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“Decision Fatigue” Leading to Possible Misdiagnosis, Medical Errors

Monday, October 6th, a study was published in JAMA Internal Medicine which examined a doctor’s likelihood to prescribe unnecessary antibiotics based on time of day. The researchers recalled past studies which analyzed the decision making of judges, suggesting that they are more inclined to deny parole later in the day. The goal of this particular study was to determine if, as the day goes on, doctors’ decisions become similarly skewed.

Reuters Health explained in an article last week, “The researchers compared electronic health records and billing data for patients who visited a primary care practice between 2011 and 2012 with symptoms of an acute respiratory infection.” Studying respiratory infection visits allowed researchers to strategically look at prescribing practices. There are types of respiratory infections, like strep throat or pneumonia, that often require antibiotics; however, other types of respiratory infections, such as the flu, should never be treated with antibiotics according to national guidelines. There are various types of infections, some requiring antibiotics and some that should never be treated with antibiotics. Respiratory infections allowed the researchers to determine if, in similar medical cases, doctors were prescribing antibiotics inconsistently or against guidelines.

The study looked at almost 22,000 respiratory infection visits, divided into two four hour shifts, 8:00am-noon and 1:00pm-5:00pm. Each shift showed that antibiotic prescribing went up for diagnoses that should and should not have been treated with medication. The study found, “Overall, doctors were 26 percent more likely to prescribe an antibiotic in the fourth hour of a shift compared to the first hour.” The researchers call this ‘decision fatigue.’

Dr. Jeffrey A Linder, co-author of the research letter told Reuters Health, “Just as an observation it kind of makes sense, doctors are human too and we get tired over the course of the day and tend to make worse-appearing decisions.” These worse-appearing decisions, pose a concern for patients and doctors alike. Linder offered suggestions as to how this problem could be corrected, one of which included the implementation of computerized decision support.

From a legal standpoint, these findings are somewhat alarming. Misdiagnosis, surgical errors, and medical malpractice cases typically originate from an error made on the part of a medical professional. ‘Decision fatigue’ is a major concern in this regard. If prescribing practices were skewed as much as 26 percent in a four hour shift, fatigue has great potential to taint the quality of other, more critical decisions.

Furthermore, when considering medical professionals who work lengthier shifts than 4 hours, it is easy to imagine that the quality of decisions would be compromised even more significantly. Though strides have been made to shorten the shiftwork of medical professionals, many still work up to 80 hours per week.

It is important to be aware of this problem and understand that fatigue inevitably affects decisions. If you feel that you were injured or harmed due to a misdiagnosis or other medical error, decision fatigue may have been a contributing factor. Talk to an attorney that specializes in malpractice cases and they will be able to work with experts to evaluate your situation. Most lawyers offer free consultations and will be willing to have an honest discussion with you regarding the potential of your case.

Contact the Marrone Law Firm, LLC toll-free at 866-732-6700 or 215-732-6700 to schedule a free consultation today. Our attorneys are available to discuss your legal matter at your convenience.

5-Year-Old Car Accident Settled in Pennsylvania Court

On June 11, 2009, a woman suffered critical injuries in a motor vehicle crash that occurred in a construction zone on Route 51 in a Pittsburgh suburb. The now 56-year-old woman was comatose for five weeks following the car accident. She also endures residual effects from her injuries, including requiring a walker and severe lapses in her short-term memory function.

This vehicle accident happened on the night of a wedding rehearsal dinner for the woman’s daughter, but the wedding was subsequently postponed for one year. The woman’s son was driving them to a restaurant, and as he was making a left turn, a vehicle traveling toward them from the opposite direction hit their car.

An Allegheny County court recently awarded the woman $15.8 million for her injuries after she filed a lawsuit alleging that the road construction company was liable for her injuries. It was ruled by a jury that the driver of the other vehicle apparently could not see the car that the woman and her son were in because traffic obstructed the view. The driver and the Pennsylvania Department of Transportation had previously settled claims with the plaintiff concerning this accident, so this award was imposed on the road contractor.

When a car accident such as this one occurs, the police investigation typically determines the cause of the wreck. A personal injury attorney might assist injured parties in obtaining police reports and building a civil lawsuit to seek compensation for damages, which may include medical expenses and lost wages. Car accident victims could also use the help of an attorney who understands the laws to negotiate insurance settlements.

Source: REP-AM, “Cheshire company ordered to pay $15.8 million for Pennsylvania crash “, September 16, 2014

Criminal Charges Filed After Fatal Roadside Crash in PA

A 41-year-old Pennsylvania man is facing six criminal charges, including homicide by vehicle, in connection with a May 13 car accident that killed a Bethlehem Township man. Authorities believe that the Allentown man was under the influence of opiates at the time of the crash.

According to Pennsylvania State Police, the victim had parked his sedan on the shoulder of eastbound Route 22 near the ramp for Route 309 and was standing behind the car when a pick-up truck struck him. Records indicate that the driver of the truck was on his way to a motel after his workday ended. He was northbound on Route 309 and merging onto Route 22 when he hit the car on the shoulder.

The pedestrian was pinned between the two vehicles and died from his injuries. The driver of the truck was transported to Lehigh Valley Hospital-Muhlenberg where his blood was drawn and analyzed. The resulting toxicology report indicated the presence of methadone and other opiates. In addition to homicide by vehicle, the man is facing charges of involuntary manslaughter, reckless endangerment, driving under the influence, homicide by vehicle while DUI and causing a fatal accident while driving without a valid license. He also faces three counts for traffic violations.

When a driver is criminally charged following a fatal car accident, the accused may also be named in a wrongful death claim brought by the representative of the decedent’s estate. Testimony and evidence presented during criminal proceedings may affect any civil case that may arise. A personal injury attorney could assist the plaintiff in such a case by gathering and reviewing evidence, including police reports and medical records, and negotiating to settle the claim. The attorney may also provide representation in court in the event that negotiations do not result in a satisfactory settlement offer.

Source: Lehigh Valley Live, “Driver was high before striking car, fatally pinning man on Route 22, cops say”, Sarah Cassi

1 Dead, 1 Injured After Fatal Accident on Route 281

A woman in Pennsylvania was killed in a fatal crash that involved a van and a motorcycle on Aug. 29. According to the police, the woman was thrown off a motorcycle that she was a passenger of and she was later pronounced dead at Ruby Memorial Hospital. The motorcycle was being driven north on Route 281 by a 49-year-old man when a van crossed into the northern lane and crashed into it. The man was also thrown off the motorcycle and had to be airlifted to a hospital.

A 44-year-old woman was driving the van, and she was not injured in the accident. Route 281 was subsequently closed after the wreck.

Dealing with an accidental death of a friend or loved one may be overwhelming for the majority of individuals. It can take a lot of time in order to recover from the emotional and financial damage left behind. From bringing a wrongful death claim to tapping into life insurance policies to pay for expenses, it may be helpful for an individual to retain an attorney for some help.

An attorney may be able to provide answers to questions that are difficult to get in times of loss. For example, an attorney may conduct their own investigation into a particular incident and identify the negligent parties that were responsible. With that information, an attorney may then build a case and bring the responsible parties to justice. An attorney might also help to file a claim and represent a client in court proceedings.

Source: Pittsburgh Post Gazette , “Woman killed in Fayette County motorcycle crash”

Car Accident on Route 49 Kills Pennsylvania Man

A Philadelphia man died after a two-vehicle accident in Cape May County on August 30. The crash happened at around 1:00 p.m. on Highway 49 near 2nd Avenue when a Mercedes Sprinter Limousine bus hit the driver’s side of a 2004 Honda CR-V.

The authorities reported that the Upper Township wreck happened when the limo bus crossed over the center line from the east and into oncoming traffic. The driver of the Honda apparently saw the limo approaching and tried to exit the roadway, but the vehicles collided and spun out. The Honda flipped over, and the driver died almost an hour after the collision.

The driver of the other vehicle went to Shore Medical Center after suffering minor injuries. An investigation is in progress, and no criminal charges have been filed.

When someone is killed in a car accident, many families start struggling with expenses while trying to mourn the passing of a loved one. If a victim died due to the negligence of another party, then a family’s financial burden may be eased when filing a wrongful death claim in civil court. This may provide a victim’s loved ones with more security in a difficult time as a family can seek compensation for medical expenses, funeral costs and lost wages. Children or a spouse might even be able to seek damages for loss of parental care or loss of companionship.

The investigation into this accident is ongoing, so it is unknown if the limo driver acted negligently. When an attorney handles a wrongful death suit, he or she may obtain a copy of a completed accident report and have a crash reconstruction worker conduct a second assessment.

Source: NBC40.net, “Philadelphia man dies in 2-car crash in Tuckahoe”

1 Dead, 5 Injured in Pennsylvania Crash

A three-vehicle accident that occurred in Franklin County on Aug. 15 has left one man dead and five people with injuries. The accident caused a closure of the highway as authorities investigated the scene.

According to police, the fatal car accident occurred at 7:48 a.m. when a vehicle being driven eastbound by a 63-year-old man drifted into the westbound lanes and into the path of oncoming traffic. The man’s vehicle crashed into the front bumper of another vehicle being driven by a 51-year-old man, causing this second vehicle to spin. The first vehicle then continued going the wrong way and crashed into the front bumper of a vehicle being driven by 33-year-old woman.

The man in the first car that was hit was transported to Chambersburg Hospital after going into cardiac arrest; he was declared dead at the hospital. The other two drivers were transported via air to York Hospital for treatment of unknown injuries. The three passengers in the woman’s vehicle, all minors, suffered minor injuries in the accident and were also taken to the hospital for treatment. The accident was still under investigation at the time of the report.

Though the cause of the accident is unknown, the family of the decedent in a similar fatal accident might choose to file a wrongful death claim once there is evidence to show that another driver was liable due to his or her negligent actions. The damages a family might receive if their claim is successful can include compensation for medical treatment and funeral arrangements as well as for the loss of services and financial support the family could have expected had the person lived. Additionally, there might be other non-economic damages available to the family. A lawyer can walk a victim’s family through the process of filing a claim and ensure that they are aware of their options.

Source: Your4State.com, “One Dead in Serious Three-Vehicle Crash on Rt. 30”, August 15, 2014

Pennsylvania Man Killed in Head-On Accident

A Ford F-150 driven by a 72-year-old Florida woman collided with a Honda Civic driven by 25-year-old man. The driver of the Ford allegedly crossed into the northbound lanes and struck the Civic, pushing it backwards. The Ford was severely damaged when it rolled onto its side before coming to a stop.

The female driver of the Ford reportedly received only moderate injuries. The driver of the Civic was declared dead at the scene of the accident, and the passengers in his car were seriously injured. The 22-year-old man and 24-year-old woman were flown to St. Luke’s University Hospital for treatment. The driver of the Ford was wearing her seat belt; reports suggest that none of the passengers in the Civic were wearing theirs.

The Pennsylvania State Police investigated the scene in the 2900 block area of Richlandtown Pike in the Springfield Township. Their reconstruction unit examined the accident, and the state police forensics unit collected evidence.

It can be difficult for a car accident victim to sort through all the difficulties that can arise after an accident occurs. Accidents like this one show that one simple action can lead to numerous injuries that may take some time to completely recover from.

Recovering from physical injuries is only complicated by attempts to recover medical expenses, lost income, vehicle repair or replacement and other costs related to the accident. An attorney may be able to help someone injured by another driver with a car accident claim. The attorney may use evidence collected during the police investigation to identify negligent parties.

Source: Lehigh Valley Live, “Allentown man killed in head-on crash in Bucks County”, Edward Sieger

Fatal Accident Possibly Caused by Fatigued Pennsylvania Teen

A Pennsylvania State Police Trooper and a Cetronia Ambulance Corps paramedic gave testimonies in an August 6 preliminary hearing for a 19-year-old Walnutport woman who faces charges for a fatal collision on Route 145. The woman reportedly may have dozed off while driving, and the charges include involuntary manslaughter, vehicular homicide, and reckless endangerment.

The crash occurred around 8:30 a.m. on April 12 after the Walnutport woman finished an 11-hour shift at a store in a Whitehall Township mall, and she only slept for a few hours before her shift because she attended college classes in the morning and afternoon on April 11. Shortly after leaving work, her Hyundai Elantra swerved while traveling north and struck a Volkswagen Jetta traveling south near Neffs Laurys and Clearview roads. The trooper reported that her speedometer was stuck at 15 mph above the posted speed limit, and the paramedic said the teen admitted she might have fallen asleep.

The 65-year-old driver of Jetta died, and her passenger needed hospitalization. The Walnutport teen said that she did not remember the crash, but the officer’s testimony claimed there were no skid marks or signs that she tried to prevent the crash. The defense attorney said the teen still may have tried to break and that her speed may have been different from what the speedometer indicated, and these matters may be resolved after the accident reconstruction expert the defense hired is finished working.

When someone died because of another person’s negligent actions, the family of the victim might consider filing a wrongful death claim in civil court to receive compensation for funeral costs or even pain and suffering. Someone who falls asleep while driving may be liable for a car accident and other liable behavior such as speeding or texting while driving.

Source: Lehigh Valley Live, “Witnesses: Teen had little sleep before fatal Lehigh County wreck, says she dozed off”, Precious Petty , August 06, 2014

Pennsylvania School Teacher Dies in Crash

A 47-year-old man died from injuries suffered in an accident that occurred on July 30 after the man lost control of his 2001 Yamaha XV8650 on Mountain Road in Lower Macungie Township and failed to negotiate a curve in the road. The man then crossed into the other lane of traffic and collided with a 2014 Chevrolet Equinox being driven by a 70-year-old.

Although the other driver swerved in an attempt to avoid the collision, that attempt was not successful. As a result of the accident, the driver of the Equinox suffered a minor injury but was not taken to the hospital for treatment. The man on the motorcycle was pronounced dead at Lehigh Valley Hospital due to blunt force trauma, and police say that he was wearing a helmet at the time of the crash.

It is being reported that state police are still investigating the crash, which is being deemed an accident. The driver of the car was wearing their seat belt when the collision occurred. There was no word as to how the man lost control of his motorcycle. According to the website of Roosevelt Elementary School where the man worked as a kindergarten teacher, counselors will be made available at the start of the 2014 school year.

Although the person who may have caused a motor vehicle accident passes away, it may be possible to take action against that person. If the injured party so desired, they could try to seek compensation from the at-fault person’s estate to cover the cost of medical care or lost wages. A personal injury attorney may be able to help gather evidence for the claim such as police reports and insurance information.

Source: Lehigh Valley Live, “Allentown kindergarten teacher dies in motorcycle crash”, Sarah Cassi, July 31, 2014

Family Files Suit for Man’s Death After Building Fell on Him

The 2013 collapse of a Salvation Army store in Philadelphia claimed seven lives, and the family of a man who was initially injured from the incident filed a lawsuit on July 22 that named multiple defendants. That man died 23 days after the building came down on him, and his family’s lawsuit claims his death can be attributed to the incident.

The 59-year-old man was shopping at the Salvation Army store on June 5, 2013 when demolition on a building next door caused a wall to collapse onto the store. He was one of 19 people who were buried in the rubble. According to the lawsuit, the man was buried in the rubble for one hour. He had a heart condition and asthma, and he suffered a heart attack at the scene of the collapse. His family’s lawyer contends that the building collapse contributed to his death on June 28, 2013, which occurred after several hospitalizations.

The two contractors named as defendants in the lawsuit are also facing criminal charges related to the collapse. One of them was allegedly operating machinery while impaired by drugs. In total, eight people may have died in connection with the incident. Another death that could be linked to the collapse was the suicide of a building inspector who had once reviewed the site.

In this case, the man’s medical history could play a large part in the outcome of the wrongful death lawsuit. Those medical records could convince the jury of a civil case that the man’s heart condition was stable prior to the accident and that its severity was increased due to his involvement with the building collapse.

Source: WPVI-TV, “7TH Death Blamed on 2013 Philly Building Collapse”, July 22, 2014

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