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deleted50478
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He should have had insurance for that. It doesn’t belong in malpractice court.
James Andrews clinic lawsuit
Started by okayplayer
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He should have had insurance for that. It doesn’t belong in malpractice court.
IF it can be proven to be block related (by EMG), permanently disabling a NFL starter due to a nerve block is pretty slam dunk malpractice.
Lost income as a result of malpractice is the reason economic damages are a component of the award.
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deleted162650
Disagree. Nerve injury is a known complication of nerve blocks. That doesn’t mean there was any malpractice involved. Crap happens. Doesn’t mean the doc F’d up.
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complications happen.
there are risks with every aspect of medicine.
not all complications are malpractice.
there are risks with every aspect of medicine.
not all complications are malpractice.
That will be up to the jury I guess.
But it's a complications that may have ended his career, which is the exact reason some on here are saying "if I'm still working don't do a nerve block on me" because even if it's not malpractice, it's still career ending.
And US juries are very sympathetic
Diving Into Sharrif Floyd's $180M suit vs. Dr. Andrews
Also, according to the article I have linked, there is an allegation the patient was not even consented for the block. Plaintiff’s attorneys are not exactly a bastion of truth, but that part should be pretty easy to sort out.
So the question is - as long as informed consent is truly obtained, including an actual real discussion of the risks/benefits/alternatives, AND the standard of care is followed (ultrasound, appropriate injection technique, etc)....you should have an adequate defense if a complication occurs. At least that’s what I’m telling myself.
But I also agree - I wouldn’t block in a professional athlete like this, or put a tube in an opera singer (if avoidable), unless they were insistent on it. Not saying you can’t/shouldn’t, it’s just my opinion. For me, since these people’s livelihood depends on it, even a remote risk of complication might be too much.
But I also agree - I wouldn’t block in a professional athlete like this, or put a tube in an opera singer (if avoidable), unless they were insistent on it. Not saying you can’t/shouldn’t, it’s just my opinion. For me, since these people’s livelihood depends on it, even a remote risk of complication might be too much.
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deleted643396
I think the benefits of PNBs outweigh the risks in a large percentage of our population. It’s certainly a better alternative than getting people hooked on opioids. I believe some people can get hooked after only a couple Percocets.
With that said, I’ve often wondered about us doing blocks for all comers (provided no contraindications, that is). There is a certain percentage of people who can have a rotator cuff done and be fine taking Tylenol and NSAIDs for a week or two. The ideal thing would be to judge what a patient’s pain tolerance will be and decide whether or not a block would be beneficial. That’s obviously not an easy task. However, in this particular case, a football player who is used to all sorts of pain might not be fazed by the post-op pain. I like the idea of consenting for a block in PACU only if needed in this case.
With that said, I’ve often wondered about us doing blocks for all comers (provided no contraindications, that is). There is a certain percentage of people who can have a rotator cuff done and be fine taking Tylenol and NSAIDs for a week or two. The ideal thing would be to judge what a patient’s pain tolerance will be and decide whether or not a block would be beneficial. That’s obviously not an easy task. However, in this particular case, a football player who is used to all sorts of pain might not be fazed by the post-op pain. I like the idea of consenting for a block in PACU only if needed in this case.
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deleted162650
Well, if in fact those allegations are true and he never consented to the surgery or the block, then ya - all involved are F'd (and very stupid).
I did like how that article got an expert opinion from Dr. Chao. Dude got busted for doin' coke off strippers' asses with players. I'd have to check, but I think he may have lost his license.
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I think this is really the point to hit home. It’s so much easier for every to just slide an LMA in a young healthy individual.
By what mechanism could he have permanent quadriceps weakness from an adductor canal block? Either it was really a femoral block and he could have sustained a true injury or I don’t think this is plausibly block related at all. I can’t think of a mechanism where blocking the saphenous nerve mid-thigh could result in PERMANENT (not transient 2/2 retrograde flow of local) injury to the femoral nerve. Hell, you could traumatically sever that nerve with a cutting needle and it wouldn’t give you quadriceps weakness.
Tourniquet, positioning related, or pre-existing.
Tourniquet, positioning related, or pre-existing.
the article also says andrews did a more complicated procedure due to the block than just a knee scope.. this makes no sense to me
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I'm interested to see the response. I can't imagine that a world renown ASC like this, that regularly handles the most high profile patients, doesn't have all of their I's dotted and T's crossed medico-legally. I wouldn't be surprised if they had consent recorded even to protect themselves. There's just no way that proper consent was not obtained nor a different procedure was performed.
The fact that he showed up to the clinic thinking it was just a medical examination when in fact it was a scheduled procedure leads me to believe that there was not a lot of comprehension for what was happening medically.
The fact that he showed up to the clinic thinking it was just a medical examination when in fact it was a scheduled procedure leads me to believe that there was not a lot of comprehension for what was happening medically.
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deleted50478
(Deleted-someone already gave my response)
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deleted50478
That’s an argument that he shouldn’t have consented to the block not an argument that there was malpractice.
He’s a big boy. You present the information and the patient makes the decision. It would be unethical to make the decision for the patient. It’s his risk to take, and he should live with the consequences of his own decision and unfortunately his bad luck.
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I wouldn't want to be in there shoes because a jury could decide anything. And anyone can sue for anything, but it doesn't mean that they will win. Just because there is bad outcome, doesn't mean there is malpractice. Otherwise we would be losing cases left and right anytime someone has a less than perfect outcome (increased LOS, pain more than average, postop infection, etc). I hope they don't have a pic of intraneural injection, or even worse, intentionally did an intraneural block.
I've always thought it would be amusing to be able to sue a lawyer for not winning a case (since losing the case was an unwanted outcome). You could sue forever until you won! And lawyers would have double the business!
I've always thought it would be amusing to be able to sue a lawyer for not winning a case (since losing the case was an unwanted outcome). You could sue forever until you won! And lawyers would have double the business!
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deleted126335
Three retirees, Two housewives, A college student, Two people between jobs. Someone on disability, a union member, and two people who were not bright enough to get out of jury duty get to evaluate your decision to perform a nerve block and how you conducted it. I am filled with trust and confidence.
All these doctors here saying they wouldn't want a block for themselves or they wouldn't block a professional athlete makes me wonder just how much benefit>risk PNBs are providing...
Lmao this case won't even make it to trial folks. No doc is gonna pay a single dime. Look up the attorney for the player. He's some scrub independent lawyer who's not even part of any sort of reputable law firm. Most likely has never tried a single medical malpractice case in his life. He has no idea what he's doing. It looks like he was also the attorney representing Aaron Hernandez's family in the case where they alleged it was the CTE that led Hernandez to commit suicide in prison (which he was in for murder). Guess what happened? That case was dismissed. You think he's gonna win a case like this? Lol. The Andrews' Institute most likely has the best representation money can buy with a team of lawyers and are undefeated in cases like these.
I’m late to the party here, but I would never take a nerve block. It isn’t even a probabilities game for me - even a small risk of nerve injury is too much. However, I would also be comfortable asking my surgeon for a max of five Percocet and then just gutting it out on Tylenol and Motrin. Surgery hurts, end of story.
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deleted126335
I’ll take the block every time. As long as the doc doing it has done plenty.
New source of revenue stream for lawyers out there
I have done a couple blocks on professional sports players, and lots of other people too.
I did go insanely into risk benefit discussion with the athletes, and I overestimated risk.
That was also very well documented and witnessed by multiple people though.
I have only had 1 of the minor league people say “no thanks.” A couple of physicians have said no, but most still want it.
I did go insanely into risk benefit discussion with the athletes, and I overestimated risk.
That was also very well documented and witnessed by multiple people though.
I have only had 1 of the minor league people say “no thanks.” A couple of physicians have said no, but most still want it.
Someone asked me for evidence that blocking a patient and placing a tourniquet over the block site causes injury. Unfortunately studies do not publish these facts. In the nerve injury cases I have seen a few were rescue blocks after prolonged tourniquet times. And most probably 4-5 were from popliteal blocks. Most importantly I have never seen an upper extremity nerve injury. Why usually upper extremity surgery the arm is free floating and free from pressure or tourniquet. Lower extremity surgery your still putting pressure on the blocked compartment of the nerve. No evidence except practicing for 6 years without a nerve injury.
I've been a patient and had blocks for Ortho surgery when I was a med student and again as an attending. I have no qualms about having another block in the future, if needed. Often, the surgery itself has a greater risk of never injury than the block.
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Yes, maybe the surgery caused the injury. However, you can’t be blamed for causing that injury if all you did was tube the patient. With a professional athlete why would you take that risk?
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deleted50478
Respect for autonomy. That’s why.
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deleted126335
A general anesthetic is almost always more of a clean getaway.
And I'm sorry, in this gig and in these days of medicine, a clean getaway is what you want...
You got that right brother.
Cant blame post op paresis numbness tingling what have you on the good ole "all in one block"
Everyone has gone block crazy since ultrasoound. and especially the billing but in my estimation it increases liability significantly..
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deleted875186
This x 1000
If I’m a patient and I’m not a professional athlete, I’ll take the small risk of the nerve block if I’m already consenting to the much riskier surgery.
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deleted162650
According to the ASA closed claims data base, you are FAR more likely to be sued for airway complications than block complications.
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deleted162650
well death is the airway complication most likely to get you sued. Dental injury is the most common airway complication to occur, but that's usually no more than a few hundred bucks at most.
How to Not Get Sued
I thought this article today was well timed for this discussion
Simple solution to not getting sued: Work less
🙂
I thought this article today was well timed for this discussion
Simple solution to not getting sued: Work less
🙂
Right but I HAVE to do deal with the airway.
Possibly injury to the nerve to the vastus medialis?
And his own occ disability policy should be paying him $15k month.
Mine would. $$ well spent for peace of mind.
He told me he had 3 policies. 2 own occ, and one not. 2/3 are currently paying him. He just really misses the clinical work, financially he’s fine though.
His story (and a couple others I know of) is why I cringe every time I see someone here talking about going without good disability coverage.
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wait so hes getting 30k a month ? why so many disability policies
I am not sure how much he’s getting or why he has 2. I know the one that is not own occ is a group policy, and the other 2 are private policies. My guess would be he bought a policy initially that did not have a rider for income increases so he then had to purchase another one when he started making more money. I’ve never heard of these companies allowing you to collect more than about 2/3 of your salary, even when combined with other policies.
This.
I have 2 policies. One through an employer (so pre-tax) which maxes out at 60% of yearly income. The other was 40% post-tax of my first job out of residency. This doesn't increase over time, but as its tax free I think it'll hold up well over time.
Sorry, meant to respond to your question and somehow responded to my own post. See response above.
so basically with two policies you will collect pretty much 100% of your salary if disabled.
