Georgia Injury Lawyer Blog

This blog will continue in our series of providing our readers with answers to frequently asked questions in the context of a serious injury case. This blog will address FAQ number 6:

6. Can my spouse recover damages if I am seriously injured and he/she misses time from work caring for me?

Answer: A spouse does not have a legal claim for their own lost wages while they miss work caring for their injured spouse. However, under Georgia law, a spouse does have a claim for loss of consortium. Loss of consortium means the loss incurred by the innocent spouse when they are deprived of their injured spouse’s “society, affection and companionship.” This is not limited to the loss of conjugal services but includes the loss of all services provided to the spouse and the intangible value of the injured spouse’s contribution to their “affection, society, comfort and companionship.” Thus, while one cannot literally file a claim for the uninjured spouse based on that spouse’s lost wages, compensation can be obtained in a serious injury case for lost of consortium which can provide a measure of compensation for other losses.

This blog will continue in our series of providing our readers with answers to frequently asked questions in the context of a serious injury case. This blog will address FAQ number 5:

5. Who will pay my lost wages while I am recovering from my injuries?

Answer: In Georgia, there is no “Pay as You Go” rule so unfortunately the answer to this question is that you may receive no lost wages at all unless your employer continues to pay you and/or you have disability benefits. When you have reached maximum medical improvement and your case is ready for settlement, your total lost wages past, present and future, is an element of your damage claim. Assuming the at fault defendant has good insurance coverage that can pay all such damages, you will then receive restitution and/or compensation for your total lost wage claim assuming, of course, that the liability of the at fault defendant has been established for the damages and has sufficient coverage to provide restitution for this part of your loss.

Unfortunately, in far too many cases, in a situation where liability is clear, the at fault defendant does not have sufficient insurance coverage to pay past lost wages, future lost wages or any lost wages. Many times the medical expenses exceed the total value of insurance coverage in a serious injury context. Once again, the public is well advised to purchase uninsured motorist coverage which then can provide coverage for lost wages in the event the at fault driver has low limits.

It is often difficult for someone who has been injured and has no source of income to “get by” while they are recovering from their injuries. Medical bills are piling in and there is no income unless the injured individual is fortunate enough to have an understanding employer who continues to provide wage benefits and/or disability coverage. In many cases where wages are cut off and the injured individual cannot work due to their injuries, it is simply a very hard time for that client and his family because there is no “Pay as You Go” rule and because it does take some time to resolve a case by way of settlement even where there are good insurance policies applicable to a particular claim. Another complicating factor is where liability is debated and the at fault driver disputes liability. This can result in litigation which many times can take a year or longer to resolve thus depriving the injured individual of any immediate relief for the lost wage claim.

We recommend that all clients who can afford it review their own insurance policies to determine if they can afford disability coverage and/or uninsured motorist coverage under their policies. The least expensive form of insurance that one can purchase to provide for protection in a serious injury case involving an automobile is uninsured motorist coverage. This coverage will protect the policyholder to the limits of such coverage even if the at fault driver has minimum or low limits. Thus, if it is affordable, one is well advised to purchase uninsured coverage because such coverage can be used not only to provide compensation for medical expenses but also lost wages.

We have written previously about the dangers of police chase cases. This week we read in the paper about a chase that occurred on January 24 involving a man fleeing the police in a stolen vehicle. As he was fleeing, allegedly with a police officer in pursuit, the suspect in the stolen vehicle engaged in increasingly dangerous behavior. Ultimately, he collided head-on with another innocent motorist, killing that motorist and decapitating a female passenger in his car. According to the news accounts, the deceased were ages 21 and 26 respectively. Yet another victim was hospitalized along with the stolen car’s driver.

This case is a classic example of why police chase cases should be limited to those involving forcible felonies. Why was it necessary to chase a suspect in a stolen car and endanger the lives of the public? In this case, two people were killed and two others seriously injured all because of the police’s intent to apprehend a suspect for a stolen vehicle. While little information is provided in the news account concerning the type of vehicle involved, our firm is currently investigating another case where three people died while the police were trying to capture a suspect driving a vehicle with a value of less than $5,000.00. Thus, we have a situation where the police are trying to arrest a suspect for stealing a $5,000.00 automobile and in the process kill three people. In the case reported in the newspaper, two people were killed because the police again were trying to apprehend a suspect in a stolen vehicle.

The continued carnage and unnecessary loss of life caused by these police chases needs to stop. Police departments should change their policies to allow chases only for violent felonies. There is no reason to endanger the public when trying to apprehend a suspect for a non-violent felony. If the suspect does not pull over and takes off, the police should let him go rather than killing the innocent members of the motoring public as happened here not to mention the passenger. The passenger may have been screaming at the top of her lungs for the suspect driver to pull over but she was killed too even though she may have done nothing wrong whatsoever. Was her life worth it?

In these cases, the death penalty is imposed on innocent members of the motoring public by dangerous pursuit policies which allow police officers to chase for non-violent offenses such as auto theft. It simply is not important enough to catch an auto thief to impose the death penalty on the very public the police are trying to protect. These chases should stop and they should stop now. Our firm will continue to resist these policies and practices by representing those who are the innocent victims of these dangerous high speed police chase cases.

We read in the newspaper this week about the death of a maintenance man at a local school system when he was electrocuted while trying to change a fixture at the elementary school. While the newspaper article did not provide many details, it was curious to us that a maintenance man would be killed while simply trying to change out a light fixture. This raises the obvious issue of whether there is third party negligence because the electrical system obviously had some problems within it, presumably hidden from the worker. In any event, this sad and tragic case is reminiscent of other cases we have handled in the past involving electrocutions.

Over the years, we have handled wrongful death and other serious injury cases arising from electrocutions. In the cases we have handled, the person being electrocuted is almost always a worker who is performing some task. Typically, the worker is unaware of the danger to himself while performing the work. If the worker survives, electrocution injuries can be very serious and have long term consequences. Typically, anyone electrocuted while on the job unfortunately dies because electrocution almost by definition is usually a fatal event.

While the facts have not yet been reported as to the reasons behind this death, in order to prevent similar incidents from occurring, it is necessary that both OSHA and state officials conduct a thorough investigation of the underlying facts. There is no doubt but there was a root cause of this tragedy which must be determined so that lessons can be learned and future similar cases avoided.

This blog will continue in our series of providing our readers with answers to frequently asked questions in the context of a serious injury case. This blog will address FAQ number 3:

3. If a client settles his or her personal injury claim against an at fault defendant, will they have to repay their own insurance carrier under current subrogation provisions of the law?

Answer: This question often comes up in the context of serious injury cases where the injured individual has incurred substantial medical expenses. If the injured individual is covered by a self-funded ERISA plan, federal law requires that reimbursement be tendered to the self-funded health insurance plan from that portion of the settlement which constitutes reimbursement for the same expenses. This is what the doctrine of subrogation means, that being that the insurance company is subrogated against the rights of the injured individual to recover monies it had to pay as a result of the negligence of the third party. If the third party pays the medical expense money to the injured individual, the health insurance company is subrogated and therefore has a right to recover those expenses back from the at fault party since the at fault party caused those expenses to be incurred. In the context of a case where the injured individual only has insurance through a ERISA self funded plan, the bad news for injured individuals is that they may very well have to repay the healthcare plan with monies recovered from their settlements.

In cases where a healthcare plan is insured, that being the plan is not fully self funded by the employer and/or the employee contributes to the premiums or the employer’s insurance company is not completely self funded, it is an entirely different matter. Georgia follows the “made whole” doctrine which means that unless the claimant is first “made whole” for all of his or her damages, there is no right of subrogation. Because all serious injury cases are factually specific, as is the analysis of arcane ERISA documents and other federally insured plans for federal employees, it is necessary that each case be addressed on a case by case basis. As a general proposition, our firm always endeavors to provide all funds recovered from a settlement directly to the client. Whether we are successful in defeating claims for subrogation, however, is dependent upon the facts. As the old saying goes, a lawyer can’t make the facts, the best lawyer can do is work with the facts involved. Thus, this frequently asked question can only be answered on a case by case basis which obviously requires advice from an attorney experienced in these matters.

The Ortho Evra contraceptive patch has been used by many young women who unfortunately have developed clot related injuries. Some users have had strokes, heart attacks, pulmonary embolisms or deep vein thrombosis as a result of using this product. This past week, the Food and Drug Administration announced a significant update to the manufacturer’s warning on the contraceptive patch. The label now warns users of the patch that they are at a significantly higher risk of developing clot related injuries than other women who use traditional birth control pills. This label change came as a result of a study conducted on behalf of Johnson & Johnson.

Users of this product who have been injured by it should consult with counsel concerning their rights. Litigation has spawned over the country concerning unsuspecting users who have developed clot related injuries. Given the new warnings, which were based on studies documenting these injuries, those who have experienced problems while using this patch should consult with counsel immediately about their legal rights and remedies.

This continues in our series of providing our readers with answers to frequently asked questions in the context of a serious injury case. This blog will address FAQ number 2:

2. Who will bear responsibility for my future medical expenses if I settle my serious injury case today?

Answer: Anytime a serious injury case is settled, there has to be an evaluation of future medical expenses. Has the injured individual recovered completely from their injuries? Are future medical expenses likely? If future medical expenses are likely they need to be considered when the issue of settlement is addressed. In short, a settlement is a once and for all payment meaning that no more monies will be paid in the future. Thus, if future medical expenses are anticipated, they have to be provided for today and then the funds set aside for those future anticipated expenses.

The problem, of course, in any serious injury case is whether available insurance proceeds are sufficient to compensate for the total value of the claim. If someone is seriously injured and the at fault driver has little or no available insurance coverage, then the question is whether the at fault driver is personally wealthy enough to sufficiently compensate the injured individual. Typically, if someone has minimum or low insurance limits it is usually because they cannot afford much greater coverage. Therefore, in a serious injury case involving minimum or low insurance limits, there is very little money available to compensate the injured individual for their present expenses, much less future expenses. In those cases, however, when a commercial entity is involved and a commercial insurance policy is available, such as a tractor-trailer case, then in those cases, it is necessary that experienced counsel consider not only current medical expenses but also the future medical needs of the client.

In the appropriate case, a structured settlement in available as a tool to provide long term medical expense coverage for the injured individual. If it is anticipated, for example, that the injured client may need future surgeries over the next 5 to 10 years, an annuity can be purchased today that will provide such coverage in the future. The annuity costs will have to be paid out of current settlement proceeds but that can be done in a tax free manner which will then set aside the funds for the long term medical care.

The answer to the question, of course, depends upon whether the at fault individual has sufficient means to address the client’s future medical needs. If there are sufficient resources available, either by way of insurance or otherwise, then experienced counsel can make allowances for the future medical costs to be incurred and can set aside funds to address those needs. Such provisions can be made through the purchase of tax free annuities. All of this dependent on the central question being whether there are sufficient available funds to address the serious needs of the client past, present or future.

We have previously written about the dangers of medication errors in hospitals. Recently another incident made the news because a celebrity was involved. Actor Dennis Quaid’s newborn twins and another child were put in serious danger when they were administered overdoses of a blood thinner. The California Department of Public Health said the Cedars-Sinai Medical Center gave the newborns 1,000 times the intended dosage of heparin. Fortunately, all three children recovered, but two needed a drug that reverses the effects of heparin.

The authorities said the "violations caused, or were likely to cause, serious injury or death to the patients who received the wrong medication," and they faulted the hospital for its "deficient practices" around administrating the drug.

The regulators' found that the hospital did not adequately educate staff about safe use of heparin, which it described as a "high alert, high risk" blood thinner, and that nurses sometimes failed to adequately read labels on vials of the drug.

The hospital has apologized to the patients' families and said it made changes to prevent a recurrence, including providing more training and requiring four pharmacy workers to verify a high-alert medication before putting it in a patient care unit.

Quaid and his wife, have sued Baxter Healthcare Corp., the makers of heparin, accusing the firm of negligence in packaging different doses of the product in similar vials with blue backgrounds.
A similar dosage error killed three premature infants at an Indianapolis hospital in 2006. Three others survived overdoses.

Our attorneys are increasingly reviewing cases where major surgical procedures are being performed at small physician-owned hospitals and surgical centers.

On January 10, 2008, the Washington Post revealed that the Department of Health and Human Services, Office of Inspector General, had issued a report concerning physician-owned specialty hospitals. The report concluded that most physician-owned speciality hospitals are poorly equipped to handle medical emergencies.

The report revealed that only 55% of the 109 physician-owned hospitals studied had emergency departments, and of those, the majority had only one bed. Fewer than a third of the hospitals had physicians on site at all times and 34% relied on dialing 911 to summon emergency medical assistance for patients who developed problems. Moreover, 7% of the hospitals failed to meet Medicare requirements that a registered nurse be on duty at all times and that at least one physician be on call or in the hospital.

Federal Medicare and Medicaid requirements do not require participating hospitals to have emergency departments, but do require they keep written policies for handling emergencies. They also cannot rely on summoning 911 services as a substitute for their own requirements of emergency care.

The issues concerning emergency care in physician-owned hospitals has been in the news recently. Last year, it was reported that a 44 year old truck driver went into respiratory arrest following elective surgery at a West Texas Hospital. The only recourse for the staff of the hospital was to call 911, which was done. But, by the time the man arrived at a larger hospital he was pronounced dead. Similarly, in 2005, it was reported that an 88 year old woman in recovery after elective back surgery suffered a heart attack after an injection of pain medication. Since no doctor was at the hospital, the nurses were forced to call 911. The lady was taken to a community hospital where she died later.

Our medical malpractice attorneys are frequently forced to decline cases which have merit from a liability standpoint, but due to caps on the amount of recovery cannot be justified in economic terms.

Last week, the Los Angeles Times ran a story concerning a 72 year old woman who entered Stanford University Medical Center for double knee replacement surgery in April. Four days later, she was dead. Her son, an anesthesiologist, felt that the case was a classic case of medical malpractice. After the operation, his mother developed sharp abdominal pain which she described as a 10 on a scale of 1 to 10. The hospital failed to diagnose the cause of her pain and continued to treat her with pain relievers. Her vital signs became unstable and she was moved to an intensive care unit, but she died of complications from an undiagnosed and untreated bowel obstruction.

According to the story, state regulators found the hospital at fault and cited it. The anesthesiologist and his family decided to sue and approached 24 lawyers. All the lawyers declined to take the case for the same reason - the medical malpractice caps on the amount of recovery didn’t justify the expenses.

California law limits pain and suffering awards in medical malpractice cases to $250,000. Unless there is a large economic loss, the cost of bringing these types of lawsuits can exceed the limit of recovery. Similarly, Georgia’s $350,000 cap prevents many lawyers from taking cases involving elderly people, unemployed persons, and young people.

The anesthesiologist, who once was an advocate of so-called “tort reform” now opposes it. Almost 30 states have enacted similar legislation, and two Republican presidential candidates, Mitt Romney and Rudolph Guiliani have recently endorsed a national approach to limits on recoveries.

Several states have set their malpractice caps considerably higher because of worries that they unfairly affect poor patients the most. In fact, some states have begun to examine the fairness of these caps especially, those not tied to the cost of inflation. The elected officials in Georgia seem content to allow the caps to remain in place.

Serious injury lawyers like ourselves often hear clients involved in serious accidents tell us that they had “full coverage” at the time of the accident and that they therefore have “excellent” insurance protection. The vast majority of the time, this is not the case at all. This is because the term “full coverage” means that one has the coverage one is minimally required by law to possess. Full coverage does not mean adequate coverage nor does it mean excellent coverage. It means minimally required coverage required by law.

Here in Georgia, in order to operate an automobile, the driver must have a minimum of $25,000.00 in liability coverage protection for any one person, $50,000.00 per accident. What this means is that if someone runs a stop sign and seriously injuries another, he has “full coverage” if he has $25,000.00 in liability insurance coverage for an innocent third-party victim, $50,000.00 for all victims in a single accident. Anyone familiar with hospital and medical costs today knows that any serious injury can hardly be compensated for $25,000.00. Indeed, any serious injury usually involves medical bills far in excess of $25,000.00.

It is heartbreaking for our lawyers to see cases where the at fault driver has “full coverage” and our clients are indeed seriously injured, sometimes with amputations, permanent disabilities and death. In those cases involving death of a family member, $25,000.00 could never adequately compensate the survivors, much less address issues such as medical expenses, funeral bills, lost wages and the like. And yet, we hear over and over again from people inexperienced in this area that they have “full coverage” thereby deluding themselves into believing that they have adequate insurance coverage.

To truly have adequate insurance coverage, one needs to have excellent uninsured motorist coverage. The at fault driver may have “full coverage” that is the minimum amounts required by law, but to have excellent coverage one must protect themselves with uninsured/underinsured insurance coverage. If the at fault driver runs the stop sign and injuries you but only has the minimum coverage required by law ($25,000.00 per person, $50,000.00 per accident), you can protect yourself through the purchase of uninsured or underinsured motorist coverage in any amount desired. One can purchase $100,000.00, $500,000.00 or $5 million. In the case where the at fault driver causes serious injury or death, the higher “underinsured” limits will provide relief whereas the minimally required “full coverage” will provide virtually no relief at all.

We continue to urge all Georgia citizens to carefully review their automobile insurance policies. What protection do you have if you are seriously injured? If you do not have uninsured/underinsured insurance protection, you are at the mercy of the at fault driver. If he/she has “full coverage,” you are seriously injured, and you do not have uninsured/underinsured coverage under your own policy, you may be in more trouble than you know.

Our medical malpractice attorneys are many times forced to turn away cases against emergency rooms where the patient is injured by clear negligence. This is caused by the gross negligence standard for emergency departments adopted by the Legislature in 2005.

With the Georgia Legislature meeting this week, Senators from both sides of the aisle, Democrats and Republicans, have joined to co-sponsor Senate Bill No. 286. This bill is designed to amend the provision of the so-called Tort Reform Bill initially passed in 2005, which essentially gave emergency rooms immunity from law suits. As part of the February 2005 bill, patients alleging malpractice in emergency rooms must prove gross negligence. Gross negligence is most often characterized under Georgia law as a reckless disregard for the safety of a patient, and in many cases has been interpreted to mean intentional harm.

Georgia’s gross negligence standard is the harshest in the country. Supporting this amendment are not only Republican and Democratic Senators, but Mothers Against Drunk Driving (MADD). MADD Director, Denise Themes, has commented that victims of drunk driving accidents usually go directly to an emergency room for treatment. She points out that given the unique conditions in the statute, it’s nearly impossible for one of those victims to prove gross negligence after the fact.

A recent study by Harvard of more than 30,000 hospital records concluded that emergency rooms have more injuries caused by negligence than all other areas of the hospital combined. According to the Institute of Medicine, preventable medical errors kill as many as 98,000 Americans each year and seriously injure another one million. This makes medical errors the eighth leading cause of death in the United States, higher than deaths in automobile accidents, breast cancer and AIDS. This bill is a commendable bipartisan effort to correct a horrible injustice caused by the laws of Georgia.

Our firm is working on a police chase metro Atlanta case involving an officer who has been in two separate high speed pursuit cases resulting in two deaths. We have learned in this case that another officer in the same department has also been involved in two other accidents that have resulted in four deaths. Thus, between these two officers within the same police department there have been 4 high speed pursuit cases we know of involving six deaths. Is the public being protected when police officers engage in these high speed police chases? We think not.

An officer cannot fire his service revolver into a crowded mall in order to stop a shoplifter. Most people understand that it would be too dangerous for an officer to fire his weapon in a crowded mall to apprehend a suspect for such a minor offense. In short, the danger to the public would far outweigh the need to apprehend the suspect. And yet, in a police pursuit context, the police are firing their proverbial guns (engaging in chases) on crowded streets, sometimes in residential areas, sometimes at night and sometimes under circumstances where there are many innocent motorists on the road, and yet, even in those cases where the need to apprehend the suspect is far outweighed by the danger to the public, the chase proceeds. The question is why these practices continue to occur year after year in this country with no meaningful decrease in the carnage on the roads.

Regrettably, it appears that the deaths and injuries which do occur in these cases simply have not affected the right people. When the injured are the family of politicians, perhaps there will be a change in the law. If the next police chase victimizes a prominent politician’s family perhaps there will be an understanding of the dangers of these high speed pursuits. Until such time, the public will continue to be “entertained” by television shows depicting the excitement and adrenalin that one feels when viewing a high speed pursuit. We can assure the public that such adrenalin and excitement would not be felt if their loved one was killed as a result of a pursuit involving a minor offense such as shoplifting. Indeed, as of the writing of this blog, we are reviewing a case where a shoplifter was fleeing from a police officer and during that pursuit, two adults and a child were killed and another adult seriously injured. Was the price worth it? Again, we think not.

It appears that litigation is the best avenue currently available to decrease these unwise and unwarranted police practices. The police do not protect the public when they kill innocent members of the public they are sworn to protect. The police should not chase non-violent offenders. There are ways to capture these suspects through license tag registration information, radio traffic and other police practices. Even if we as a society have to let a shoplifter or traffic offender go, is this not the more prudent approach than to impose the death penalty on innocent third parties having nothing to do with the crime? If the reader says that he or she disagrees with this conclusion, then I would ask the reader to ask themselves why then should the police not fire their weapons in a crowded mall? The analysis is the same.

Our serious injury attorneys frequently see cases in which insurance companies refuse to pay valid claims and then turn on their insureds accusing them of fraud.

Last Tuesday, the Western Missouri Court of Appeals upheld a jury verdict of nearly $8.5 million against State Farm Mutual Automobile Insurance Company for breach of contract claims and malicious prosecution against a claim holder. The case originated in 1997 when Jennie Hampton reported that her vehicle had been stolen and filed a claim with her insurer, State Farm. Several days later, the car was found abandoned and burned.

State Farm allegedly investigated the claim and denied it on the grounds that Hampton had listed her engine as being in excellent condition when State Farm contended that the car had suffered an engine failure. The Company further alleged that Hampton and an acquaintance towed the car after the engine failure and burned the vehicle. State Farm took their claims to the district attorney’s office and allegedly pressured prosecutors there to file insurance fraud criminal charges against Hampton and the acquaintance.

The criminal charges were tried and Hampton and the acquaintance were acquitted.

In a 3 - 0 ruling, the Appellate Court affirmed the judgement against State Farm holding that State Farm not only improperly denied the claim but also pressured the prosecutors to file criminal charges against Hampton.

The consumer group, Public Citizen filed a lawsuit in the U.S. District Court for the District of Columbia, asking the court to force the Food and Drug Administration to act upon a petition the consumer group filed with the agency 16 months ago. According to the lawsuit, despite long-standing evidence that fluoroquinolone antibiotics can cause tendon ruptures, the FDA has failed to increase its warnings to patients and physicians about the dangers of the medicines.

The FDA failed to respond to the Public Citizen asked the agency to put a “black box” warning on fluoroquinolone antibiotics (such as Cipro, Levaquin and others) to make doctors and patients more aware of the risk of serious tendon injury before tendons actually rupture. The petition also urged the FDA to send a warning letter to physicians, as well as require an FDA-approved medication guide to be dispensed when prescriptions are filled. According to the lawsuit, the FDA is violating the Administrative Procedure Act by not acting upon the petition.

From November 1997 through December 2005, the FDA received 262 reports of tendon ruptures, mainly of the Achilles tendon, 258 cases of tendinitis and 274 cases of other tendon disorders in patients using fluoroquinolone antibiotics. An additional 74 tendon ruptures have subsequently been reported to the FDA for a total of 336. Because only a small fraction of cases are typically reported to the FDA, the actual number of ruptures and other tendon injuries attributable to the antibiotic is much higher.

In a study published yesterday in the New England Journal of Medicine, the authors concluded that in nearly one-third of cases of sudden cardiac arrest occurring in hospitals, the staff takes too long to respond, greatly increasing the risk of brain damage and death. The authors research indicates that these delays contribute to thousands of deaths a year in the United States alone.

The study was based on the records of 6,789 patients at 369 different hospitals whose hearts suffered from conditions that could be reversed by the use of an electronic defibrillator.

Experts say that the defibrillator shock should be administered to the patient within two minutes after the heart stops beating. But, the study found that it took longer in 30% of the cases. The results of the delays were striking. When the defibrillator was delayed, only 22.2% of patients survive long enough to be discharged from the hospital as opposed to 39.3% when the shock was administered properly.

The delays were found to be more likely in patients who suffered heart stoppages at night or on the weekends, or who were admitted for a non-cardiac illness in a hospital with fewer than 250 beds and in units without heart monitors.

The authors of the study surmised that the problem may be even more widespread than their study revealed. They pointed out that the hospitals which were part of the study have joined a national registry on cardiac arrest which means there have already adopted special efforts trying to meet guidelines involving the use of debibrillators. Thus, they feel that these hospitals actually performed better than the average hospital.

The authors estimated that 370,000 to 750,000 hospitalized patients have a cardiac arrest every year in the United States. They reported that in a third to one-half of the cases, the cardiac arrest is caused by an abnormal rhythm that can be corrected by a shock from a defibrillator.

The reasons for the delays were varied. Sometimes, especially at night and weekends, it was felt that not enough personnel were available in smaller hospitals. Also, in some hospitals, nurses other than those in intensive care units, were not allowed to use defibrillators. Another factor that the authors pointed out was that the traditional defibrillators used in hospitals require that a doctor or nurse look at the patient’s heartbeat, verify that the problem is correctable by the defibrillator, adjust the machine and deliver the shock. In contrast, the automatic defibrillators that have come into use in public places are meant to be used by laymen. They can be connected to the chest of someone who has collapsed, the machine will sense electro activity in the heart and deliver a shock only if it is needed. These devices are designed to be almost foolproof, but so far they have not been used widely in hospitals.

One expert in the field commented that some patients would be better off having a cardiac event in a shopping mall than in a hospital.

A few months ago there was a large amount of news coverage regarding the death of a woman from eating contaminated oysters at an Atlanta restaurant. Now, the Georgia Department of Agriculture is alerting consumers that norovirus has been found in some raw oysters harvested in Louisiana. Georgia Agriculture Commissioner Irvin announced that raw oysters harvested from the West Karako Bay Section of Growing Area 3 in Louisiana from Dec. 3 through Dec. 21 may possibly be contaminated with norovirus. Inspectors are looking for these oysters in Georgia retail and wholesale facilities.

The FDA has received reports of norovirus infection in seven people who ate raw oysters on Dec. 13 at a restaurant in Chattanooga, Tenn. The Tennessee Department of Health's test results from two of the ill patients were positive for norovirus. The FDA confirmed the presence of norovirus in shell oysters harvested from the West Karako Bay section of Growing Area 3 and served at the Tenn. restaurant.

The Louisiana Department of Health and Hospitals closed the affected growing area on Dec. 21. The FDA is working with the states involved to determine if any additional actions may be necessary to ensure public health protection.

The original shipper of the oysters is Prestige Oyster Company of Theriot, La. The company shipped the oysters to Bon Secour Fisheries in Bon Secour, Ala. Bon Secour Fisheries, in turn, shipped the oysters to the restaurant in Chattanooga. It is possible that oysters from the designated area are still available in other retail and food service settings.

Symptoms of norovirus infection include nausea, vomiting, diarrhea and stomach cramping. Affected individuals often experience low-grade fever, chills, headache, muscle aches, and a general sense of tiredness. Most people show symptoms within 48 hours of exposure to the virus, with the illness lasting one to two days. However, the illness can become serious for the very young, the elderly and people with weakened immune systems.

Persons with weakened immune systems, including those affected by AIDS, and persons with chronic alcohol abuse, liver, stomach or blood disorders, cancer, diabetes or kidney disease should avoid raw oyster consumption altogether, regardless of where the oysters are harvested.

The Food and Drug Administration has issued a warning about fentanyl pain patches. The fentanyl skin patch contains fentanyl, a potent narcotic. The skin patch was approved by FDA in 1990 for use in patients with persistent, moderate-to-severe pain who have become opioid tolerant – meaning that they have been using another strong opioid narcotic pain medicine around-the-clock, and have been using the medicine regularly for a week or longer. The skin patch is most commonly prescribed for patients with cancer.

The FDA has continued to receive reports of deaths and life-threatening side effects after doctors have inappropriately prescribed the patch or patients have incorrectly used it.

In addition, the agency is asking manufacturers of all fentanyl patches to update their product information and to develop a medication guide for patients.

The FDA has received recent reports describing deaths and life-threatening side effects after doctors and other health care professionals inappropriately prescribed the patch to relieve pain after surgery, for headaches, or for occasional or mild pain in patients who were not opioid tolerant. In other cases, patients used the patch incorrectly: The patients replaced it more frequently than directed in the instructions, applied more patches than prescribed, or applied heat to the patch – all resulting in dangerously high fentanyl levels in the blood.