On May 3, 2012, Edwards & Ragatz, P.A. hosted its 3^rd annual Law Day in May Celebration. The social/fundraiser for Jacksonville Area Legal Aid was held at EverBank Plaza Lobby and Veranda, 501 Riverside Avenue, Jacksonville, FL 32202 from 5:30 p.m. to 8:30 p.m.

“Our Law Day in May event has a dual purpose – as a social event for everyone in the legal community, and more importantly, as a fundraiser for Jacksonville Area Legal Aid. We chose JALA because it is an organization that does outstanding work for our local community. Law Day is a time when we are supposed to reflect on the role of the justice system and its importance to our society. What better way to recognize that commitment than to give back to an organization that helps those who need access to justice the most,” Said firm partner, Eric Ragatz.

The event  featured an open bar, Bold City Brewery beer, a delicious arrangement of  heavy hors d’oeuvres by Tom & Betty’s and live music performed by Ron Rodriguez. Guests were asked to bring a $25 donation to Jacksonville Area Legal Aid. 100% of the money raised went straight to JALA.

This year’s Law Day theme is “No Courts, No Justice, No Freedom.”  When asked to explain what this year’s theme meant to her, attorney Lindsay Tygart said, “Simply put, this year’s theme is designed to celebrate the importance of our judicial system and raise awareness regarding court funding shortages that, unfortunately, are occurring all across the country. “

Law Day is an annual event, which was originally conceived in 1957 when American Bar Association President Charles Rhynes envisioned a special national day to mark our commitment to the rule of law.  The following year, President Dwight D. Eisenhower established the first Law Day.  Law Day was made official in 1961 when Congress issued a joint resolution designating May 1 as the official date for celebrating Law Day.  You can read the 2012 Law Day Proclaimation here..

View Pictures from The Jax Daily Record

4 Stages of a Bed Sore
The definitions of the four pressure ulcer stages are revised periodically by the National Pressure Ulcer Advisory Panel (NPUAP) in the United States.

Normal Skin	Deep Tissue Injury	Stage 1	Stage 2
Stage 3	Stage 4	Unstageable

• Stage I is the most superficial, indicated by non blanchable redness that does not subside after pressure is relieved. The skin may be hotter or cooler than normal, have an odd texture, or perhaps be painful to the patient. Although easy to identify on a light-skinned patient, ulcers on darker-skinned individuals may show up as shades of purple or blue in comparison to lighter skin tones.
• Stage II is damage to the epidermis extending into, but no deeper than, the dermis. In this stage, the ulcer may be referred to as a blister or abrasion.
• Stage III involves the full thickness of the skin and may extend into the subcutaneous tissue layer. This layer has a relatively poor blood supply and can be difficult to heal. At this stage, there may be undermining damage that makes the wound much larger than it may seem on the surface
• Stage IV is the deepest, extending into the muscle, tendon or even bone. 
• Unstageable pressure ulcers are covered with dead cells, or eschar and wound exudate,such that the depth cannot be determined.
• Suspected Deep Tissue Injury  Purple or maroon localized area of discolored intact skin or blood-filled blister due to damage of underlying soft tissue from pressure and/or shear. The area may be preceded by tissue that is painful, firm, mushy, boggy, warmer or cooler as compared to adjacent tissue.
   

 Treatment
According to the Mayo Clinic, the first step in treating a sore at any stage is relieving the pressure that caused it.  A person with pressure sores needs to be repositioned regularly and placed in correct positions. People using a wheelchair should change position as much as possible on their own every 15 minutes and should have assistance with changes in position every hour. People confined to a bed should change positions every two hours.  Special cushions, pads, mattresses and beds can help a person lie or sit in an appropriate position, relieve pressure on an existing sore and protect vulnerable skin from damage. A healthy diet and proper hydration are also crucial to wound healing.

Sometimes for wounds to heal properly, it needs to be free of damaged, dead or infected tissue. There are several ways to remove these tissues called debridement:

• Surgical debridement involves cutting away dead tissues.
• Mechanical debridement uses one of a number of methods to loosen and remove wound debris, such as a pressurized irrigation device, a whirlpool water bath or specialized dressings.
• Autolytic debridement, the body’s natural process of recruiting enzymes to break down dead tissue, can be enhanced with an appropriate dressing that keeps the wound moist and clean.
• Enzymatic debridement is the use of chemical enzymes and appropriate dressings to break down dead tissues.

In order to promote healing, the wound must also be cleaned and dressed. It’s essential to keep wounds clean to prevent infection. A stage I wound can be gently washed with water and mild soap, but open sores are cleaned with a saltwater (saline) solution each time the dressing is changed. A dressing promotes healing by keeping a wound moist, creating a barrier against infection and keeping the surrounding skin dry. A variety of dressings are available, including films, gauzes, gels, foams and various treated coverings. Pressure sores that fail to heal may require surgical intervention. The goals of surgery include improving the hygiene and appearance of the sore, preventing or treating infection, reducing fluid loss through the wound, and lowering the risk of cancer. In general, most pressure wounds are repaired using a pad of the person’s own muscle, skin or other tissue to cover the wound and cushion the affected bone (flap reconstruction).

Bed sores can also be extremely painful and the processes of debridement, cleaning and dressing the wound can further add to the pain level for the patient. The use of nonsteroidal anti-inflammatory drugs — such as ibuprofen (Motrin, Advil, others) and naproxen (Aleve, others) as well as topical pain medications, such as a combination of lidocaine and prilocaine, can help the patient deal with the pain.  Pressure sores that are infected and don’t respond to other interventions may be treated with topical or oral antibiotics.

What should you do if a loved one develops a Bed sore?

Bedsores are not a minor skin irritation- as they can result in lasting injury, and even death. The Centers for Medicare & Medicaid Services (CMS) has defined pressure ulcers (bed sores) as “never events” – errors in medical care that are clearly identifiable, preventable and serious in their consequences for patients. The occurrence of “never events” indicates there is a problem in the safety and credibility of a health care facility.  Additionally, dehydration and malnutrition do not just happen without someone acting in a negligent way.  It is important to protect the ones you love. Medical providers have a responsibility to provide basic levels of care as defined by the law and individual facilities’ policies and procedures. Do not hesitate to contact us if you suspect a loved one is the victim of nursing home abuse or medical malpractice. We will get to work immediately and investigate your claim. If negligence is found and evidence of abuse or malpractice exists, we will ensure that the facility is held responsible and your loved one is protected.  Contact one of our attorneys today for a free consultation.

Sources: http://www.npuap.org/resources.htm
http://www.mayoclinic.com/health/bedsores/DS00570
http://www.cms.gov/

Jacksonville Jury finds HCA-Memorial Negligent, Fraudulent- Awards Family $178 MILLION

A lawsuit conducted in Duval County Circuit Court against Memorial Hospital concluded today when the jury awarded Clay Chandler and his family $ 10 Million in punitive damages. This amount is in addition to the $168 million in liability this jury awarded last Friday. In addition to the compensation awarded, the jury found that Memorial Hospital committed medical negligence and fraud in the Chandler case. This verdict is one of the largest seen in Northeast Florida and the charge of fraud is a rare occurrence in a civil case.

Clay Chandler, a former Lieutenant in the Clay County Sheriff’s Office, was a patient at Memorial Hospital between March and May 2007. He was admitted to Memorial Hospital to undergo laparoscopic gastric bypass surgery under the care of Dr. John Deperi. Complications arising from the surgery were severe and went undiagnosed or treated in a timely manner causing Chandler to go into cardiac arrest and septic shock. He ultimately suffered a hypoxic brain injury and was in a coma from March 17, 2007 through approximately April 4, 2007. While Chandler was in ICU in a comatose state, physician orders directed health care personnel to apply two drops to both eyes every 8 hours for three days. Hospital records indicate that only two applications of drops to his eyes were performed. During that period Chandler’s eyes were described as being red with drainage and edema, and he suffered permanent damage to both corneas. While a patient in Memorial’s critical care unit, he also suffered contractures (frozen joints) and bedsores – all due to a lack of basic human care and absolutely below the standard of care for which hospitals are universally responsible.

“This case was about honesty and safety rules and a hospital corporation that ignored them,” said Chandler’s attorney Tom Edwards, of the Jacksonville trial law firm Edwards & Ragatz. “The evidence presented to the jury showed that HCA – Memorial Hospital deceived the public and the Chandlers about their bariatric program that they call the Memorial Bariatric Surgery Center. They obtained a prestigious national certification called the “Bariatric Center of Excellence” but evidence showed they then did not follow the basic patient safety standards that were a part of this program – including letting a surgeon do these very complex surgeries unsupervised when his file showed he was not qualified to do the surgery. Because of the failure to follow basic safety standards, Clay is brain damaged, permanently disabled and needs full time care for the rest of his life.”

“The Chandlers are pleased that this Jury found that HCA/Memorial Hospital should be responsible for Clay’s care and not the tax payers and health insurers of the state of Florida,” said Edward’s law partner Eric Ragatz.

Memorial Hospital of Jacksonville is part of HCA, the nation’s leading provider of healthcare services that includes 164 hospitals and 11 freestanding surgery centers in 20 states and England. HCA revenues in 2010 were more than $30 billion.

Previous Coverage
Motion for Punitive Damages
Original Suit- February 2010

Media Coverage
Jacksonville.com
First Coast News
Action News Jax
News4Jax
WOKV
ADR.com
Clay Today
MSNBC
Tennessean
Wall Street Journal
AAJ News Brief 1/24/12
Fox Business
Nashville Business Journal
Lawyers.com
Jacksonville Business Journal
Lawyers USA
RBRlaw.com
Patrick Malone & Associates via JD Supra

LEGALPR PRESS RELEASE
Contact: Doug Perkins: doug@legalpr.net
800-704-9033 or 904-838-7801

 Claudia Oltean: claudia@legalpr.net
800-704-9033 or 904-838-7807

• An estimated 13.5 percent of hospitalized Medicare beneficiaries experienced adverse events during their hospital stays
• An additional 13.5 percent of Medicare beneficiaries experienced events during their hospital stays that resulted in temporary harm.
• Physician reviewers determined that 44 percent of adverse and temporary harm events were clearly or likely preventable.

See link below to read the rest of the report:

Levinson, DR.  Adverse Events in Hospitals:  National Incidence Among Medicare Beneficiaries.  Nov. 2010  OEI-06-09-00090 

If you believe you or a loved one are a victim of medical negligence please don’t hesitate to contact one of our attorneys today for a free case evaluation.

Lechner has served on the JJA Executive Board for the past two years. This year he received an AV rating from Martindale- Hubbell, the highest rating available by the national attorney peer-review rating service and became a Board Certified Trial attorney, meaning the Florida Bar recognizes him as an expert in his field of law.

The Jacksonville Justice Association (JJA) is a non-profit organization of civil justice attorneys that represent those injured by negligence or malpractice. It was established in 1996 with the goal of providing civil justice attorneys with the tools and resources needed to improve and enhance their trial practices.  Members benefit from quarterly networking meetings, continuing legal education seminars and an extensive deposition and legal document databank.

 Edwards & Ragatz, P.A., is a law firm located inJacksonville,Florida, that represents the injured, victims and consumers in all courts. The firm’s attorneys are experienced in handling all types of personal injury and death cases, as well as complex commercial litigation. The firm’s attorneys are recognized nationally as trial experts. The attorneys serve in prominent positions in local and state trial lawyers’ associations and have testified before the legislature on issues of importance to the justice system.

Best Lawyers

Edwards was the ABOTA- “Jacksonville Trial Lawyer of the Year” in 2009. ABOTA is a selective peer organization of both plaintiff and defense trial lawyers. Edwards has served as President of the Jacksonville Bar Association, President of the Florida Justice Association, President of ABOTA Jacksonville and numerous other organizations- including the area grievance committee which is responsible for prosecuting attorneys accused of ethics violations. He also served on numerous committees appointed by our Supreme Court, including the committee that drafted the Judge’s code of ethics and the committee that writes the jury instructions for trial. 

Best Lawyers compiles its lists of outstanding attorneys by conducting exhaustive peer-review surveys in which thousands of leading lawyers confidentially evaluate their professional peers. The current, 18th edition of The Best Lawyers in America (2012) is based on more than 3.9 million detailed evaluations of lawyers by other lawyers.

The lawyers being honored as “Lawyers of the Year” have received particularly high ratings in our surveys by earning a high level of respect among their peers for their abilities, professionalism, and integrity.

Steven Naifeh, President of Best Lawyers, says, “We continue to believe – as we have believed for more than 25 years – that recognition by one’s peers is the most meaningful form of praise in the legal profession. We would like to congratulate Thomas S. Edwards, Jr. on being selected as the ‘Jacksonville Best Lawyers Medical Malpractice Law Lawyer of the Year’ for 2012.”

Edwards & Ragatz, P.A., is a law firm located in Jacksonville, Florida, that represents the injured, victims and consumers in all courts. The firm’s attorneys are experienced in handling all types of personal injury and death cases, as well as complex commercial litigation. The firm’s attorneys are recognized nationally as trial experts. The attorneys serve in prominent positions in local and state trial lawyers’ associations and have testified before the legislature on issues of importance to the justice system.

Selection to Best Lawyers is based on an extensive and rigorous peer-review survey, comprising of more than 3.9 million confidential evaluations by fellow top attorneys.

 Edwards is the senior partner of Edwards & Ragatz, P.A. His other accomplishments include being a Board Certified Civil Trial Lawyer, rated AV by Martindale Hubbell, awarded the “Spartans at Thermopylae” award for extraordinary work in protecting the court system, and membership in Florida Trend Magazine’s Legal Elite and Florida’s Super Lawyers.

 Best Lawyers is the oldest and most respected peer-review publication in the legal profession. Best Lawyers compiles lists of outstanding attorneys by conducting exhaustive peer-review surveys in which thousands of leading lawyers confidentially evaluate their professional peers. In the U.S., Best Lawyers publishes an annual referral guide, The Best Lawyers in America, which includes 41,149 attorneys in 126 practice areas, covering all 50 states and the District of Columbia. The current, 17th edition of The Best Lawyers in America (2011), is based on more than 3.1 million detailed evaluations of lawyers by other lawyers.

CDC Supports National Initiative to Improve Patient Safety

On Tuesday, April 12, Health and Human Services Secretary Kathleen Sebelius announced an initiative, the Partnership for Patients: Better Care, Lower Costs, aimed at protecting patients in America’s health care facilities through the prevention of health care-acquired conditions. CDC is one of several federal agencies participating in the initiative. Medical advances have brought lifesaving care to patients in need, but many of these advances come with a risk of health care-acquired conditions, including infections, falls, pressure ulcers (or bed sores), and blood clots (known as deep vein thrombosis).

“Americans expect and deserve safe health care,” said CDC director Thomas R. Frieden, M.D., M.P.H. who has made patient safety a top priority at CDC. “CDC has an established track record of improving the quality of health care delivery. This new initiative will help protect patients and ensure that they live healthier, longer, and more productive lives while reducing healthcare costs.”

Health care-acquired conditions represent a significant burden on the health care system. At any given time, about 1 in 20 patients has an infection related to hospital care. These infections cost the U.S. health care system billions of dollars each year and lead to the loss of tens of thousands of lives.

In hospitals and other health care facilities, falls are among the most frequently reported incidents for inpatients. Pressure ulcers, which can occur in health care settings or at home, affect more than 2.5 million people annually. In total, health care-acquired conditions can have devastating emotional, financial, and medical consequences.

Public health officials and clinicians know how to prevent many health care-acquired conditions. However, the problem has been in getting proven protective measures adopted and used consistently in all health care facilities. CDC works with federal, state and local public health and healthcare partners to prevent these conditions.

• CDC conducts rapid field investigations to address emerging health care safety issues.
• CDC conducts cutting-edge infection prevention research, turning that knowledge into evidence-based guidelines that health care providers can use.
  • Several published studies have shown that health care-associated infections (HAIs) can be decreased as much as 70 percent when existing CDC prevention recommendations are put into place. [See top CDC prevention recommendations]
• CDC has funded 51 locally based HAI coordinators and has supported 30 state-based HAI prevention networks to drive progress toward goals in the HHS Action Plan to Eliminate Healthcare-associated Infections.
• CDC is working with patient and professional organizations to raise awareness and promote the implementation of current clinical guidelines for the prevention of deep vein thrombosis. CDC has been actively working to prevent deep vein thrombosis by collecting statewide registry data and tracking the quality of hospitalized stroke patients for the past decade through the Paul Coverdell National Acute Stroke Registry.
• CDC has developed a fall risk assessment tool for practitioners that can be used in clinical settings, because the most effective single approach for fall prevention is an individualized risk factor assessment by a physician or health care provider coupled with referral and treatment.

Tracking progress toward prevention is key to achieving success in improving patient safety. CDC provides the nation’s health care facilities with a free system to track infections, monitor prevention progress, and collaborate with peers. The system, called the National Healthcare Safety Network (NHSN), is used in over 4500 U.S. hospitals and is part of the Centers for Medicare and Medicaid Services pay-for-reporting program. CDC is enhancing NHSN to track the occurrence of deep vein thrombosis and the implementation and impact of prevention measures in participating hospitals. CDC also is beginning work with the acute care community to provide guidance for tracking and preventing pressure ulcers in high-risk injured patients.

Together, public and private partners can expand upon the successes seen in individual healthcare facilities and employ these best practices nationwide to protect all Americans and ensure safe healthcare.

For more information about the Partnership for Patients, visit http://www.HealthCare.gov/center/programs/partnership.

For more information about preventing healthcare-associated infections (www.cdc.gov/hai), falls (http://www.cdc.gov/HomeandRecreationalSafety/Falls/), pressure ulcers, or blood clots (http://www.cdc.gov/ncbddd/dvt/), please see the CDC resources provided.

Source of Media Release: http://www.cdc.gov/media/releases/2011/s0415_patientsafety.html