Author: YostLaw

Periventricular Leukomalacia in Newborns

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Periventricular leukomalacia (PVL) is an injury to the brain which occurs when tissue deep in the baby’s brain, called the white matter, dies away or is damaged.   If a baby’s brain does not receive enough oxygen during labor and delivery, the brain cells in the baby’s white matter can die or be damaged.  The patches of damaged or dying brain cells which lead to a diagnosis of PVL can be seen on brain imaging studies, such as ultrasound and magnetic resonance imaging (MRI), which are tests typically performed on infants whenever there is suspicion the baby did not receive enough oxygen during labor and delivery.

The severity of PVL varies from child to child, depending on the size and location of the damaged brain tissue.   Infants who suffer PVL are more likely to develop cerebral palsy (CP) because the brain injury caused by PVL can damage the nerve cells that control movement.  Nerve cells damaged by PVL can cause the growing child’s muscles to tighten, stiffen and uncontrollably contract and spasm.   Muscle groups in any part of the body may be affected, with involuntary leg spasms and contraction being the most common.  Severe damage caused by PVL can also cause seizures and developmental delays.

There is no treatment for PVL.  Monitoring a baby for development of PVL and managing the problems caused by this brain damage are the responsibility of your baby’s doctors.

PVL can severely impact your child’s development and quality of life.   If your child suffered a brain injury at birth, contact The Yost Legal Group today at 1-800-YOST-LAW (800-403-7259). The attorneys at Yost Legal Group are experienced, caring professionals ready to investigate your claim with compassion and determination. Call us today to receive a free, confidential consultation about your possible case.

We handle all cases on a contingency fee basis. This means you will never pay an attorney’s fee up front, and you owe us nothing unless we win your case.

Stryker LFIT V40 Update

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In August 2016, Stryker recalled its LFIT V40 femoral head hip implant based on higher than expected taper failure rates.  A taper lock failure occurs when the femoral head of the hip implant comes loose from the stem of the hip implant. Many people implanted with this faulty device suffer from severe pain, inflammation, loss of bone strength and mobility, and difficulty in walking. In some cases, excessive metal debris from the components causes an adverse metal reaction known as metallosis. Typically, when the LFIT V40 device fails, the person must have a revision hip surgery to remove and replace this defective Stryker product. Many people selected the LFIT V40 hip implant system because Stryker marketed this product as lasting longer than hip implants containing plastic or ceramic components, and being more suitable for persons wishing to maintain a physically active lifestyle.

The widespread failure of the LFIT V40 resulted in the filing of numerous lawsuits in federal courts all across the country. This, in turn, led to the creation of a Multidistrict Litigation (MDL) in the United States District Court in Boston, Massachusetts.  A MDL consolidates lawsuits filed in different U. S. District Courts nationwide into a single district court to make it easier to coordinate issues and proceedings that will apply to all cases.  As of May 2018, 271 lawsuits were pending in the LFIT V40 MDL.

Trials in what are known as bellwether cases usually take place used in a MDL.  Bellwether trials involve a small group of cases selected from the total MDL pool of cases.  A bellwether trial serves as a test case that the Court and the parties select to test their evidence and arguments, with the goal of moving the overall litigation towards resolution.  These trials are used in mass tort actions like the LFIT V40 MDL, where hundreds of persons have been injured by the same defective and dangerous medical device.  Bellwether cases generally have facts that are typical and representative of other cases in the wider litigation.  The outcome of a bellwether trial often informs the parties on whether they will continue to litigate or settle their claims, and on what terms. If these bellwether trials result in good jury verdicts for the plaintiffs, they may set the stage for settlement discussions that involve all the cases in the MDL.

Judge Indira Talwani will be overseeing the LFIT V40 MDL and has ordered that the initial bellwether trial group of cases be selected by October 5, 2018. Specific case work up in these cases will then take place through a process known as discovery. The first LFIT V40 MDL bellwether case is scheduled to be tried by a jury in September of 2019.

When patients are forced to undergo painful and costly revision surgery following the implant of a defective and dangerous product such as the LFIT V40, corporations like Stryker who manufacture and market these defective products must be held accountable. Our experienced lawyers work for those individuals who have been harmed by this defective Stryker hip implant product. If you or a loved one has been injured or required revision surgery following a Stryker LFIT V40 femoral head implant, or another defective hip device, the attorneys at the Yost Legal Group will investigate your potential claim and lawsuit. For a free consultation, please call us at 1-800-YOSTLAW.

Enhanced Underinsured Motorist Coverage – What Every Maryland Driver Needs to Know

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Effective July 1, 2018, Maryland insurance companies will begin to offer Enhanced Underinsured Motorist Coverage (“EUIM”) to individuals with private passenger automobile insurance policies, including motorcyclists. Commonly referred to as “stacking”, this new coverage will allow you to combine, or “stack”, your underinsured motorist coverage (UM) with the policy limits of the at-fault driver, ultimately increasing the amount of money to which you may be entitled, following an auto accident.

For instance, it is June 19, 2018, and you are involved in an auto accident on your way to the grocery store. At present, the existing law provides that your UM coverage only pays for the difference between the at-fault driver’s coverage and your UM coverage. Therefore, if the at-fault driver carried a $30,000 policy, and you had purchased $100,000 of UM coverage, the most you could recover following this accident is $100,000 ($30,000 from the at-fault driver’s policy and $70,000 from your own UM coverage). However, once the EUIM law goes into effect, you will be able to stack your UM policy with the at-fault driver’s policy. Meaning, if your accident were to occur after July 1, 2018, and after you made the election for EUIM, the most you could recover following this accident in this scenario is $130,000 ($30,000 from the at-fault driver’s policy, stacked on top of the $100,000 from your own EUIM coverage).

Why is it necessary for you to make the election for EUIM with your auto insurance carrier? Currently, the minimum required liability coverage for an insured vehicle in Maryland is $30,000 per person and $60,000 per accident. For example, under the current law, if you were involved in a serious auto accident and your medical bills were $110,000, you would be personally responsible for $10,000 of those bills. Even more, because all of the money went towards repaying your medical bills, you wouldn’t receive anything for your pain and suffering. This new law, however, will provide extra coverage for injured people when they are involved in accidents with individuals that either have: no insurance; the minimum insurance coverage; or coverage that was less than the coverage you obtained through your own policy.

It is critically important to note that, this coverage is not automatic. Accordingly, in order to obtain EUIM, you must elect so, in writing to your auto insurance carrier, on a specific form. More specifically, the new law requires that optional EUIM be offered to consumers “at the time of purchase of a private passenger motion vehicle liability insurance policy.” Md. Code § 19-509.1(c). For this reason, it is extremely important that when you renew or obtain a new auto insurance policy, that you evaluate how such additional coverage could benefit you if you or a loved one were involved in an auto accident, when deciding whether to select EUIM coverage. For more information or questions regarding auto injuries and/or the new Enhanced Underinsured Motorist Coverage, please call Adam P. Frank at the Yost Legal Group.

Birth Injury Due To Placental Abruption

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The placenta is an organ that develops inside a woman’s uterus during pregnancy. Once a baby is conceived, the placenta forms to supply oxygen and nutrients to the baby, as well as remove waste products from the baby’s blood. The placenta attaches to the uterine wall, and the baby’s umbilical cord arises from it.

In some cases, however, the placenta can separate from the uterine wall, causing the baby to stop receiving an adequate supply of oxygen, and causing the mother to bleed vaginally, up to and including the loss of a life-threatening amount of blood.  Placental abruption can occur if the mother suffers forceful blunt trauma injury, such as from a serious fall or during a car accident, but the placenta can also detach from the uterine wall, completely or partially, due to complications of the pregnancy itself – including a sudden loss of amniotic fluid, very high blood pressure (pregnancy-induced hypertension or preeclampsia) or an infection within the uterus (chorioamnionitis).

Symptoms of placental abruption include vaginal bleeding and abdominal pain, sometimes including back pain, which can start suddenly and be constant or mimic contractions, but typically with little or no time between each contraction.   If there are any signs of a placental abruption an immediate delivery, usually by caesarian (c-section), may be required to stop the dangerous bleeding in the mother and restore the vital supply of oxygen to the fetus.   Failure to promptly deliver the baby can result in permanent brain injury due to loss of oxygen (hypoxia).

Even partial separation of the placenta from the uterine wall can become hazardous in a matter of minutes. It is important that the medical staff that has put you in their care are capable of identifying causes and risk factors of placental abruption and promptly recognizing and treating placental abruption if it occurs.  Management of suspected placental abruption should include prompt assessment of both the mother and baby and includes careful monitoring of the mother’s blood pressure and bloodwork and constant monitoring for any irregularities in the fetal heart rate.

If your child suffered a brain injury at birth, contact The Yost Legal Group today at 1-800-YOST-LAW (800-403-7259). The attorneys at Yost Legal Group are experienced, caring professionals ready to investigate your claim with compassion and determination. Call us today to receive a free, confidential consultation about your possible case.

We handle all cases on a contingency fee basis. This means you will never pay an attorney’s fee up front, and you owe us nothing unless we win your case.

Microcephaly Following Hypoxic Brain Injury at Birth

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Microcephaly is a medical condition defined by a small head circumference. It is noticeable as a disproportionately small head for the size of the growing child. There are many different ways this condition can develop, including preventable brain injury at birth, which stunts the growth of the baby’s brain and skull.

Acquired microcephaly in very young children can be caused by lack of oxygen during birth. If signs of the baby suffering from hypoxia during labor and delivery were not promptly recognized by medical professionals and treated by earlier delivery, including emergency caesarian section, and neonatal intensive care unit (NICU) therapies, including cooling the infant to lower body temperature (therapeutic hypothermia), the lack of oxygen during labor and delivery can cause brain damage leading to microcephaly.

A complete physical examination is required to evaluate a child with possible microcephaly. It may take up to a few months to discover that your child has been harmed, as repeated skull measurements are taken every few months to determine a decreased rate of head growth and a below average head size.

Reduced head circumference and brain growth can severely impact your child’s development and quality of life.   If your child suffered a brain injury at birth, contact The Yost Legal Group today at 1-800-YOST-LAW (800-403-7259). The attorneys at Yost Legal Group are experienced, caring professionals ready to investigate your claim with compassion and determination. Call us today to receive a free, confidential consultation about your possible case.

We handle all cases on a contingency fee basis. This means you will never pay an attorney’s fee up front, and you owe us nothing unless we win your case.

Another Stryker Hip Recall: LFIT V40

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The reputation of medical device manufacturer Stryker Corporation has been called into question in the past, after having to recall two of its metal hip replacement systems in 2012. More recently, the company once again faces criticism and outrage for its negligence in distributing yet another defectively designed hip replacement system. On August 29, 2016, Stryker sent an Urgent Medical Device Recall Notification Letter to all surgeons who implanted the LFIT V40 femoral head as part of total hip replacement surgeries. The LFIT V40 femoral head experienced a significant failure rate that has caused many patients to suffer from the crippling health hazards of a deteriorating metal hip implant.

The main concern with the Stryker LFIT V40 focuses on the juncture where the femoral head of the hip implant meets the stem of the hip implant. This is called the “taper lock juncture.” The issue lies in the poorly designed juncture, which has been shown to cause friction between components of the device. This can lead to the disconnection of the femoral head from the stem of the hip implant, as well as the release of cobalt and chromium ions into the body. That means that patients implanted with the LFIT V40 face an increased risk for side effects such as catastrophic hip implant failure, metal poisoning, pseudotumors, tissue damage, and bone damage. Patients experiencing these adverse side effects may suffer symptoms including pain, difficulty walking, joint dislocation, swelling, and inflammation.

Patients who contact their doctor complaining of these symptoms will likely undergo a blood test to check for elevated levels of cobalt and chromium in their blood. Elevated cobalt and chromium levels are a strong indicator that the Stryker LFIT V40 is failing. Another test commonly ordered is called a Metal Artifact Reduction Sequence (MARS) MRI. This MRI helps detect the presence of soft tissue damage, as well as pseudotumors. Pseudotumors are abnormal pockets of fluid surrounding the hip joint caused the release of cobalt and chromium ions from the defective Stryker device. In most cases, failure of the device requires a  total revision surgery, forcing patients to go back under the knife to have the recalled device removed and replaced.

Critics of Stryker Corporation point out that the 2016 recall is too little, too late for users of the LFIT V40, which has been on the market since 2011. The company failed to adequately warn of the risks associated with the device despite several studies proving dangerous side effects, some dating back as early as 2014.  Our experienced lawyers fight for individuals who have been harmed by defective products. If you or a loved one has been injured or required revision surgery following a Stryker LFIT V40 femoral head implant, or other defective hip devices, the attorneys at the Yost Legal Group will investigate your potential claim and lawsuit. For a free consultation, please call us at 1-800-YOSTLAW.

Compartment Syndrome, Post-Operative Onset

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Compartment syndrome is a potentially devastating post-operative complication in which increased pressure results in insufficient blood supply to muscle and nerve tissue within the effected internal space. Causes of compartment syndrome in the post-operative patient include: being left too long in a position during surgery that blocked one or more blood vessels; or, having bandages or casts too tightly applied.

This medical condition can arise in response to bleeding and/or swelling in any area of tissue that has little or no capacity to expand because it is covered by fascia, a tough, inflexible membrane. The role of fascia is to cover and hold muscle tissue in place, but its strength and lack of elastic properties means that in the event there is bleeding or swelling beneath this rigid layer, the fascia will not stretch to relieve the pressure building beneath it. Instead, the fascia layer holds the swelling or bleeding in place, which creates crushing pressure that cuts off the blood supply to the muscle and nerve tissue below. Compartment syndrome occurs most often in the legs, but it can also affect the arms, hands, feet, and buttocks.

Acute compartment syndrome (ACS) is a surgical emergency, and unless the pressure within the effected space is relieved quickly and blood flow to the affected muscle and nerve cells is rapidly restored, necrosis of the soft tissues and permanent disability may occur. The most important factor of outcome is early recognition and speedy surgical intervention to open the fascia (fasciotomy).

The five Ps (pain, pallor, pulselessness, paralysis and paresthesia) are taught as the clinical symptoms of compartment syndrome. Pain is typically ‘out of proportion’ to the injury and is severe enough to require increasing the dosage of pain medication.

If the compartment pressure is left untreated or the diagnosis is delayed, severe rhabdomyolysis, irreversible nerve and/or muscle damage, loss of limb, or even death may occur. Compartment syndrome warrants prompt evaluation and treatment by a trained medical professional.

If you or a loved one has suffered permanent injury due to acute compartment syndrome, contact The Yost Legal Group today at 1-800-YOST-LAW (800-403-7259). The attorneys at Yost Legal Group are experienced, caring professionals ready to investigate your claim with compassion and determination. Call us today to receive a free, confidential consultation about your possible case. We handle all cases on a contingency fee basis. This means you will never pay an attorney’s fee up front, and you owe us nothing unless we win your case.

Important Reminders for Personal Injury Plaintiffs

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Chorioamnionitis

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Chorioamnionitis is a serious complication during labor that may result in serious, irreversible injuries to the mother and child at birth.  Affecting approximately 10% of pregnancies, this condition is also known as intra-amniotic infection (IAI).  Chorioamnionitis is characterized by inflammation and infection of the fetal membranes (amnion and chorion) due to a bacterial infection. This intrauterine infection typically occurs when bacteria ascends from the vagina, through the cervix and into the uterus. This condition is most often associated with prolonged labor.

Maternal fever is the most important clinical sign of chorioamnionitis. A temperature greater than 100.4°F is considered abnormal in pregnancy. Chorioamnionitis is most commonly diagnosed based on clinical signs, which should be discovered by the physician during examination. Findings of rapid heart rate (maternal tachycardia and/or fetal tachycardia), a mother’s elevated white blood cell count (leukocytosis), uterine tenderness, and/or malodorous amniotic fluid or vaginal discharge can also aid in diagnosing chorioamnionitis. However, accessing the amniotic fluid or the placenta for culture can be invasive and is sometimes dangerous.

Carefully monitoring the mother’s temperature, especially when labor is prolonged, is an effective way to avoid this potentially deadly complication. A timely diagnosis, with prompt antibiotic treatment and delivery may help reduce the potentially devastating outcome of maternal and neonatal infections. If left untreated, chorioamnionitis can cause sepsis, premature birth and brain damage in babies affected.

The cost of care for a child with cerebral palsy, or any birth injury, is very high. If your child’s birth injury was caused by chorioamnionitis or other intrauterine infection, contact The Yost Legal Group today at 1-800-YOST-LAW (800-403-7259). When you call, you will speak with an experienced Baltimore Medical Malpractice attorney absolutely FREE. We handle all cases on a contingency fee basis. This means you will never pay an attorney’s fee up front, and you owe us nothing unless we win your case.

Diagnosing Hip Implant Pseudotumors with MARS MRI

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The symptoms related to defective metal-on-metal hip implants can be extremely overwhelming for some patients. For many individuals, the device that was supposed to restore their quality of life has instead resulted in pain and immobility. Several of the negative side effects of the metal-on-metal hip implants can be difficult to diagnose. Fortunately, there is now a test available to better monitor and diagnose pseudotumors, a serious condition that often occurs with metal-on-metal hip implants. This test, known as metal artifact reduction sequence magnetic resonance imaging, or MARS MRI, improves on traditional methods used in the past.

Metal-on-metal hip replacements manufactured by companies like Smith & Nephew, DePuy, and Zimmer can cause pseudotumors in some patients implanted with these devices. A pseudotumor is a soft-tissue mass formed when metal particles irritate the tissue around the hip. Symptoms of a pseudotumor can include pain around the hip, swelling around the foot and ankle, joint dislocation, and clicking of the hip implant. In the past, doctors used two methods to detect hip pseudotumors: conventional MRI’s and ultrasound scanning. Both these imaging tests present problems that limit their effectiveness in accurately diagnosing pseudotumors.  Conventional MRI’s often obscure soft tissue,  making a proper diagnosis by MRI difficult. Diagnosis by ultrasound scanning depends heavily on the interpretation of the doctor reading it, meaning that a pseudotumor can go undiagnosed if the scan is read incorrectly. The MARS MRI provides a solution to these problems.

A MARS MRI’s capacity to produce high resolution images provides an enhanced visualization of the soft tissues surrounding metal-on-metal hip implants. The technology used results in far less image distortion compared to other testing methods. This makes the MARS MRI the most accurate test to detect the formation of a pseudotumor. While a MARS MRI cannot prevent the development of a hip pseudotumor, it can help with early diagnosis and intervention. Knowing that metal on metal hip implants can cause pseudotumors, MARS MRI’s promote  better monitoring and represent an important diagnostic tool for patients implanted with these devices.  With a more exact image of the tissue around the hip implant, doctors can provide better advice to their patients about the need for a revision surgery.

Manufacturers of metal-on-metal hip implants ignored the serious risks and complications of pseudotumors caused by their defectively designed products. Our experienced lawyers fight for individuals who have been harmed by the negligence of the manufacturers of these dangerous devices. If you or a loved one has been injured or required revision surgery following a metal-on-metal hip implant or other defective hip device, the attorneys at the Yost Legal Group will investigate your potential claim and lawsuit. For a free consultation, please call us at 1-800-YOSTLAW.

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