My Hip Journey
The purpose of this site is to educate & empower one another exposing the good, bad & the ugly naive patients experience with little or no plan of care at the hands of inexperienced physical therapists & interns/surgeons who often practice on patients without prior dialogue or consent. Then the patients are often ignored, minimized, mistreated & dismissed. Please share your story here where you will be heard & valued. (484) 482-3292 myhipjourney@gmail.com
Saturday, February 15, 2025
Friday, February 14, 2025
Does Abuse Exist in The Medical System, Elderly & Disabled?
What is Patient Abuse?
Patient abuse encompasses a range of harmful behaviors and actions that violate a patient's rights and dignity. It can manifest in different forms, including physical, emotional, verbal, psychological, neglect, and financial exploitation. Patient abuse is an infringement on a patient's fundamental rights to receive proper care, respect, and protection.
Recognizing the Signs
Recognizing the signs of patient abuse is essential in identifying and addressing instances of mistreatment promptly. By being aware of the indicators, patients, their families, and healthcare providers can take appropriate action to prevent further harm. It is crucial to understand that signs of patient abuse may vary depending on the type of abuse and the individual's circumstances.
To facilitate recognition, here are some common signs associated with different forms of patient abuse:
Type of Abuse and Signs of Abuse
- Physical Abuse: Unexplained injuries or bruises, broken bones or fractures resulting as a result of different techniques resulting in severe harm.
- Emotional and Behavioral Abuse: Fear, anxiety, or depression, agitation or withdrawal, sudden changes in behavior
- Verbal and Psychological Abuse: Humiliation or insults, threats or intimidation, isolation or ignoring the patients legitimate concerns.
- Neglect and Financial Exploitation: Poor personal hygiene or lack of medical care or medication, unusual financial transactions or missing assets
It is important to note that these signs may not always be definitive proof of patient abuse, but they should raise concerns and prompt further investigation. If you suspect any form of patient abuse, it is crucial to report it to the appropriate authorities and seek support and resources for the affected individual.
By understanding what patient abuse entails and recognizing the signs, we can work together to create a safer and more compassionate healthcare environment for all patients. Promoting awareness, prevention, and intervention are vital steps in protecting vulnerable individuals and ensuring their rights are upheld.
Physical Signs of Patient Abuse
When it comes to identifying patient abuse, recognizing the physical signs is crucial. These signs may manifest as visible injuries or marks on the patient's body. It is important to be vigilant and attentive to any unexplained physical changes that may indicate abuse.
Unexplained Injuries or Bruises
One of the most common physical signs of patient abuse is the presence of unexplained injuries or bruises. These injuries may appear in various locations on the body and may vary in severity. Some common areas where these injuries may be observed include the arms, legs, back, or face.
It is important to note that while occasional bumps and bruises can be a part of everyday life, repeated or unexplained injuries should raise concern. The table below provides examples of potential signs of patient abuse related to unexplained injuries or bruises.
Physical Signs and Description
- Multiple bruises in different stages of healing: Bruises at various stages of healing can indicate a pattern of ongoing abuse.
- Injuries inconsistent with the patient's medical condition or explanation: Injuries that do not align with the patient's reported medical history or explanation may indicate abuse.
- Frequent injuries in unusual locations: Injuries in uncommon areas, such as the inner thighs or abdomen, may warrant further investigation.
Broken Bones or Frequent Fractures
Another physical sign of patient abuse is the presence of broken bones or frequent fractures. These injuries are often a result of physical force or trauma inflicted upon the patient. It is important to be cautious when encountering patients with recurrent fractures or a history of multiple bone injuries.
The following table highlights potential signs of patient abuse related to broken bones or frequent fractures.
Physical Signs and Description
- Multiple fractures occurring in a short period: Repeated fractures within a short span of time may indicate ongoing abuse.
- Fractures in different stages of healing: Fractures at various stages of healing can suggest a pattern of recurrent injuries.
- Inconsistent or vague explanations for fractures: Inadequate or inconsistent explanations given for fractures may raise suspicions of abuse.
Restraining Marks
Restraining marks, such as bruising or redness around the wrists or ankles, can be indicative of physical abuse. These marks may suggest that the patient has been physically restrained against their will. It is important to pay attention to any signs of physical restraint, especially if they appear frequently or without a legitimate medical reason.
The table below outlines potential signs of patient abuse related to restraining marks.
Physical Signs and Description
- Bruising or redness around wrists, ankles, or other body parts: Marks indicating the use of physical restraints can be a sign of abuse.
- Consistent presence of restraining marks: Frequent or persistent presence of restraining marks may indicate ongoing abuse.
- Presence of other injuries alongside restraining marks: The combination of restraining marks with other injuries may suggest physical abuse.
Recognizing and documenting these physical signs of patient abuse is essential for ensuring the safety and well-being of patients. If you suspect that a patient may be experiencing abuse, it is important to report your concerns to the appropriate authorities or healthcare professionals to ensure that appropriate action is taken.
Emotional and Behavioral Signs of Patient Abuse
Recognizing the emotional and behavioral signs of patient abuse is crucial in identifying and addressing instances of mistreatment. Abuse can deeply affect a patient's emotional well-being and behavior, often leaving lasting psychological scars. In this section, we will explore some common indicators of emotional and behavioral abuse.
Fear, Anxiety, or Depression
One of the telltale signs of emotional abuse is the presence of fear, anxiety, or depression in the patient. Abused patients may exhibit excessive fear or apprehension, especially when interacting with certain individuals or in specific environments. They may also display signs of anxiety, such as restlessness, irritability, or difficulty sleeping. Moreover, a significant change in the patient's overall mood, including prolonged periods of sadness or unexplained depression, can be indicative of emotional abuse.
Agitation or Withdrawal
Abused patients may exhibit behavioral changes, often manifesting as agitation or withdrawal. They may become easily agitated, displaying signs of irritability, aggression, or hostility towards others. On the other hand, some patients may withdraw and become socially isolated, avoiding interactions or activities they previously enjoyed. These changes in behavior can be a result of the psychological trauma caused by abuse.
Sudden Changes in Behavior
Another important sign to look out for is sudden and unexplained changes in a patient's behavior. This can include drastic shifts in personality, interests, or daily routines. For example, a previously outgoing patient may suddenly become introverted, avoiding social interactions. Or a patient who was once punctual and organized may start displaying disorganized or erratic behavior. These sudden changes can be an indication of emotional distress resulting from abuse.
It is important to note that emotional and behavioral signs alone may not definitively confirm patient abuse. However, they serve as red flags, prompting further investigation and intervention. If you suspect abuse based on these signs, it is essential to report your concerns to the appropriate authorities and ensure the safety and well-being of the patient.
By understanding and recognizing the emotional and behavioral signs of patient abuse, we can work towards creating a safer and more supportive environment for vulnerable individuals. Being vigilant and proactive in identifying these signs can help protect patients from further harm and ensure they receive the care and support they deserve.
Verbal and Psychological Signs of Patient Abuse
In addition to physical signs, patient abuse can also manifest through verbal and psychological means. These signs may be more subtle but can have a profound impact on the well-being and mental health of the patient. It's important to be aware of these signs to identify and address patient abuse effectively.
Humiliation or Insults
One of the verbal signs of patient abuse is the use of humiliation or insults towards the patient. Abusive individuals may belittle, mock, or degrade the patient, undermining their self-esteem and causing emotional distress. This can occur in private or in the presence of others, exacerbating the humiliation experienced by the patient.
Threats or Intimidation
Another red flag of patient abuse is the presence of threats or intimidation. Abusers may use fear as a tactic to control and manipulate patients. They may issue threats of physical harm, punishment, or retaliation to instill fear and ensure compliance. Patients who constantly live in fear or feel threatened should not be taken lightly, as these signs can indicate an abusive environment.
Isolation or Ignoring
Isolation or ignoring is a form of psychological abuse where patients are intentionally excluded or ignored by their caregivers or healthcare providers. This can manifest as purposeful neglect, where patients are denied social interaction, emotional support, or basic human contact. Isolation can lead to feelings of loneliness, anxiety, and depression, exacerbating the emotional toll of patient abuse.
Understanding and recognizing these verbal and psychological signs of patient abuse is crucial for early intervention and prevention. By being vigilant and observant, healthcare professionals, caregivers, and family members can play a vital role in identifying and reporting instances of patient abuse. It is essential to create a safe environment where patients feel empowered to speak up and seek help if they experience any form of abuse.
Neglect and Financial Exploitation
In addition to physical, emotional, and verbal abuse, patient abuse can also manifest in the form of neglect and financial exploitation. It is crucial to recognize the signs of neglect and financial abuse to ensure the safety and well-being of vulnerable patients.
Poor Personal Hygiene or Malnutrition
Neglect can be observed through the neglect of a patient's personal hygiene and nutrition. Patients who are subjected to neglect may have unkempt appearances, poor oral hygiene, or unclean living environments. Lack of proper nutrition can result in visible weight loss, malnourishment, or dehydration.
Signs of Neglect and Examples
- Poor personal hygiene: Unkempt hair, body odor, dirty clothing
- Malnutrition: Visible weight loss, sunken eyes, pale skin
Lack of Medical Care or Medication
Another sign of patient neglect is the absence of necessary medical care and medication. Patients who are neglected may not receive timely medical attention for their existing health conditions or may be denied access to prescribed medications. This can lead to worsening of their health conditions and preventable complications.
Signs of Neglect and Examples
- Lack of medical care: Delayed or missed medical appointments, untreated injuries or illnesses
- Absence of medication: Inconsistent or no administration of prescribed medication
Unusual Financial Transactions or Missing Assets
Financial exploitation occurs when a patient's finances or assets are misused or taken without their consent. Caregivers or others in positions of trust may exploit patients financially, leading to significant financial losses. It is important to be vigilant for any unusual financial transactions, sudden changes in the patient's financial situation, or missing assets.
Signs of Financial Exploitation and Examples
- Unusual financial transactions: Unauthorized withdrawals, excessive spending, sudden changes in financial accounts
- Missing assets: Disappearance of valuable possessions, unexplained loss of money
Recognizing the signs of neglect and financial exploitation is crucial in protecting vulnerable patients. If you suspect any form of patient abuse, it is important to take action by reporting your concerns, seeking support and resources, and promoting awareness and prevention to ensure the safety and well-being of patients.
Taking Action Against Patient Abuse
When it comes to patient abuse, it is crucial to take immediate action to protect the well-being and safety of vulnerable individuals. Recognizing the signs of abuse is just the first step. This section focuses on the actions that can be taken to address patient abuse effectively.
Reporting Suspected Abuse
If you suspect that a patient is being abused, it is essential to report your concerns to the appropriate authorities. Reporting suspected abuse helps ensure that the victim receives the necessary support and intervention. The reporting process may vary depending on the specific circumstances and location, but here are some general steps to follow:
- Document the details: Make a note of the observed signs of abuse, including dates, times, locations, and any other relevant information.
- Contact the appropriate authorities: Report the suspected abuse to the appropriate agency or organization, such as a local law enforcement agency, adult protective services, or a healthcare facility's designated reporting line.
- Provide accurate information: Be prepared to provide the details of the suspected abuse, as well as any supporting evidence or documentation you may have.
- Follow up: If you have reported abuse, follow up with the appropriate authorities to ensure that your concerns are being addressed and that the necessary actions are being taken.
Seeking Support and Resources
Support and resources are crucial for both the victims of patient abuse and those who suspect or report abuse. If you are a victim or know someone who is, it is important to seek help from the following sources:
Resource and Contact Information
National Domestic Violence Hotline: 1-800-799-SAFE (7233)
National Sexual Assault Hotline: 1-800-656-HOPE (4673)
National Child Abuse Hotline: 1-800-4-A-CHILD (1-800-422-4453)
National Adult Protective Services Association: www.napsa-now.org
Remember, seeking support is not limited to the victims alone. If you suspect abuse or want to learn more about preventing patient abuse, reach out to these resources for guidance and assistance.
Promoting Awareness and Prevention
Raising awareness about patient abuse is a crucial step in preventing future incidents. By promoting awareness, we can work towards creating a safe and supportive environment for patients. Here are some actions that individuals and organizations can take to promote awareness and prevention:
- Educate healthcare professionals: Provide training and resources to healthcare professionals to help them recognize and respond to signs of patient abuse effectively.
- Establish reporting mechanisms: Encourage the implementation of clear and accessible reporting mechanisms within healthcare facilities to ensure that suspected abuse is promptly addressed.
- Advocate for policy changes: Support initiatives that aim to strengthen laws and regulations related to patient abuse and advocate for the rights and protection of vulnerable individuals.
- Foster a culture of empathy and respect: Promote a culture within healthcare settings that prioritizes empathy, respect, and patient-centered care, thereby reducing the likelihood of abuse.
By taking action against patient abuse, we can contribute to a society that values and safeguards the well-being of all individuals. It is our collective responsibility to recognize, report, support, and prevent patient abuse in order to create a safer and more compassionate healthcare system.
Sources
Monday, February 10, 2025
Manipulation
Assertive pressure and manipulation are two distinct forms of influence that can significantly impact an individual's ability to adhere to established guidelines. Assertive pressure is characterized by a direct and respectful communication style, where individuals express their needs or expectations clearly, fostering an environment of mutual understanding. This approach encourages compliance through reasoned dialogue, promoting a sense of accountability and responsibility among all parties involved. It is essential to recognize that assertive pressure can lead to positive outcomes, as it often aligns with organizational goals and enhances collaboration.
Conversely, manipulation involves coercive tactics aimed at undermining an individual's autonomy and distorting their decision-making process. Individuals who manipulate often employ deceitful strategies, exploiting vulnerabilities to achieve their objectives. This behavior can create a toxic atmosphere, where compliance is achieved through intimidation or guilt rather than genuine agreement. It is imperative to identify such tactics and resist them, as they can severely hinder personal and organizational integrity. Recognizing the signs of manipulation is crucial for maintaining a healthy and productive environment.
To effectively navigate these dynamics, individuals must cultivate assertiveness while remaining vigilant against manipulative behaviors. Establishing clear boundaries and communicating expectations transparently can empower individuals to stand firm against undue influence. Engaging in open dialogue and fostering a culture of respect will not only enhance compliance with organizational rules but also promote a more harmonious workplace. Embrace assertive pressure as a tool for growth and collaboration, and reject manipulation in all its forms to ensure a thriving and ethical organizational climate.
Wednesday, January 29, 2025
Help For Disabled Veterans
Veteran Services and Support Network
Next Steps:
Monday: 8:00 AM - 5:00 PM EST
Tuesday: 8:00 AM - 5:00 PM EST
Wednesday: 8:00 AM - 5:00 PM EST
Thursday: 8:00 AM - 5:00 PM EST
Friday: 8:00 AM - 5:00 PM EST
Saturday: Closed
Tuesday, January 28, 2025
THE POWER OF GOOD & EVIL
What good is this if they dont hold Doctors, Surgeons & Physical Therapists up to the light and/or allow them to lie, lie, lie? They have the power to destroy a person's Quality of life & livelihood without any accountability Thats not right but one day we will all be held accountable to God Almighty.
January 13, 2025, all applicants for health care practitioner licenses must submit a full set of fingerprints to the Pennsylvania State Police for an FBI criminal history background check as a requirement for licensure. Individuals who are already licensed in Pennsylvania will not need to complete this background check to renew their current license.
As the Department works to finalize the necessary steps to access official FBI background check results, the Bureau will temporarily continue to accept applicant-submitted FBI Identity History Summary Checks to permit applicants to complete their licensure requirements during this transitional period. FBI Identity History Summary Checks are available at https://www.fbi.gov/services/cjis/identity-history-summary-checks.
Saturday, January 25, 2025
Do Surgeons Decline With Age?
The issue of surgeon retirement age presents a significant concern within the medical community, particularly as it relates to patient safety and surgical outcomes. Research indicates that the physical and cognitive capabilities of surgeons may decline with age, leading to potential risks in surgical performance. The rapid advancements in medical education and technology further exacerbate this issue, as older surgeons may find themselves increasingly disconnected from the latest practices and techniques in their field. The absence of a federally mandated retirement age in the United States compounds the problem, allowing surgeons to continue operating despite evidence suggesting a decline in their abilities.
Anecdotal evidence, alongside objective assessments, highlights the reluctance of many surgeons to retire, often due to personal attachment to their profession or financial considerations. This reluctance poses a substantial risk to patient safety, as the cumulative effects of aging can lead to increased complications during surgery. The medical community must confront this uncomfortable reality and establish clearer guidelines regarding the retirement of surgeons, ensuring that patient welfare remains the paramount concern.
In light of these challenges, it is imperative that hospitals and medical institutions take proactive measures to evaluate the performance of aging surgeons. Regular assessments should be instituted to monitor both physical and cognitive capabilities, thereby ensuring that surgical teams are composed of individuals who can meet the demands of modern surgical practices.
Failure to address this issue not only jeopardizes patient safety but also undermines the integrity of the surgical profession as a whole. It is essential for the medical system to engage in this critical discourse and implement necessary changes to safeguard the future of surgical care for every patient not just some.
Friday, January 3, 2025
Skills - Compassion
Being highly skilled without compassion in the medical field is not enough. While technical expertise is crucial, it is equally important to have empathy and compassion for patients. Without these qualities, healthcare professionals risk providing subpar care and failing to meet the emotional needs of their patients. Research has shown that compassionate care leads to better patient outcomes, increased patient satisfaction, and improved overall healthcare experiences. Therefore, it is imperative that medical professionals prioritize both their technical skills and their ability to empathize with and support their patients.
Patients who receive care from healthcare professionals lacking in compassion often report feeling neglected, unheard, and dehumanized. This can have detrimental effects on their mental and emotional well-being, exacerbating their physical health conditions. In contrast, healthcare providers who demonstrate compassion are more likely to establish trust and rapport with their patients, leading to improved patient compliance, better treatment outcomes, and increased patient satisfaction. Moreover, compassionate care has been shown to reduce patient anxiety, enhance pain management, and even contribute to faster recovery times.
In conclusion, being highly skilled without compassion in the medical field is simply not enough. Healthcare professionals must recognize the importance of empathy and compassion in their practice. By prioritizing these qualities alongside their technical expertise, they can provide holistic care that addresses both the physical and emotional needs of their patients. It is essential that medical education and training programs emphasize the development of compassionate skills to ensure that future healthcare professionals are equipped to provide the highest quality of care to their patients.
Monday, December 16, 2024
GROWING TRENDS IN ORTHOPEDICS
There is a growing trend in the orthopedic industry & that is issue of total & up-front transparency regarding the benefits along with the potential hazards associated with hip and knee implants.
It is of paramount importance. patients often place their trust in the white lab coat peoples recommendations of healthcare professionals and the FDA.
Moreover, the reliance on manufacturers to provide safety data raises significant doubts about the integrity of the information presented to both doctors and patients. The financial incentives that exist within the industry can create an environment where the potential risks of these implants are downplayed or obscured. This lack of accountability is troubling, as it undermines the trust that patients place in their healthcare providers. It is imperative that patients receive comprehensive, unfiltered information about the risks associated with the variety of hip and knee implants to make informed decisions about their treatment options.
In light of these concerns, it is essential to advocate for greater transparency and independent research into the safety of hip and knee implants. The current state of affairs, where vested interests may compromise patient safety, is unacceptable.
Patients deserve to be fully informed about the potential hazards of the devices & methods performed & how many of these procedures they have done prior to operating on you. Let's face it some Doctors may receive kickbacks from various manufacturers & makes them free bias to the procedures & prosthetics used on you. Until significant changes are made in how information is shared and regulated, the outlook remains nebulous at best and patients will continue to face undue risks in their pursuit of relief from pain and mobility issues. Here is a list of 10 things that can possibly go wrong: #1 leg length discrepancies #2 infections because of not properly followed basic protocols to clean & maintain sterile implements. #3 ambulisomes in the blood and heart which recently happened with Dr David Nazarian failing to follow basic protocols with a recent knee replacement failing Nazarian was trained by the infamous University of Penn but now Dr Nazarian operates under the tutelage of Rothman Orthopedics Specialty Hospital & Thomas Jefferson Health Systems The family lost their beloved Mother which no amount of money can compensate such a catastrophic outcome & loss @ the hands of total negligence and incompetence.
Wednesday, November 20, 2024
DESERVES TO BE REPEATED
Hello to whoever is reading this i just want to send well wishes and raise your awareness to what you are going to be facing when approaching hip or knee surgery
(To be continued....)
Sunday, November 17, 2024
THE VALUE OF BEING HEARD AS A PATIENT & A PERSON
Being heard and valued as an orthopedic patient is paramount, particularly in the context of hip or knee replacement procedures. Prior to surgery, patients must engage in open dialogues with their healthcare providers to articulate their concerns, expectations, and medical histories. This communication fosters a collaborative environment, ensuring that treatment plans are tailored to individual needs. It is essential for patients to voice their preferences regarding pain management and rehabilitation strategies, as these discussions can significantly influence postoperative outcomes and overall satisfaction with the surgical experience.
During the surgical process, patients must feel assured that their voices continue to hold weight. An effective orthopedic team will prioritize patient education, clearly explaining the surgical procedure, potential risks, and expected recovery trajectories. This transparency not only alleviates anxiety but also empowers patients to take an active role in their care. It is crucial for patients to ask questions and seek clarification about any aspect of their treatment to ensure they fully understand the process and can make informed decisions regarding their health.
Post-surgery, the value of being heard and valued persists as patients navigate their recovery journey. Regular follow-up appointments provide opportunities for patients to report their progress, express any concerns, and adjust rehabilitation protocols as necessary. It is imperative that healthcare providers remain receptive to patient feedback during this phase, as it can lead to modifications in care that enhance recovery and quality of life. Patients should actively participate in their rehabilitation, advocating for their needs and preferences, which ultimately contributes to a more favorable outcome and a sense of empowerment in their healthcare experience.
Wednesday, October 9, 2024
Tuesday, October 8, 2024
$2.5 MILLION SETTLEMENT :: ROTHMAN HOSPITAL & DR. DAVID NAZARIAN
Source: LEGAL INTELLIGENCER
Taking legal action against a hospital or Doctor might feel hopeless at times. Remember that hospitals & Doctors are responsible for providing safe care, and if negligence caused your loved one's death or if you suspect negligence or any treatment or medical care below the standard of care before, during or after hip, knee and/or back and any & all Medical and/or Orthopedic procedures you really deserve answers.
Dont wait. Call today!
Justice is just a call away
Ask for Tyler today.
(610) 891 - 9212
"Injustice anywhere is
a threat to justice everywhere"
- Dr. Martin Luther King
Contact Sachetta & Baldino today
Jury Returns $2.5M Award Against Rothman Specialty Hospital & Dr. DAVID NAZARIAN, M.D. for Failing to Prevent Blood Clot After Surgery :: MALPRACTICE :: NEGLIGENCE :: DEATH

Jury Returns $2.5M Award Against Health Care Providers for Allegedly Failing to Prevent Blood Clot After Surgery
"I am extremely happy for the family of Mrs. Koesterer. The verdict vindicated their feelings that the life of their mother, who was age 86, was worth more them a nominal sum. It seems to dispel the insurance industry myth that the life of an elderly person is minimal and confirms that no matter the age, all lives are precious," said the plaintiff's attorney, Thomas Sacchetta of Sacchetta & Baldino.
June 07, 2024 at 10:46 AM
CLICK BELOW NOW
Correction: The article incorrectly stated the verdict was against Thomas Jefferson University Hospital. The verdict was only against Rothman Orthopaedics & Dr. David Nazarian.
A Philadelphia jury returned a $2.5 million verdict against Rothman Orthopaedics & DAVID NAZARIAN, M.D. in a wrongful death suit,
finding the Clinical Team NEGLIGENT
in failing to properly treat an elderly patient following hip surgery, which led to a lower left extremity deep vein thrombosis and a pulmonary embolism.
The case, Koesterer v. Thomas Jefferson University Hospital, was tried for three days before Philadelphia Court of Common Pleas Judge Gwendolyn N. Bright, with the suit stemming from the death of Virginia Koesterer, after she suffered a massive venous thromboembolism (VTE).
Koesterer's estate alleged her death was the result of negligence on behalf of numerous health care workers and health care facilities, claiming her VTE originated from a deep vein thrombosis (DVT) formed during or soon after her hip surgery the morning before.
Daniel Koesterer, as executor of Koesterer's estate, sued defendants Thomas Jefferson University Hospital, Thomas Jefferson University Hospitals, Thomas Jefferson University Physicians, Jefferson Health, Jefferson Health System, Reconstructive Orthopaedic Associates II, Reconstructive Orthopaedic Associates II, and Dr. David Nazarian. At trial against the Reconstructive Orthpaedic defendants and David Nazarian, he claimed the defendants failed to properly treat Koesterer for her increased rise of venous thromboembolism development, which he claimed was a breach in the standard of care.
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"I am extremely happy for the family of Mrs. Koesterer. The verdict vindicated their feelings that the life of their mother, who was age 86, was worth more them a nominal sum. It seems to dispel the insurance industry myth that the life of an elderly person is minimal and confirms that no matter the age, all lives are precious," said Koesterer's attorney, Thomas Sacchetta of Sacchetta & Baldino. "The carrier only valued Mrs. Koesterer life at nuisance value. The jury in our case took their job seriously, considered all the evidence, and delivered a fair verdict based on all the evidence."
According to the plaintiff's pretrial memorandum, Koesterer "clearly had a significant past medical history with known increased risk of development of venous thromboembolism," yet all of her anticoagulation medications were stopped before her left total hip arthroplasty.
The plaintiff alleged that Koesterer wasn't adequately mobilized during her postoperative period, and that her blood pressure wasn't adequately maintained, despite the acknowledgment that it should be. Sacchetta claims her orthopedic providers were made aware of her hypotensive episodes.
"This combination of lack of adequate care was a breach in the standard of care and led to the development of Ms. Koesterer's left lower extremity DVT, which ultimately led to a PE that caused her death. Had the standard of care been met, by adequately caring for Ms. Koesterer with maintenance of her aspirin, a bridging anticoagulation therapy, appropriate mobilization, and/or maintenance of her blood pressure to prevent hypotension, Ms. Koesterer would not have developed a left lower extremity DVT that led to a PE and her death," the plaintiff argued in the filing.
The memo further alleged that NAZARIAN failed "to follow the cardiology recommendation of aspirin immediately following surgery," and that this was a breach of the standard of care and "increased the risk of harm to Ms. Koesterer contributing to her death." The hospital, Thomas Jefferson University Physicians, and Thomas Jefferson Health Systems "violated their duty to Ms. Koesterer to ensure her safety and well being while under their care," by failing "to properly oversee all medical providers to ensure that patients safety and that proper medical care was provided," according to the memo.
"Additionally they failed to formulate, adopt, and enforce adequate rules and policies to ensure that quality care for patients including Ms. Koesterer by failing to have proper policies and enforce said policies as is relates to anticoagulation. The breaches of care by the hospital with regard to their failure to enforce the policies and to oversee the medical personnel was a direct violation of the standard of care and caused and increased the risk of harm to Ms. Koesterer thereby causing her death," the plaintiff's filing said.
Defendants, Nazarian, Reconstructive Orthopaedic Associates II, and Reconstructive Orthopaedic Associates II, argued in their pretrial memo that the plaintiff's claims were without merit and denied all allegations of negligence.
According to the defendants, Koesterer was admitted to the hospital for a planned hip replacement by Nazarian. Approximately 1,000 units of heparin were administered intraoperatively, and after the procedures, and Nazarian ordered a 2 mg tablet of warfarin, and entered an order for 2.5 mg warfarin tablets to be given to her once a day.
Koesterer was later seen by Dr. Kenneth Rosenberg at the request of Nazarian. Rosenberg noted that Koesterer "had permanent atrial fibrillation on warfarin with a controlled rate of diltiazem and recommended continuing it unless her systolic went under 100," that the Jefferson Antithrombotic Service (JATS) was following Koesterer for warfarin management, and that Koesterer was on Plavix, which "Dr. Rosenberg felt that aspirin was acceptable for a few days for DVT prevention," according to the defendants.
According to the memo, the morning of Sept. 19, 2019, it was noted that Koesterer denied chest pain, shortness of breath, and bleeding, and that Dr. Taki Galanis planned to start warfarin 2.5 mg that evening and check Koesterer's internal normalized ratio the following day. Galanis also noted that bilateral compression devices were to be continued.
The defendants claim that the cardiology and orthopedic surgery teams were working on plans for antiplatelet resumption, and that the present plan for Koesterer was to continue the current dose of warfarin the evening she died. According to the memo, Koesterer became hypotensive that night, and was later found in ventricular fibrillation and declared dead.
Marcie A. Courtney, a principal at Post & Schell, represented Thomas Jefferson University Hospital, Thomas Jefferson University Hospitals, Jefferson University Physicians, Jefferson Health, and Jefferson Health System.
Marshall L. Schwartz, a partner at O'Brien & Ryan, served as counsel for the defendants Nazarian, Reconstructive Orthopaedic Associates II, and Reconstructive Orthopaedic Associates II.
Neither attorney immediately responded to messages seeking comment.
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