Cape Cod Personal Injury Lawyer

A New Study Shows that Stopping the Heart is the Best Method for Bypass Surgery

Carrie Strasser — Thu, 12 Nov 2009 10:30:54 GMT

A study published last week in the New England Journal of Medicine and reported in the New York Times found that bypass surgery performed using a heart-lung machine, or pump, was more successful in the long term than the recently popular off-pump procedures.

In the study, published Thursday in the New England Journal of Medicine, 2,203 patients were randomly assigned to have their bypass surgery on pump or off. Because the study was sponsored by the Department of Veterans Affairs, the patients were mostly men.

A year later, those who had had off-pump surgery had poorer outcomes. Fewer bypasses stayed open and patients were more likely to have needed a repeat operation or to have had a heart attack or to have died. They were no less likely to have had strokes or difficulty thinking.

Initially, doctors switched to off-pump procedures for fear that the pump could lead to strokes, memory problems or personality changes. The increasingly popular off-pump procedure requires doctors to operate on a still-beating heart.

Off-pump procedure patients had fewer blood transfusions but spent a longer period of time in the operating room. Patients of both procedures spent similar lengths of time in intensive care, on ventilators and in the hospital.

Certain surgeons who have made the off-pump procedure their common practice say they will not change because they have developed an expertise in the procedure and the study does not reflect their actual outcomes.

Approximately 20% of the over 200,000 people having bypass surgery each year opt for the off-pump procedure. In the beginning, this procedure was not easy with surgeons having to operate on a moving, beating heart. Many surgeons were pressured into learning this procedure and instruments were soon developed that assisted in keeping the heart steady.

However, despite the fact that some surgeons eventually became "experts" at off-pump procedure, the purpose of the study, says Dr. Michael Lauer, Director of Cardiovascular Sciences at the National Heart, Lung and Blood Institute, was to determine "how well will the procedure work in the hands of a typical surgeon." Dr. Lauer added that very few surgeons have actually attained a high level of expertise in this off-pump procedure.

Originally posted at InjuryBoard by Carrie Strasser

Landlords Can Now Be Liable for Pit Bull Attacks

Bruce Bierhans — Fri, 06 Nov 2009 09:30:29 GMT

It has long been the law in Massachusetts, and in many other states, that if your dog causes injury, you are liable regardless of whether or not you were negligent. This is called "strict liability" and imposes automatic liability on the dog "owner".

However, if you were suing a landlord that was not the dog owner, you had to show that the dog had "vicious propensities" prior to the attack and that the landlord knew or had reason to know of those propensities.

In the case of Nutt v. Florio, the Massachusetts Appeals Court has ruled that where the dog at issue was a pit bull, the issue of the landlord's negligence may go to the jury for a determination of whether or not "the dog had dangerous propensities, whether the defendants knew or should have known about them, and, if so, what actions would have been reasonable, in light of their duty as landlords to protect tenants from reasonably foreseeable risk of harm."

In effect, the court is saying that if a pit bull is involved, you don't necessarily have to show that the dog attacked in the past. The landlord's knowledge that a dog is or may be aggressive may impose a burden on a landlord to be alert for their tenants' safety, particularly where there are complaints from other tenants, or other evidence of "potential" aggression. As stated by Lawyers Weekly, a landlord may now be liable for injuries even though the landlord was not the animal's owner and there was no evidence that the animal had ever attacked anyone before.

Originally posted at InjuryBoard by Bruce Bierhans

Reverse Mortgage Abuses

Bruce Bierhans — Fri, 09 Oct 2009 16:39:13 GMT

What a surprise! An article in todays SanFran Chronicle reports that reverse mortgages have "the potential to spawn another subprime-style financial crisis." This, according to a report released by the National Consumer Law Center in Boston.

The report discusses "aggressive marketing tactics" that pressure elders to use RM loan proceeds to purchase other potentially inappropriate financial products, such as annuities, and even things such as luxury items.

A reverse mortgage permit homeowners over 62 to receive a lump sum, periodic payments or credit line checks. The borrower doesn't make mortgage payments, but interest and fees accumulate over the life of the loan and the loan must be paid when the borrower dies, sells or leaves the home for more than one year. The interest compounding feature can be quite a problem. The article discusses the story of one woman that learned, when she went to refinance her home, that she owed over $600k on a home that was worth only $120k. She had only received $120k in payments on the loan.

The state of California has legislation pending that would establish a suitability checklist for reverse mortgages. The NCLC report recommends that anyone that arranges a RM establish that they are acting in the best interest of the senior.

As in all matters, you are your own best guardian. Of course, a responsible attorney can guide you through the decision making process. Borrowers beware!

Bruce A. Bierhans

Originally posted at InjuryBoard by Bruce Bierhans

Pfizer Settles Again...

Carrie Strasser — Thu, 03 Sep 2009 09:19:41 GMT

Today, the New York Times reported on Pfizer's $2.3 billion settlement payout over allegations that it conducted illegal marketing of Bextra, a painkiller that was taken off the market in 2005. This settlement is the largest health care fraud and criminal fine payout to date.

Since 2002, Pfizer has paid out settlements four times over allegations of illegal marketing activities. A large factor contributing to the high amount of this settlement figure was Pfizer's repeated misconduct over the years. Despite the fact that this may be the largest settlement sum of its kind, the $2.3 billion amount equals less than three weeks of Pfizer sales. This prompts one to wonder whether such a high amount targeted at addressing Pfizer's recidivism will actually have any effect whatsoever on Pfizer's behavior in the future.

John Kopchinski was the former Pfizer sales representative who initiated the complaint that prompted the government to investigate allegations surrounding Bextra.

"The whole culture of Pfizer is driven by sales, and if you didn’t sell drugs illegally, you were not seen as a team player,” said Mr. Kopchinski, whose personal share of the Pfizer settlement is expected to exceed $50 million. Mr. Kopchinski left Pfizer in 2003.

Bextra, approved by the FDA in 2001 to treat arthritis and menstrual cramps, was marketed by Pfizer for the treatment of acute pain. This, despite the fact that it wasn't proved to be any more powerful than Ibuprofen and the side effects with increased doses were great. Pfizer urged its sales representatives to tell doctors to use Bextra to treat acute pain and surgical pain at high doses that were not FDA approved. Pfizer held weekend getaways to resort locations for doctors to promote their drugs, paying all the attendees' expenses.

Originally posted at InjuryBoard by Carrie Strasser

Our Wii Donation: A New Twist in Wellfleet

Bruce Bierhans — Wed, 19 Aug 2009 20:59:16 GMT

Our lawfirm was thrilled to have recently donated a Wii gaming device to the Council on Aging and Senior Center in my own beloved community of Wellfleet, Massachusetts.

While many contributing firms have donated the devices to rehab facilities and hospitals, I was encouraged to find out how much use these devices could have in "wellness" programs at a local senior center. Our SC director, Suzanne Grout-Thomas informed me that she could use the device in interactive fitness programs, dance and interactive fitness games.

Our SC is the first on the Outer Cape to have the use of the device and we know it will be put to great use.

Bruce A. Bierhans

Originally posted at InjuryBoard by Bruce Bierhans

Independant Contractor or Employee? The Strippers Ruling

Bruce Bierhans — Wed, 19 Aug 2009 20:45:35 GMT

The last time you went to an "adult entertainment" venue (no one reading this blog, I'm sure), did you think the "dancers" were independant contractors or employees of the venue. What...you weren't thinking about that? Well...if you're an employer, you'd better start thinking about it.

On August 6, a Superior Court Justice ruled that 70 exotic dancers were employees and not independant contractors, and further ruled that the employer violated the Massachusetts Employee Classification Law by misclassifying the stripper/employees. The dancers, employed at King Arthurs Lounge alleged they were "service employees" entitled to earn wages and keep their tips. The employer argued that the dancers only provided an "independant service" that was not an essential part of the business. The judge said that this was a "thinly veiled" argument (yes; he used that language) and that the dancers provided a service "integral" to the conduct of the business.

Of course, the employer will appeal. However, the law itself does contain a relatively stringent three part test. If the employer fails to meet even one part of the test, the worker will be considered an employee; not an IC:

a) The worker must be free from the employers presumed control and direction in performing the service;

b) The service must be "outside" the employers usual course of business, and;

c) The worker must be customarily engaged in an independant trade, occupation, profession or business of the same type.

The statute, M.G.L ch 149, Sec.148B provides for both civil and criminal penalties.

Every employer that uses Independant Contractors MUST review their relationships with staff to insure that they are not violating the law. Failure to do so may result in you being "stripped" of some significant cash.

Bruce A. Bierhans

Originally posted at InjuryBoard by Bruce Bierhans

High-tech MRIs - Helpful or Unnecessary?

Carrie Strasser — Tue, 18 Aug 2009 11:46:37 GMT

Last week, Time magazine reported that women who are diagnosed with early-stage breast cancer and who rely on results from high-tech MRIs, usually choose more aggressive and sometimes unnecessary treatment plans.

But that may not be such a good idea, say researchers in a commentary appearing in CA: A Cancer Journal for Clinicians, a publication of the American Cancer Society. The authors looked at studies pitting preoperative use of MRI, which relies on magnetic waves, against mammograms and similar tests that use radiation to take pictures of breast tissue. Researchers found that women choosing MRIs often ended up with more aggressive surgery — much of which wasn't necessary — than women who did not use the scans. What's more, employing the newer and more sensitive MRI technology did not improve a woman's chance of surviving cancer or her chances of avoiding a recurrence of tumors.

Women who had the MRIs usually chose more aggressive surgery because the MRI scans pick up more cancer lesions than mammograms.

However, doctors question whether these lesions are more bark than bite. In women with early-stage breast cancer, the chance of recurrence ranges from about 5% to 10% in the ten years following the first diagnosis. Multiple studies over the past 30 years have shown that a lumpectomy followed by radiation therapy provides women with the same survival and recurrence rates as a mastectomy. After a lumpectomy, a patient may still have cancer in the breast but radiation usually destroys the remaining disease.

MRIs, or magnetic resonance imaging scans, are sensitive enough to detect small tumors and other abnormalities that mammograms might miss. This leads to increased anxiety in patients and causes them to pursue more aggressive treatments than might be necessary. Dr. Larry Norton of Sloan Kettering Cancer Center in New York City explained that while a lumpectomy may leave small cancers around the surgery site, the radiation that follows will most likely destroy it. If you don't have the radiation treatment, Dr. Norton explains, then you are much more likely to get a recurrence in the same location.

For more information on breast MRIs, click here.

For general information on MRIs, click here.

Originally posted at InjuryBoard by Carrie Strasser

Cape Innovations in Alternative Fuel Research

Kwon Faith — Wed, 05 Aug 2009 11:00:21 GMT

The Cape Cod Times reported recently that “Dealing with the Cape’s pond scum could prove to be a financial windfall.” Yes, algae-based biodiesel is being explored as the next big alternative to fossil fuels, right here on the Cape.

A Wellfleet based alternative-energy company called Plankton Power has begun collaboration with the military, government, oil industry and research organizations to initiate construction and production of an algae farm and biorefinery on the Massachusetts Military Reservation.

It was reported that the seaweed and algae we see floating around the waters have a much higher purpose than just annoying swimmers, boaters and fishermen. Algae converts into a biodiesel with a composition nearly identical to that of petroleum diesel, but is more efficient, produces lower emissions, degrades quickly and is not hazardous if it comes in contact with your skin. It is even purported to perform better than traditional diesel, especially in lower temperatures.

While it does cost more to convert algae into biodiesel, the production rate is higher than even soybean or canola (three weeks as opposed to six months). The hurdle they face now is proving this method will be cost effective.

Efforts in the area of algae-based biodiesel research are already in progress in, of all places, Iowa, and Exxon Mobil is even investigating the economic aspects of algae biodiesel.

With all the attention alternative energy sources have garnered lately, this is one method that has yet to be fully explored, and still another step in reducing the United States’ dependence on foreign resources.

Originally posted at InjuryBoard by Kwon Faith

One Step Closer Towards Greater Food Safety

Carrie Strasser — Fri, 31 Jul 2009 09:58:34 GMT

The New York Times reported that on Thursday, the House passed legislation to require more frequent inspections of food processing plants and to grant the government the authority to actually order that tainted foods be recalled.

This will allow the Senate to consider the legislation in the fall. While the legislation was supported by a vast majority of Democrats, the Republicans were split with many fearing that the new rules would add greater burdens on farmers.

The legislation seeks to remedy problems in the food safety system that have been discussed for decades. Its chief sponsor, Representative John D. Dingell, Democrat of Michigan, said it would “fundamentally change the way in which we ensure the safety of our food supply.”

The measure would require the Food and Drug Administration to conduct inspections every 6 to 12 months at food processing plants that it deems high-risk. These could include plants that have experienced food safety problems in the past or that handle products that spoil easily, like seafood.

Other processing plants that deal with lower-risk food items would need to be inspected at least once every three years. Supporters of the new legislation argue that the current system allows some facilities to go for 10 years or more without an F.D.A. inspection.

This new system will be funded by a yearly fee of $500.00 paid by the food processing plants. For larger companies with multiple plants, there will be a cap of $175,000.00. This fee would cover approximately 40% of the F.D.A.'s costs to implement the increased inspections.

Another significant part of this legislation is the power it grants the F.D.A. to order recalls of tainted food, since under the current system, it can only ask companies to recall such foods. Additionally, there will be increased inspection requirements on imported foods and a system whereby the F.D.A. will better be able to trace food products and ingredients to identify the source of food-borne illnesses.

Originally posted at InjuryBoard by Carrie Strasser

The Crime of the 21st Century? Elder Financial Abuse

Bruce Bierhans — Thu, 16 Jul 2009 09:33:54 GMT

On the heels of our Harwich elder securites fraud case:

Fred Joseph, president of the North American Securites Administrators Association has described elder financial abuse as "the crime of the 21st century". A column in todays Washington Post by financial writer Michelle Singletary expands upon the comments.

The typical victim? A 75 year old woman living alone (what a surprise!). Typical scams?

Forging signatures on legal instruments; promising lifelong care in exchange for money or property; using credit cards without authorization, and con men involved in scams by gaining victims trust (in the Harwich case, our conman desribed his involvement in his church at length).

The article also describes certain red flags to watch for as fraud alerts. See www.na-saa.org and search for "Senior Investor Resource Center".

By way of update on the Harwich case. Positive negotiations are progressing.

Bruce A. Bierhans

Originally posted at InjuryBoard by Bruce Bierhans