, LLP.

Breast Cancer Misdiagnosis & Delayed Diagnosis Cases

Being diagnosed with breast cancer can be devastating. However, not being diagnosed with breast cancer when you have it can be even worse. But how are breast cancer misdiagnosis and delayed diagnosis cases handled? Expert attorney Dan Hodes explains the difference, “Breast cancer delay in diagnosis cases essentially comes in four different forms. Number one would be the situation where a woman discovers a lump on examination. A mammogram is ordered, which comes back as negative.”

 Hodes explained, “Not all breast cancers are picked up on mammography. A small percentage of cancers are not seen on mammography. So the question then becomes, should the clinician follow up further, or is it reasonable, under that circumstance, for that physician to conclude that in the face of a palpable mass with a negative mammogram that breast cancer does not exist?”

“The standard of care does require more in the face of a palpable mass and a negative mammogram. The standard requires an ultrasound, and if that mass still persists, a biopsy. So, scenario number one is the failure to follow up on a clinically palpable mass in the face of a negative imaging study.”

Other circumstances do occur that are common, Hodes explained, “Scenario number two is a situation where there may or may not be a palpable mass, but the mammogram and/or ultrasound study is misread. And that happens, unfortunately, not uncommonly.”

Scenario number three is a situation where a biopsy is misread. Again, that happens more often than it should. There would be a fourth scenario; that would be the situation where a surgeon, in attempting to do a biopsy, simply doesn’t get the lesion which he or she sought to get. That happens with some frequency as well. Those would be the four commonest scenarios, the first three being more common, and the fourth being the least.”

If by some reason the cancer is not diagnosed or misdiagnosed the attorneys must decide who is at fault. Sometimes this is extremely hard to do and takes many experts as well as time to determine. According to Hodes, “Where there is a failure to follow up on a mass on an imaging study, either the primary care physician or the OB/GYN that is doing that examination might be liable. In a situation where someone fails to appreciate an area of suspicion on an imaging study, the radiologist might be liable.

In a situation where the mass wasn’t properly diagnosed microscopically, the pathologist might be liable and lastly, a surgeon or radiologist performing the biopsy might also be liable.” As with any cancer, early detection is extremely important to the person’s survival however not all cases can be detected early therefore how do we know when a doctor is libel. Dan Hodes, an expert breast cancer misdiagnosis and delayed diagnosis attorney, “Understand that undiagnosed and untreated breast cancer is invariably a progressive disease. So any period of delay is not good. From the standpoint of a possible case, it would be incumbent upon the plaintiff to prove that the period of delay was of sufficient length so as to have impacted negatively on either prognosis or treatment.”

The one of the most difficult points of the case is actually evaluating if your case has legal merit. Dan Hodes, states, “If a woman has undergone regular breast examinations and mammograms, and is later diagnosed with breast cancer, she should certainly consider investigating whether the cancer was missed - particularly is she has a history of a persisting lump. Obtaining copies of old records and original breast imaging studies would be the appropriate first step. If a biopsy had been performed in the past, then results of those biopsy slides should be obtained.”

As with most cancers, early detection is extremely important to the person’s survival however not all cases can be detected early therefore how do we know when a doctor is liabel. Dan Hodes, an expert breast cancer misdiagnosis and delayed diagnosis attorney, “Understand that undiagnosed and untreated breast cancer is invariably a progressive disease. So any period of delay is not good. From the standpoint of a possible case, it would be incumbent upon the plaintiff to prove that the period of delay was of sufficient length so as to have impacted negatively and quantifiably on either prognosis or treatment.”

“So, if I’m looking at a breast cancer case, if there’s a delay of six months or more, that is likely consequential. I’ve actually handled cases involving delays of less than that, which involve higher grade cancers. As a general rule, I would say that six months and beyond probably would impact significantly on treatment and prognosis.”

You must remember each case is different as for the time of delay and affects of the misdiagnosis. If you or someone you love have possibly been misdiagnosed or delayed being diagnosed, remember the following:

1.        Get your medical records as soon as possible. Hodes recommends the patient get a copy herself because of possible record tampering. In some cases records received by the patient a different than those obtained by the doctor which indicates possible liability.

2.        Don’t miss the statute of limitations! Hodes states, “In California, the statute of limitations requires that an action be commenced within one year of the date a person knew, or had the means to know, that they suffered injury or damage as the result of malpractice AND within three years of the date of ‘injury’ itself. As a practical matter, a woman should consult with a lawyer just as soon as is practical following diagnosis to assure that any case is commenced in a timely manner. Filing a case more than one year after the diagnosis poses a risk that the statute of limitations will be raised by the defense as a means to dismiss the case.”

3.        Always find a highly educated and experienced breast cancer misdiagnosis or delayed diagnosis attorney! These cases are a very “niche” area and should be handled by someone experienced in these matters in order to provide detailed insight. Remember most of medical malpractice cases go to trial so hiring an experienced well-seasoned trial lawyer will benefit your case!

Heather Barry, Publicist

Legal Image Marketing & Public Relations

Harley Davidson has been an icon for cycle enthusiast for over 100 years. In 1901 William S. Harley designed his first engine to fit a bicycle. In the past, Harley Davidson has been named one of the safest motorcycles on the road however a recent defect in certain of the Harley model line, known as the “Harley Wobble,” has side-swiped the company’s safety record. A well documented safety issue affecting thousands of owners, the “Harley Wobble” also known as the “rear steer” and even “death wobble”, can develop if the engine is not constrained in all three axes. An unconstrained engine develops an elastic relationship between the swing arm and frame of motorcycle. The “wobble” is so well known that motorcycle repair shops often openly advertise repairs for the defective models. 

Kevin Liebeck, attorney Hodes Milman LLP, explains the elements which must transpire in order for the defect to appear. “Well, it’s a rather transient phenomenon as far as its occurrence in nature, if you will. It is going to be a function of getting the motorcycle into a situation where it has some dynamic inputs that are going to excite this particular condition. You’ll ordinarily find it in turns when the rear tire of the motorcycle is being loaded with a lateral “g” component. That’s when you’re going to begin to distort the relationship between the swing arm and the frame and you may start to see an input into the motorcycle as the longitudinal plane of the motorcycle frame and swing arm diverge from one another. In simpler terms, what you’re effectively having happen is that the rear wheel is changing its angle relative to the centerline of the motorcycle and is, in essence, steering it.

Although thousands of these accidents have occurred due to what is believed to be the so-called “Harley Wobble”, Harley Davidson has yet to institute a recall. Liebeck states, “If they admitted the problem exists, I would expect that they are going to have a whole lot of people suing them for injuries that they have sustained as a result of these accidents.” Harley Davidson’s stand is that the occurrence of this situation or if this even happens, the driver is likely to blame due to excessive speed or reckless driving. Harley is, however, aware of several aftermarket kits to correct the problem that they don’t believe happens. The kit is designed to restrain the engine laterally so the rider will not be subjected to the “wobble”. Cycle World conducted a test on one of the after market kits and found it to be remarkably effective.  The question Cycle World asked in their review is the same one consumers should be asking: why didn’t Harley do this?

How the problem occurs or whoever is to blame, the fact is thousands of injuries have occurred minor to major. Some of the injuries are road rash, amputations, brain injuries, and even death. Usually the more severe injuries are a result of being thrown from the motorcycle or car crash collisions.  When these injuries occur legal action can be taken. Damages available are dependent on the state’s law but most can expect there are going to be special damages. Past, present, and future loss of earnings are taken into consideration depending on the severity of injuries. For instance, if the injuries are too severe that the individual can’t return to work for months or even years then present and future loss of income is applicable. In addition to that their medical bills, past and future, can also be included within the compensation. In some states general damages such as pain and suffering and emotional distress may also be available. In the case of a more severe injury such as amputation or paralysis the family may also be entitled to compensation.  For example, if the spouse is left to bear the brunt of household duties because the injury no longer allows them to participate.

In general most people believe motorcycles are dangerous and accidents occur largely because of carelessness.  These misconceptions  work to Harley’s advantage. The majority of cases are settled, however settlement amounts are not public. Liebeck explains, “We don’t know the amounts of the settlements as they are always confidential. Harley keeps these secret because they don’t want people to know what sort of ballpark range they are willing to pay on these claims.” Liebeck also recommends retaining experienced representation, “Any lawyer that’s experienced in products liability knows that some of these companies play extremely aggressive hardball and some of them are much more inclined to settle quickly and easily. Any manufacturer that has the capacity to hire a sophisticated law firm to defend them will - and believe me, Harley does. So, if you deal with an attorney that doesn’t have experience in these matters, then Harley is not going to take you seriously. You need somebody who is going to get Harley’s attention. This holds true for any defense attorney. The first thing they are going to do is assess their opponent. It’s not just about case either; it’s about who’s bringing the case because if it’s somebody that they know can actually deliver the goods, they know that they’re going to deal with this situation. Whereas if it’s somebody that they don’t think can deliver the goods, they have the luxury of sitting back and waiting to see if they make a mistake. Frankly, your case is only as good as who’s going to prosecute it for you.” Liebeck also recommends researching your state’s statute of limitations.

These cases are heavily dependent on expert witnesses. Sometimes you will need a civil engineer to assess the road in order to determine if design may have played a role. In some circumstances a private investigator is required to track down or question witnesses. Of course the individual’s physician or other medical experts may need to testify to the extent of the person’s injuries. Life care planners may also be needed to determine future medical cost as well as economist to calculate loss of past and future wage loss.

In any circumstance getting sound expert advice is critical to any individual thought to be injured due to suspected negligence.