Inteview with Orlando injury attorney Charles Franklin
Many injuries victims that arrive at local hospitals are the result of auto accidents. Ever wonder how those large hospital bills are paid for? Who pays for that $30,000 medical bill for a broken leg? Car accident attorney Charles Franklin paid us a visit to clear up some of the details.
John: How are hospital bills usually paid for after a car accident?
Attorney Franklin: It depends on the severity of the injury and if you carry PIP insurance. If you live in Florida, Personal Injury Protection insurance is required by all drivers. It is used to cover medical expenses and lost wages up to 10K no matter who was at fault for the accident. This is perfect for minor injuries and saves the time of going through litigation. One problem is medical expenses in the US are outrageous. I have seen MRIs go for $2500 to $5000. It’s absurd.
When the PIP is exhausted, the victim of the accident will (hopefully) contact an auto accident attorney. It is the attorney’s job to gather evidence and send a demand package to the at fault driver’s insurance company. The goal is to get the at fault driver’s insurance company to pay for the remaining medical bills.
John: Does car insurance take care of the bills only if you were driving a car? For example you would not be able to use car insurance if you fell and broke your wrist.
Attorney Franklin:Not exactly. You could have been a passenger in a friends car who got into an accident after driving recklessly. You health insurance should cover medical expenses if you broke your wrist by tripping. Now if you broke your wrist while trying to avoid being struck by a vehicle, that’s another story.
John: Do you still use your own health insurance?
Attorney Franklin:That is tricky. Car insurance is responsible for medical payments up until it runs out. After that your own health insurance should pick up where the car insurance left off.
John: What if you don’t have health insurance?
Attorney Franklin:If this is the case it is very important to contact an attorney. Hopefully the at fault driver was carrying decent bodily injury protection at the time of the accident. The other thing we can do is negotiate medical bills on behalf of our clients. Not all medical bills are set in stone, if fact many of them are over inflated to compensate of other people who do not pay. There have been many times where we were able to slash out client’s medical bills by half. For example say a client has $50,000 in medical bills but both the client and the at fault driver had minimal insurance. (Minimal insurance in FL is $10K) The most the client would be able to obtain would be $20k, most of the time in this situation the hospital will take what it can get.
This is not something that people normally think about. Most assume some sort of insurance will pay for medical bills when they arrive. It is good to be one step ahead of the game. Your car insurance can be just as important as your health insurance. You never know when you are going to need them.
How long has it been since there has been a true medical breakthrough? What comes to mind with you are asked what the most influential medical breakthrough was? Penicillin? The polio vaccine? The CT scanner? According to attorney Charles Franklin, the MRI has been one of the most influential breakthroughs of the past 50 years. Opinions may vary but the MRI machine has been one of the greatest diagnostic machines for medical professionals. Mr. Franklin still feels it still has room for improvement.
As a personal injury attorney, I see victims of car accidents on a daily basis. Many times a client will come to me with pain that just will not go away. They may appear fine on the outside, no cuts or bruises but complain of severe back or neck pain. The story is almost always the same. I am told they have been to multiple doctors after their accident but nobody is able to figure out what the problem is. It is frustrating because these people are stacking up medical bills from a car accident that was not their fault. My job is to present evidence to a judge and jury showing that my client is indeed injured and in need of compensation. If I have a doctor telling the jury that he has not found anything physically wrong with my client it makes the case looks bad. Most people do not just lie about physical pain. Usually the problem is not figured out until they are sent to an orthopedic specialist who schedules them a MRI scan that the problem is determined. Hairline fractures in vertebrae are often missed by a standard radiography machine and usually do not cause external bruising.
What do you think needs to be improved about the MRI?
The biggest complaint I hear from people feeling claustrophobic and the noise of the machine. You are basically are shoved into a white tube while you hear clunking as the machine scans your body. It is still safer than a CT scanner because no radiation is used. I would like to see research done on reducing the physical size of the machine and the cost. I have seen many hospitals charge $2500 per scan and it is common for multiple scans to be performed. I practice personal injury law in Florida, a no fault state where personal injury protection insurance is required by all drivers. My clients have access to 10k in PIP insurance but that money is depleted quickly after just two scans –and that’s just for the diagnostics, not treatment.
You were thinking of starting a funding a research project?
Yes. I think if we can get enough money going to pay engineers for a think tank some actual progress can be made. The problem is only large companies like GE or Toshiba are able to produce these machines. So yes, I have been looking to set up a fund and match whatever is donated to it. Right now I am looking for motivated individuals to help create a video that will entice others to donate to the project. If successful, this could potentially benefit healthcare patients around the world. I would like to see the cost of these machines brought down from 1.4 million to somewhere around two hundred thousand. That way hospitals would not have to charge outrageous prices to eventually pay for the machine before it becomes out dated.
A brief history of the MRI:
In 1886 Nikola Tesla discovered the rotating magnetic field and patented his discovery in 1888. This concept is the backbone of how the Magnetic Resonance Imaging (MRI) machine came to be. The magnetic field strength is measured in Tesla units. This unit was named after Nikola in 1956 by the International Electro-technical Commission-Committee of Action. The stronger the magnetic field the more Tesla is produced. All MRI strengths are labeled in Tesla. The next step in history toward the invention of the MRI was made in 1937 by Isidor I. Rabi when discovered nuclear magnetic resonance (NMR). Rabi found that atomic nuclei show where they are by taking in or expelling radio waves after being exposed to a large magnetic field.
Although Rabi discovered the concept of NMR he never specifically scanned for the composition of chemicals. The first NMR technique was published by Physical Review in 1946 from the efforts of Felix Bloch. Apparently at the same time American physicist Edward Purcell had discovered the same thing. They both found new techniques to identify chemicals and compounds using NMR technology and were mutually awarded the Nobel peace prize in 1952. This would not be the last time the credit to the discovery of magnetism would be awarded to more than one person.
Enter chemist Paul Lauterbur and physician Raymond Damadian. Lauterbur had been using NMR for years before Damadian had. Damadian was the first to think of using NMR for humans in 1970 but he initially had not thought of producing an image from this technique. He wanted to use NMR to distinguish cancerous tissue from regular tissue without exposing the patient to radiation. Since cancerous tissue holds more water it sends out radio signals for a longer period of time when exposed to a large magnetic field. His findings were published in the journal Science in March of 1971 in which he claimed a large scanner for cancer could be build. Later that summer Lauterbur outlined a way to use NMR to produce a 2D image of tissue. In autumn of 1972 Lauterbur successfully scanned two test tubes and a clam using the NMR technique and magnetic field gradients to map out points to produce an image.
Meanwhile Damadian had been working on his full body scanner machine. He filed for a patent for the “apparatus and method for detecting cancer in tissue” in 1972 and was granted it in 1974. Damadian’s first prototype scanner was ready for testing in 1977. He one of his graduate students Mike Goldsmith put together a wearable antenna coil using copper wire, cardboard and capacitors. The first successful full body scan was done to graduate student Larry Minkoff and the group was able to construct a image using colored pencils from the 106 data points.
In 1978 Peter Mansfield found that fast imaging could be done by creating the MRI protocol echo-planar imaging. That year Mansfield presented the first human image of his own abdomen. Damadian went on to produce the first commercial MRI scanners with his company FONAR in 1980. Other companies like Toshiba, Siemens, and General Electric began manufacturing and selling MRI scanners since the 1980’s. However in 1997 Damadian’s company FONAR was awarded 128 million dollars in from each of these companies due to patent infringement. In 2003 the Nobel Prize was awarded to Lauterbur and Mansfield for their contributions leading to the development of the MRI.
In comparison here is a video of a CT scanner without the cover.
The wonder robot has been legally performing surgeries for 13 years now. Is it everything we thought it would be?
In the year 2000 the Da Vinci surgical robot was approved by the FDA to perform surgeries on adults and minors. The 1.7 million dollar machine allows surgeons to perform minimally invasive complex surgery. The surgeon controls the robot by manipulating a series of foot pedals and two hand controllers while peering at a 3D image of the surgical site. It is able to turn shaky movements of the doctor into exact instrumental movements. Since its’ introduction, 2500 surgical robots have been installed in hospitals around the world and have performed 1.5 million surgeries.
The problem, as with anything, is not all of the surgeries have gone as planned. One particular incident happened in 2007 when part of the robot’s arm fell off while performing surgery inside a prostate cancer patient. It was bad enough that the urologists needed to make the incision larger in order to remove the part that broke off. This kind of mistake almost always results in a lawsuit which is why doctor’s insurance coverage is so high. The problem is not necessarily the machine.
Patient Complaining of Injuries
It seems to be one of the most common issue patients have are burn related injuries. The Federal Drug Administration’s database, current lawsuits, and attorney’s dealing with the cases all point to a fairly common issue: Heat Related injuries.
“When performing surgery on sensitive organs like the intestines or the ureter, temperature is a important factor.” Says a spokes person for the Orlando personal injury lawyer group. “Patients who are in pain will come to us and inquire about what is involved with a medical malpractice lawsuit. It is not until we pull the medical records that we find the link between the burn and the Da Vinci robot.”
When these injuries do happen, the doctor does not always know it as the field of vision is limited. If the doctor is performing surgery by hand there is never a concern that his hand will over heat. The machines mechanical arms get warmer, the longer the surgery goes on.
Steep Learning Curve
Technically a surgeon can be certified to use Da Vinci over the weekend. Surgeons learning how to use Da Vinci take a multi step course that starts with an hour of online training. Next they view two entire robot procedures that are about four hours long followed by a required 7 hours of practice operating using a pig for practice. The first 2 procedures performed on a human patient must be done with a more experienced Da Vinci surgeon, but after that the doctor can go solo.
Most doctors are not going to just jump into using a expensive machine that they have never used before however hospital have been pushing for doctors to take on more procedures to make money. Rushing any surgery is never a good idea, especially if you are doing it with a 1.7 million dollar robot. It may be a case where, like the scalpel, the surgical robot is only as good as the surgeion who uses it. The past year had a increase in the number of lawsuits related to the robot. So far 10 lawsuits have been filed between 2011 and 2012.
UPDATE: The funding to keep the clinical trials blog was running out until a orlando car accident lawyer swooped in and replenished funding. Our thanks go out to them! If you are interested in using their legal services they have a short Youtube video you can watch to learn more.
Regenerating our bodies through developing completely new body parts or even fixing up impaired ones with only a few cells scraped from your flesh is really a exciting region of scientific research known as bioengineering. Each and every surviving cell in a organ is normally maintained through the bloodstream, which gives food and oxygen as well as passes through our circulatory system. Effective body organ bioengineering depends on creating this type of approach to blood circulation effective at attaining and aiding the vitality needs of each surviving cell.
Blood vessels are located everywhere inside us and the walls of them are usually multiple cell layers in size. These walls are made up of endothelials, smooth muscles and a few other cell types that form the needed balance. It’s not exactly easy manufacturing a naturally complex process like this. When humans are tiny embryos, we have a natural pre written program that is responsible for creating multiple kinds of gene specific cells; all from a lone stem cell know as the pluripotent cell. Each pluripotent cell contains a large number of instructions responsible for telling the other cells what to do, where to go, and how to grow. Being able to use the ability of pluripotnet stem cells to help bioengineer organs always tends to bring up certain ethical problems because for years, the only way to obtain these cells was to get them from a human embryo. Our bodies naturally have a stem cell source commonly referred to as adult stem cells. These cells go into action when our body needs to repair itself. The only issue with utilizing adult stem cells for bioengineering is they are already specialized for a particular organ. On top of that it is virtually impossible to obtain a decent size to be able to even use. There are ways around this… One common method is to increase the number of cells by growing them. The issue with this is it is a slow and expensive process that is susceptible to failure. Not to mention messing with cells like this will alter what they are normally suppose to do. So even if you do manage to get them to grow there is a chance they will just keep going and never stop.
Our biggest issue is not getting enough new, pliable stem cells to efficiently get a blood supply to a manufactured organ. One solution is to use a full grown adult cell that is able to grow very well outside of the body, and turn it back into a pluripotent cell. A research team in the United Kingdom and in China have already been developing on this very idea. It’s called a “partially induced pluripotent stem cell,” and can be used as the building block for various different kinds of cells. The best part about it is it does not have the potential of turning into a cancer. The growth is completely controlled.
The Science behind it:
It begins with a kind of cell called a fibroblast. These are cells that give structural support to every organ in the body. The researchers were able to create four parts of specific DNA instructions that bring the cells back to a younger state. When this happened the instructed cells enter a genetically liquid state where the cell could turn into anything. For example it could form fat, nerves, bone, or even blood vessels. These reset cells were monitored with how they grew and survived. None of them displayed any types of growing out of control. Eventually some of the reset cells started to form endothelial cell like structures by becoming hollow. These are the cells that make up the vessels in your blood.
Is there a possibility that these reset cells could be told to naturally develop into other things? In order to find out, the team administered a molecular liquid to the cells that was created to help them turn into a fully functional endothelial cell. Amazingly these cells formed into hearty blood vessel structures that could take on standard tasks like taking in lipoproteins. The team then slowly added these cells to a manufactured bioengineering set up, they linked up to create natural vessels that were made up of various cells types that were vascular. When the team injected these cells into the injured leg of a mouse, the reset cells attached and integrated with the muscle to improve the flow of blood and recreate the needed circulatory system to restore a O2 supply to the muscle that was damaged.
It is only a matter of time before these cells are approved to human clinical trials. We could use these cells to help keep donated organs alive while they are waiting to be transported.
For the first time in medical history, United States doctors have managed to cure a child born with HIV. Doctors working for the Univeristy of Mississippi Medical Center held a press release reporting that the child does not need medication for HIV, will have a normal life expectancy, and will not be infectious to other people.
The Mississippi born two and a half year old infant has tested negative for the virus for over a year without taking any medication. The case was brought to light on March 3rd at the Conference on Retroviruses and Opportunistic Infections in Atlanta, Georgia.
The invention of better drugs and public awareness has cause the number of babies born with HIV to drop significantly. Generally pregnant women who carry HIV are administered anti-retroviral drugs in order to minimize the number of viruses in their blood. After the child is born, it also goes on a course of similar drugs. It is reported that this prevents 98% of the virus transmission from the mom to the newborn.
According to Dr. Hannah Gay, the child’s care giver at the University of Mississippi Medical Center, this case is the first functional cure of a child infected with HIV. Although there is a chance that a small amount of the virus remains, a patient is considered functionally cured when standard testing results are negative for the HIV virus. Not even the most sensitive test are able to detect any traces of the virus one year after medication has been stopped.
Treatment began approximately 30 hours after the baby was born. Generally, HIV positive children are placed on a 3 anti-retroviral drugs that are administered via syringe. The doctor decided to perform a more aggressive treatment due to the mother not receiving any antiretroviral drugs during pregnacny. The mother had not discovered she was HIV positive until she was too close to delivery.
Blood taken from the baby showed it was infected with the virus, most likely before birth. In a positive turn of events a month after starting therapy, the HIV levels had in the blood had dropped low enough that the routine testing was not able to detect it.
Treatment was continued routinely for a year until the month started missing appointments. Eventually they stopped coming and did not show up again for six months. Doctors were expecting the virus levels to be extremely high however, they were shocked to see all of the results coming back as negative.
After examining the findings, Dr. Gay corresponded with Katherine Luzuriga, an exceptional immunologist at Massachusetts Medical School. The child’s blood was sent to the John Hopkins Children’s center where it was retested with more accuratcy. They found slight traces of HIV but no virus capable of reproducing.
Scientist are still unsure of exactly why the treatment was so effective. They suspect the treatment was so effective because of it’s potency and administered quickly after birth. The success has given hope that the doctors may eventually be able to completely remove the virus from all infected newborns.
About 1,200 kids in the United Kingdom and Ireland live with HIV they contracted from the womb, breast milk, or during childbirth. The issue is far more severe in third world countries, over 2.3 million children are infected in Africa.
THE QUICK SCIENCE BEHIND IT:
The drug blocks the HIV virus from replicated in short-living active immune cells. It also blocks the infection from longer living white blood cells (CD4) which the virus can lay dormant in for years. Treatment only works with newborns because the virus has already infected the CD4 cells in adults. Basically it is stopping the virus before it gets a total grip on the immune system.