Attorneys sometimes use the media to direct public pressure on defendants to settle cases that never should have been filed. These are weak cases.
Strong cases generally work the way through the court system. Strong cases do not need the media to distract. Weak cases do.
In one recent case, a post-surgical patient experienced wound breakdown. There was some necrotic tissue. The goal was to debride the tissue back to vascularized margins. Then perform a reconstruction.
Is this a common presentation of an uncommon complication? Yep.
Is wound breakdown listed as a possible complication in the informed consent document? Yep.
So, what did the attorney feed to the media?
That the wound had maggots crawling out of it. The implication was the wound was so neglected, you’d have to go back to the pre-antibiotic era (like the Civil War) to see such a horrible wound.
But this description was fiction.
The maggots were sterile, and used therapeutically as a 510(k) FDA-cleared medical device for debridement. In the 2020 article “Maggot Therapy in Wound Healing: A Systematic Review”:
The full text of five studies, involving 580 patients with chronic wounds, was retrieved. Four studies used the Lucilia sericata species. The maggot therapy facilitated faster and more effective debridement of non-viable tissue. It enabled faster development of granulation tissue and increased reduction in the wound surface area compared to hydrogel dressings. Maggot therapy had no effect on disinfection or complete healing rate for the wound. Conclusion: Maggot therapy should be considered for faster wound debridement, granulation tissue development, and wound surface area reduction as well as in surgical contraindications.
With the right patients, maggots work.
So do medicinal leeches.
Medicinal leeches can be used in venous drainage disorders after a replantation of fingers, auricles, lips and parts of the nose. In head and neck reconstructive surgery, there are many studies that confirm the success rate of hirudotherapy in hematoma evacuation or in dealing with complications after scalp replantation and transfers of free and pedicled flaps. Leech application therapy can also be indicated as a part of non-surgical methods that improve conditions of the venous system.
And surprise, surprise. So do fecal transplants. For controlling intractable Clostridium difficile infections.
The common thread is the yuck factor. The media will take the bait. And the public will be shocked.
Still, these are specific medical devices used to treat difficult conditions. The reason they are considered by physicians is because other treatments are less effective or have not worked. And no patient is exposed to any of these treatments without a thorough discussion of the risks, benefits, and options.
What do I think of unethical attorneys who propel salacious media stories based on weak cases? Sometimes, it’s inevitable. It’s like flies being attracted to s$^*t. Or maggots being attracted to fecal transplants.
What do you think?
