Miami Injury Lawyer Blawg

I have often written about the danger of bicycle riding in South Florida. Cyclist are confronted with angry drivers, distracted drivers, and on Wednesday a cyclist was struck by driver under the influence of narcotics.

Ikuyo Ohigashi was arrested Wednesday afternoon on charges of DUI property damage and DUI serious bodily injury to another. Ohigashi, was traveling west on Lake Worth Road at about 12:18 p.m. Wednesday when she struck 65-year-old Pertti Viljo Savela, who was riding his bicycle in the bicycle lane near Corrigan Court.

Savela, was thrown from his bike and hit his head on Ohigashi's windshield, shattering the glass. He suffered a brain injury, multiple rib fractures, a bruised lung, and a large laceration on his head. He was flown by Trauma Hawk to Delray Medical Center.

As reported by The Palm Beach Post, Ohigashi told deputies she saw Savela in the bicycle lane and thought he "wobbled over" into her vehicle lane. She also told a deputy that she had taken a 750 mg Vicodin pill several hours before the crash.

She tested negative for alcohol in her system and was too dehydrated for an accurate blood test, which is an indicator of narcotic use, the affidavit said.

Less than two hours before she hit Savela, Ohigashi's SUV crashed into a Dumpster which in turn pushed into another car in a Palm Beach parking lot, according to Palm Beach police. She was charged with failure to leave information. She also reported to deputies that she had hit a tree or shrub as she left her home. Palm Beach police said she also was involved in a crash on Sunday.

In hopes of reducing Car Accidents, The National Transportation Safety Board said on Tuesday that it had voted to recommend the ban on the use of mobile devices by drivers, citing what it said were the risks of distracted driving.

The recommended ban applies to hands-free devices, a recommendation that goes further than any state law to date. The agency said it is recommending that drivers be allowed to use their phones for emergency purposes only.

This proposed ban is in would go a long way in reducing accidents caused by distracted driving. Hopefully, Florida will follow the lead and pass long overdue legislation.

As if there are not enough Bicycle Accidents caused by distracted drivers, a cyclist was killed Monday Night by a police officer.

According to Davie police, an on-duty Pembroke Pines police detective struck and killed a bicyclist Monday night in Davie.

As reported by The Miami Herald, Police spokesman Capt. Dale Engle said the crash happened shortly after 9:15 p.m. when The Pines detective's unmarked police cruiser was westbound in the 6600 block of Stirling Road, and struck the cyclist.

The bicyclist died at the scene.

Davie police did not say where the detective was going or why he was outside Pembroke Pines at the time of the crash.

Continue reading "Bicyclist Killed In Davie By Pembroke Pines Police Officer" »

Bicycle accidents are often caused by defective design and defective manufacturing. Recently, Trek bicycle components have come under criticism for breaking.

Now, Trek is recalling approximately 27,000 bicycles because of faulty seat clamp bolts on affected seat posts. The bolt can break, which poses an obvious potential for harm. Four injuries have been reported due to the issue.

The bikes affected are 2012 model year.

Models include:
Trek 7.2 FX, 7.3 FX, 7.4 FX, and 7.5 FX, as well as District and 9th District WSD, Livestrong and Disc models.

Consumers should check the SKU number stamped on the bottom bracket. If the last two numbers are "12" you may have an affected bike and should contact a local Trek dealer immediately.

Continue reading "After 4 Injuries Trek Recalls Bicycles" »

The M.R.I. was long thought to be an invaluable diagnostic tool. However, scans are easily misinterpreted and can result in misdiagnoses leading to unnecessary or even harmful treatments. That being said, The M.R.I. is only as good as the person reading the test, and should only be a one part of the final diagnosis. To that end, the doctor's physical examination and the patient's complaints should all be considered in the ultimate diagnosis and recommended treatment options.

As reported by the New York times, Dr. James Andrews, the go-to sports medicine orthopedist wanted to test his suspicion that M.R.I.'s, might be a bit misleading. So he scanned the shoulders of 31 perfectly healthy professional baseball pitchers. As a brief aside, Dr. Andrews signed an exclusive 10-year, $200 million deal with the New York Yankees that will prohibit him from operating on the elbows, shoulders and knees of any athlete not in the Yankee organization.

The pitchers scanned were not injured and had no pain. But the M.R.I.'s found abnormal shoulder cartilage in 90 percent of them and abnormal rotator cuff tendons in 87 percent. "If you want an excuse to operate on a pitcher's throwing shoulder, just get an M.R.I.," Dr. Andrews says. I would argue that Dr. Andrews never performed surgery on a pitcher's throwing shoulder solely on the basis of an MRI study.

He and other eminent sports medicine specialists are taking a stand against what they see as the vast overuse of magnetic resonance imaging in their specialty.

M.R.I.'s can be invaluable in certain situations -- finding serious problems like tumors or helping distinguish between competing diagnoses that fit a patient's history and symptoms. They also can make money for doctors who own their own machines. And they can please sports medicine patients, who often expect a scan.

"It is very rare for an M.R.I. to come back with the words 'normal study,' " said Dr. Christopher DiGiovanni, a professor of orthopedics and a sports medicine specialist at Brown University. "I can't tell you the last time I've seen it."

In sports medicine, where injuries are typically torn muscles or tendons or narrow cracks in bones, specialists like Dr. Andrews and Dr. DiGiovanni say M.R.I.'s often are not needed -- they usually can figure out what is wrong with just a careful medical history, a physical exam and, sometimes, a simple X-ray.

M.R.I.'s are not the only scans that are overused in medicine but, in sports medicine, where many injuries involve soft tissues like muscles and tendons, they rise to the fore.

In fact, one prominent orthopedist, Dr. Sigvard T. Hansen, Jr., a professor of orthopedics and sports medicine at the University of Washington, says he pretty much spurns such scans altogether because they so rarely provide useful information about the patients he sees -- those with injuries to the foot and ankle.

"I see 300 or 400 new patients a year," Dr. Hansen says. "Out of them, there might be one that has something confusing and might need a scan."

The price, which medical facilities are reluctant to reveal, depends on where the scan is done and what is being scanned. One academic medical center charges $1,721 for an M.R.I. of the knee to look for a torn ligament. The doctor who interprets the scan gets $244. Doctors who own their own M.R.I. machines -- and many do -- can pocket both fees. Insurers pay less than the charges -- an average of $150 to the doctor and $960 to the facility.

Steve Ganobcik is something of a poster child for what can go wrong with the scans. A salesman who turns 44 on Saturday, Mr. Ganobcik twisted his knee skiing in Colorado in February. He continued skiing anyway and skied again the next two days as well, not wanting to cut his vacation short.

When he got home to Cleveland, his knee still bothered him, so he saw a sports medicine orthopedist. The doctor immediately ordered an M.R.I. and said it showed a torn anterior cruciate ligament, or A.C.L. It is one of the most common -- and most devastating -- sports injuries. The standard treatment is surgery, with a difficult recuperation lasting six months to a year.

Mr. Ganobcik looked into surgical techniques and decided he wanted a different one than the one his doctor offered. So he saw another sports medicine orthopedist who, agreeing that Mr. Ganobcik's ligament was torn, scheduled the operation.

Meanwhile, Mr. Ganobcik heard that Dr. Freddie H. Fu, chairman of the division of sports medicine at the University of Pittsburgh, had what might be an even better technique, so he went to see him.

To Mr. Ganobcik's surprise, Dr. Fu told him his ligament was not torn after all. His pain was from a fracture in a long bone in the lower leg that the other doctors had also noticed was broken. An M.R.I. at the University of Pittsburgh confirmed it, showing a perfectly normal A.C.L. (Dr. Fu adds that Mr. Ganobcik's original scans had an image that was ambiguous. He wanted a better one, to see if Mr. Ganobcik's ligament had been partly torn and was healing or had never been torn at all. He would not need surgery with a partial tear, but he would need more careful recuperation.)

Dr. Fu's suspicions were raised by Mr. Ganobcik's story. He could never have continued skiing with a torn A.C.L. The diagnosis "made no sense," Dr. Fu said, and that, illustrates a common problem: relying on an M.R.I. instead of a history and an exam, as I noted at the beginning of this story

Continue reading "An M.R.I. is Only One Piece Of The Puzzle" »

A detached retina occurs when the retina is pulled or falls away from its normal position. The retina is a light-sensitive layer of tissue that lines the back of the eye. It converts visual images into nerve impulses in the brain that allow us to see.

During an automobile accident, the forces of the crash can put pressure on a number of internal organs causing bleeding, pain and chronic disabilities. When the head strikes a blunt object such as a steering wheel or window, a tear or break in the retina can occur. These tears can lead to retinal detachment and if left untreated, can cause permanent damage to the eye and even blindness.

A retinal detachment is painless. If you have any of these symptoms, contact an eye doctor immediately:

Sudden appearance or increase in the number of "floaters," which are shapes that float in the eye and are seen in the field of vision
Brief flashes of light in the eye
Loss of the eye's central or peripheral field of vision
A curtain appears to fall over part of the visual field
Sudden changes or blurring of vision

There are two types of surgical procedures for treating a Retinal Detachment:

Vitrectomy-- Which is the surgical removal of vitreous fluid that is pulling on the retina and causing detachment

Scleral buckle--the surgical placement of a flexible band or band(s) around the eye.

See the video below:

As a Bicycle Accident Attorney I have repeatedly said that bicycle accidents in MIami are far too common. On Thursday morning a group of Miami Police Officers learned first hand just how dangerous it can be to ride in MIami when a woman in a black SUV plowed into a line of cops on bikes Thursday morning, injuring three officers.

As reported by The Miami Herald, the Miami officers were part of a group in a bicycle certification program and were headed south on 27th Avenue when Teresa Quintanilla, 56, driving a Honda CRV crashed into the bike formation.

She hit three officers, including Renee Beaudry, 44, who was lifted onto the hood of Quintanilla's vehicle and smashed the windshield on impact. Also injured were Richard Diaz, 41, and Miguel Mercado, 47.

Diaz was discharged Thursday but Beaudry and Mercado were still hospitalized in stable condition late Thursday, Reyes said.

The police were training as part of a week-long course for the bicycle squad, and there's an officer in a patrol car who stays ahead of the pack and stops traffic when the cops need to cross streets-a luxury other cyclist in Florida do not enjoy.

Continue reading "SUV Crashes Into Group of Miami Bike Patrol Officers" »

The Million Dollar Advocates Forum is pleased to announce that MIami Personal Injury attorney Mark Alexander Kaire of Miami, Florida has been certified as a member of the Multi Million Dollar Advocates Forum. Mr. Kaire is presently a Life Member of the Million Dollar Advocates Forum, one of the most prestigious groups for trial lawyers in the United States. Membership in the Million Dollar Advocates Forum is limited to attorneys who have won million and multi-million dollar verdicts, awards and settlements. The organization was founded in 1983 and there are approximately 4000 members located throughout the country. Fewer than 1% of U.S. lawyers are members. Forum membership acknowledges excellence in advocacy, and provides members with a national network of experienced colleagues for professional referral and information exchange in major cases. Members of the Million Dollar Advocates Forum must have acted as principal counsel in at lease one case in which their client has received a verdict, award or settlement in the amount of one Million dollars or more. Members of the Multi-Million Dollar Advocates Forum must be Life Members of The Million Dollar Advocates Forum and must have acted as principal counsel in a case which resulted in a multi-million dollar verdict, award or settlement. Mr. Kaire is a member of both the Million Dollar Advocates Forum and the Multi-Million Dollar Advocates Forum. Mark Alexander Kaire is a graduate of University of Miami School of Law and specializes in Medical Malpractice and personal injury.

Two triathletes died last week during the swim portion of a Triathlon on the hudson river in New york city. The athletes went into cardiac arrest during the swim portion of the event and died. Cardiac arrest, (also known as cardiopulmonary arrest or circulatory arrest) is the cessation of normal circulation of the blood due to failure of the heart to contract effectively.

A cardiac arrest is different from (but may be caused by) a heart attack, where blood flow to the muscle of the heart is impaired.
Arrested blood circulation prevents delivery of oxygen to the body. Lack of oxygen to the brain causes loss of consciousness, which then results in abnormal or absent breathing. Brain injury is likely if cardiac arrest goes untreated for more than five minutes. For the best chance of survival and neurological recovery, immediate and decisive treatment is imperative.

Cardiac arrest is a medical emergency that, in certain situations, is potentially reversible if treated early. When unexpected cardiac arrest leads to death this is called sudden cardiac death (SCD). The treatment for cardiac arrest is cardiopulmonary resuscitation (CPR) to provide circulatory support, followed by defibrillation if a shockable rhythm is present. If a shockable rhythm is not present after CPR and other interventions, clinical death is inevitable.

The risk of sudden death in a triathlon is 1.5 deaths per 100,000 participants compared with 0.8 deaths per 100,000 participants in a marathon.

As reported by the New York Times, a 2010 study published in The Journal of the American Medical Association showed that 13 of the 14 deaths in triathlons from 2006 to 2008 took place during the swim legs. Autopsies on nine of the victims found that seven had heart abnormalities, which researchers think were exacerbated by the stress of swimming in open water.

"What do you do if your goggles come off? If you bump into a boat? If someone swims over you? If any of these things happen in the open water and you're not prepared for it, you can panic and can get into real trouble."

"So many things can go wrong in an open-water swim," Dr. Stuart Weiss, the New York City Triathlon medical director, said last week. "There's some combination of water, adrenaline, pushing yourself hard, and all these things somehow work together to put people into an abnormal heart rhythm."

Organizers of the race said last week that they were considering requiring open-water swim certifications for 2012 entrants, as well as certification of a recent medical checkup showing a clean bill of health. But a spokesman indicated that USA Triathlon was less far along on such considerations.

"The topics of athlete certification, as well as its feasibility, and the current requirements for swim starts continue to be discussed and evaluated, and we will consider all options moving forward," the spokesman, Chuck Menke, said.

Cook said that swim certification was necessary.

"You need some form of certification that says this person can swim in open water for, say, one hour," he said. "If they don't pass it, they shouldn't be let in the race."

The rising numbers of untrained first-time triathletes comes as part of the sport's phenomenal growth in recent years. USA Triathlon membership has grown from 16,000 members in 1993 to 140,000 in 2010.

The surge reflects a change in perception. Not long ago, the notion of doing a long-distance swim, followed immediately by long-distance cycling and running, seemed impossible for all but the most elite endurance athletes.

But now triathlons are often seen as the province of weekend warriors, albeit especially fit ones. That in turn has attracted first-time triathletes who often lack specific training. The number of one-day memberships in USA Triathlon, which one needs to compete in its sanctioned events, rose to 326,732 in 2010 from 100,000 in 2000.

Triathlon organizers are also aware of the dangers, typically assigning more lifeguards than the USA Triathlon minimum of one per 50 participants (one per 30 for ocean swims). They also are moving away from the especially chaotic mass starts. At the New York race, swimmers started in groups of 20 every few seconds, although that change was made because of choppy water.

"USA Triathlon-sanctioned events must meet the requirement of a minimum of three minutes between start waves and no more than 150 athletes per wave," said Kathy Matejka, the event services director of USA Triathlon. "Time-trial starts, which include fewer than 20 athletes starting at shorter intervals, also are permitted."

Continue reading "Triathlons Need Better Safety Rules" »

Florida Personal Injury Lawyers know that Injury Lawsuits often become a battle of experts. The issues which are most commonly contested are those of Causation-whether the subject accident caused the injury in question, and Permanency-whether the injury resulted in a permanent injury.

For the injured Plaintiff the testimony on the above issues is typically presented by the treating physician. In contrast, the defendant will retain and pay an expert to examine the Plaintiff and render opinions. Specifically, Florida Rule of Civil Procedure (FRCP) 1.360(a)(1)(A) allows the defendant in a personal injury case to have a qualified expert of its own choosing perform a medical examination on the plaintiff with regard to the injury or injuries in controversy. This type of examination has come to be referred to as a "compulsory medical examination," or "CME."

In light of the fact that the opinions and testimony of the defense hired doctor are so critical, it is imperative to discover as much information as possible about the defense doctor and to videotape the actual examination.

Florida Law allows the Plaintiff's attorney to inquire as to the amount of money the particular doctor earns by conducting these examinations, the number of times he has examined individuals on behalf of the particular defendant and/or defendant law firm, the number of depositions given, trial testimony, etc. It is imperative to secure this information to show the doctor's bias.

Likewise, it is also important to videotape the examination. To that end, without videotaping the examination it is difficult to challenge the doctor on his examination, and what the actual Plaintiff's complaints were on a given day. It is not unusual for a defense doctor to testify that the Plaintiff did not have complaints on a given day, to minimize the complaints or the findings during an examination.

The video shown below is an actual video from a Compulsory Medical Examination.

The video makes it clear why it is so important to videotape these examinations.

As a Miami Bicycle Accident Lawyer and Cyclist, I can conclude that the collarbone is the most frequent bone to be broken in bicycle accidents. For cyclists, collarbones are made to be broken because during a crash the first part of their body to hit the ground is often a shoulder, elbow or wrist. The force can be transmitted up the arm to the collarbone, which is one of the body's most vulnerable bones.

Elite cyclists are even more at risk because they carry as little upper-body muscle as possible, providing little protection to a bone that is already close to the surface.

The clavicle(collarbone) is an S-shaped long bone that acts as a strut to attach the shoulder to the axial skeleton. Its most anterior apex attaches to the sternum via the sterno-clavicular joint and at the posterior apex it broadens and flattens to attach to the acromion via the acromio-clavicular joint. The bone acts as an attachment point of several muscles such as the sternocleidomastoid, pectoralis major, and the sternohyoid muscles medially and on the lateral side the anterior deltoid, trapezius and the pectoralis major's clavicular head.

As written by the Boulder Center For Sports Medicine, with respect to characterizing clavicle fractures we tend to divide the bone into thirds with a medial, middle and lateral portions.

Fracture to the medial third of the clavicle are rare and make up less than 3 percent of breaks, while the lateral third is the second most frequently involved portion and accounts for 15-30 percent of all fractures.

The middle third of the clavicle is the narrowest section of the bone and lacks the muscular and ligamentous attachment of the ends. These facts when taken together are thought to make it more susceptible to injury and it is indeed the most frequent site of fracture (70-80 percent of all clavicle fractures). See video below which illustrates injury and treatment options.

Displacement is a term that means the bony ends of a fracture do not align and these mid-shaft fractures tend to have high rate of displacement with an incidence found to be between 48-73 percent. This high rate is likely related to the muscular attachments at the ends of the clavicle pulling the fracture fragments of bone away from their normal anatomic alignment, along with the actual weight of the upper extremity itself contributing to this distraction in some cases.

In cases of clavicle fracture it is extremely important to assess for concomitant injuries to the lungs, the surrounding neurovasculature, and other musculoskeletal issues such as associated rib fractures, AC joint separation and other scapular injuries to name a few.

In these injuries the clinician's goal from a management standpoint should be to heal the clavicle in a fashion that recreates its function as a solid support for the shoulder girdle to elicit the return of pain-free range of motion, normal strength and to avoid bony non-union and malunion (bone fragments heal together but there is persistent pain and or loss of shoulder function). The means of accomplishing this goal by bringing about the least risk and harm to the patient is ideal.

To operate or not?
Historically in regards to midshaft clavicle fractures it was thought that the best approach was non-operative management even in cases of large displacement with damage to vasculature/nerves, open fractures (bone fragments pierce the skin) and painful non-unions being the most common indications to proceed with operative intervention. Over the last decade this approach has come under increasing scrutiny, with newer studies of completely displaced fractures showing much higher patient dissatisfaction rates than previously thought in those treated with non-operative management. These rates were secondary to a markedly increased rate of non-union than formerly documented (up to 21 percent) as well as malunions causing considerable shoulder girdle dysfunction. Taking this into account with the improved surgical fixation techniques and much lower complication rates over the last decade, it has made operative interventions much more viable from a management standpoint.

The approach to the patient with clavicle fracture should be on a very individualized basis with age, activity level, personal preferences, fracture type and monetary/insurance concerns playing important roles in the decision process.

Juan Mauricio Soler, a professional cyclist was hospitalized with severe brain injuries and multiple fractures following a crash during the Tour of Switzerland. Soler crashed in the sixth stage at the Swiss tour last week after he lost control of his bike and crashed into a wall. Thankfully he is now out of immediate danger, but the risk of developing a pneumothorax remains. Soler was placed into an induced coma, and now the team doctor, Dr. Alfredo Zuniga said Soler is showing encouraging signs of improvement.

"It can be said that the life-threat has disappeared. He has begun to make light movements and tests seem to rule out spinal injury, although we should be aware of further studies," Zuniga said in a Movistar communiqué.

"Now we have to see the evolution of a possible neurological damage, a process in which we must be patient," he continued. "The cerebral edema is subsiding, the intracranial pressure is declining and the development of pneumothorax is also positive. Mauricio is still in the intensive care unit and he will stay there for several days".

Continue reading "Cyclist Who Sustained Severe Head Injury, Still Runs Risk OF Developing A Pneumothorax" »

A driver plowed into a group of bicyclists on a midnight ride Thursday in a suspected drunken driving crash that injured 11 riders, at least one critically.

The riders were taking part in a weekly midnight ride starting in Koreatown, near downtown Los Angeles. The group consisted of about 100 cyclists who were on a ride about 8 miles south of downtown Los Angeles when they were struck by a Honda Civic shortly before 2 a.m.

Some bicyclists told KTTV a woman driving the car appeared to be using a cell phone before the crash. They said she slowed down then sped up and slammed into the group, sending some riders flying into the air and dragging at least one under her car.

As reported by the Associated Press, the car turned from a blind corner and hit riders who had stopped in a traffic lane to wait for others to catch up, said Sgt. David Krumer, the LAPD's bicycle liaison. There were no skid marks so it was difficult to determine how fast the car was moving, Krumer said. In addition, He could not confirm reports that a streetlight in the area was out.

"It appears that they were stopped in traffic" and some who had dismounted to chat with friends technically were pedestrians, Krumer said.
Bicyclists have a legal right to use the right traffic lane unless they impede traffic, and pedestrians are barred from traffic lanes, Krumer said. Violators potentially could be cited, he added.
However, drivers have a legal responsibility to exercise caution regardless of the circumstances, Krumer said.

Night rides have become increasingly popular in congested areas. For example, a group from Aventura, Fl. rides at 5:00 a.m. and routinely meets up with other groups that are riding on Key Biscayne near downtown Miami.

"There's no traffic so you can more easily get a group of 50 to 60 riders together and stay together as a group," Krumer said.

However, it is not necessarily safer than daytime rides.

"If you're driving at 2 in the morning, that's when all the DUI drivers are likely to be out," he said.

Continue reading "Drunk Driver Crashes Into Pack of Bicyclists" »

In what has become an all too common occurrence, police are seeking leads in
a hit-and-run crash in which a bicyclist was struck and killed on the Sheridan Street Bridge in Hollywood, FL.

The bridge's cameras were rolling on May 13, when Willmar Edwardo Galeano, 45, of Pembroke Pines, rode his bicycle westbound on the bridge over the Intracoastal Waterway. Galeano was struck from behind by a white van that also was westbound at 9:21 p.m.

The van left the scene.

Galeano was taken to Memorial Regional Hospital and died from his injuries two days later, police said.

The portion of video released by police shows the final seconds before the van struck Galeano.

Continue reading "Police Looking for for a Hit and Run Motorist Who Struck and Killed a Cyclist" »

A bicycle accident claimed the life of Leopard-Trek's Wouter Weylandt after crashing on the descent of the Bocco mountain pass around 25km from the finish line during the Giro d'Italia Monday.

Race officials said his left pedal got stuck in a wall at the side of the road, forcing Weylandt to tumble around 20 meters to the ground below.

Weylandt, 26, was left bloodied and unconscious and required a cardiac massage after the crash.

He received emergency medical treatment by race doctors and was scheduled to be airlifted to hospital but had to wait as an emergency helicopter looked for a suitable landing spot.

Weylandt is the first professional rider to die in a crash since 2003 while racing since Kazakhstan's Andrei Kivilev succumbed to head injuries the morning after a crash on the second stage of Paris-Nice.

Kivilev's death, while the rider was travelling at a seemingly innocuous speed, signalled the introduction of the mandatory wearing of helmets in the professional peloton.

Weylandt, who hailed from Ghent, is the first fatality on the Giro since 1986 when Emilio Ravasio crashed on the first stage and fell into a coma to die several days later.

Although life and career-threatening crashes are a regular occurrence in cycling, the last fatality on the world's biggest race, the Tour de France, was over a decade ago.

On the race's 15th stage in 1995 Italy's Fabio Casartelli -- a member of Lance Armstrong's Motorola team -- died a few hours after sustaining injuries in a crash on the descent of the Portet d'Aspet in the Pyrenees.