In a recent post, I outlined the steps patients need to take when a health care provider prescribes medications. It is important that patients feel empowered to ask questions and to make sure they know what medications they are taking and why.

As an experienced medical device injury lawyer, I want patients to understand the risks involved in surgical procedures and feel empowered to ask questions about recommended surgeries, particularly those involving robotic devices. Whether your physician is recommending that you take a particular medication or undergo a surgery, you need to know that you have a right to ask questions and to get as much information as you need to feel comfortable.

Patients should be asking similar questions of their health care providers when a surgical procedure is recommended as when medications are prescribed. It is unwise to undergo any surgical procedure unless the patient knows why the surgery is recommended, whether there are less invasive alternatives and how the physician intends to perform the surgery.

A very important and alarming example of this relates to robotic surgery which has become more and more common for certain conditions. If the surgeon is recommending a robotic surgical procedure to you as a patient, usually for a hysterectomy or prostatectomy, the patient should ask several key questions:

What are the alternatives to using a robot for the surgery?

Which procedure takes longer (robotic or non robotic)?

How many times has your surgeon performed the robotic procedure?

How and where did the surgeon learn to perform the robotic surgery?

Why is the robotic surgery being recommended better than laparoscopic or open procedure for the particular problem involved?

What is the rate of complications and the nature of the complications associated with robotic surgery?

What complications are associated with robotic surgery?

Robotic surgeries are coming under greater scrutiny and there are problems and issues that are resulting from these procedures.

Our law firm represents many clients who have undergone robotic surgeries in which, for example, bowel perforations have occurred. Other serious problems with the robotic equipment involve a failure of the insulation to prevent electricity contacting the patients tissue and other structures outside the operative site, stitches coming apart that were placed by the robot, holes in the bladder, cuts to the patient’s ureter and other problems.

These issues and risks should be disclosed by your surgeon prior to any robotic surgery. In addition, patients should question their surgeon when he or she promotes robotics as the best way to operate in any given surgical procedure. The patient should also be told that the hospital, surgeon and the anesthesiologist make more money by performing a robotic surgery than another approach.

In summary, patients must take their health care seriously, not be intimidated and be their own health advocates by asking the questions and making the inquiries.
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Too often people are intimidated by health care providers and follow their direction without asking important questions. They often fail to do what they can to protect themselves by asking those questions and not being afraid to do so or by going on the internet to research a drug prescribed or a surgical procedure recommended.

I always encourage people to ask questions, do research and even call me for advice BEFORE undergoing a surgical procedure or taking a particular drug. In my work as San Francisco injury lawyer, I have represented many patients who ultimately became harmed by drugs and procedures they did not know would hurt them. Sometimes they were never informed of the risks involved in taking the medication or having a particular surgical procedure or medical device implant.

Health care providers are required by law to obtain an informed consent whenever they recommend treatment. In California, our supreme court has established that a physician is required to disclose “all information relevant to a meaningful decisional process.” Cobbs v. Grant (1972) 8 Cal.3d 229, 242. That means doctors and other medical practitioners must tell patients what alternatives exist to recommended treatment, what risks are presented by the recommended treatment, and what to expect if they follow the medical advice being given them.

In our law practice, we have represented many clients who have suffered serious injury as a result of having been inadequately informed. At trial involving patient injuries, often the jury instructions we propose which are well-established in California have to do with informed consent, the failure to provide informed consent and related issues that a jury must decide.

When a doctor prescribes a drug, the patient needs to ask the following questions:

First, why are you prescribing this drug and are there other drugs that perform the same or similar functions?

Second, is this a new drug on the market? (Doctors are very susceptible to persuasion by drug reps that they should try new drugs which do not have a track record and can be dangerous);

Third, what are the side effects of the drug; are there any side effects that can cause death or serious injury?;

Fourth, what should I look for when taking the drug to determine whether or not I am suffering ill effects from the drug; what should I do if any changes occur after I begin to take the drug?

After these questions are answered, the patient should go on line and research the drug for side effects. The Food and Drug Administration has a website where one can access adverse event reports pertaining to drugs and medical devices which are on the market. That is also a good resource for information. Taking these steps might well avoid the types of serious injuries that our clients have suffered from drugs prescribed by their physicians.

If you have concerns after asking these questions and researching the drug itself, call your doctor and discuss these with him or her. Do not feel that you are being a “difficult” patient or are outside your rights to be very comfortable about your own health. Do not let your physician or medical staff cause you to believe that you do not have a right to know these things. You do. If you believe that your doctor is not willing to fully discuss and address your concerns, consider finding a physician that is more open and willing to go through this process with you.

The same issues and concerns for patients apply to recommended surgical procedures. Next post, I will share important information about informing yourself about surgical risks.
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A new study was recently released out of the University of Buffalo take a closer look at vehicle safety. As San Francisco auto injury lawyers, we want our readers to know the latest information on staying safe on our roads and highways in California.

The researchers have found that accident outcomes often relate to the match of vehicles involved in the crash. This might seem obvious, but there are nuances to these findings. One is that although lighter vehicles generally fare worse on an impact with a heavier vehicle, The laws of physics dictate that in a crash between two vehicles all things are not equal. The driver of a passenger car for example is 7.6 times more likely to lose his or her life than an SUV driver in the same crash. But when a car with a high front end crash rating crashes with an SUV with a lower front test crash rating, the car driver’s likelihood of loss of life goes down to 4.5 times as likely than the SUV driver.

Another interesting conclusion to come out of this study is that in head-on crashes, the type of vehicle being driven is more important than the crash-test rating in survival prediction. This means that as car buyers, we should not assume that a good crash-test score provides a guarantee in a head-on crash, since much depends on the type of vehicle each driver is driving at the time of an accident and the match-up of vehicles is an important factor.

Car buyers also need to know that selecting an SUV for safety doesn’t necessarily ensure better outcomes. We have to keep in mind that SUV’s have a higher center of gravity and that makes them more likely to roll over in an accident. That alone can cause a fatality. In the past few years, electronic stability control (ESC) has been mandatory in SUV’s and it helps to avoid rollover. Wearing a seatbelt also is a major factor in surviving a rollover.

Those driving heavy vehicles do have an advantage over smaller, lighter vehicles in the event of a crash. But smaller vehicles are safer than they have ever been. And that means that everyone is safer these days. Safety equipment including air bags, antilock brakes and ESC have resulted in many vehicles doing better in both insurance industry and government tests.
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Intuitive Surgical, which makes the da Vinci surgical robot has just issued a notification, but not just any notification, this one is marked urgent and it is making national news. We learned of this independently, because we closely follow the issues with these devices and represent those injured during robotic surgeries. As robotic surgery injury lawyers, with expertise in the safety issues related to da Vinci robotic devices, we want the public to know of this danger.

The company’s “urgent medical device notification” is intended to warn hospitals and physicians that the maker has “identified a potential issue” with the device. The maker wants medical professionals to know that internal burns can result from the use of one of the robot’s instruments. We want our readers to know about this danger.

Surgical injury cases have been on the rise and the safety of the da Vinci Robotic device has been an issue for some time. This urgent notification states that there are “micro-cracks” in some of these devices. The problem is focused on what are called “monopolar curved scissors” which the maker is now stating may leak and then create “a pathway for electrosurgical energy to leak to tissue during use and potentially cause thermal injury.” In other words, the device can burn the patient’s tissues.

A major concern relating to this is that the micro-cracks are likely not going to be visible to the medical professionals using the device in surgery … they are too small to be seen. Although the company has yet to confirm specific injuries to patients, they have issued this notification. We call it a warning to patients and to medical professionals — patients must be made fully aware of the risk of injury and if they are injured they should contact legal professionals for guidance.

The company has also included Precautions and Warnings for Usage of the EndoWrist Monopolar Curved Scissors as part of the urgent notification. Medical professionals need to understand this additional risk, even taking these “precautions” and must inform their patients of the risk of internal burns. If patients are injured during such a surgery, whether they have been informed of the risk or not, they need to protect their legal rights and get additional medical support.
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There are times in our community when tragedy strikes and we all feel it. The horrific limo fire and loss of life on the San Mateo-Hayward Bridge last week is felt by many across the Bay Area. So much so that the California Highway Patrol has asked that the public mourn in ways other than placing memorials on the bridge where the accident happened. This itself presents a road hazard that could lead to more injuries and accidents.

In our work as California injury and wrongful death lawyers, we have counseled many families after serious and fatal injuries have occurred. The family and friends of those killed and hurt in this tragedy will have a very long road ahead to deal with the scope of what has happened.

There were nine women in the limo as it traveled on the bridge. Smoke apparently began in the back of the limo and some of the women attempted to get the driver’s attention about it. He misunderstood and then realized that there was smoke in the back of the vehicle. He pulled over, but the situation worsened quickly and the smoke quickly turned to fire. Only four of the women were able to get out of the limo and survived this terrible accident. The other five were not able to leave the vehicle.

Part of the reason this accident has reached the hearts of so many is that the victims were on their way to a bridal party. Another victim was recently married. Eight of them were nurses. This particular limo was licensed to carry eight passengers, not nine. This could well become a problem for the limo company in the aftermath of this horrific situation.

From tragedy could come some change. The accident will likely cause reform in the limo industry and perhaps even laws and regulations to improve safety. The accident is currently under investigation, but something went terribly wrong to cause such a horrific fire. Some speculate that the cause related to a short in the electrical system.

The California Highway Patrol and the California Public Utilities Commission have jurisdiction over the regulation of transportation firms. We know that the 1999 Lincoln Town Car was not required to carry a fire extinguisher and it is now anticipated that State Senator Jerry Hill (D-San Mateo) will introduce a bill to make it mandatory that limousines have fire extinguishers.
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We all want to be safe on the roads and learn to drive defensively. But sometimes serious injury and loss of life can occur with only a single vehicle. Single vehicle crashes can actually be more dangerous than many other types of crashes. About 8,000 people are killed in sIngle vehicle roadway departure accidents every year. As San Francisco car accident lawyers, we know that single vehicle crashes can not only cause very serious injury, they can be fatal.

Earlier this week a tragic accident of this kind occurred in the Lake Shore area of San Francisco. The auto crash occurred on Monday night. The driver, a 25-year-old man, was at the wheel of his own vehicle when he lost control and hit a curb. He was driving on Lake Merced Boulevard, near Sunset. The impact caused the car to veer off the road, hit a poll and then roll over. The driver was pinned under the car and fire rescue attempted to extricate him from the vehicle and took him to San Francisco General Hospital, he did not survive his injuries. He also had not been wearing a seatbelt. Our hearts go out to his family and friends as they grieve this loss.

Reports indicate that speed was a factor in this accident. This is often the case with road departure motor vehicle accidents. This is stunning, because drivers generally have control over how fast they are traveling unless they have a medical emergency or their vehicle is defective in some way.

Sadly, in most cases, these crashes are completely avoidable and experts say there are several key factors that contribute to single vehicle crashes. One of these is speed. It is also important not to drive when fatigued. Finally, as always, do not drink and drive.
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The Toyota Motor Corp. and U.S. subsidiaries have agreed to settle investigations by 29 attorneys general and will pay 29 million dollars to participating states. The settlement closes the claims with these states that the company misled consumers about the safety of its vehicles.

Toyota has been paying out significant reparations for many safety and communications issues associated with various defects. For example, the company already paid a large sum totaling $48.8 million to the National Highway Traffic Safety Administration for its failure to let regulators know about defects that became the subject of recalls.

The company has also recently agreed to pay about $1.4 billion to end national class action claims that its vehicles suddenly and unintentionally accelerated, which devalued the owner’s vehicles. The company had been sued by hundreds of owners since about 2009, when the car maker began receiving complaints about the sudden acceleration issue. Some individual cases involving injury and death due to the defect may still be litigated. The company is said to be trying to settle some of the larger of these cases before they get to juries.

The state investigations resulted from the claims of sudden acceleration. The company had insisted that its vehicles were safe, despite recurring issues with the acceleration systems in several models. Toyota has agreed to correct communications issues between Japan and the United States with regard to safety problems. It must also advise buyers about defects in previously-owned vehicles and repairs made on those cars.
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The federal government has sued the manufacturer of the Nap Nanny, sold in stores nationwide including San Francisco, because the products’ maker has failed to voluntarily recall it. As San Francisco child injury lawyers, with a long history of expertise in infant safety recalls, we applaud the efforts of the Consumer Product Safety Commission.

The problem with the product is that “at least five infant deaths and more than 70 complaints” of infants falling out have been provided to the federal government. They say that the maker of this product was not providing sufficient warnings to consumers about the dangers and risks associated with it.

The Nap Nanny has been sold for several years and includes a foam pad with a cover made of fabric. The baby is supposed to be strapped into a three-point harness. The product has been sold in several versions, but essentially it is a baby recliner designed for sleep, rest, and play.

The original Nap Nappy was recalled in July of 2010 after one infant died and 22 others were found hanging out or falling over the edge. The CPSC says that the manufacturer has not warned consumers of the risks of using it, even after these incidents occurred.

According to the CPSC, the various generations of the product contain “defects in the design, warnings, and instructions that pose a substantial risk of death and injury to infants.” The government has asked that the manufacturer cease selling the products and let the public know that it is not only defective, but that they are entitled to a full refund for it.

The CPSC noted that after its staff had discussed this course of action, the company refused to recall the product voluntarily in a way that “would address the hazard posed by consumer use of the product in a crib or without the harness straps being securely fastened.” Instead, the manufacturer says that they “stand behind the safety of the product when used as instructed.” They say that parents whose children have been injured or have died did not use the product correctly and that the product is not dangerous when used properly.

We urge parents to review their use of this and other child and infant products. If you purchased one of these products, return it to the store where it was purchased and let them know you are aware that the federal government says it is unsafe.
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The Consumer Product Safety Commission (CPSC) is quietly stopping the entry of bad toys into the United States. The 2012 statistics are impressive. Two million toys that are considered to be dangerous and to violate the safety rules and regulations in our country, were stopped at the borders and prohibited from getting into the hand of our kids. This is particularly important as the holidays approach and parents are out buying toys they hope and expect will be safe for their children. As California consumer law and child injury lawyers, we applaud these efforts.

The cumulative effect of these border stops amount to a big effort by the border patrol and the CPSC. Estimates are that in the past four years, over eight million units of toys that amount to about 2,400 types of toys have been seized and prohibited from arrival over the borders for failure to comply with our consumer safety standards.

It is still very important that parents pay attention when purchasing toys for age appropriateness. We have previously warned about buying toys and cribs at garage sales or as hand me downs. Sometimes these older toys or cribs have been taken out of store circulation as unsafe, but have remained in the homes of parents. A well-meaning relative might provide a toy to a child that is not safe and has been recalled. This is dangerous and can lead to injury or fatality.

For example, this past year, the “CPSC recalled 38 toys, three of which involved a lead violation.” Although toy recalls have been declining, there are still many every year. In 2011 there were 34. Fatalities related to toys have declined as well. In 2011 there were 13 in total, down from 19 in the previous year. Fatalities can involve choking, asphyxiation and drowning.

Things like balloons can become fatal in the hands of a child. Kids can choke or suffocate on balloons that are deflated or broken. Small toys and their smaller parts are always something to be avoided with little, especially little ones under the age of 3.

Another area of concern are scooters or other riding toys. We have seen kids riding these on neighborhood streets, along with cars. This is unwise. When riding it is important that parents are present and that kids wear helmets. Other products that have shown to be dangerous to kids are magnets. Kids under the age of 14 should not be around high-powered magnets. If there are in proximity to these, an adult should be present.
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One of the most heart wrenching tragedies happened earlier this week very close to home. A young teen was riding her bicycle to school and was hit by a car and lost her life. As California cycling injury lawyers, we want to express our sympathies to her family and school community.

According to reports, the bicycling teen and the vehicle that fatally injured her were making a right turn at the same time. She was wearing a helmet. Authorities are still trying to piece together how this bicycle accident occurred. The driver stopped and stayed at the scene. Police say that the cause of the collision is not clear and that the driver will not be charged.

The teen’s family is not speaking about this tragedy. She attended Woodside High School and resided in Redwood City. According to the statement issued by her school principal, she was an engaged and committed student and athlete.

Unlike in this accident, we read often read reports about situations in which a person is hit while riding a bicycle or walking, and the motorist leaves the scene. Hit and run accidents appear to be on the rise all over the country.

California law requires that motorists stop after an accident that involves the injury of another person. Under California Vehicle Code section 20001, drivers must, among other things, immediately stop, provide identification to other parties or law enforcement and provide reasonable assistance to the injured person or persons. This driver appears to have done everything right.

We hope that over time, the young teen’s family can heal and that her school community can as well.
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