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Anthony S. Bottar, senior partner of Bottar Law, PLLC, a law firm based in Syracuse, New York, was re-elected by his peers to the 2010 edition of Super Lawyers – Upstate Edition.

Mr. Bottar was 1 of 45 upstate New York attorneys recognized for representing those injured due to medical malpractice (1 of only 4 attorneys recognized in Syracuse). Mr. Bottar was 1 of 25 upstate New York attorneys recognized for representing those injured by dangerous and defective products (1 of only 3 attorneys recognized in Syracuse). Mr. Bottar was also recognized for general plaintiff’s personal injury.

Mr. Bottar has enjoyed continuous listing in Super Lawyers since 2007, the first year that Super Lawyers began honoring upstate New York attorneys. Super Lawyers website can be found at www.superlawyers.com.
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Loretto announced today that it is closing two Syracuse-area nursing homes over the next two years. The involved homes are Loretto-Oswego and Rosewood Heights. Loretto’s press release did not discuss the motives for the closures including whether or not the decision was driven by costs, patient population, medical malpractice, and/or quality of care concerns.
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Many years ago, thrombolytic therapy was approved for the acute treatment of a stroke. Despite this therapy, very few patients are receiving treatment in time to prevent stroke sequela. There are several explanations for the failure to diagnose a stroke and the failure to timely treat a stroke.

First, many patients wait too long to go to the hospital after experiencing stroke symptoms. On average, patients alone at symptom onset waited more than three and one-half (3.5) hours to go to the hospital (as compared to roughly 2 hours for those not alone). Awakening from a sleep with symptoms increases delay. Transport to the hospital by emergency medical services decreases delay.

Second, many hospitals wait too long after a patient arrives in the emergency department to obtain a CT scan, the results of which may result in a stroke diagnosis and prompt thrombolytic therapy. On average, hospitals take just over 1 hour to perform the diagnostic study. A hospital may depart from accepted standards of care, an be liable for hospital negligence or medical malpractice, for exceeding time standards set by the a National Institute of Neurological Disorders and Stroke advisory committee.

In sum, delay in presenting to the hospital, when joined with hospital delay, can lead to a failure to timely diagnose a stroke and, in turn, a poor outcome such as brain damage.
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St. Joseph’s Hospital Health Center, Syracuse, New York, recently obtained certification as the only accredited chest pain center in Central New York. The certification was issued by the Society of Chest Pain Centers.

As an accredited chest pain center, St. Joseph’s Hospital promises immediate treatment for patients who come to the hospital complaining of chest pain and shortness of breath. The new protocol for immediate treatment may decrease medical malpractice claims for delays in treatment that lead to heart damage. Early treatment is critical during a heart attack.

According to Richard Caputo, M.D., a Syracuse-area cardiologist, “[t]he average patient arrives in the Emergency Department more than two hours after the onset of symptoms, but what they don’t know is that the sooner a heart attack is treated, the less damage to the heart and the better the outcome.”

In addition to its recent accreditation as a chest pain center, St. Joseph’s Hospital is the only Syracuse-area hospital that is designated by the American Heart Association as a Missing Lifeline STEMI hospital, for the treatment of heart attacks.
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The New York State Department of Health Office of Professional Medical Conduct (“OPMC”) has suspended for thirty days the license of a Syracuse doctor specializing in obstetrics and gynecology. According to OPMC, Dr. Richard Caputo, who operated a practice known as The Good Life Centre for Women, “improperly used forceps to deliver babies and exposed patients to unnecessary risks.”
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According to materials examined by Hearst reporters and graduate students at the Toni Stabile Center for Investigative Journalism, medical professionals are not always truthful on death certificates. Especially so where the true cause of death may trigger a medical malpractice or wrongful death lawsuit, or where the true cause of death may lead to scrutiny from the New York State Department and/or Center for Disease Control.

In most cases, relevant information about a patient’s death was left off of the death certificate. An example includes the death of Norine Zazzara, 81, who died at St. Joseph’s Hospital Health Center in Syracuse, New York. According to her death certificate, she died of pneumonia. However, her medical records revealed that she had contracted MRSA while admitted for leg swelling, which led to pneumonia, ventilator respiration and eventually death. MRSA was omitted from Ms. Zazzara’s death certificate.
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According to Peter Rosi, M.D., a Chicago-area obstetrician who has been sued more than ten times, and criminally prosecuted, for medical mistakes including errors made during home births, and pediatric care leading to infant brain damage, “[e]ighty percent of complications in childbirth are psychological.” Dr. Rosi contends that “[b]abies can be killed by a mother’s attitude.”

In Illinois, Dr. Rosi advised pregnant women whose home births ran into problems to drive long distances to hospitals where he had privileges. For example, Dr. Rosi has testified that he instructed a woman in labor to crouch on all fours in the back seat of her car while her family drove her 75 miles to a hospital where he had medical privileges. Dr. Rosi followed the laboring mother in his car. While there were 7 closer hospitals which could have performed a c-section, Dr. Rosi did not advise the family to go there for emergent medical care. According to court records, the baby was born dead, following inhalation of his own waste. When questioned about his handling of this case, Dr. Rosi testified that “[b]abies die.”

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A Syracuse jury has awarded a Cortland man $10,000,000.00 for injuries arising out of a 2004 medical mistake. According to the Post-Standard, a Cortland man presented to Crouse Hospital in 2004 for surgery on his spine. Approximately one week later, the man returned to the hospital with complaints of back pain. The neurosurgeon failed to diagnose the man as suffering from a cerebral spinal fluid leak that was secondary to a tear.

Eventually, the man developed meningitis and became septic. When corrective surgery was finally performed, the man aspirated and went into a coma. He came out of the coma, but developed multi-system organ failure which resulted in a condition that left him largely paralyzed from the waist down.

The neurosurgeon was found 100% responsible. The Syracuse jury did not find Crouse Hospital negligent.
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A 2007 horror story today recounted by the Virginian-Pilot explains a labor and delivery gone wrong at Langley Air Force Base. Cindy Wilson, a 37 year old sergeant, gave birth by cesarean section just before midnight at the 1st Fighter Wing Hospital; however, she never held the baby. During delivery, Cindy’s obstetrician erred by severing her uterine artery causing massive internal bleeding – which went unidentified. During frantic efforts to save Cindy’s life, two surgical sponges were left inside her abdomen. Twelve hours after giving birth, Cindy was pronounced dead.

In the months after the death, Cindy’s parents learned that they had virtually no recourse against the negligent doctors and hospital staff. An investigation was promised – and was conducted. However, the findings were shrouded in secrecy by Federal Law. Worse, Cindy’s husband and parents cannot sue the military under the Feres Doctrine.

The problem with the Feres Doctrine is that military doctors do not have to worry about lawsuits. In turn, there is nothing to discourage malpractice or substandard medical care. For example, gossypibomas (surgical sponges left inside a patient) are almost unheard of in the non-military medical community because special counting procedures have been devised. Not so in military operating rooms.

According to Jonathan Turley, a George Washington University law professor, “the Feres Doctrine [is] . . . one of the most grotesque rules created in the history of this republic,” Turley said. “It has done untold damage to thousands of military personnel and their families.”

The comparison drawn between military and civilian medicine is relevant, as many civilian doctors blame medical malpractice lawsuits for rising malpractice insurance premiums and defensive medicine. However, it is clear that patients suffer where lawsuits are not available to ensure that doctors and other health care providers meet the standard of care.
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While much ink has been spilled over medical malpractice insurance rates for New York doctors and hospitals – commonly referred to as the “medical malpractice crisis” – what the medical profession does not want the public to know is that the crisis lies in the number of medical mistakes.

Several recent studies, including those conducted by the Institute of Medicine, HealthGrades, the United States Agency for Healthcare Research and Quality, and the Kaiser Family Foundation, reveal the following troubling statistics:

  • 50,000 to 100,000 Americans die annually due to preventable medical errors. Stated differently, more people die each year because of medical malpractice than because of motor vehicle accidents, breast cancer or AIDS.
  • Roughly 32,000 Americans die annually due to hospital negligence.
  • Approximately 1,000,000 people are injured annually due to medical mistakes.
  • Medication errors account for 7,000 deaths annually.
  • 80% of doctors surveyed reported that they had observed a colleague make a medical mistake. Only 10% reported the mistake.
  • 84% of doctors surveyed reported witnessing a colleague take a shortcut that could injure a patient.
  • 50% of nurses surveyed reported that they had observed a colleague make an error. Only 10% reported the error.
  • 50% of nurses surveyed reported working with a colleague who appears incompetent.
  • 62% of nurses surveyed reported witnessing a colleague take a shortcut that could injure a patient.
  • Medical mistakes cost America $17,000,000,000 to $29,000,000,000 each year (less than 1/3 of the annual costs relate to lawsuits).

At the heart of the “medical malpractice crisis” are insurance industry investment practices. According to Victor Schwartz, General Counsel, American Tort Reform Association: “Insurance was cheaper in the 1990s because insurance companies knew that they could take a doctor’s premium and invest it, and $50,000 would be worth $200,000 five years later when the claim came in … An insurance company today can’t do that.”
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