Washington DC Metro Medical Malpractice Lawyer Blog

By Michael Cohen, M.D. and Gerard E. Mitchell, Esq

The most common symptoms presented to family physicians and other primary care practitioners are complaints of headaches. Who doesn't have an occasional headache? A general practitioner with 2,000 patients will probably have 300 patients present with complaints of headaches each year. What causes headaches, and what can be done about it?

Headaches can be caused by all anatomical sites, organs and tissues of the head. Headaches can also be located in different parts of the head -- in the forehead, the back of the head (deep or superficial), originating from the eyes, ears, emanating from the throat, or sinuses.

Headaches can last all day long. Or they might only occur in the evening. Sometimes they wake you up in the morning, or your headache begins right after you wake up. Some headaches appear only on weekends. Sitting in front of a computer or watching television brings on headaches in some people. Maybe your headaches begin only when the weather is very cold or hot. Loud noises might be the culprit. Or all of the above! Finally, headaches can be associated with additional symptoms like nausea, vomiting, light sensitivity, or noise intolerance (not necessarily loud noise), and can cause anxiety and depression. Headaches can interfere with work, recreation, the most basic maintenance of daily life, and one's basic duties and tasks.

Your physician will begin by taking a good history, and about 75% of headaches can be reliably diagnosed if the physician can elicit this information from the patient. Physicians are trained to assess the cause by the characteristics of the headache. In the majority of these headaches treatment is proposed by your physician, and it may result in excluding certain foods and drinks, beginning with common irritants like chocolate, coffee or cheese. Allergies causing headaches can also be narrowed down by certain relatively easy measures like avoiding some animal products or certain garments. In some patients medication can also help if carefully thought out and carefully used. In 25% of patients with headache complaints, the patient needs further studies and evaluations to arrive at the proper diagnosis before treatment can be instituted.

Headaches can emerge from serious diseases, such brain cancer or a severe brain infection, or even intracranial bleeding. Imaging with a CT scan or MRI can lead to findings of the cause of the headache when the headache is due to a process which changes brain and skull anatomical relations and appearances.

General hematological and biochemical studies are also important. Anemia can cause headaches in a young menstruating woman, resulting from excessive menstrual bleeding. Once corrected, the pain will resolve. Viral hepatitis can raise liver enzymes and this can lead to severe headaches as well. Allowing the disease process to go through its natural cycle, or obtaining treatment as with Hepatitis C, will typically lead to resolution of the headache. Headaches can be caused by tension at work, and reducing stress levels often results in significant gains and frequently in the resolution of the pain.

Treatment of headaches has to be prescribed with the utmost care and with a clear plan to comply with the Hippocratic oath of "First do no harm," because many of the anti-headache drugs are toxic and have serious side effects. For example, several migraine headaches are treated with drugs that may cause bone marrow suppression and even death. In cluster headaches patients are occasionally treated with steroids, frequently with poor indication and serious adverse events. Beta-blockers and anti-epileptics are also prescribed with poor indications. Also, in headache treatment more and more chronically afflicted patients are referred to interventional invasive therapies. These include the use of electrical stimulators and local nerve treatments. In some patients treatment is provided by surgeons, typically a neurosurgeon, or by an ENT specialist, an ophthalmologist, or a pain specialist.

All these treatments present opportunities but they all also carry significant risk of failure. When patients experience failures in treatment, the consequences can be severe for the patient. Inappropriate surgical procedures can result in paralysis of facial muscles or neuro-ophthalmic injuries to the eyes or sinuses. Strokes may also result from local injections of drugs that may be transported to the central nervous system.

If you have been injured in the course of headache treatments you may want to consult a lawyer who is experienced and knowledgeable in the evaluation of the applicable standards of care and consequences of failed headache therapies.

Part 1

Despite recently-implemented policies and procedures to prevent it, reports of wrong-site surgery (e.g., amputating a right leg when a left leg should have been removed) still occur. The Joint Commission (JC) - a not-for-profit group that accredits the nation's hospitals - estimates that wrong-site surgeries occur around 40 times per week. The number of cases reported to the JC nearly doubled from 2004 to 2010. Please note that this number includes only reported cases, since approximately half of the states in the U.S. do not require hospitals to report cases of wrong-site surgery. Therefore, it is difficult to pin down the real number of cases.

A study noted that only one in three of these reported cases resulted in a medical malpractice case. There are a multitude of reasons for this, but - for starters - tort reform and damage caps make it difficult if not impossible to pursue cases where injuries are not severe enough to warrant the time and expense of litigation. It is often said that these reforms and caps are in place to drive down costs and help consumers, yet healthcare costs have continued to rise, as have reports of medical mishaps.

The Joint Commission approved a Universal Protocol for Preventing Wrong-Site, Wrong-Procedure, and Wrong-Person Surgery in July 2003, which became effective and mandatory for all accredited hospitals, ambulatory care centers, and office-based surgery facilities on July 1, 2004. The three principal components of the Universal Protocol are a pre-procedure verification, site marking, and a pre-incision "time-out."

Despite the implementation of the Universal Protocol, wrong-site, wrong-procedure, and wrong-person surgeries continue to occur in U.S. hospitals at alarming rates. Some reasons for this may include the increased time pressure put on physicians, as well as their lack of willingness to adhere to "protocols" and their underestimation of their fallibility. In addition, many of these errors are the result of simple oversights - failing to double-check imaging reports, not displaying imaging in the operating room, ensuring that x-rays are not flipped backwards, failing to double-check that the correct patient is on the operating table, or failing to take the required "time-out" or doing it halfheartedly or lackadaisically.

Email is used by nearly everyone in the United States -- from you to your family, friends, coworkers, and perhaps even your physician. Many physicians now send your prescriptions electronically to your pharmacy so when you arrive, you are spared the 20-30 minutes of waiting for the pharmacist to fill your script. Do you feel that your physician would pay more or less attention to you if you communicated with your doctor electronically, as a follow-up to a recent office visit?

Your physician is the same healthcare provider who cared for your now deceased father, so you feel comfortable and fortunate being his patient. Some of your health issues include hypertension, obesity, cardiomegaly, gastroesophageal reflux, asthma, chronic bronchitis, and high cholesterol. Your healthcare provider runs annual laboratory tests and orders radiological studies. You, and certainly your doctor, know you are at high risk for cardiovascular disease, however, you are not referred for a comprehensive cardiac workup. Your physician referred your father to a specialist, who received appropriate cardiology management, and he lived to his mid-eighties. However, you are not prescribed an appropriate medication regimen despite persistent laboratory abnormalities and serious cardiac signs and symptoms that worsened over time.

You and your physician exchange multiple emails. You state your concerns about new onset symptoms over the past few weeks of chest pain and pressure, fatigue, clamminess, diaphoresis (perfuse sweating), and elevated blood pressure readings. The doctor replies by email that everything is fine and no treatment or evaluation is necessary. Shortly thereafter, you suffer a fatal cardiac arrhythmia and myocardial infarction and are pronounced dead.

Given this man's serious family history, is trusting examination by email the best way to practice medicine? He placed his trust in the physician, having been reassured several times that there was nothing to worry about. Had he not been reassured, it was highly likely that he would have made an appointment, seen his doctor face-to-face, and hopefully the doctor would have examined him and referred him to a specialist.

As far as we know, email and texting haven't yet taken the place of a personal in-office visit, and hopefully it never will.

Laurie A. Amell, Esq. is a partner with the law firm of Stein, Mitchell, and Muse, LLPShe is also a nurse, and is listed in Best Lawyers of America, Super Lawyers, and is the Past President of the D.C. Trial Lawyers Association.

These days doctors and hospitals are busier than ever. Reimbursements for medical services are being cut every year, and to make up for lost income many providers are simply seeing more patients. The unfortunate result is overbooked schedules, long waiting times, and often a reduced quality of care. Therefore, it is vitally important for a patient to be an advocate when obtaining medical treatment. Here are some suggestions to help you get the best medical care for yourself or your loved ones:

• Bring a list of questions to the doctor's office. When seeing a doctor, patients often feel rushed (doctors usually are), and may be nervous, forgetting to ask questions they had in mind earlier. You should think beforehand about questions you want to ask, and write them down to bring to the appointment.
• Trust your intuition. You know your body better than anyone. If you feel something is amiss and the doctor is "brushing you off," don't be afraid to raise your concern a second or third time, or to obtain an opinion from another doctor. You might need to pursue an answer on your own.
• Bring a friend or loved one to your appointment. Most appointments go fast and are over quickly, and it is easy to forget what the doctor said. A second set of ears in the room will help you retain what you were told.
• If it is not possible for someone to accompany you, bring an electronic recording device. Just be sure to ask the doctor first if you may record the appointment. Many cell phones now have recording features. An alternative is to bring pen and paper and take notes.
• Schedule yourself for either the first or last appointment of the day. If you are the first appointment of the day, the doctor will not yet be behind schedule, so your visit should feel less rushed. If you are the last appointment of the day, you may have to wait for a doctor who is late, but if you have much to discuss and want time to express all your concerns, this is the best time to do it.

In today's overburdened healthcare system, mistakes and oversights are bound to happen. Unfortunately, it may no longer be prudent to simply trust the doctor and accept his word. If you believe something is wrong and has been inadequately addressed, be persistent and follow-up as much as you feel necessary -- chances are the doctor will take your concerns seriously. Above all, it is up to you to make sure you get the right medical care to maintain your health.

Stein, Mitchell, and Muse, LLP has successfully handled cases of negligent medical treatment for more than 40 years. If you have questions about a possible claim, we invite you to contact our office for a free consultation.

At one time or another we will undoubtedly experience insomnia. If we're fortunate, it won't last long (acute insomnia). For some individuals, however, it can last for weeks, months, and even years (chronic insomnia). Insomnia affects the brain and causes numerous health problems, including confusion, headaches, depression, irritability, and memory problems. It also puts you at risk for high blood pressure, Type 2 diabetes, and obesity, among other things.

Sleep apnea, which reduces airflow and wakes you repeatedly throughout the night, is often to blame. Sleep apnea can be extremely serious if left untreated. A sleep study is usually recommended, and if sleep apnea is diagnosed, a device such as a CPAP machine can be worn at night to help you get the sleep your body needs.

Your healthcare provider should be aware of any long-term sleep difficulties that you are experiencing, so that a timely diagnosis and remedy can be made.

Laurie A. Amell, Esq. is a nurse, an attorney specializing in medical malpractice and serious personal injury, and is a frequent speaker in her areas of expertise. She can be contacted at Stein, Mitchell, and Muse, LLP.

Low back pain is one of the most common causes of disability in adults of all ages and both sexes. Low back pain can result from many causes. Low back pain is common among persons such as truck drivers or data processors, whose occupations require that they sit long hours behind the wheel or at a desk, without opportunity to walk or exercise. Hard physical labor can also cause severe back pain, as with an auto mechanic who bends over all day fixing cars. Sports injuries, whether due to bearing excessive weight or making strenuous movements, often bring about significant back pain.

On the anatomic level, low back pain can originate from the bones, ligaments, muscles, nerve roots, the meninges which cover the spinal cord, and even the skin. In addition, some back pains have genetic origins, such as poor alignment of the vertebral bodies, vertebral instability, vertebral degeneration like spondylolisthesis or ankylosing spondylolisthesis, vertebral disc abnormalities, or nerve entrapments. All can cause severe pain. There are also many serious diseases that can affect the anatomical structures of the low back and cause pain. Thus, infection, bleeding, and benign and malignant tumors can also cause back pain.

The medical specialist most commonly consulted on back pain is the orthopedic surgeon, sometimes in conjunction with a neurosurgeon. Both specialists routinely treat spinal disease as part of their medical practice. Some people go to a chiropractor to manipulate their back in the hope of alleviating pain. In the last 15 years more and more patients get surgical treatment for their low back pain. Low back surgeries have varying degrees of success and failure. Failures include death and serious complications, including nerve damage, bleeding, and infections, all of which are fairly common, especially following surgeries performed with medical devices such as rods, plates, or other types of hardware.

Serious complications or adverse results, such as paralysis or persistent new-onset pain, should be evaluated to assess whether the surgery was indicated and whether the surgery was performed in accordance with applicable standards of care. When analysis of back surgery is performed after surgical failure your lawyer has to assess with medical experts if you had a bad result which can happen without negligence or whether your surgeon used unacceptable techniques, materials, or defective prosthetic devices or cements. It is essential that competent medical-legal analysis be employed in the evaluation of failed surgeries or other low back procedures. In recent years, for example, a product known as Norian XR bone cement manufactured by Synthes Inc. has been found to cause severe bleeding and even death due to a deleterious effect on blood and blood producing organs. Several death cases have been reported to the USFDA.

If you or someone you know has suffered serious injury after failed back surgery, a law firm with expertise in medical malpractice should be consulted. Our team of experienced medical malpractice attorneys can be reached at (202) 737-7777.

Many of us make New Year's resolutions each year, and this year should be no different. This short series will be slightly different than previous blogs on our website in that we will cover health issues that all of us should be aware of, such as the effects of obesity, high blood pressure, good nutrition and diets that don't work, exercise, and getting enough sleep. Your health care provider may or may not discuss these issues with you, but as a nurse and an attorney, I want to cover topics such as these to remind us of the importance of maintaining good health in 2012.

Our first series will be "Getting Enough Sleep," and will appear here within the next few days. This topic is actually more important than you might think, so please return to our website to learn more about the benefits of sleeping, and the ramifications of long-term insomnia.

Laurie A. Amell is an attorney, nurse, and partner at Stein, Mitchell, and Muse, LLP and regularly participates as a speaker in continuing education classes.

Another common childhood cancer is lymphoma. Non-Hodgkin's lymphoma refers to cancers that form in the lymphatic system, including small or large cell lymphomas, as well as B and T cell lymphoblastic lymphomas. Because the lymphatic system runs throughout the body, lymphoma can begin anywhere and spread very easily.

As with other cancers found in children, symptoms can mimic many diseases and include flu-like fever and chills, night sweats, and loss of appetite. One of the more unique symptoms is swelling of the lymph nodes, which is often painless. These swollen lymph nodes can help provide a diagnosis, which can be confirmed through biopsy and CT scans of the affected area.

Unlike AML and ALL, Non-Hodgkin's lymphoma does have stages and spreads at a relatively slower rate. Treatment is the same as with AML, but typically very aggressive chemotherapy is the primary method. After a diagnosis of lymphoma is made, testing can be done to determine the type and stage of the cancer, and to select an appropriate course for treatment. Fortunately, childhood Non-Hodgkin's lymphoma has a high cure rate.

Acute Myelogenous (or Myeloid) Leukemia (AML), is a rare disease of the hematopoietic system (blood forming system) in the bone marrow. It appears in 1.2% of all cancers, and strikes all ages.

The disease is caused by proliferation of white blood cells. There are many types of AML which are categorized by genetic and hematology laboratory parameters. Different types require different treatment regimens and carry different prognoses. If too many white cells are found in the bloodstream, a diagnosis of AML should be considered. Normally humans have 4,000 to 8,000 leukocytes. These numbers can increase to 20,000 or more if the patient has an infection. When the number of leukocytes is more than 15,000 without signs and symptoms of an infection, leukemia should be considered.

In Acute Myeloid Leukemia there is usually a sudden rise of white blood cells to over 25,000. When looked at under the microscope lens, they are seen to be atypical, with large cells and prominent nuclei, i.e., immature embryonic cells also known as blasts. The symptoms of AML are associated with the replacement of normal white and red blood cells with these immature blast cells in the bone marrow and in peripheral blood. As a result of this replacement, patients develop a tendency to bleed easily, such as when brushing their teeth. They also tend to develop infections which the body cannot withstand.

Treatment requires rapid diagnosis, and blood and blood product transfusions, as well as chemotherapy. In children, effective treatment is more achievable than in adults. Failure to diagnose this condition in a child can lead to loss of an opportunity to induce a remission leading to death.

A 47-year-old male with a clean medical history presented to a psychiatrist with new onset depression. There was no family history of depression. The patient was married with three children, owned his own garage business, and worked as a car mechanic. He reported a stable and happy family life. Until recently, he had been doing well.

The psychiatrist prescribed antidepressant medication, but his patient was not responding to several different drug treatment regimens. As a result of the depression, the patient was unable to work, and had to move out of his home due to anger management issues and deteriorating behavior.

Two years later, at age 49, the patient was seen by his family physician. A routine laboratory work-up including biochemistry data revealed high calcium of 16 mmol/L and low phosphate of 6 mmol/L. Measurement of endocrine data disclosed high parathyroid hormone levels. He was referred to an endocrinologist and then to an endocrine surgeon. A parathyroidectomy was performed. Within six months the patient recovered from his depression and was back to work.

Often patients with hyperparathyroidism wander through the corridors of medical offices between various specialists with depression and/or behavior problems. If the diagnosis of hyperparathyroidism is not made in a timely manner, the patient can lose his or her job and family. A medical malpractice claim can be brought on behalf of patients who have been misdiagnosed with depression without specific cause when a reasonably thorough evaluation would have pointed to hyperparathyroidism.

The parathyroid glands are most commonly four pea-sized glands. Anatomically they are attached to the back of the thyroid gland and its capsule. They produce the parathyroid hormone, PTH or parathormone. This hormone maintains physiological levels of calcium and phosphates in the serum and blood. Aberrations in the production of this hormone can cause serious illnesses, including kidney stones, gallbladder disease, mental disease, and cardiovascular disease. The remedy starts with a proper diagnosis and is typically followed by parathyroidectomy.

It is well-known and generally accepted that skin cancers and melanomas originate in people who have longstanding exposure to sun rays, especially in sea-goers who don't use appropriate body cover and/or protective sunscreens.

When a patient has had significant exposure during their childhood and beyond, and especially in patients with a family history of skin cancer, total body examination by a dermatologist, even on a yearly basis, may be important. In patients who have had any type of skin cancer, it is mandatory to keep them under surveillance, at least in the first 5 years post detection and surgical resection of skin cancer. The reason for this standard is that following skin cancer detection in patients, the likelihood of detecting a second cancer greatly increases as compared to the rate in the general population.

The most common skin cancer is basal cell carcinoma, which is relatively benign even though in sensitive skin areas like the skull and face it can cause serious penetration into the bone and even into the brain if not detected and excised in a timely way.

Squamous cell carcinomas are more aggressive than basal cell carcinoma and can lead to spread of cancer cells systemically and lead to life-threatening metastatic cancer with a poor prognosis and limited therapeutic treatment modalities.

The most feared cancer of the skin is melanoma, which if it has metastasized is a deadly disease that cannot be cured. The only chance the patient has is early detection and early removal of a melanoma lesion.

We represented a 50-year-old man who had several basal cell carcinomas which were removed by excision. However, his physician neglected to properly follow the patient. As a result, a melanoma was not timely detected, and this melanoma spread systemically in all the patient's organs. Unfortunately this young husband and father died, leaving a widow and young children behind who depended so much on him. Our team successfully represented the family, and the case resolved prior to trial.

We have a team of medical professionals on staff that work with the highly successful medical malpractice attorneys at Stein, Mitchell, and Muse, LLPto prepare your case for trial. If you or a loved one have been the victim of medical malpractice, give our team a call at 202-737-7777 for a free consultation.

Acute Lymphoblastic Leukemia (ALL) is probably the most frequent type of leukemia in children age ten and under. As with all forms of cancer, it is imperative that treatment begins immediately, especially as this disease progresses to a life-threatening point extremely quickly, sometimes in as little as a few weeks. Symptoms mimic many other possible diseases including flu and cold, thus ALL is usually not considered until a complete medical history has been obtained from the parents, and the child has undergone blood work with medical examination by a pediatrician.

White blood cells are needed to fight infection, but in someone with ALL the body produces abnormal versions of these cells, which tend to duplicate quickly and crowd out the red blood cells that are necessary to carry oxygen and carbon dioxide to and from tissues in the body, causing organs to shut down.

ALL's rapid progression is one distinction from "chronic" lymphoblastic leukemia and can be present for many years. Testing such as complete blood count, liver enzyme tests and several others can confirm or rule out ALL. Symptoms include weakness, fatigue, frequent fevers, weight loss, loss of appetite, bruising, joint pain, breathlessness, swelling in lower limbs, and tiny red spots or lines in the skin due to low platelet counts. The exact cause of ALL is unknown, but it is likely from damage inflicted to DNA, possibly by chemicals, drugs or radiation in our environment.

We know the gravity of cancer. Even as adults, we are frightened when we or our loved ones are given the diagnosis. For many, the difficult fight against the disease now feels impossible as the worsening economy leaves us without health insurance; a growing number unable to seek medical attention when we suspect that something is wrong, powerless to get help at the crucial point when cancer is in its early stage.

But more devastating is when we discover that our children's symptoms we thought were from a lingering flu or cold, are signs of cancer. Most of us don't even consider that infants and children can develop the disease. Worse still is the startling reality that symptoms like breathing difficulties, inability to crawl or stand, swelling, weight loss, and bruising may even lead some physicians to suspect child abuse, dangerously delaying a proper diagnosis and hurtling parents into a nightmarish battle to prove their innocence - all the while being terrified for the wellbeing of their child.

Knowing if your child's symptoms are signs of cancer can prevent this situation and help you get appropriate treatment faster. In this series we will explore the different types of cancers found in children, and the signs and symptoms to watch for.

Laurie A. Amell is a nurse and a medical malpractice attorney who practices in Washington, D.C., Maryland, and Virginia. Stein, Mitchell, and Muse, LLP has a team of three nurses, an in-house physician, and expert attorneys specializing in medical malpractice who are available to consult with you regarding a potential case. Call us at 202-737-7777 for a free consultation.

During the past year, many drugs have been unavailable to physicians and patients. This situation has caused a health crisis and a national confidence alarm among patients. The drug shortages are a major problem and have also caused many patients to suffer anxiety, depression and mental anguish. As a result of the shortages of vital drugs consumers have been switched to less effective drugs or been forced to pay significantly more for their medications.

Antibiotics and other anti-microbiologicals are primarily the drugs in short supply. This may have caused infection resistance and sepsis in patients. Also anti-neoplastic (anti-cancer) chemotherapeutic drugs have seen dramatic shortages and patients who had effective treatment with one drug had been switched to other drugs - frequently with serious consequences for the patients, i.e. more adverse effects and less efficacy in treatments. Patients have reported sleepless nights and extreme worry about the continued crisis.

Why are pivotal drugs missing and/or in short supply? The main cause is that pharmaceutical companies stop making drugs when they don't provide sufficient profits! And some medical practitioners fail to stock up on certain medications if these medications don't provide a sufficient margin of profit for the practice. Profit margins are presented as a legitimate concern of healthcare providers and pharmaceutical companies. There are no laws that require manufacturers, pharmacies, or healthcare providers to have all approved drugs available to patients. When patients are not treated with a medication they need, and because of this suffer injury or death, who is responsible? This question will be answered in the future as patients file claims that seek to establish or preserve their right to receive standard of care diagnosis, management, and care - including the medications they need.

The medical malpractice team at Stein, Mitchell, and Muse, LLP evaluates cases of improper medications or lack of treatment due to shortages of medications or denial of treatment that are driven by the economic motives of the healthcare providers. If you would like to discuss your situation with one of our lawyers, please call (202) 737-7777.

Endoscopists using the water-infusion method of screening colonoscopy found significantly more adenomas if they added indigo dye, compared with the water method alone, a new study has shown. "Indigo carmine enhances any surface irregularities" when used as part of screening colonoscopies, Dr. Joseph W. Leung said in a late-breaking abstract session at the annual meeting of the American College of Gastroenterology.

Indigo carmine is used to enhance adenoma (polyp) detection in chromo-endoscopy, which is a more cumbersome process than the water method, Dr. Leung said. He and his colleagues at the Sacramento VA Medical Center in Mather, California conducted a randomized, controlled trial to assess the value of adding indigo carmine to the water method. The colonoscopies were performed by two endoscopists who had experience with both methods. Patients were blinded as to which procedure they had, and all patients underwent intravenous conscious sedation. In both groups, air was suctioned out of the rectum to remove any fecal material and stool or cloudiness was suctioned out, followed by another infusion of clear water. Apparently colon preparation and surface enhancing play an important role in adenoma detection.

Early detection of a polyp is critical because polyps evolve to cancer over time, and if not resected can metastasize and result in death. Colonoscopy evaluations have a low but significant false negative rate, and repeat colonoscopies may sometimes detect undiagnosed but pre-existing adenomas. In high risk patients or symptomatic patients, however, a single colonoscopy may be the only chance to detect an adenoma before it becomes cancerous. Therefore, when doing a colonoscopy it is important to utilize the best available technique to detect these potentially lethal abnormalities. A patient can ask the physicians performing the study how they plan to do the study and how that method enhances detection. Failure to detect may be based on failure to adhere to available guidelines or using outmoded techniques.

Stein, Mitchell, and Muse, LLP has successfully handled numerous cases of undiagnosed cancer following failed colonoscopy procedures. Our experienced medical malpractice team is available at (202) 737-7777 for a free, no obligation consultation.