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Archive for October, 2012
Ohio Jury Renders Negligence Verdict On Different Basis Than What Lawyers Argued – Verdict Rightfully Upheld
Monday, October 29th, 2012
A medical negligence case in Ohio resulted in a verdict for an injured young boy against a doctor. What was surprising was that neither side argued the basis of the jury’s verdict. I know both lawyers well and they are super lawyers. But sometimes the jury sees things differently and makes their decision based on facts that neither attorney argued. As long as there is evidence to support the jury’s theory of the case then the verdict should stand.
The facts of the case are critically important . So read them carefully.
On March 22, 2002, Kyle Smith, who was then nine years old, was playing a game with two other children at the home of a family friend. The children were holding hands and spinning around to see who would fall first.Kyle fell and hit the left side of his head against a coffee table. Jesse Smith was in the next room and heard Kyle hit the coffee table so hard that he could hear the glass in the table rattle. Smith took Kyle home and told Longbottom what had happened. After Kyle vomited and began to experience jaw pain, his parents took him to the emergency room at Mercy Hospital Clermont.
While they were waiting to see a physician, an emergency room nurse, Diane Kruse, R.N., gave Kyle’s parents a pamphlet on head injury that stated any head injury should be considered serious, irrespective of whether the person was rendered unconscious thereby, and that it was most important that the injured person be watched closely for the first 24 hours.
The pamphlet stated that a responsible person must stay in the room with the patient and watch for a list of symptoms, including whether the patient is mentally confused, cannot be awakened from sleep, is unusually drowsy or vomits persistently, or the patient’s pupils are of unequal size. The pamphlet further stated that if the patient cannot be awakened, then the person watching the patient was to call 911 and have the patient returned to the emergency room.
Nurse Kruse later testified that it was her usual practice to explain the pamphlet to the parents of a child who suffered a head injury but to defer to the physician the final determination as to whether the instructions in the pamphlet were indicated for any given patient.
Kyle was seen by Dr. Huber, who performed a neurological exam on Kyle and found the results to be normal. He sutured the wound on Kyle’s ear, gave him some medicine to prevent infection, and discharged him. He chose not to order a CT scan for Kyle because he did not believe one was necessary. Kyle’s parents later testified that Dr. Huber told them that they did not need to worry about the instructions in the head injury pamphlet because Kyle’s head injury was “not typical” and that they should just let him “sleep it off.”
Dr. Huber disputed this, testifying that his standard practice was to tell the parents of patients like Kyle to follow the instructions in the head injury pamphlet and that he had done so on this occasion.
Kyle and his parents returned home from the emergency room sometime around midnight. Kyle threw up just a little bit, gagged a few times, and had the dry heaves. Longbottom made a bed for Kyle on the couch so that she could sleep next to him. Kyle went to sleep around 12:20 a.m. Longbottom heard Kyle talking in his sleep at about 2:00 a.m. and then fell asleep herself around 2:00 a.m. or 2:30 a.m. Around 5:00 a.m., Longbottom awoke and noticed that Kyle had vomited, and that he was choking and gasping for air. Longbottom screamed for Smith, who called 911. Just before the police and ambulance arrived, Smith told the 911 dispatcher that when he and Longbottom had asked Dr. Huber at the emergency room if they should wake Kyle every two hours, Dr. Huber told them “no, it won’t be a problem.”
Kyle was air-cared to Cincinnati Children’s Hospital. Upon his arrival, he was found to be near death. A CT scan of his head revealed a massive epidural hematoma causing a midline shift of his brain and brain herniation. Dr. Kerry Crone performed emergency surgery on Kyle to remove the hematoma. Dr. Crone told Kyle’s parents that he was not sure if Kyle would live. After spending several days in the hospital’s ICU, Kyle survived. He then spent several weeks in the hospital relearning such tasks as swallowing, eating, communicating and walking. As a result of the incident, Kyle sustained permanent injury to his brain and now walks with an altered gait.
The matter was tried to a jury over nine days in 2010. Kyle and his parents argued that Dr. Huber was negligent in failing to order a CT scan for Kyle when his parents brought him to the emergency room at Mercy Hospital and that this failure proximately caused Kyle’s injuries. Both sides presented expert testimony in support of their respective positions on this issue.
Another issue raised at trial was whether Dr. Huber advised Kyle’s parents to follow the instructions in the head injury pamphlet, with Kyle’s parents and Dr. Huber providing conflicting testimony on the matter as set forth above. Dr. Huber acknowledged during his testimony that if he actually did tell Kyle’s parents that they did not need to follow the instructions in the head injury pamphlet—an assertion that Dr. Huber denied—then such advice would have fallen below the standard of care.
The jury returned a verdict in favor of Kyle and his parents for $2,412,899 after finding that Dr. Huber had been negligent in the care and treatment of Kyle and that Dr. Huber’s negligence directly and proximately caused Kyle’s injuries. In response to an interrogatory asking them to state in what respects Dr. Huber was negligent, the jury answered, “Based on the evidence, we believe, Dr. Gary S. Huber did not instruct the parents about the possibility of significant head injury or how to observe and monitor Kyle for such injuries.” (Read full case)
The Real Defense Here Is The Doctor Blew It But You Can Not Prove It Made a Difference
A close reading of the case discloses the classical defense that, ” even if I was negligent you did not prove it made any difference in the outcome”. In legal parlance you did not show my conduct was a proximate cause. The Court reviewed the evidence to see if proper instructions on monitoring the child would have caused the parents to bring the child back to the hospital due to worsening symptoms in time for surgery that would have prevented the brain herniation.
Even though no expert directly stated that it would have made a difference, the parents were able to show underlying facts that lay people could understand that tended to make it more likely than not, that the parents would have realized the child was worsening and brought him back to the hospital in time for the doctor to do the surgery. Certainly the family should be aided by the presumption in failure to warn cases that had a proper warning been given it would have been followed. ftp://www.ca6.uscourts.gov/opinions.htm/00a0292p-06.htm
But Was The Time Frame a Problem
He was discharged from the hospital at 10:40. At midnight when the parents got him home the boy threw up a little , gagged a few times and had the dry heaves. If they had been instructed that these were symptoms of progression and to get him back to the hospital he could have been back there by 1:am and surgery commenced. But instead the parents fell asleep and did not attempt to wake him every two hours. So when mother awoke at 5 am she saw her child had vomited was gasping for air and was in trouble so she got the child air carried back to the hospital for surgery.
The surgeon said it was likely that the herniation occurred after the child left the hospital the first time and before they got him back to the hospital , at least prior to the time he was air carried back to the hospital. So there was a window of 5 hours when the herniation occurred. Given the fact that the symptoms of severe brain injury are progressive and that Kyle was responding at 12 am and the mother was still up at 2am and nothing further untoward happened one could infer the herniation occurred sometime after 2 am.
If the parents had not been lulled to sleep by the inadequate discharge instruction they could have had the child back at the hospital by 1am, surgey performed and the herniation prevented. Since the experts testified to underlying facts and opinions the jury should be at liberty to infer from their common experience that this injury would likely been prevented.
I mean in a criminal case they find people guilty all the time without a body or witness to the accident or expert that says the defendant was the killer. Why should a civil case be any different especially where the burden of proof is substantially less.
For another take on this case (that Mike Lyon defense attorney probably loves) check out the blog post by esteemed Professor and trial lawyer Ron Miller. http://www.marylandinjurylawyerblog.com/2012/10/can_a_jury_make_up_their_own_t.html
Oh by the way Professor, can you comment on if a CT scan had been given initially at the hospital would it have shown enough to warrant admission and observation and timely surgery? Please leave it on my Google Plus Profile
By Anthony Castelli Attorney
8170 corporate Park Drive
Cijncinnati, ohio 45242
Wednesday, October 17th, 2012
The meningitis toll now has risen to 9 in the State of Ohio according to the Ohio Department of Health. This up from 7 a mere 24 hours ago . Warren County, Ohio has reported their first person with fungal meningitis. Hamilton county had previously reported one person with the disease as a result of the tainted steroid shots compounded by the New England Compounding Center .
Ohio Menigitis Outbreak by the Numbers and Counties
Here is the current toll in Ohio as of 10/17/2102 5:30 PM EST
Crawford County a 40 year old female
Warren county a 52 year old Male
Hamilton County a 65 year old male
Morrow County 45 year old male, and females age 47, 50, 55, 52, 62
All of these meningitis cases are fungal and linked to the tainted batches from the NECC.
In Ohio there were four facilities that purchased the batch of steroid for primarily epidural inection .
The Four Ohio Facilities That Gave The Steroid Injections With Fungus
Here are the facilities in Ohio that have reported having the contaminated steroid:
Marion Pain Clinic
BKC Pain Specialists in Marion
Cincinnati Pain Management Center
Ortho-Spine Rehab Center in Dublin
More Problems with Products From NECC
Unfortunately there have been new reports of fungal meningitis infections from other products made by NECC. A cardioplegic solution has been implicated as well as another type of steroid used for back injections.
Local offices that received one or more of those medications are:
The Christ Hospital Spine Surgery Center
Cincinnati Eye Institute
Cincinnati Pain Management, Cornell Road
Greater Cincinnati Pain Management, Hunt Road
Medical Weight Management Center
Middletown Surgery Center, Franklin
Physicians Healthsource Inc.
Professional Radiology, Blue Ash
Western Hills Interventional Pain
SW Ohio ASC, Middletown
Anthony Castelli Attorney in Cincinnati, Ohio is following the meningitis outbreak closely. As a personal injury lawyer he has had many back injury clients that have received epidural steroid injections. He has discussed this with the Hamilton County Health Department as well as with a Doctor at University Hospital infectious disease clinic. Anthony is accepting clients injured by the tainted steroid from NECC. For your free case consultation with Anthony please call 513-621-2345 or 1-800-447-6549
Tuesday, October 16th, 2012
As a Cincinnati personal injury lawyer reviewing meningitis outbreak cases for legal redress there are certain questions I have for people that have received the tainted drug. There are also questions I have for the medical community. And then there are critical things to know about this outbreak.
5 Critical Facts About Fungal Meningitis
1. This disease can cause stroke and death.
2. The quicker it is diagnosed and treated the better your chances of recovery.
3. The Cincinnati Pain Management Center has been identified as 1 of four facilities in Ohio having received the tainted drug from NECC.
4.The Cincinnati Pain Management Center has injected over 200 patients with the drug.
5. You should get to a doctor for evaluation if you have been told you received a tainted dose or if you think you got a tainted dose.
Who is the Best Facility to Treat Meningitis
I called the Hamilton County Health Department and asked Dr Camille Jones who is the best facility in this area to treat meningitis. She would not refer me to anyone specific other than to say an infectious disease doctor.
In my research I noted the the University Hospital has an infectious disease center. I called the Center and asked to speak to Dr. Pampush Kaul director of the infectious disease center to see if she could shed some light on what someone should do that has been diagnosed with infectious fungal meningitis or has been given a shot containing the tainted steroid from the NECC. Hopefully she will return my call.
If you have been infected or given the shot I know this must be terrifying. And that you are probably looking for the best medical help possible. The CDC guidance is somewhat general. You would think in affected areas they would have some coordination of where you would go and who you would see medically that can help you and also help add to the fund of knowledge that just does not seem to be out there.
Anthony Castelli Attorney in Cincinnati is reviewing is reviewing cases for damage claims and lawsuit of fungal meningitis victims. At present his criteria is:
Steroid shot on or after May 21, 2012 through October 5th, 2012 from a named purchaser of the tainted steroid.
The individual was told by a government agency or medical personal that gave them the shot that they received a tainted dose.
You can call Anthony Castelli at 513-621-2345 or 1-800-447-6549 for a free case consultation.
Resource: CDC patient guidance
Sunday, October 14th, 2012
The Cincinnati Pain Management Consultants in Ohio on Cornell Road have been implicated by the Center for Disease control as having injected the tainted steroid batches compounded by the NECC . The first article on the subject incorrectly had stated this terribly misleading incorrect headline:
Local clinic got meningitis-linked steroids
But unlikely local patients received doses.
See for yourself at this link http://news.cincinnati.com/article/20121005/NEWS/310050126/Local-clinic-got-meningitis-linked-steroids That’s from the article atributed to Janet Morse of Cincinnati.com . There has been no retraction by Janet Morse or cincinnati.com that I saw. Maybe I missed it
In fact, Reports From CDC and Hamilton County Health Department confirm Cincinnati Pain Management injected tainted Steroid. This is what Bill Price reported of wcpo.com:
“Hamilton County Public Health officials confirmed the Tri-State victim received an injection at Cincinnati Pain Management in Sycamore Township. He is currently receiving treatment at a local hospital, but no information on his condition has been released.
Over 200 patients at the Cincinnati Pain Management clinic have been contacted by Hamilton County Public Health. So far, the Springfield Township man in the only person in Hamilton County to have developed a confirmed case of fungal meningitis.”
In addition, CDC and state health departments have released the names of approximately 75 healthcare facilities in 23 states that have received contaminated product.” One was the Cincinnati Pain Management Center.
Who is Cincinnati Pain Management Center
They do have a web presence http://cincypain.com/ If you search this site there you see this in one link:
They also have another link on their site where these four doctors along with others apparently have a separate anethesia practice. These four doctors listed above are anesthesiologists and the only doctors listed on the Cincinnati Pain management center web site. My initial questions for them is;
Was Dr Chandoke misquoted, misinformed or did he make the statement as reported.
Why did they use NECC as a source of the steroid?
What checks did they go through to see that the steroid was safely prepared?
How much did an injection cost?
Did they prepare a prescription and purchase the steroid per patient or in bulk?
Were their any intermediaries involved?
Have you been able to reach all of the patients injected?
Should I get a Lawyer’s Help and How Can I Afford It
Most if not all lawyers that are investigating these case will take them on a contingency fee. and they will advance expenses of litigation. The first lawsuit against NECC has already been filed. Don’t you think NECC , and the whole chain of distibution have lawyered up. If you received an injection of steroids made by NECC since May 21 by Cincinnati Pain Management you may be at serious.risk.
Anthony Castelli Attorney in Cincinnati would be honored to speak with those of you concerned if you have contracted meningitis or want to know if you have a case and should be compensated. Call 513-621-2345 or 1-800-447-6549 to get your questions answered at a free consultation directly with Anthony.
Menningitis Outbreak – What We Have Is a National Public Health Emergency Without a Federal Declaration
Sunday, October 14th, 2012
The National Disaster Medical System Federal Partners Memorandum of Agreement defines a public health emergency as “an emergency need for health care [medical] services to respond to a disaster, significant outbreak of an infectious disease, bio terrorist attack or other significant or catastrophic event. For purposes of NDMS activation, a public health emergency may include but is not limited to, public health emergencies declared by the Secretary of HHS [Health and Human Services] under 42 U.S.C. 247d, or a declaration of a major disaster or emergency under the Robert T. Stafford Disaster Relief and Emergency Assistance Act (Stafford Act), 42 U.S.C. 5121-5206).”
The Act has provisions for infectious diseases that have the potential to threaten national security by incapacitating public employees, the military, etc. It does not have a provision for multi-state iatrogenic (man made) non infectious events such as the fungal meningitis outbreak. While “covered events” such as an outbreak of swine flu trip the coordination of specific public responses, “noncovered events” such as this outbreak of fungal meningitis rely on individual states to determine their own response systems. The risks associated with the event are transferred to the individual, affording them little or no protection beyond existing regulation.
Where tracking has occurred, an effort has been made to track from the clinic level to the consumer wherever they may be located. Consumers who reside in other states have been directed to their resident state departments of public health for information. If the state has not been notified that clinics in their jurisdiction received contaminated materials, they have not stood up a statewide response. Consumers in the opportunity threat zone cannot find their way to adequate information within their functional treatment zone. That’s a problem. It appears that at this time, the best way to find information is through the department of public health for the state in which you received treatment.
Because a multistate coordinated response has not been put into place, we are observing a host of predictable problems that increase the difficulty for individual affected consumers:
Barriers to recall at the physician practice level – Consumers are reporting that medical practitioners did not track the information necessary for an effective recall. Medical records do not reflect the necessary information about dosage, product, and lot code. Dosage vials may have been used across multiple consumers and traceability is non existent. Phyisician procurement systems lack identifying information, product specifications are missing, ingredient declarations are absent, lot tracking numbers are not codified into inventory management. Consumer records may be incorrect or incomplete. In some cases, consumers received contaminated injections after the national recall was issued on September 25, leading providers to conclude incorrectly that injections issued after that date are not covered by event procedures.
Barriers to care – Because rimary care is separated from pain management and emergency response, another layer of complexity is added to the process. Local hospitals are responding inconsistently to individuals who present with symptoms. In some cases, physicians are refusing to treat due to fear of personal litigation. It may be difficult for individuals to resolve the payor responsibility issues, particularly where the originating treatment arises from a workman’s compensation injury but the person is affected by a secondary injury due to exposure to contaminated materials. Treating to the limits of personal insurance plans promotes wide variation in treatment response. Where diagnostic procedures require prior authorization or the fungal medications are not approved for payment, those costs will be passed on to the consumer. This creates immediate access to care issues
In some states, physician practices routinely charge patients for copies of their records and may refuse to release health records without a hefty fee. While many of use maintain emergency contacts, this is not the same as a designated care partner who can act on our behalf when we are incapacitated. Someone who is acknowledged with the right to become actively involved in treatment decisions must be sorted out in the middle of the crisis.
Evaluate this in terms of who is affected by the outbreak
Most of the affected are already affected by disabling levels of chronic pain which already limits personal resources for response. While some of their pain events may have originated in a work place accident, for many, a long standing battle with chronic pain is reflected in their histories. Already disadvantaged, this man made emergency will result in adding insult to injury on many levels. It is important to understand this event in terms of the system in which it has occurred and the layers of failure that resulted in personal injury on a wide scale.
This article was written by an citizen health care advocate Terri Lewis. She is not an attorney. With so many lawyers out there seeking fungal meningitis cases sometimes critical issue fly under the radar and points of view that demand systematic changes are missed.
Terri is a Doctoral Candidate in Rehabilitation Counseling and Administration at SIU-C, a trained Red Cross responder, a researcher, and a subject matter expert in issues that result in health care failure for persons with chronic pain that originates with spinal chord injury. She has extensive experience in community health care integration, public policy and ethics. Terri collaborates with worldwide consumer communities of care and research communities of practice.
Anthony Castelli Attorney is focusing on helping victims of this fungal meningitis outbreak and long term preventatitve measures. Anthonyis investigating his belief that there may be many negligent parties as this crisis is deeper and wider than just NECC.
Saturday, October 13th, 2012
Four facilities in Ohio have been identifed by the CDC as having purchased and used the tainted steroid from the NECC. However news reports are seemingly contradictory whether the Cincinnati Pain Managment Center on Cornell road in Cincinnati, Ohio used the steroid.
A press release issued by the Ohio department of Health stated in pertinent part:
After the federal Centers for Disease Control and Prevention (CDC) notified ODH that tainted medication from the Mass.
drug maker went to four Ohio healthcare facilities, state health officials have worked closely with
the clinics, local health officials and the CDC to contact patients who may have received tainted medicine.
The four clinics are Marion Pain Clinic and BKC Pain Specialists in Marion, Cincinnati Pain Management and Ortho-Spine Rehab Center in Dublin.
Cincinnati.com reported with respect to Ohio cases the following:
“Mike Samet, spokesman for Hamilton County Public Health, said his agency helped health departments in surrounding counties locate people who could possibly have been exposed to tainted medicine at Cincinnati Pain Management Consultants of Sycamore Township. That’s the region’s only facility identified as a recipient of shipments from New England Compounding Center, a Massachusetts company that recalled its products. A rare type of meningitis was found in people who received epidural injections of the company’s steroid medication. Federal health officials suspect the medication was tainted with fungus, but they say the original source of contamination had not been found.
As of Monday, 105 people in nine states were diagnosed with the non-contagious brain infection; eight have died. Nationwide, about 13,000 patients may have been exposed to batches of preservative-free methylprednisolone acetate that are suspected of being linked to the outbreak, the U.S. Centers for Disease Control said. That medication was distributed to about 75 facilities in 23 states. The list includes Ohio and Indiana but excludes Kentucky.
Locally, health officials identified 200 Cincinnati Pain Management patients who may have been at risk; as of Monday, officials had questioned 193 of them about possible symptoms of meningitis. They made telephone calls and even went door-to-door, Samet said, sometimes enlisting help from police and ambulance crews to find people who needed to be alerted.
Officials referred 56 patients to emergency rooms, mostly Bethesda North, for precautionary examinations. Only one person was strongly suspected of having meningitis, but that person’s tests came back negative, Samet said, adding, “There’s one case confirmed in the entire state of Ohio, and it’s not here.” Officials wouldn’t disclose the county of residence for that 65-year-old man, saying they wanted to protect his identity.
On Friday (Oct 5), a doctor at the Sycamore Township clinic said it was doubtful any patients were injected with doses from New England Compounding Center because the clinic had stopped using that center’s products even before the meningitis concerns arose.”
However further reports are contrary to the statement attributed to Cincinnati Pain Management
Further reporting on October 9th by WCPO.com indicated that:
“An office manager with Cincinnati Pain Management said they are no longer using the potentially contaminated batch of medication. They are also continually following up with patients who were given the injection to make sure they are doing well. That batch of medication came from the New England Compounding Center, Inc.”
On October 11th Wcpo news person Bill Price reported that:
The Ohio Department of Health has linked two more cases of meningitis to tainted steroid injections distributed by the New England Compounding Center, including one case in Hamilton County.
The total number of cases in Ohio is now three, which includes an unnamed 65-year-old man from Springfield Township in Hamilton County. A 39-year-old woman from Morrow County and a 40-year-old woman from Crawford County have also contracted the disease.
Each of the patients is reported to have contracted fungal meningitis after receiving steroid shots for back and joint pain.
Hamilton County Public Health officials confirmed the Tri-State victim received an injection at Cincinnati Pain Management in Sycamore Township. He is currently receiving treatment at a local hospital, but no information on his condition has been released.
The Associated Press reported on October 12th that:
“One case was recently reported in the Tri-State. A Springfield Township man is currently being treated for fungal meningitis after receiving a tainted injection from Cincinnati Pain Management. Officials have not released any other details on his condition at this time.”
Although the Cincinnati Pain Management initially reportedly denied using the drug, it is now clear from the sources quoted that Cincinnati Pain Management had in fact used the drug which has allegedly infected a 65 year old man in Hamilton county. This initial denail is concerning in light of the further facts reported.
Due to the long incubation period just because one injected with the tainted steroid has not felt symptoms does not mean that you will not be getting this symptoms. Even if you have not contracted meningitis but received the tainted steroid and had a lumbar punture that confirmed you were disease free you may still have a case against the New England Compounding Center or other entities that may be responsible.
By Anthony Castelli Attorney personal injury attorney. Anthony is closely following the developments in the fungal meningitis health care crisis. He has spoken with attorneys in Tennessee and Minnesota and Indiana regarding the investigation ongoing. You can call 513-621-2345 or 1-800-447-6549 to see if you meet the criteria for the meningitis cases Anthony is willing to review and accept. The consultation is free and you can sit down directly with Anthony to discuss your options.
His office located at 8170 Corporate Park Drive is less than a mile from the Cincinnati pain management facility.
For more information on the fungal mennigitis outbreak go to Anthony Castelli’s web site devoted solely to the crisis.
Thursday, October 11th, 2012
As an Ohio personal injury attorney and with an office close to one of the facilities alleged to have purchased some of the
tainted steroid from the New England Compounding Center I wanted to provide you with this update on the outbreak of meningitis.
The toll now is 12 dead and 137 infected the Centers for Disease Control and Prevention said. this is a slight increase from the last update of 119 confirmed cases in 10 states.
If you believe you have been infected get to your doctor immediately.
The states where the fungal meningitis has been identified in the outbreak are:
States With Outbreak of Fungal Meningitis
Ohio Florida Indiana Maryland Michigan
Tennessee Virginia New Jersey
Minnesota North Carolina
Tennessee so far appears to have been the hardest hit State. Officials are reporting that at least 36 people in Ohio have received the injections. The injections were for back pain and are called epidural steroid injections. It is anticipated that more cases will be reported as the time from injection to symptoms can range up to and even exceed 30 days.
Dr. William Schaffner, who has been tracking the outbreak at the Vanderbilt University Hospital in Nashville, Tenn., said the sooner they find the infected, the better the odds of recovery.
“Whether each and every vial was contaminated is not known. But we have an increasing number of patients who are being infected,” he said.
Symptoms include: fever, headache, stiff neck and confusion.
Seventy-six facilities in 23 states received the contaminated product, which was shipped from the New England Compounding Center. Injections may have started as early as May 21. (as reported by CBS news)
The New England Compounding Center in Framingham, Mass., made a steroid used in contaminated injections tied to the outbreak. Ohio has suspended the Ohio distribution license of a Massachusetts pharmacy linked to a meningitis outbreak.
The Ohio State Board of Pharmacy’s director says the board on Tuesday suspended the pharmacy’s license to distribute in Ohio after seeing evidence that its professional practice presented a danger of immediate and serious harm to others.
State health officials on Wednesday revised the number of Ohio patients who received potentially contaminated injections from 430 to 424. The Ohio health department says 410 have been contacted. here is a link to the latest press release put out by the Ohio department of Health
Anthony Castelli is monitoring this outbreak . His office is only a few minutes from one of the facilities that purchased the steroid. He is offering free consultation to people injected with the tainted drug through epidural steroid injections.
Call Anthony today at 1-800-447-6549 0r 513-621-2345
Tuesday, October 9th, 2012
The deadly fungal meningitis outbreak linked to the New England Compounding Center has reached Ohio. In fact it has been confirmed that four locations in Ohio received the tainted steroid for use in epidural injections primarily for back pain.
The four locations in Ohio that have purchased the steroid from NECC are:
Ortho-Spine Rehab Center in the Columbus suburb of Dublin,
Cincinnati Pain Management,
Marion Pain Clinic,
BKC Pain Specialists, also in Marion.
The Centers for Disease Control and Prevention said on Saturday it has confirmed one case in Ohio although it did not say where. The Ohio Health Department said a 65-year-old man had been sickened, but it would not release his name or hometown to protect his identity.
The man’s illness was likely caused by a tainted steroid injection from a specialty pharmacy New England Compounding Center in Massachusetts that has been linked to the outbreak in other states, the health department said.
The Centers for Disease control is undertaking an investigation of the outbreak and is issuing advisories. Here is an exerpt of one of its web pages about the meningitis outbreak.
Frequently Asked Question For patients: Multistate Meningitis Outbreak Investigation
Is the source of the outbreak known?
CDC is investigating medications and products that are associated with this outbreak of meningitis. At this point, the original source of the outbreak has not been determined. However, injectable steroid medication has been linked to the outbreak. The lots of medication that were given to patients have been recalled by the manufacturer. (The focus is on the New England Compounding Center. The Center has taken down its web site and has recalled all its products.)
The type of epidural medication given to patients affected by this outbreak is not the same type of medication as that given to women during childbirth.
What states received the implicated product?
California, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Maryland, Michigan, Minnesota, Nevada, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Virginia, and West Virginia.
The names of the facilities that have received medication from one of these lots are available at http://www.cdc.gov/hai/outbreaks/meningitis-facilities-map.html.
It has been estimated that over 13000 may have been exposed to the contaminated steroids. This advisory for patients has been issued by the CDC:
Patients who have had an epidural steroid injection since May 21, 2012, and have any of the following symptoms, should talk to their doctor as soon as possible:
- New or worsening headache
- Sensitivity to light
- Stiff neck
- New weakness or numbness in any part of your body
- Slurred speech
- Increased pain, redness or swelling at your injection site
Nine people have died so far linked to the tainted steroids. The New York AP reported the following:
The CDC count of cases reached 105 on Monday, including eight deaths. A ninth death was reported late Monday by a Nashville, Tenn., hospital.
Tennessee has the most cases, followed by Michigan, Virginia, Indiana, Florida, Maryland, Minnesota, North Carolina and Ohio.
All had received shots for back pain, and investigators suspect a steroid medication made by a specialty pharmacy. About 17,700 single-dose vials of the steroid sent to 23 states have been recalled. Inspectors found at least one sealed vial contaminated with fungus, and tests were being done on other vials.
The first known case of the rarely seen fungal meningitis was diagnosed last month in Tennessee. The steroid maker, New England Compounding Center of Framingham, Mass., recalled the drug, and over the weekend recalled everything else it makes.
“While there is no indication at this time of any contamination in other NECC products, this recall is being taken as a precautionary measure,” the company said in a statement.
Meningitis is an inflammation of the lining of the brain and spinal cord, and a back injection would put any contaminant in more direct contact with that lining.
Symptoms on meningitis include severe headache, nausea, dizziness and fever. The CDC said many of the cases have been mild and some people had strokes. Symptoms have been appearing between one and four weeks after patients got the shots.
A Michigan man whose wife’s death was linked to the outbreak said Monday that he, too, was treated with steroids from one of the recalled batches.
“Not only have I lost my wife, but I’m watching the clock to see if anything develops,” George Cary said, as friends and family gathered for his wife’s wake in Howell, 60 miles northwest of Detroit.
His wife, Lilian, 67, had been ill since late August, but meningitis wasn’t detected until Sept. 22, her husband said. She suffered a stroke and died Sept. 30, he said.
This video is a good summary of the fungal menningitis outbreak.
By Anthony Castelli Attorney a personal injury lawyer having handled product liability cases as well as serious personal injury and fatalaties caused by negligence or product contamination or defect. Anthony is following closely the outbreak of the viral meningitis and is available for consultation for serious injury and death caused by fungal infections.
He welcomes your call at 1-800-447-6549 or 513-621-2345
8170 Corporate Park Drive #220
Monday, October 8th, 2012
Urgent Safety Bulletin on Meningitis Outbreak
A deadly outbreak of fungal meningitis has been tied to contaminated steroid injections prepared by the New England Compounding Center. If you have had epidural steroid injection contact you doctor immediately or go to the emergency room even if you have not experienced any symptoms.
The first known case was diagnosed a little over two weeks ago in Tennessee.
Symptoms may not develop until more than a month after the injection. Immediate medical treatment is critical to prevent serious injury or death.
What Is Meningitis
Meningitis is an infection of the pia-arachnoid and the CSF fluid that surrounds the brain.
FDA Recall and Action
The FDA has issued a recall of the tainted steroid and has released a list of 34 different drugs this morning that included steroids, epidural anesthetic used to block pain during child birth, and surgery and saline solutions that are compounded to make different medications.
Health officials say 76 medical facilities in 23 states received the contaminated steroid injections from NECC. A list of the 76 affected medical facilities is on the CDC’s website at www.cdc.gov/hai/outbreaks/meningitis-facilities-map.html.
The first press release by the FDA was released 10-5-2012 and can be found at http://www.fda.gov/Drugs/DrugSafety/ucm322734.htm
The Center for Disease Control and Prevention issued an official advisory on October 4th stating in pertinent part:
Physicians should contact patients who have had an injection (e.g., spinal, joint) using any of the three lots of methylprednisolone acetate listed above to determine if they are having any symptoms. Although all cases detected to date occurred after injections with products from these three lots, out of an abundance of caution, CDC and FDA recommend that healthcare professionals cease use of any product produced by the New England Compounding Center until further information is available.
For patients who received epidural injection and have symptoms of meningitis or basilar stroke, a diagnostic lumbar puncture (LP) should be performed, if not contraindicated. Because presenting symptoms of some patients with meningitis have been mild and not classic for meningitis (e.g., new or worsening headache without fever or neck stiffness), physicians should have a low threshold for LP. While CDC is aware of infections occurring only in patients who have received epidural steroid injections, patients who received other types of injection with methylprednisolone acetate from those three lots should also be contacted to assess for signs of infection (e.g., swelling, increasing pain, redness, warmth at the injection site) and should be encouraged to seek evaluation (e.g., arthrocentesis) if such symptoms exist.
For guidance on diagnostic testing that should be performed on patient specimens, physicians can go to http://www.cdc.gov/hai/outbreaks/meningitis.html. State health departments should be informed of patients undergoing evaluation. Clinicians should report any suspected adverse events following use of these products to FDA’s MedWatch program at 1-800-332-1088 or www.fda.gov/medwatch.
If you think you are at risk you are urged to contact your doctor immediately.
Provided as a public service by Anthony Castelli Attorney. Anthony is a Ohio personal injury lawyer with over 30 years experience. He offers free consultation on serious personal injury matters. He can be reached at 513-621-2345 or 1-800-447-6549
His web site is www.castellilaw.com
Wednesday, October 3rd, 2012
As a personal injury lawyer with clients in serious pain I worry about the recent pronouncements by the FDA about
purchasing drugs from bogus online pharmacies. The FDA has put up a resource page to help consumers of drugs educate themselves on this issue. This site has comprehensive information on many issues faced .
Know The Risks
Some of the risks discussed from running afoul of a bogus pharmacy are:
The drugs you receive may look real, but they could be counterfeit, contaminated, expired or otherwise unsafe. If you receive counterfeit or substandard medicines, they could keep you from getting better, make you sick or worse.
Medicine that is approved for use in the United States has been reviewed for safety and effectiveness by the FDA. Medicine that may be approved in other countries or produced by unknown sources may have slight variations or different ingredients that could cause you to get sicker, develop a resistance to your medicine or cause new side effects. If you take more than one medication, these differences could also affect the way other medicines work or cause harmful interactions.
Most fake online pharmacies lack adequate safeguards to protect personal and financial information, and some intentionally misuse the information you provide. These sites may infect your computer with viruses or sell your personal information to other rogue websites and Internet scams. If you buy medicine from a fake online pharmacy, you also risk being harassed by repeated emails and phone calls or being charged for products you never ordered or received.
How Can You Protect Yourself From Bogus Online Pharmacies
The FDA gives some guidance is how to identify these rogue pharmacies. They caution these items as things to tip you off:
- Allow you to buy drugs without a prescription from your doctor
- Offer deep discounts or cheap prices that seem too good to be true
- Send spam or unsolicited email offering cheap drugs
- Are located outside of the United States
- Are not licensed in the United States
Know Your Online Pharmacy
The FDA caution you to know your online pharmacy. They say that fake online pharmacies can manipulate their web sites so check the pharmacies license.
USE THIS LINK TO CHECK THE LICENSE
Once you have identified a state-licensed online pharmacy, also make sure the pharmacy:
- Requires a valid prescription from your doctor;
- Provides a physical address and telephone number in the United States; and
- Has a licensed pharmacist to answer your questions.
- By Anthony Castelli Attorney a personal injury lawyer practicing Ohio law. Anthony offers free consultations on serious bodily injuries. Call today for a free legal consultation and claim review. 513-621-2345Sources: Federal Drug Administration
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