Maryland Accident Law Blog

Outsourcing of Radiology Raises Concerns About Quality of Care

November 3, 2011 | Lebowitz & Mzhen

The word “x-ray” may still conjure images of doctors standing before backlit panels reviewing transparent x-ray scans and arguing over diagnoses. This bears little resemblance to the reality of modern x-rays. In a practice known as teleradiology, doctors and hospitals outsource x-rays and similar procedures to companies who may be located on the other side of town or the other side of the world. Doctors and technicians employed by these companies review the x-rays and issue a report. This practice, while perhaps increasing efficiency, also increases risks of misdiagnosis or even simple miscommunication, with potentially serious consequences.

A recent article published by MSNBC tells the story of a Pennsylvania woman who went to the hospital on a Friday night in 2005 complaining of a severe headache. The emergency room doctor thought it might be a cerebral hemorrhage, a potentially fatal condition, so he ordered a CT scan. The hospital electronically sent the CT scan data to a radiologist located across the state. The radiologist diagnosed a possible tumor rather than a hemorrhage. Since a tumor was not immediately life-threatening, the hospital sent her home with painkillers.

The woman returned to the hospital by ambulance about seven hours later, in even worse pain. The ER doctor ordered a more detailed CT scan, which was sent to a different radiologist. While the radiologist had a Pennsylvania medical license, his office was in Hong Kong. The radiologist identified an abscess around the mass in the woman’s brain, a condition that is very frequently fatal if not caught in time. The radiologist did not note the significance of his finding, i.e. its likelihood to be fatal, in his report to the hospital. Another radiologist at the Pennsylvania company also noted the abscess but did not report its significance.

The woman went home again, and later collapsed when the abscess ruptured. She spent eleven weeks in a coma while doctors tried to drain the fluids from her brain. She survived with permanent brain damage affecting memory and daily functions. The hospital settled a lawsuit with her family for a confidential amount.

Reliability of Federal Product Safety Database Questioned in Lawsuit

October 27, 2011 | Lebowitz & Mzhen

A lawsuit filed by an anonymous “Company Doe” seeks to block “baseless allegations” on a new website that allows consumers to post information on hazardous products. The website, SaferProducts.gov, represents an effort to “crowdsource” reporting of dangerous and defective products in the marketplace. The Consumer Products Safety Commission (CPSC) created the site and lunched it about six months ago. The lawsuit brings to light concerns raised by business groups that the website creates the potential for consumers to defame companies by posting false, misleading, or inaccurate information. One side of this dispute involves the right of manufacturers to do business without false disparagement. On the other side is the public’s interest in freely available information on hazardous products.

The CPSC is an independent agency of the federal government with a mandate to protect the public “against unreasonable risks of injuries associated with consumer products.” It regulates over 15,000 different consumer products by investigating claims of faulty, defective, or hazardous products. It can then issue recalls of products already released into the market or ban products yet to be released. In addition to SaferProducts.gov, the agency operates the National Electronic Injury Surveillance System (NEISS) which collects data on injuries caused by dangerous products from emergency rooms. Congress passed the Consumer Product Safety Improvement Act in 2008, which authorized the creation of a public database to collect information on product concerns.

In its first four months, according to the Government Accountability Office, the website received 5,464 consumer complaints. Of those, the CPSC found 383 of them to be “materially inaccurate.” In 204 of those reports, consumers had incorrectly identified the manufacturers of the allegedly hazardous products. The total number of reports received, while possibly low because of lack of widespread knowledge of the system yet, may be considerably lower than the number of reports received by the CPSC through its other programs. Annually, it collects over 360,000 reports through NEISS, 23,000 reports directly from manufacturers, and around 15,000 reports through the agency’s website and hotline.

SaferProducts.gov is the first service that gives members of the public the opportunity to directly report problems, and to access information reported by others. The CPSC clearly disclaims that it “does not guarantee the accuracy, completeness, or adequacy of the contents” of the website’s database. This potentially presents a problem both for manufacturers who may find themselves unfairly maligned, and for a public needing accurate and up-to-date information on hazardous products.

Family Files Wrongful Death Lawsuit Against California School Over Death of 12 Year-Old

October 19, 2011 | Lebowitz & Mzhen

The parents of a 12 year-old boy who died in September 2010 from acute cardiac arrest have filed suit against the school district where the child was enrolled, the child’s P.E. teacher, and two doctors who treated him. The lawsuit alleges negligence against the school district and teacher for failing to exercise reasonable care in the child’s physical education, and it alleges that the doctors were negligent in their prescribed restrictions on the child’s physical activities.

The child suffered from hypertrophic cardiomyopathy, a condition that causes thickening of the heart muscle, according to court documents. This makes it more difficult for the heart to pump blood efficiently. The congenital condition can result in sudden cardiac arrest and death, and is a leading cause of heart-related death among young athletes. The lawsuit alleges that, while temperatures in Los Angeles were at a record high of 107 degrees in September 2010, the school and P.E. teacher required the child to participate in physical education classes. The school and teacher allegedly knew about the child’s heart condition. The child allegedly suffered cardiac arrest on the morning of September 28, 2010 during his physical education, while under the teacher’s supervision. He died shortly afterwards.

The primary claim of the lawsuit is negligence. To prevail on a claim of negligence, a plaintiff must prove four elements: (1) the defendant owed a duty of care, (2) the defendant breached that duty, (3) the breach caused injury to the plaintiff, and (4) plaintiff has suffered damages as a direct result. The plaintiffs have also claimed negligence by medical professionals, which is a higher standard of negligence. Ordinarily, a negligence claim requires proof of a duty of care for a reasonable person. Medical malpractice imposes a higher standard of care on doctors and other medical professionals because of their specialized training. Since the school district and teacher named in the lawsuit care for children in the course of their daily professional duties, a court might apply a higher standard of care to them than it might to a person not accustomed to dealing with children. The lawsuit specifically alleges failure to follow the requirements of Section 504 of the Rehabilitation Act of 1973, which addresses protection of children with disabilities.

Fatal Bicycle Accident in Severna Park in Dark Lighting Conditions

October 13, 2011 | Lebowitz & Mzhen

Police are investigating a fatal bicycle crash that happened the evening of Friday, October 7, 2011 in Severna Park, Maryland. A 40 year-old cyclist sustained fatal injuries after a car struck him from behind on northbound Veterans Highway. The collision drove the man into the car’s windshield. Police responded shortly after 7:30 p.m., and the cyclist was pronounced dead after arriving at the hospital by helicopter.

The initial investigation has not shown any evidence of speeding or alcohol use as a factor in the accident. Police named “bicyclist visibility” as the accident’s cause, noting that the cyclist was dressed in dark, non-reflective clothing and that the accident occurred in a dark area of the highway. The driver of the car apparently simply could not see the bicycle, according to the investigation.

The Maryland Department of Transportation reports that there were 686 reported bicycle crashes in 2009, the most recent year for which statistics are available. Of those, there were 10 fatalities and 578 injuries. The Department notes that 40% of all bicycle crashes and 57% of all fatal crashes occur between 4:00 p.m. and 8:00 p.m. The cyclist was found to be at fault in 86% of all fatal Maryland crashes and 52% of the total crashes. “Fault” in bicycle accidents is determined the same way as in accidents involving only automobiles.

Maryland law treats bicycles the same as automobiles. Cyclists must take reasonable safety precautions, and car drivers must give the same consideration to a bicycle as they would to another car. For an automobile, reasonably safe driving in the evening or at night involves the use of head- and taillights and extra attention to surroundings that may be obscured by darkness. For cyclists, reasonably safe operation involves not only lights but some form of reflective clothing. Riding a bicycle at night is particularly dangerous, given the difficulty of seeing bicycles in the dark. Maryland law only requires helmets for people under the age of 16, but it applies all the same rules of the road to bicycles as to cars. Bicycles must obey traffic lights and signs, and cyclists may not wear headphones while riding.

Lawsuit Alleges Deliberate Exposure of Baltimore Children to Lead Poisoning

October 6, 2011 | Lebowitz & Mzhen

A lawsuit filed on September 15, 2011 alleges that the Kennedy Krieger Institute, a Baltimore research facility associated with Johns Hopkins University that cares for disabled children, exposed multiple children to lead poisoning during a study of lead paint conducted by the Institute in the 1990s. The class action suit alleges negligence, battery, fraud, and violations of Maryland’s consumer protection act. The number of children, many of whom would now be adults, who may be involved in the suit is not yet known.

The study, conducted from 1993 to 1999, looked for a cost-effective method to abate lead in children’s blood levels. Part of the study involved moving families into subsidized homes with varying levels of treatment to reduce exposure to lead paint and dust. Some homes had full removal of lead paint, and some had other remedial measures. The families included children ages 12 months to 5 years. Researchers would collect dust and water samples from the houses and blood samples from the residents over a 2-year period to compare the effectiveness of different methods at reducing lead exposure.

The lawsuit alleges that children received dangerous levels of exposure to lead in paint and dust in the houses used in the study. Researchers from the Institute allegedly assured the families that the homes were “lead safe,” and did not specifically disclose the potential dangers of lead exposure. The lawsuit further alleges that the Institute did not provide any medical treatment to participating children. Some children reportedly suffer permanent neurological injuries because of the exposure, lack of warning, and lack of treatment.

This lawsuit is only the latest in a larger legal battle related to this study. Another lawsuit reached the Maryland Court of Appeals in 2001, when the court drew a comparison between this study and the Tuskegee experiments of the early- to mid-20th century. The Tuskegee experiment deliberately withheld treatment for syphilis from African-American men who participated in the study, leading to considerable suffering and preventable deaths. The Institute still disputes this comparison.

$21 Million Wrongful Death Suit for Murder of Inmate on Prison Bus Is Going to Trial

September 29, 2011 | Lebowitz & Mzhen

A lawsuit against the state of Maryland and various state departments, state officials, and state employees may proceed to trial according to a ruling by Baltimore City Circuit Judge Sylvester B. Cox. The trial is scheduled to begin October 11, 2011. At issue is whether state officials and employees were negligent in failing to prevent the murder of one inmate by another on a prison bus.

In the early morning of February 2, 2005, a prison bus was transferring 36 inmates from a prison in Hagerstown to a facility in Baltimore. Five corrections officers were also passengers on the bus. As the bus traveled on Interstate 70, inmate Kevin Johns attacked and murdered fellow inmate Phillip E. Parker, Jr. by slashing his neck with a razor blade and strangling him. Parker died about ten minutes after the bus reached its destination.

Johns was convicted of Parker’s murder but was held not criminally liable because of mental illness. Johns already had two prior murder convictions. He committed suicide in prison in 2009.

This Maryland Accident Law Blog reported in May 2006 on the wrongful death lawsuit filed by Parker’s parents, Melissa Rodriguez and Philip E. Parker Sr., against the state, the Department of Public Safety and Correctional Services, the corrections officers on the bus and the bus driver, and other related state agencies. The lawsuit alleges that corrections officers did nothing to intervene in or prevent the attack, even though two officers were seating a few feet behind the two inmates. The officers were allegedly watching videotapes or listening to music and eating when the attack occurred. The plaintiffs’ attorney claims to have evidence that Parker lay dying for 10 minutes with no one trying CPR, as well as evidence that the officers had insufficient training for such situations. The suit seeks $21 million in damages, as well as punitive damages.

The Maryland attorney general’s office asked the court to dismiss plaintiffs’ claims, arguing that the officers had no knowledge of a specific threat against Parker, and that they therefore cannot be held liable for what occurred. Judge Cox disagreed, holding that “it can be reasonably inferred in this case that the officers were, at a minimum, negligent.” Judge Cox’s order denying the state’s motion to dismiss means that the lawsuit may now proceed to trial. The plaintiffs will have to prove by a preponderance of the evidence that the defendants are legally liable for Parker’s death.

Two Senior Citizens Killed in Benedict, Maryland, Car Accident

September 20, 2011 | Lebowitz & Mzhen

A four-vehicle automobile accident in Benedict, Maryland, around noon on Friday, September 9, 2011 killed two local senior citizens and injured at least three others. Franz and Evelyn Isabelle Sommer, a married couple, were driving east on Route 231 in their Ford Focus near the Patuxent River Bridge when a Penske rental truck rear-ended their vehicle. The collision caused the Sommers’ vehicle to veer into the westbound lane of Route 231, where it collided head-on with a Mitsubishi Galant. The Penske truck went on to strike a Saturn L200 in the westbound lane. The Sommers’ car and the Saturn L200 were wedged under the Penske truck.

Five people were taken to the hospital for injuries: Deborah Ellen Parkinson, the driver of the Galant; Kimberly Leighanne Garcia, the driver of the Saturn and two children who were in her car; and Michael Anthony Duckett, the driver of the Penske truck. Police report that none of the injuries were life-threatening. A passenger in the truck was unharmed, according to police on the scene. According to witnesses, Parkinson’s vehicle flipped over in the accident, and she had to be pulled out by firefighters.

Investigators have concluded that Duckett’s failure to control the speed of the truck caused the accident, and that alcohol was not a factor. Criminal charges have not yet been filed, pending the completion of the investigation. Duckett could potentially face up to ten years in prison if he is charged under Maryland’s “manslaughter by vehicle” statute, which covers deaths resulting from “driving, operating, or controlling a vehicle or vessel in a grossly negligent manner.”

In addition to any potential criminal charges, the driver of the truck could also face civil liability to all of the people injured in the accident, from a wrongful death claim by relatives of the Sommers to injury claims by the other drivers and their passengers. The driver of the truck is responsible not only for the actual rear-end collision of his truck and the Sommers’ vehicle, but for every collision directly caused by that collision. At least three collisions occurred in this case, causing multiple injuries.

A popular notion is that a driver who rear-ends another driver is by definition “at fault.” This is not always the case, but it is a useful principle. If the driver of the rear-ended vehicle behaved negligently, such as braking abruptly without good cause, then both drivers may be at fault. If a driver swerves into a lane of traffic and is rear-ended by a car already in that lane, the swerving driver is probably 100% at fault. A driver who rear ends a vehicle because he was pushed into the car after being rear-ended himself should not be liable, but the driver doing the original rear-ending might be liable for all collisions in that situation. A better general principle to apply to rear-end collisions might be that the driver who creates the conditions leading to the rear-end collision should be primarily liable, and that the driver is liable for injuries caused by those collisions.

Reduction in Car Accident Fatalities Among 16 Year-Olds Matched by Rise Among 18 Year-Olds

September 16, 2011 | Lebowitz & Mzhen

Restrictions placed on teenagers’ driving privileges has led to a decrease in the number of fatal automobile accidents among 16-year-olds. Research suggests, however, that the risk may simply have shifted to older teens, as a corresponding rise in traffic fatalities has occurred among 18-year-olds. A study published in the September 14 issue of the Journal of the American Medical Association reviewed data from crashes nationwide covering the years 1986 to 2007 and found an increase in fatal car accidents as teens get older. 16-year-olds average 28.2 fatal crashes per 100,000 person-years, compared to 36.9 for 27-year-olds and 46.2 for 18-year-olds.

Graduated driver licensing laws, known as GDLs, limit driving privileges of 16-year-olds until they gain experience in lower-risk driving situations. Most GDL’s establish three stages: a “learner’s” period requiring supervised driving, an intermediate period with limited unsupervised driving, and a full privilege period identical to an adult driver’s license. Some states add restrictions on nighttime driving, use of cell phones while driving, and number of passengers allowed in cars operated by teenagers. New Jersey requires drivers without full privileges to display a “new driver” decal on their vehicles.

Maryland’s GDL allows entry into the learner’s stage at 15 years, 9 months, and requires a minimum of 9 months in that stage with a minimum of 60 hours of supervised driving. Young drivers may enter the intermediate stage at age 16 years, 6 months and after completing the learner’s stage. Intermediate drivers cannot drive unsupervised between midnight and 5:00 a.m. and cannot have passengers under the age of 18 for the first five months. All restrictions may be lifted at age 18.

By limiting new drivers’ exposure to high-risk, dangerous situations, GDLs appear to have successfully reduced the total number of fatal car accidents among 16- and 17-year-old teens. Researchers suspect, however, that at least part of the higher rate of fatalities among 18-year-olds may be due to teens deferring obtaining a driver’s license until age 18, thus skipping the GDL process entirely. This results in 18-year-old new drivers who have not gone through the training process encompassed by GDL’s.

“[Older teens] are saying, ‘The heck with your more complicated process,'” says Justin McNaull, director of state relations for the American Automobile Association. At 18, teenagers can, in many cases, get their license in a matter of weeks.

No national database exists to show the total number of 16-year-old drivers compared to older new drivers. The hypothesis is therefore largely anecdotal, as it is not clear if there are fewer 16-year-old drivers nationwide. The study’s finding suggest that there is no net change in the total number of traffic fatalities, at least as related to GDL’s, but rather that the risk has shifted to slightly older drivers.

Maryland Lawsuit Seeks to Hold Bar Liable for Intoxicated Boating Accident

September 8, 2011 | Lebowitz & Mzhen

A lawsuit filed in a U.S. District Court in Maryland seeks to hold a bar liable for injuries sustained in a 2008 boating accident. Early in the morning on June 5, 2008 a ski boat carrying 10 people crashed into an abutment on the Route 90 bridge in Ocean City, Maryland. Conditions at the time were foggy, and the collision caused all of the boat’s occupants to fall into the water. Everyone was rescued, although several sustained injuries. Only one passenger required hospitalization, while 6 passengers were treated at the hospital and released, and 3 were treated at the scene.

Scott Howard Shepard, who was operating the boat at the time of the accident, was eventually charged with operating a vessel while impaired, negligent operation and reckless operation. He received a 30-day jail sentence. Shepard and the boat’s passengers had been at Seacrets, a resort nightclub. The club’s water taxi had ferried them to their boat prior to the accident.

In March 2011, passenger Danielle Vollmer, who had been treated and released from the hospital, filed suit in the United States District Court in Baltimore against Shepard and Seacrets. The claim against Shepard appears to be an ordinary negligence claim, while the claim against Seacrets incorporates maritime law claims and a claim for dram shop act liability. Her complaint states that “Seacrets knew or should have known that ferrying and encouraging a severely intoxicated patron such as Shepard to his boat, and then later ferrying the plaintiff to board and depart on the same boat with Shepard, created a condition of danger to the plaintiff and the public.” She is seeking $1 million in damages from each of the defendants.

Vollmer’s case against Seacrets will be interesting to watch. Maryland is one of 12 U.S. states that does not have a statute or caselaw providing for dram shop liability. “Dram shop” liability holds a bar that sells alcohol, or a host that serves alcohol, to a visibly intoxicated person strictly liable for damages subsequently caused by that person. For example, a bar that sells liquor to an individual who would appear intoxicated to any reasonable person would be liable to a person injured by the intoxicated individual, to the extent that the injuries were a result of the person’s drunken state. This most often involves DUI accidents. 38 states have laws allowing this sort of liability, but not Maryland.

That may change in the near future, though. In June 2011, Montgomery County, Maryland judge Eric M. Johnson stated in an order that it is time for Maryland’s law to change. Judge Johnson was presiding over a lawsuit against a bar by the family of a child killed by a drunk driver who had been served beer at the bar prior to the accident. In rejecting the bar’s motion to dismiss the lawsuit, Judge Johnson wrote:

The facts of this case undoubtedly should serve as the impetus to adjusting Maryland jurisprudence on the topic of dram shop liability…This court is of the opinion that while the Maryland legislature has not enacted dram shop legislation, it has not expressly prohibited it … A bar owner who continuously serves drinks to intoxicated individuals and makes no attempt to ensure that the individual has alternative means home should expect that the intoxicated patron can get into an accident.

Judge Johnson’s order does not have any force of law beyond that particular lawsuit, but it may herald a change in how bars are treated when a bar patron causes an accident.

$5M Baltimore Wrongful Death Lawsuit Filed Against Man Convicted of Involuntary Manslaughter in 2008 Inner Harbor Drowning

August 30, 2011 | Lebowitz & Mzhen

The family of Ankush Gupta is suing Wayne Black for Maryland wrongful death. Black, 21, pleaded guilty to involuntary manslaughter in Gupta’s drowning. Now, the victim’s loved ones are seeking $5 million in damages. Gupta was 22.

Prosecutors say that in 2008, Black asked Gupta, who had stopped at Inner Harbor on his way to Montgomery County with friends, for a cigarette before shoving him into the water and running off. Gupta, who could not swim, drowned. The two men did not know each other.

Black eventually confessed that it was he who pushed Gupta and he was originally charged with first-degree murder. As part of his plea agreement, Black is to be sentenced to four years behind bars.