Medical Justice provides free consultations to doctors facing medico-legal obstacles. We have solutions for doctor-patient conflicts, unwarranted demands for refunds, online defamation (patient review mischief), meritless litigation, and a gazillion other issues. We also provide counsel specific to COVID-19. If you are navigating a medico-legal obstacle, visit our booking page to schedule a free consultation – or use the tool shared below.

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We’ve been protecting doctors from medico-legal threats since 2001. We’ve seen it all. Here’s a sample of typical recent consultation discussions…

  • Former employee stole patient list. Now a competitor…
  • Patient suing doctor in small claims court…
  • Just received board complaint…
  • Allegations of sexual harassment by employee…
  • Patient filed police complaint doctor inappropriately touched her…
  • DEA showed up to my office…
  • Patient “extorting” me. “Pay me or I’ll slam you online.”
  • My carrier wants me to settle. My case is fully defensible…
  • My patient is demanding an unwarranted refund…
  • How do I safely terminate doctor-patient relationship?
  • How to avoid reporting to Data Bank…
  • I want my day in court. But don’t want to risk my nest egg…
  • Hospital wants to fire me…
  • Sham peer review inappropriately limiting privileges…
  • Can I safely use stem cells in my practice?
  • Patient’s results are not what was expected…
  • Just received request for medical records from an attorney…
  • Just received notice of intent to sue…
  • Just received summons for meritless case…
  • Safely responding to negative online reviews…

We challenge you to supply us with a medico-legal obstacle we haven’t seen before. Know you are in good hands. Schedule your consultation below – or click here to visit our booking page.

 

Gives a whole new meaning to the word “heartburn”, doesn’t it? We’ll start at the end. The patient, a 60-year-old male with lung disease, emerged from the surgery uninjured. No malpractice suit has been filed – yet. We’re not holding our breath, but the patient does not seem hostile. With that said, there are plenty of take-home points regarding the placement of potentially volatile tools within the operating suite. 

Anyone can imagine this incident taking a turn for the deadly.  

Here’s what happened: The patient was undergoing emergency surgery to address a torn aorta. The patient also had an “enlarged” lung, a symptom of the patient’s pulmonary disease. The patient’s lung was fixed to his sternum, and the surgeons needed to crack his sternum to access his heart. In doing so, a bulla within the lung was punctured. 

The anesthesiologist responded by increasing the amount of oxygen in the patient’s anesthetic inhalant. 

The inciting spark was discharged from an electrocautery device, used by the surgeons to control the bleeding of the patient’s wounds. The device was laying close to dry surgical packs, swathed in highly oxygenated vapors. A spark was ignitied when the electrocautery device made contact.  

The fire was quickly extinguished and neither the patient nor the surgeon was injured. Is extinguishing a fire concentrated within the patient’s chest cavity part of the standard of care? Perhaps not explicitly, but we wager it’s implied.  

This is not the first time this has happened – at least seven other similar incidents have been reported. While the precise circumstances vary, the stories share several common threads. Each incident involved a patient with chronic lung disease. And each incident involved an increased flow of oxygen into the patients’ lungs, dry surgical packs, and electrocautery devices, as stated by the presiding surgeon, Dr. Ruth Shaylor. 

“While there are only a few documented cases of chest cavity fires–three involving thoracic surgery and three involving coronary bypass grafting–all have involved the presence of dry surgical packs, electrocautery, increased inspired oxygen concentrations, and patients with COPD or pre-existing lung disease”, explains Dr. Shaylor. 

“This case highlights the continued need for fire training and prevention strategies and quick intervention to prevent injury whenever electrocautery is used in oxygen-enriched environments. In particular surgeons and anaesthetists need to be aware that fires can occur in the chest cavity if a lung is damaged or there is an air leak for any reason, and that patients with COPD are at increased risk.” 

The take-home point: Recognize how mundane tools may interact in dangerous ways. Each item that contributed to the fire is, in isolation and in the hands of a surgeon, virtually harmless. They become dangerous when they are combined under specific circumstances – elevated oxygen levels, a punctured bulla, etc. The dangers are easy to identify in retrospect, but during the “heat” of surgery, they can be easy to overlook. Take these stories to “heart” so you (and your patients/colleagues) don’t get “cooked.” 

What do you think? Let us know your thoughts in the comments below. 

Medical Justice provides free consultations to doctors facing medico-legal obstacles. We have solutions for doctor-patient conflicts, unwarranted demands for refunds, online defamation (patient review mischief), meritless litigation, and a gazillion other issues. We also provide counsel specific to COVID-19. If you are navigating a medico-legal obstacle, visit our booking page to schedule a free consultation.

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Request a Consultation with Our Founder

Medical Justice Founder and CEO, Jeff Segal, MD, JD, provides consultations to doctors in need of guidance. 

Meet the Experts Driving Medical Justice

Our Executive Team walks with our member doctors until their medico-legal obstacles are resolved.

Jeffrey Segal, MD, JD

Chief Executive Officer and Founder

Dr. Jeffrey Segal, Chief Executive Officer and Founder of Medical Justice, is a board-certified neurosurgeon. Dr. Segal is a Fellow of the American College of Surgeons; the American College of Legal Medicine; and the American Association of Neurological Surgeons. He is also a member of the North American Spine Society. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.

Dr. Segal was a practicing neurosurgeon for approximately ten years, during which time he also played an active role as a participant on various state-sanctioned medical review panels designed to decrease the incidence of meritless medical malpractice cases.

Dr. Segal holds a M.D. from Baylor College of Medicine, where he also completed a neurosurgical residency. Dr. Segal served as a Spinal Surgery Fellow at The University of South Florida Medical School. He is a member of Phi Beta Kappa as well as the AOA Medical Honor Society. Dr. Segal received his B.A. from the University of Texas and graduated with a J.D. from Concord Law School with highest honors.

In 2000, he co-founded and served as CEO of DarPharma, Inc, a biotechnology company in Chapel Hill, NC, focused on the discovery and development of first-of-class pharmaceuticals for neuropsychiatric disorders.

Dr. Segal is also a partner at Byrd Adatto, a national business and health care law firm. Byrd Adatto was selected as a Best Law Firm in the 2021 edition of the “Best Law Firms” list by U.S. News – Best Lawyers. With over 50 combined years of experience in serving doctors, dentists, and other providers, Byrd Adatto has a national pedigree to address most legal issues that arise in the business and practice of medicine.