Hospital Negligence Lawsuit Dropped by Florida High Court

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On November 30, 2016, The Florida Supreme Court announced the decision to dismiss a negligence suit filed against a hospital over the death of patient Ashley Lawson.  Lawson escaped from Shands Teaching Hospital and Clinic, Inc.  The Shands psychiatric hospital is now known as the UF Health Shands Psychiatric Hospital and is located in Gainesville, Florida.

The main legal issue in this case was whether the conduct of the hospital was ordinary negligence or was medical negligence (medical malpractice).  In Florida, if the facts alleged constitute a claim for simple negligence, then there are no pre-suit proceedings required, no medical expert witnesses required, and it is usually much easier and much less expensive to try the case.  However, if the facts stated in the suit are medical negligence allegations, then there are a number of procedural hurdles that a plaintiff must overcome.  Additionally, the case is usually much more expensive and time consuming to try.

Patient Was Mentally Ill.

Ashley Lawson was admitted to the hospital on November 1, 2012, because of a psychiatric illness, impulsive behavior, drug abuse and several suicide attempts, according to reports.  According to her estate’s initial jurisdictional brief, Lawson was transferred to the locked impatient unit at Shands for her own safety.

Lawson Allegedly Freed Herself.

According to reports, an employee’s badge and keys were left unattended, which gave Lawson the opportunity to free herself and escape on January 23, 2013.  Lawson died soon after she had escaped.  She was struck and killed by a tractor trailer on Interstate 75.

A Request To Reconsider The Ruling.

On November 15, 2016, the Florida Supreme Court abandoned its denial of a motion from defendant-appellee Shands Teaching Hospital and Clinics, Inc. asking it to reconsider its ruling from September 13, 2016.  The earlier ruling denied a motion for voluntary dismissal filed by the plaintiff, the Estate of Ashley Lawson.  The court’s earlier denials had decided not to dismiss the case by a 4 to 3 split decision, with Chief of Justice Jorge Labarga and Justices Barbara J. Pariente, James F.C. Perry and R. Fred Lewis in the majority and Justices Ricky Polston, Charles Canady and Peggy Quince dissenting.

Since the ruling on November 15, 2016, Lawson’s estate had relinquished its right to file a brief on the merits, noting that the parties are “contractually prohibited from further litigation in this matter.”  This language seems to indicate that a settlement had been reached between the parties.  Shands Hospital filed a motion on November 27, 2016, looking for instructions on its due process rights and its counsel’s duty to proceed.  Shands stated:  “Respondent believes it should be entitled to submit a merits brief to this court and present oral argument since, as this court has made apparent through its orders, it views this case as involving an important issue of statewide impact.”

Where Do You Draw The Line?

This case in particular has raised questions on where the line should be drawn between medical negligence and ordinary negligence.  However, in the motion for reconsideration, Shands Hospital stated that there was no certification of a question of great public importance or a certified district conflict made in the lower court’s decision in the case.

Shands Hospital’s motion to dismiss the case had been denied by the trial court.  Shands then appealed the Florida First District Court of Appeal. The three-judge panel on the Court of Appeal was unable to come up with a definitive result, so the entire Court of Appeal decided to review the case and final reached a 8-6 decision to trump the lower court’s denial.

After that, Lawson’s estate brought the case to the Florida Supreme Court, seeking reversal based on its argument that the First District Court of Appeal’s decision allegedly conflicted with two Fifth District Court of Appeal decisions on what constitutes ordinary negligence versus medical malpractice (medical negligence).  The estate asked for an extension to file its initial merits brief, stating that the parties were discussing a settlement. On July 28, 2016, the estate filed a notice for voluntary dismissal because a deal was in place.

The Supreme Court took the position that the settlement notwithstanding, the Supreme Court should move forward with the case.  Court’s will often do this when they expect that the legal question will come up again and again in the future, unless they go ahead and decide it.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.  We represent medical students, interns, residents, and fellows in disputes with their graduate medical education (GME) programs.  We represent clinical professors and instructors in contract disputes, employment disputes, clinical privileges matters and other disputes with their employers.  We often act as the physician’s personal counsel in medical malpractice litigation.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at http://www.TheHealthLawFirm.com

Sources:
“Shands Teaching Hospital and Clinic Inc. v. Estate of Ashley Lawson.” FindLaw. (August 28, 2015). Web.

Hale, Nathan. “In Shift, Fla. High Court Drops Hospital Negligence Suit.” Law360. (November 30, 2016). Web.

“Justice Won’t Drop Case In Shands Vista Patients Death.” The Gainesville Sun. (September 16, 2016). Web.

“Court Sides With Hospital In Death of Escaped Patient.” Health News Florida. (August 31, 2015). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. http://www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

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“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2016 The Health Law Firm. All rights reserved.

Always Be Certain Your Correspondence Is Professional. Don’t Detract From Your Professional Reputation: 30 Tips (Part 3 of 3)

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

This is Part 3 of a 3 part series on this issue.

I continue with my tips for preparing good, professional correspondence.

19.    In longer correspondence, use section headings (in bold or underlined) or headings for each issue, to better organize it. Think of these as road signs on a long road.  They help the reader to know where he or she is at any given time.

20.    When using headers, skip two lines before the header and one line after the header. This helps to set off the new section and header and show a definite division.

21.    Keep your language objective and professional.  Do not ever use profanity [Oops, I just went back and removed the word “damn” I used above.]  Do not ever use any comments even remotely resembling racism, sexism, or antisemitism or prejudice.  Do not be sarcastic.

22.    Be direct and concise in your language.  To the greatest extent possible, use the same terminology and wording that the other party uses, or has used, or whatever statutes, regulations or governing documents with which you are dealing use (but also, be sure you know what the words and terms mean).

23.    If there are any deadlines by which you must respond, be aware of these and make sure your response is received by that date.  Remember “received” means “actually received” by the correct person (or office) at the correct address.  It does not mean “mailed by” or “postmarked by.”  If you have correspondence or a document to which you a response must be received aby a ceratin date, you need to make sure it is in the receiving person’s hands by that date, even if you must hand carry it.

24.    In closing your correspondence conclude by stating what action is next, whether this is action you intend to take, or action you are requesting the other party to take.  For example:  “I expect to hear from you within ten days as to whether you grant my request or not.”  “Please contact me with hearing dates within the next fourteen days.”  “I will forward you a refund within five days.”  “I will send you my records within five days.”

25.    Always advise the other party of exactly how they should contact you;  provide multiple means of contacting you.  If you are very busy or have an assistant who is authorized to act for you, provide that person’s name and contact information, as well.  Then be available to receive the return communication(s).  Don’t give telephone numbers you never answer.

26. If you intend to request a formal hearing say “I request a formal hearing.”  If you want a refund, state:  “I request a full refund.”  If you want to appeal the decision, state:  “I want to appeal the decision.”  Don’t be wishy-washy or vague.  For example, don’t say, “I am looking for an attorney to file an appeal for me,” when what you mean to say is “I appeal the decision” or “I request an appeal.”

27.    In dealing with dates and deadlines, remember that ten days is ten days;  fourteen days is fourteen days, twenty-one days is twenty-one days.  Made up rules such as “weekends and holidays don’t count” are just that, made up (outside of formal legal proceedings).  If the other party has given you “fourteen days to respond,” this means fourteen days from the date on the letter, unless specifically stated otherwise.  Fourteen days means fourteen days, unless it is specifically stated otherwise (e.g., “you have fourteen business days to reply”).

28.    Include a professional closing above your signature.  This should be “Sincerely,” “Sincerely yours,” “respectfully submitted,” or some other professional closing.

29.    In your signature block, include your full typed name, with credentials and title or position listed.  For example, your full name, followed by your degree and other credentials (e.g.,  “John J. Smith, M.D., F.A.A.C.P.”) should be on the line immediately below where you sign.  Next should be listed your position within your organization (if applicable) (e.g., “Chair, Pediatrics Department”).

30.    If you have enclosures, list them at the end of the correspondence, giving a brief or shortened description and numbering them.  List and number them in the order you discuss them in your correspondence.  Be sure they are properly organized, labeled and divided, especially if any are lengthy.

Following these simple rules most people learn in middle school, will help to keep your correspondence professional looking and in conformity with what most professionals see on a daily basis.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at http://www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. http://www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords: The Health Law Firm, legal representation for health care physicians, reviews of The Health Law Firm, tips for professional correspondence, The Health Law Firm attorney reviews, legal representation for nurses, professional correspondence for a legal dispute, owners of health care businesses defense attorney, physicians defense lawyer, 30 tips for professional correspondence, The Health Law Firm reviews

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 2016 The Health Law Firm. All rights reserved.

 

Always Be Certain Your Correspondence Is Professional. Don’t Detract From Your Professional Reputation: 30 Tips (Part 2 of 3)

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

This is Part 2 of a 3 part series on this issue.

I continue with my tips for preparing good, professional correspondence:

5.    Use titles or honorifics.  In the “business address” of your correspondence, always use the complete name of the person to whom you are writing (if known) together with that person’s honorific or professional title (e.g., Mr., Ms., Dr., Nurse, Prof., Dean, etc.).  This shows both respect and professionalism.

6.    Always use the complete mailing address, including title, of the person to whom you are sending it.  In the business address of your correspondence include not only the person’s name and honorifics, but title or position and division within the institution or organization to which you are sending it.  In the case of large organizations, you should include the building and suite or room numbers and any internal routing codes, designations, “mail stops” or other organizational routing codes, that the agency or business you are writing requires to route its mail internally.  Large organizations, especially government agencies, all have large mail rooms which sort and route all mail the organization receives from any source.  Correct internal routing codes will help ensure that your correspondence gets to the correct person or official in a timely manner.

7.    Always use a salutation.  This is self-explanatory, but see below.

8.    In your “salutation,” always use the person’s last name with a title or honorific.  It is customary to use the term “Dear” in a salutation in formal writing, so this is permitted.  But you may leave it out.  For example, “Dear Secretary Jones:” or “Secretary Jones:” or “Dear Dr. Johnson:” is correct.  Never refer to the person by that person’s first name in any type of formal correspondence or correspondence that anyone else might read.  Never say:  “Dear Sue:” or “Sharon:”.  Even if you know these people well enough to call them by their first names, don’t do it in this situation;  it’s unprofessional and may be interpreted as “talking down” to the person.

9.    Always end your “salutation” with a colon, not a comma.  A comma is only used in informal communications to those you know well or socially, such as a letter to your mother or a note to your girlfriend.  Unless this is your mother or your girlfriend to whom you are writing, use a colon.  For example, “Dear Secretary Jones,” or “Dear Sue,” is incorrect.  “Dear Secretary Jones:” or “Ms. Smith:” is correct.

10.    Type your correspondence or have it typed for you.  Do not send handwritten letters in formal or professional matters.  Do not write on the other person’s correspondence or documents and send it back.  Prepare and send a professional looking letter or e-mail, even if you must pay someone to type it for you (and if you are sending an e-mail, I know you can type a little bit yourself, anyway).  To do otherwise is to show laziness, disrespect and unprofessionalism.

11.    Always use a type font in your correspondence (inlcuding e-mails) of at least 12 points (10 characters per inch).  Do not use a small, difficult to read type fonts, for example, the size of the type font that most e-mail software defaults to.  Smaller type fonts than 12 points become difficult to read, especially if scanned/rescanned, faxed/refaxed or copied/recopied.  Change the default font in your e-mail software or computer word processing software, if necessary.  You can do this, regardless of how difficult it may seem at first;  I know you can do it, because I can do it.  Make your professional correspondence easier to read, not more difficult to read.

12.    Never use unprofessional looking type fonts for your communications.  Stay away from script type fonts, italics or novelty type fonts.  These are notoriously more difficult to read and look unprofessional.  You are not publishing a flyer for a high school bake sale.  Times New Roman, CG Times and similar type fonts are more professional looking and easier for a person to read.  Use Courier or Letter Gothic type fonts if necessary.

13.    Keep the correspondence to which you are responding unmarked.  One reason to not write on or mark up the other person’s documents or correspondence is that you may need them as evidence in a court of law or a hearing some day.  Nothing looks less professional than a document you are trying to use as evidence when a different person has made handwritten marks all over it.  The impression is similar to one in which a child with a box of crayons has gotten to it.  You don’t want this or need this.  Show respect and self-control.  Keep the other side’s documents pristine.  They will look much better that way as your “Exhibit 1” in the court hearing.

14.    Use a good concise, descriptive reference line or subject line (often called the “re:” line).  Make it a very brief summary.  State what the content of your letter is about.  State if you are responding to a letter or document that you received from the “addressee” (the person to whom you are addressing your correspondence) of your letter.

15.    Include the recipient’s routing information.  If the intended receiver of your letter or correspondence (the “addressee”) included reference numbers, file numbers, account numbers, case name and numbers, a policy number, a routing number, or other similar information on its letter to you, repeat these back in the reference line of your correspondence.  This will help make sure that your correspondence gets routed to the correct file and recipient more timely.  This is especially crucial in large organizations and government agencies.

16.    The contents of the body of your correspondence should be easy to read and easy to understand.  To this end, be sure to use short sentences and short paragraphs.  Each paragraph should convey one idea. Use headers and section titles, if necessary, to organize your correspondence, especially if it is lengthy.  Remember, headings within your letter that help to organize it are like street signs in a busy city.  They will really help any subsequent reader (and this may be a judge or jury) to navigate his or her way through your letter.

17.    Be sure to skip a line between each paragraph and, preferably, indent the first line of each paragraph.  [Note:  Some writers will tell you not to indent the first line of each paragraph in professional correspondence.  However, I feel that this makes the correspondence more difficult to read, so I encourage indenting or tabbing in on the first line of each paragraph.]  This makes it easier on the reader and more likely that your ideas will not get lost in a crowd of words.

18.    Keep your paragraphs short and to the point.  Nothing turns readers off as much as a single lengthy paragraph written from margin to margin taking up the whole page.  I suppose some people may have never been taught what paragraphs are.  However, I am willing to bet that most were.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. http://www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords: The Health Law Firm, legal representation for health care physicians, reviews of The Health Law Firm, tips for professional correspondence, The Health Law Firm attorney reviews, legal representation for nurses, professional correspondence for a legal dispute, owners of health care businesses defense attorney, physicians defense lawyer, 30 tips for professional correspondence, The Health Law Firm reviews

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 2016 The Health Law Firm. All rights reserved.

Always Be Certain Your Correspondence Is Professional. Don’t Detract From Your Professional Reputation: 30 Tips (Part 1 of 3)

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

I review multiple letters, e-mails, memoranda, and other types of correspondence prepared by my physician and nurse clients during the course of my legal representation of them.  Many times, this is the result of a dispute with a hospital, a dispute with their peers or the medical staff, a dispute with an insurance company, a law suit filed by a patient, a complaint being investigated by the licensing agency, or another serious legal matter.

In numerous cases, way too many cases, such correspondence is unprofessional and defeats the purpose of the reason why you are sending the correspondence.  Often enough it is so bad, it will be disregarded by the reader to whom it was directed. I have seen this from doctors, nurses, dentists, psychologists, owners of health care businesses, and many, many other highly educated professionals who really should know better.

When such documents are dictated and transcribed by a professional medical transcriptionist, they are usually correctly formatted and many of the errors I notice are avoided.  However, when the health professional types his or her own document, that is when I see the most errors.

To avoid these errors that make your correspondence and professional communications look unprofessional, follow these tips.

Remember Why You Are Writing.

Remember, the basic purpose of your correspondence is to communicate ideas effectively.  In many cases, it will be to invoke your legal rights in certain situations (such as an appeal or a hearing request).  Sometimes it will be to attempt to persuade your hospital, your peers, or your employer to take certain action or to refrain from certain action.  Remember that your correspondence is often the first impression that the other side will have of you.  Do you want it to be an impression that you are sloppy, lazy, unprofessional, not knowledgeable, uneducated, or confused?

Whether you are communicating in a letter or via e-mail, these rules hold true.  In many (if not all) situations involving legal proceedings or legal issues, it is probably best to communicate via a letter sent by U.S. mail or some other reliable service (e.g., Federal Express, Airborne Express, DHL, etc.).  Even if you are transmitting your information via an e-mail, it is my suggestion to prepare it in the form of a paper letter (if your e-mail is not set up to insert your letterhead) and then scan it in and send it electronically.

I discourage legal communications via e-mail in serious matters because they are often difficult to obtain, isolate, and authenticate when you need them for hearings.  Additionally, they are rarely secure, often available to many others who shouldn’t see them and easily susceptible to being accidentally sent to others who should not see them at all.

Horror Stories of Unprofessional Correspondence.

Why do I feel this blog is necessary?  Because of all the horrible correspondence I have seen written by allegedly highly educated professionals, mostly physicians and nurses.  That’s why.

Here are just a few:

Physician never wrote a separate response to any charges or allegations made against him on any peer review documents.  He would just hand write (scribble, actually) his remarks on the bottoms and in the margins of whatever document he was sent to him and then send it back.

Nurse practitioner was required to respond to serious charges of negligence resulting in an adverse outcome to a patient.  She hand wrote, on unlined paper, a response letter that was not addressed to anyone, not dated, not signed and did snot state who was sending it.

The physician was required to provide his analysis of a patient’s case for peer review purposes.  His typed letter of three pages, single spaced, contained one long paragraph.  I used to work for a Medical Corps Admiral when I was a Navy JAG Corps officer.  He would just glance at such correspondence and state:  “I can tell this doctor doesn’t have any idea what he is talking about.”  Failing to follow good correspondence procedures will show others your thoughts lack organization and cohesion.

A health professional was required to complete an application for clinical privileges.  He wrote all of the answers by hand, not even staying within the lines on the form, writing over the questions and around in the margins of the application.  This is what he signed and turned in.  Believe me, this did not look very professional.

Physician was requested to respond to a medical staff inquiry from the hospital.  Her response came back typed in 22 characters per inch (cpi) size type font, almost too small to read.  Perhaps she was just trying to save a sheet of paper.  But many of us would have had to pull out a magnifying glass to be able to read it.  If you are actually trying to communicate your ideas, make your correspondence easier to read, not harder to read.

A dentist was notified of a pending complaint investigation being opened against her dental license.  She wrote her response to the charges back to the investigator, without using any business address or title, and began her response statement “Dear Sharon,”.  Do not treat others informally, especially in professional or formal situations.  You will be deemed to be unprofessional when you do so.

Tips for Good Professional Correspondence.

Here are some pointers on professional communications that should be followed in all of your professional written communications about business, professional or legal matters, even in e-mails. Please note, the terms below in quotation marks have certain defined meanings.  If you don’t know what these terms mean, look them up.

1.    Always remember that the reason you are sending the correspondence is to attempt to effectively and accurately communicate your position and ideas.  If you are trying to make your message indecipherable or difficult to understand, ignore these tips.  If you are trying to come across as someone who doesn’t give a damn about how he or she is perceived, ignore these tips.  If you want to come across as unprofessional, ignore these tips.

2.    Make sure you include your complete and correct “return address” and contact information.  This includes your physical or mailing address, telephone number, telefax number and e-mail address, so that the other party knows exactly how to reach you.  In cases where you already have this on your letterhead, be sure to use your letterhead.  Also, it appears more professional to create a letter head with the information in it and to use your new letterhead instead of having a professional business letter with a typed “return address.”  However, a typed “return address” is better than none.

3.    Don’t use someone else’s letterhead.  Don’t use your hospital, medical group or institutional letterhead for your own personal communications, unless you are the owner.  Use your personal letterhead (see above), instead.  If you are being accused of poor utilization review, unprofessional conduct, or personal use of hospital (or company) property, then using someone else’s letterhead just helps prove the charge against you.

4.    Date your correspondence.  Date your correspondence.  Date your correspondence.  Nothing shows a lack of professionalism and lack of attention to detail as sharply as undated correspondence.  It will certainly be difficult to prove when your letter or document was sent if you do not have a date on it.  A year or two later, it may be completely impossible to do so.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords: The Health Law Firm, legal representation for health care physicians, reviews of The Health Law Firm, tips for professional correspondence, The Health Law Firm attorney reviews, legal representation for nurses, professional correspondence for a legal dispute, owners of health care businesses defense attorney, physicians defense lawyer, 30 tips for professional correspondence, The Health Law Firm reviews

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 2016 The Health Law Firm. All rights reserved.

Investigating Caribbean Medical Schools for USMLE Irregularities

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

We are asking whether the National Board of Medical Examiners (NBME), perhaps acting through the Educational Commission for Foreign Medical Graduates (ECFMG), is investigating Caribbean medical schools such as Ross University School of Medicine, Dominica, West Indies (RUSM); Aureus University School of Medicine, Aruba (AUSM); American University of the Caribbean School of Medicine, St. Maarten (AUCSM); Atlantic University School of Medicine, St. Lucia (AUSOM); or others, based on recent potential client consultations. We have had recent reports that seem to indicate at least one such investigation might be ongoing and relate to allegations that students may have been advised to falsify information provided on applications to take the United States Medical Licensing Examination (USMLE), Step 1, Step 2CK and Step 2CS.

Providing incorrect. incomplete or false information on an application to take one of the Step examinations is, of course, defined as “irregular behavior.”  This is a term used by the USMLE to refer to a number of different types of situations.  Please see a previous blog I wrote on this subject by clicking here.

Unfortunately, if you are accused of irregular behavior and you are not successful at disproving this charge, your transcript of USMLE step examination test scores will be marked with an entry of “Irregular Behavior.”  It is on there for life.  To someone reading this transcript, this often is interpreted the same as “Cheater.”  We have heard from those who have suffered this outcome that it has prevented them from matching for residencies and obtaining jobs.  To see another blog I wrote about this, click here.

From what we have been able to piece together, there are allegations that one or more staff members at one or more Caribbean medical schools advised to delete any reference to a prior medical school attended on that person’s application to take a Step examination.  Why this could have been done, we can only speculate.

Regardless, we have been informed that officials from one or more of the organizations involved in approving those who sit for the Step exams have been requesting affidavits from students relating to all of the facts and circumstances surrounding such advice from a medical school employee.  In another case, we have seen a written request from one of the organizations for any information regarding any conversations that student had with officials at two different Caribbean Universities, including complete details.

The last such big scale investigation of which we were aware centered around the now defunct Optima University prep course cheating scandal involving hundreds of foreign medical graduates.  To read an article I wrote on this, click here:

To see a blog I wrote on this, click here:

Hopefully, this matter will not turn out to be as serious as the Optima University matter was.

For some tips on preparing for a hearing to defend against allegations of irregular behavior, see this prior blog I wrote by clicking here.

Regardless, if you are approached by an investigator, receive a letter asking for an affidavit or statement from you or if you are accused of irregular behavior, please at least consult with a good, experienced attorney who knows about such matters before you do anything else.

What characteristics should you be looking for in an attorney to represent you in such cases?  Here are some questions I suggest you ask or research to obtain answers to before hiring an attorney.

1.
  What is your legal specialty?  Do you have one?  Is it recognized as a legal specialty by your state Bar association and supreme court?

2. 
Are you familiar with the NBME, USMLE and ECFMG, and hearings on irregular behavior?  Explain.

3.  How many hearings have you done where you appeared before a committee on irregular behavior of the ECFMG or NBME?

4.  How many physicians have you represented and in what types of cases?

5.  How long have you been practicing law?

 6.  Have you ever been disciplined by your state bar or any court or organization before which you practiced? (Research this one for yourself.)

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at http://www.TheHealthLawFirm.com.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. http://www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

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“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2016 The Health Law Firm. All rights reserved

Cuban Lung Cancer Vaccine Followed Up With Clinical Trials In The United States

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A lung cancer vaccine that was developed in Havana, Cuba, will be the first such clinical trial to be approved by The Food and Drug Administration (FDA) for testing to take place in the U.S.  The approval was announced on October 26, 2016, by New York Governor Andrew Cuomo with officials from the Roswell Park Cancer Institute in Buffalo, NY.  The trial could start as soon as November 2016 and will enroll around 60 to 90 patients. They are estimating that it will take about three years to complete.

This lung cancer trial will test the CIMAvax-EGF vaccine, combined with an immunotherpay drug called Opdivo. Opdivo has already been approved in the U.S. To learn more about the CIMAvax-EGF vaccine visit the Roswell Park Cancer Institute website by clicking here.

A Research Partnership.

Governor Cuomo praised the fact that the FDA’s action followed the promotion of a research partnership between Roswell and Cuba’s Center of Molecular Immunology (CIM) that occurred during a New York state trade mission in 2015.

Leading Cause of Cancer Deaths.

Lung cancer is the leading cause of cancer deaths in the U.S. There is a five year survival rate of only 17 percent of those who fall ill with lung cancer.  According to Grace Dy, the principal investigator in the Roswell Park trail, “We’re at an early stage in the development of this vaccine, which has never before been given to U.S. patients, so we have a lot to learn through this study, But the evidence so far is encouraging.”

The vaccine developed by CIM has been approved by a number of countries such as Paraguay and Peru.  Even though the vaccine has been approved by several countries already, Len Lichtenfeld, deputy chief medical officer as the American Cancer Society, has taken a cautious stance on the matter.

Litchenfeld stated, “currently we do not have the information we need to have to know whether or not this vaccine could be useful in treating lung cancer or possibly be used to prevent cancer in patients at high risks of developing lung cancer. The studies that have been reported from Cuba are small and have limitations that prevent us from knowing how the treatment could be applied to the typical patient with lung cancer.”

Currently, the United States and Cuba are working collaboratively to make certain that this vaccine will be as effectively as possible and help those suffering from lung cancer.

Contact Experienced Health Law Attorneys.

The Health Law Firm routinely represents pharmacists, pharmacies, physicians, nurses and other health providers in investigations, regulatory matters, licensing issues, litigation, inspections and audits involving the DEA, Department of Health (DOH) and other law enforcement agencies. Its attorneys include those who are board certified by The Florida Bar in Health Law as well as licensed health professionals who are also attorneys.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at http://www.TheHealthLawFirm.com.

Sources:
“CHIPSA Looks Into Cuban Lung Cancer Vaccine United States Is Studying.” CHIPSA Hospital. (2016). Web.

Lee, Kelvin. “Where Does CIMAvax Currently Stand?” Roswell Park Cancer Institute. (March 28, 2016). Web.

McGinely, Laurie. “In A First, U.S. Trial To Test Cuban Lung Cancer Vaccine.” The Washington Post. (October 27, 2016). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. http://www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone: (407) 331-6620.

KeyWords: Legal representation for Food and Drug Administration (FDA) investigations, FDA investigation fraud defense attorney, legal counsel for clinical research, clinical research defense attorney, reviews of The Health Law Firm, The Health Law Firm reviews, misconduct in science legal defense, clinical investigator defense attorney, institutional review board (IRB) investigation defense, legal representation for health care professionals, Department of Health (DOH) investigation defense attorney, scientific investigation attorney, legal counsel for Food and Drug Administration (FDA) investigations, Food and Drug Administration (FDA) investigations defense attorney, The Health Law Firm, clinical investigation misconduct defense counsel, National Institutes of Health (NIH) grant fraud defense attorney, Office of Research Integrity (ORI) defense attorney

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2016 The Health Law Firm. All rights reserved.

 

Universities Turning to New Unconventional Strategies to Prevent Medical Errors

4 Indest-2009-3By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A study by patient safety researchers published in the British Medical Journal (BMJ) in 2016 revealed that common medical errors are now the third leading cause of death in the United States. Now, universities are looking to address this problem by focusing on ways of teaching students, clinicians and administrators to look at these problems in a new light.

Click here to read the study published in the BMJ.

Teaching a Martian to make a PB & J Sandwich.

These new programs focus on the importance of communicating medical directions. So, what does making a peanut butter and jelly sandwich have to do with preventing medical errors? Well, the program sheds new light on just how carefully worded medical directions need to be. For example, students in these new programs are directed to explain how to make the sandwich to someone who is completely unfamiliar with the English language, such as a Martian.

Simple directions become much more confusing to those who are not familiar with our ways of speaking. Donna Woods, an associate professor who directs this new course work, further elaborated on this concept by saying, “Invariably the student will write, ‘open the bag of bread’ and so the acting patient (the Martian) rips the bottom of the bag of bread instead of opening the twisty tie at the top of the bag.”

The new method is meant to teach the students that their directions can often be misunderstood and not carried out as intended. Therefore, medical professionals need to be aware of this and be very precise in their delivery of medical directions.

The Importance of Doctor-patient Communications.

The new course also focuses on doctor-patient communications and has implemented an unconventional method of teaching it. The class splits into two teams and are directed to build the tallest building possible. They are to build according to how the customer or in their case, the patient desires it. In this study, the patients were instructed to only reveal how they wanted their building to look if asked. This method highlights how in the hustle and bustle of the medical world, the act of asking patients what they need and want is often overlooked.

This type of course, paired with new methods, are designed to show students why the medical field can be so complicated and the ways in which they can improve it to avoid common medical errors.

To learn more on the dilemma of medical errors in the U.S., click here to read one of my prior blogs.

Contact Health Law Attorneys Experienced in Representing Health Care Professionals and Providers.

At the Health Law Firm we provide legal services for all health care providers and professionals. We represent physicians accused of wrongdoing, in patient complaints and in Department of Health investigations. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, Durable Medical Equipment suppliers, medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other healthcare provider. We represent facilities, individuals, groups and institutions in contracts, sales, mergers and acquisitions.

The lawyers of The Health Law Firm are experienced in both formal and informal administrative hearings and in representing physicians in investigations and at Board of Medicine and Board of Osteopathic Medicine hearings.

To contact The Health Law Firm, please call (407) 331-6620 and visit our website at www.ThehealthLawFirm.com.

Sources:

Sweltlitz, Ike. “Teaching a Martian to make a sandwich helps clinicians catch medical errors.” The Boston Globe. (November 7, 2016). Web.

White, Jesse. “5 strategies for hospitals to prevent medical errors.” Healthcare Business Technology. (May 19, 2016). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.

Key Words: New course work to prevent medical errors, medical errors in the health care field, legal representation for medical errors, importance of communicating medical directions, importance of doctor-patient communications, medical errors defense attorney, medical negligence defense attorney, legal representation for health care professionals, legal representation for medical students, legal representation for medical fellows, legal representation for medical residents, medical student defense attorney, defense attorney for medical fellows and residents, reviews of The Health Law Firm, The Health Law Firm attorney reviews

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2016 The Health Law Firm. All rights reserved.