The choice of words in Judge Barbier’s decision is interesting. “Gross negligence” and “willful misconduct” are not commonly heard. They are not simple everyday phrases. Legally, these four words hold a great deal of meaning.  Anastasia Pantsios, a writer for www.ecowatch.com explains the judge’s word choices for this particular situation in this way: “The difference between a finding of “negligence” and “recklessness” is significant, possibly exposing BP to claims beyond the 2012 $9.2 billion settlement it reached with most non-governmental plaintiffs.”

The language of legal decision making is part science and partly an art as well. The words we choose and use have important meaning both in and out of legal spheres. If you want to learn more about the language of a piece of litigation that is important to you, ask us. We love to talk about the rich, meaningful and sometimes complex language of law. And unfortunately, we have a lot of experience with cases where there is “gross negligence” and/or “willful misconduct”.

We’ll walk you through the confusing parts and clearly explain the importance, power and beauty of the legal language of your case, because it is important to us that you understand the meaning to the laws, rulings and decisions that are important to you.

Did Santa bring an extra surprise this season?  Are you carrying a bundle of joy?

Even if it’s too early to tell family and friends about your pregnancy, it’s not too early to take care of yourself.  A key part of taking care of yourself and your new little one is making sure that any medications you take during your pregnancy (prescription or over the counter) are safe and not TERATROGENIC.

TERATROGENIC means that the substance can go past the placenta and enter into your developing baby.

It is best to see your obstetrician right away and to get clear advice as to which medications are considered safe and which contain a risk.

The following are just some of the drugs that are known to cause birth defects:

• Antibiotics:  While penicillins, cephalosporins and erythormycin are considered relatively safe, tetracyclines, sulfa drugs, ciprofloxacin, and other antibiotics can cause birth defects when taken by a pregnant woman.

• Benzodiazepines: Tranquilizers, sleeping pills, and anti-anxiety drugs can cause problems in newborns including breathing, temperature regulation, and muscle problems.
• Accutane and related dermatological drugs: Accutane poses an extremely serious risk of birth defects or death. This drug should never be used by a pregnant woman under any circumstances. Soriatane is also a dermatological drug that is extremely harmful to a developing fetus, and should not be used by any woman for three years prior to conception.
• NSAIDS: Aspirin and other drugs in the same family (salicylates) can cause birth complications and birth defects when used late in pregnancy.
• Antidepressants.
  • Paxil: In 2005, the FDA warned that Paxil can double the risk of heart birth defects when used during the first trimester of pregnancy.
  • Prozac: In 2006, a major study found that Prozac also doubled the risk of delivering a child with the birth defect PPHN (Primary Pulmonary Hypertension).
  • SSRI’s (selective serotonin reuptake inhibitors) are capable of harming the fetus, particularly when taken in the 1^st trimester.  Symptoms of this harm have included irritability, agitation, nasal congestion, diarrhea and some tumors.

It is the duty of the health care professional to weigh the risks of untreated depression on the part of the mother against the dangers of the prescribed medication.

• Anti-cancer drugs: Teratogens such as aminopterin, Bulsulfan, Chlorambucil, Cyclophosphamide, Mercaptopurine, and Methotrexate can cause serious birth defects including cleft palate, underdevelopment, other physical defects and mental retardation.
• Anti-seizure medications: Anticonvulsants such as Toprimate and Valproate, as well as phenytoin, calproic acid and trimethadione.  These can cause serious birth defects including spina bifida, organ deformities, cleft palate, microcephaly and facial defects.  Pregnant mothers with epilepsy need specialized care, and may require a change in medication for the duration of the pregnancy.
• Blood-thinning drugs, like Warfarin can cause mental retardation as well as vision problems in babies.
• Certain thyroid medications
• Sex hormones (androgens, estrogens and DES) have caused damage to sexual organs.
• Blood pressure drugs.  Drugs called angiotensin-converting enzyme (ACE inhibitors) have been documented to cause problems in pregnancy.  ACE inhibitors can stunt the fetus’ growth and cause kidney problems and even death.
• Asthma medications
• Live Vaccines
• Lithium
• Thalidomide

If you are concerned that you may have been prescribed a medication that is unsafe to take during your pregnancy, feel free to contact our office for a free consultation.  We are happy to help you make such a determination.

“For the report, researchers analyzed data from the Fragile Families & Child Wellbeing Study, a study involving nearly 5,000 mostly unmarried parents of children born in urban areas. Over the course of the survey, from 1998 to 2000, almost half of the fathers spent time in prison or jail.

The study found negative effects of incarceration on fathers’ engagement with children, “but only when fathers were living with their children prior to incarceration,” according to the report.”

It was determined by the researches that being incarcerated had little effect on the parenting skills of fathers who did not previously live with their children.  This was true even after their release from prison.

Another interesting finding was that incarceration increased the likelihood that the non-incarcerated mother would connect with a new life partner, which could offer support of a new family member to the children, “ leading to greater family complexity.” 

Make a resolution to get through the holidays drinking LESS.  (Obviously, if you are problem drinker, you need to get through the holidays completely alcohol-free.)

Easier said than done?  Not true!  Consider these suggestions.  

1. Sit next to the sober people!  Just as you can lose weight if you eat what the skinny people do, you will drink less if you are hanging out with the non-drinking party-goers.  This does not limit you to pregnant women and the kids; plenty of people don’t drink or are even the designated driver for the evening.  And they are looking for you, the person who isn’t drinking!
2. Volunteer to be the designated driver.  When you are the designated driver (and you announce it loudly at the beginning of the party), there is no social pressure to drink and you have the responsibility to be completely sober.  When you know you are driving family and friends home and their safety depends on your behavior, that tempting drink seems pretty unimportant.
3.  Limit your alcohol to just the mealtime.  Enjoy your glass or wine, beer or cocktail, but limit it to while you are sitting at the table.
4. Host the party so that you can control the amount and what type of alcohol is served.  If scotch is your weakness, you, the host, can decide not to buy the scotch!
5. Visualize the behavior you desire.  John McGrail, Ph.D., author of The Synthesis Effect, says, “Imagine yourself not going beyond your appropriate limit and walking out of the event feeling great, with a big smile on your face.  Having pictured the desired behavior, your inner computer will choose that reality, making it much easier to drink less or not at all.”
6. Involve your partner in your decision to cut back drinking.
7. If you are attending a traditionally drinking-heavy event, limit your time there or limit how much you will drink before you leave.  Then, immediately leave when you have hit either your time limit or your drink limit.
8. Be aware of mood fluctuation.  Avoid being tempted by drink when facing depression or anxiety.
9. Keep water or a non-alcoholic drink with you all night.  Sip this drink regularly, slowing down your intake of alcohol.

And, of course, if despite all precaustions, you are in an accident caused by weather, another driver or yourself, feel free to give us a call.  Advice is free and we’d love to help.

November has been designated as “Prematurity Awareness Month,” in an effort to educate the public about the risk factors for premature birth and about preventive measures that pregnant women can take to decrease their risk of delivering prematurely.

The earlier a baby is born, the more severe his or her health problems are likely to be.  More infants die from preterm-related problems than from any other single cause.  Some premature babies require special care and spend weeks or months hospitalized in a NICU (neonatal intensive care unit).  Those who survive may face lifelong problems such as:

• Cerebral Palsy
• Intellectual Disabilities
• Breathing and Respiratory problems
• Visual problems
• Hearing loss
• Feeding and digestive problems

Even if a woman does everything “right” during pregnancy, she can still have a premature baby.  Here are some known risk factors for having a premature baby:

• Having had a previous preterm birth
• Carrying more than one baby (twins, triplets, etc.)
• Problems with the uterus or cervix
• Chronic health problems with the mother
• Cigarette smoking
• Certain infections during pregnancy

What can you do to prevent a premature birth?  The Centers for Disease Control and Prevention suggest the following to reduce the risk of premature birth:

• Quit smoking, and avoid alcohol or drugs.
• Get prenatal care as soon as you think you may be pregnant and throughout your pregnancy.
• Talk to your health care provider about how to best control high blood pressure and diabetes.
• Talk to your health care provider about maintaining a healthy diet, including 400 micrograms of folic acid daily before and during early pregnancy.
• Talk to your health care provider about your options if you have previously had a preterm birth.

Warning Signs of Preterm Labor:

In most cases, preterm labor begins unexpectedly and with no known cause.  It’s important to seek care if you think you might be having preterm labor, because your doctor may be able to help you and your baby.

The warning signs are –

• Contractions (every 10 minutes or more often)
• Change in vaginal discharge (leaking fluid or bleeding from the vagina)
• Pelvic pressure (the feeling that the baby is pushing down)
• Low, dull backache
• Cramps that feel like a menstrual period
• Abdominal cramps with or without diarrhea

While the vast majority of surgical procedures are successful in avoiding complications, as with any major medical procedure, sometimes the surgeon makes a mistake.  Sometimes the nurses make a mistake.  Sometimes the hospital’s protocols are not followed, or followed incorrectly.

Just a couple of weeks ago, a report was published that detailed the unsettling number of “devices” – surgical sponges, towels, catheters, needles, retractors and other items used by the surgeon during surgery – that were inadvertently left, or “retained,” in patients’ bodies after surgery.

Foreign objects left inside your body after surgery are seriously problematic – they can cause illness, infection, and even death.  Surviving patients may suffer from “both physical and emotional harm, depending on the type of device retained and the length of time it is retained,” according to the report.  95% of the patients studied in the report required additional care and/or an extended hospital stay, and approximately 2% of the patients died from complications relating to the retained objects.

The Joint Commission, in its report, told the story from a 2012 New York Times article, about a woman from Kentucky who had undergone a hysterectomy and four years later, began to complain of severe abdominal pain.  A CT scan revealed that a surgical sponge had been left in the woman’s body.  “Upon surgical exploration, the retained sponge was found to have caused a serious infection, which required bowel resection.  The patient suffered from severe health issues, anxiety, depression, disability and social isolation.”

It is medical malpractice for a surgeon to leave an object inside a patient during surgery.  If something like this has happened to you, or you think that it might have happened to you (or to a loved one), it is always worth a call to a competent attorney who is experienced in litigating medical malpractice cases.

Turner & Turner are experts in litigating medical malpractice cases and one of our legal team would be delighted to speak with you at any time.

One category of injury from falls among the elderly that you might not be aware of is that of traumatic brain injury (TBI).  TBI is, in fact, a very serious health concern for seniors.  According to SeniorJournal.com, approximately 22% of all TBI-related hospitalizations involve adults aged 75 years and older, and males are more often diagnosed with TBI than are females (59%).

Ileana Arias, director of the National Center for Injury Prevention and Control at the Centers for Disease Control, was quoted in the web article as saying that “falls are the leading causes of TBI.”  She went on to describe a Traumatic Brain Injury as being “caused by a bump, blow or jolt to the head that affects how the brain normally works.”

“Adults ages 75 and older have the highest rates of TBI-related hospitalizations and death, tend to recover more slowly or die more often from these injuries than do younger people,” says Dr. Arias.

As opposed to a broken bone, the symptoms of a TBI can be subtle, and, therefore, missed for days or even weeks.  TBI symptoms such as confusion, speaking or thinking slowly or becoming lost are also symptoms associated with aging and dementia, and therefore not as easily identified as a problem in an elderly person.  It is essential to have a senior evaluated for TBI by a healthcare professional if they have sustained a fall or an injury relating to a fall.

Of course, preventing the fall to begin with is the best way to prevent TBI.  Here are some of Dr. Arias’ recommendations to help prevent falls in the first place:

Exercise is important as it improves balance and coordination, preventing the likelihood of a fall.

1. Make home and surroundings safer by making modifications such as placing frequently used items within reach, installing grab bars next to the toilet and in the shower/tub.
2. Ask the senior’s health care provider to review all medications – both prescription and over-the-counter, as the way some medicines can work in the body can change as a person ages.
3. Have vision checked regularly.  Poor vision can lead to falls.

Also, as the winter months begin to draw near, please make sure to clear snow and ice from the walkways and driveways of seniors’ homes.

Costume Safety

• Attach reflective tape or stickers to your child’s costume and treat bucket or bag.  In the dark, the little ones in dark costumes can be difficult for drivers to see, and the reflective tape will help with visibility.
• Avoid masks as they can limit visibility for the little ones, causing them to trip.  Consider face make-up instead.  Ditto for long, dragging costumes or dresses.  Walking up and down the front steps of people’s homes, sometimes with lit candles inside pumpkins, can make these costumes hazardous.
• Look for labels on costumes, wigs and other accessories that indicate that they are flame resistant.
• If a sword, cane or stick is part of your trick-or-treater’s costume, make sure it is not too long or sharp.    A child may be hurt by these items if s/he stumbles or trips.
• Do not use decorative contact lenses without an examination and prescription from an eye care professional.

While Walking…

• Children 12 years old and under who are trick-or-treating should always be accompanied by an adult.
• Older children and teens who are trick-or-treating without adult supervision should walk in groups, stay in familiar, well-lit areas, carry cell phones for communication with parents and agree on a time to return home by.
• Both children and adults should carry flashlights to help light the way in the dark.
• Only go to homes with porch lights that are on and never go into a home to get a treat.
• Stay on sidewalks, avoid roadways.  Only cross the street in groups, at approved crosswalks.  And remember to look both ways as you cross the street.
• Carry a cell phone for easy communication and in case of emergencies.
• Contact law enforcement (kids should also know how to dial 9-1-1) if any suspicious or unlawful activity occurs.

How to Keep Your Home Safe for Trick-or-Treaters

• Remove any hazards from your front yard that someone might trip over, including garden hoses, rakes, lawn ornaments and the like.
• Wet leaves or snow should be removed from walkways.
• Keep your front yard well-lit by replacing burned-out bulbs.
• Light your jack-o-lantern with a flashlight instead of a candle.

Enjoying the Goodies!

• Eat a healthy dinner before going out trick-or-treating.  A full tummy will make it less tempting to sample the goodies along the way!
• Have your children wait until they get home to sample their treats.  An adult should check through all of the treats and discard anything that is unwrapped, spoiled or otherwise suspicious.
• Try to ration goodies for the days and weeks following Halloween to avoid upset stomachs.

Sources inclue:  The American Academy of Pediatrics, Michigan State University Extension

Perhaps it is that good feeling we get when munching on pink candies or giving a gift of a sparkly pink bracelet that makes articles such as “What’s Behind the Pink of Breast Cancer Awareness Month?” so jarring.

The opinion piece, which appeared in the OpEd section of the Los Angeles Times on October 16^th, makes us take a step back from the all of the pink hype and re-focus our energies and our attention on the actual cause that we are trying to help by shopping for pink underwear and neckties.

In her thoughtful piece, Patt Morrison, LA Times columnist, wonders how much good these types of campaigns actually do.  According to Morrison, “the world of breast cancer causes is awash in pinkwashing,” asking the excellent question “what does it really mean, that anodyne marketing phrase, “a portion of the proceeds from this product will be donated to help fight breast cancer”?

Morrison cites the breast cancer activists Breast Cancer Action, who have taken the entire pink product movement to task for what they say is promoting the purchase of many products that actually contain the toxins that may cause breast cancer to begin with (cleaning products with chemicals, food products that contain hormones, etc.)

Like any type of marketing campaign, even one for an excellent cause such as breast cancer research, the answer must lie in the age-old warning to consumers:  Caveat Emptor, or “let the buyer beware.”

It is completely fine for you, the person spending money on a “pink” product, to ask the store clerk or manager “how much money from the purchase of this product is actually going to help fund breast cancer research?”  If the clerk or manager is unable to answer your question, hopefully they will offer to look into it for you, or else you could contact the store’s corporate offices for further clarification.

We would like to not be overly cynical and we do believe that most organizations, whether it be your favorite sports team or candy maker, are trying to do a good thing by “pinkefying” in October. Hopefully, by raising overall awareness about breast cancer, more people might consider making a direct donation to a cancer charity (in addition to buying whatever “pink” products they like).  Even more importantly, seeing pink will hopefully help as a reminder for the importance of regular self-examination, doctor’s appointments, and mammograms.

Q: What is the Health Insurance Marketplace?

A: The Health Insurance Marketplace allows you to compare different insurance plans by filling out one application.  You can find out about your cost saving opportunities at the Marketplace, as well.  The Marketplace is accessible online or by phone (1-800-318-2596), 24 hours a day, 7 days a week.

Q: When is the enrollment period?

A: For 2014, the six-month enrollment period began on October 1^st and continues until March 2014.

Q: What coverage does a health insurance plan in the Marketplace have to provide?

A: All private health insurance plans in the Marketplace must offer minimum essential health benefits, which include coverage for the following:

Ambulatory patient services (outpatient care you get without being admitted to the hospital)

Emergency services

Hospitalization

Maternity and newborn care

Mental health and substance us disorder services, including counseling and psychotherapy

Prescription drugs

Rehabilitative services and devices

Laboratory services

Preventive and wellness services and chronic-disease management

Pediatric services

To read the Affordable Care Act in its entirety, visit the U.S. Department of Health and Human Services’ website, www.hhs.gov.