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Annually, well more than one million Americans have refractive surgery to correct their vision. Refractive surgery is any type of surgery that alters the refractive power of the eye. Lasik is the most well known of the procedures, but others are available, including Lasek, PRK, and Epi-Lasik. Most of the refractive surgeries rely on laser, but Conductive Keratoplasty (CK) uses radio wave energy.

Unfortunately, as common as the procedures have become, preventable injuries do occur. Most of the injuries can be divided into five major categories:

  • Contraindications for surgery
  • Surgeon error
  • Failure to treat postoperative complications in a timely and proper manner
  • Failure to obtain informed consent
  • Equipment malfunction

Contraindications for Refractive Surgery
Some patients are poor candidates for refractive surgery. Eye diseases, such as keratoconus, corneal dystropies, or retinal detachments, are the most common contraindications for these patients.

A surgeon is supposed to evaluate the patient prior to surgery. A policy statement from the American Academy of Ophthalmology (AA0) explains the reasoning for the surgeon evaluation:

“The best interest of the preoperative patient is served by preoperative evaluation by the operating surgeon. Ethical and qualify of care standards are met only if the individual patient’s needs are addressed…. It is the ophthalmologist’s responsibility to provide quality control, prospectively, in the preoperative assessment.”

Unfortunately, the preoperative evaluation by the surgeon is not always done. This increases the chances that contraindications are missed. The consequences of performing surgery with contraindications can be extremely severe, including the need for corneal transplants.

Other reasons for negative surgical outcomes include poor skills of technicians responsible for reading measurements and surgeons taking unnecessary chances.

Surgeon Error
The surgeon’s inadequate technique or skills may result in poor alignment of the corneal flap or cutting into the cornea. In some instances, the wrong prescription is programmed into the laser.
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worker2.jpgMost work-related injuries are caused by acute, single incident accidents. Absent the accident being the result of horseplay, injuries caused this way are typically compensable under Florida’s workers’ compensation system.

Are injuries caused by repetitive trauma over a period of time compensable? So long as the injured worker’s evidence establishes the following elements, the answer is Yes: (1) prolonged exposure; (2) the cumulative effect of which is injury or aggravation of a preexisting condition; and (3) the job subjected the injured worker to a hazard greater than that to which the public is exposed. See Festa v. Teleflex, Inc., 382 So.2d 122, 124 (Fla. 1st DCA 1980). (See, however, Rodriguez v. Frito-Lay, Inc., 600 So. 2d 1167 (Fla. 1st DCA 1992) which seems to do away with the requirement that the job subjected them to a hazard greater than that to which the public is exposed.) (See, also, University of Florida v. Massie, 602 So. 2d 516 (Fla, 1992), a Supreme Court case which provides that for a preexisting condition to be compensable, the condition must be aggravated by some non-routine, job related physical condition, or by some form of repeated physical trauma. By requiring physical stress, this case is aimed at limiting, if not altogether eliminating, mental stress as being enough to establish entitlement for aggravation of a preexisting condition.)

Significantly, in repetitive trauma cases the proof required to overcome the non-compensable presumption in 440.02(1), Fla. Stat., “clear and convincing evidence,” rather than the lower “preponderance of the evidence” standard. “Clear and convincing evidence” is evidence of a quality and character designed to produce in the judge of compensation claims’ mind a firm belief or conviction, without hesitation, as to the truth of the allegations.

The facts of the first workers’ compensation case I took to final merit hearing illustrate the law well. My client was a 60+ year old woman, who, we alleged, developed inververtebral cervical disc herniations through years of repetitive trauma from lifting box spring mattress frames. She worked in a warehouse and her job was to construct the frames, ranging in size from single to king, then physically lift and place each frame, one on top of the other, onto a dolly located beside her work station. She slowly developed severe cervical pain that forced her to retire. The employer and its insurance company denied responsibility for her injuries. Unable to point to a single incident to explain the disc herniations, we brought a Festa repetitive trauma claim against the employer/carrier.
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Much has been reported lately about Florida Republican gubenatorial candidate Rick Scott invoking 75 times his Fifth Amendment right against self-incrimination in a civil case brought by a Nevada company.

The Fifth Amendment to the United States Constitution was ratified in 1791. It provides as follows:

“No person shall be held to answer for a capital, or otherwise infamous crime, unless on a presentment or indictment of a Grand Jury, except in cases arising in the land or naval forces, or in the Militia, when in actual service in time of War or public danger; nor shall any person be subject for the same offense to be twice put in jeopardy of life or limb; nor shall be compelled in any criminal case to be a witness against himself, nor be deprived of life, liberty, or property, without due process of law; nor shall private property be taken for public use, without just compensation.”

The Fifth Amendment can be asserted in any proceeding, civil or criminal, administrative or judicial, investigatory or adjudicatory; and it protects against any disclosures which the witness reasonably believes could be used in a criminal prosecution or could lead to other evidence that might be so used. Kastigar v. U.S., 406 U.S. 441 (1972). Accordingly, assuming that Mr. Scott reasonably believed his statements could be used against him in a criminal prosecution, he had the constitutional right those 75 times to refuse to answer questions put to him under oath.
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Workplace forklift accidents are common in Florida and often result in catastrophic injuries or death. Our law firm is currently handling two forklift accident cases, each involving serious injuries.

Employees injured in forklift accidents should be eligible to receive workers’ compensation benefits through the employer or its insurance company. The workers’ compensation benefits will consist of medical benefits and lost wages. Because of Florida Statute 440.11, these are the only benefits that will be available from the employer in most cases. There will be no compensation [from the employer] for pain and suffering, and only a remote chance of being indemnified for the loss of future earning capacity.

To be compensated for these damages, the injured worker must be able to make out a case of negligence against a third party, such as the forklift manufacturer or an outside forklift maintenance company. This is our strategy in one of the two forklift cases, in which the forklift failed to slow when it was being operated in reverse, causing the operator’s foot to be crushed between the forklift and a wall. In our other forklift case, we have eliminated third party liability as the cause.
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Federal law requires all cars sold [to the public] in the United States to meet the Federal Motor Vehicle Safety Standards (FMVSS). It sounds good, but it’s not.

The FMVSS are minimum standards for vehicle safety. Many of the standards applicable today were issued in the 1960s and 1970s, cover only a limited number of car safety and performance aspects, and manufacturers are allowed to self-cerfity compliance (in contrast to the approval of new drugs by the FDA, which has demanding requirements before drugs can be put into the hands of consumers), while the creation of better standards is subject to political pressure, with rule making through the National Highway Traffic Safety Administration (NHTSA) being a quasi-legislative process. Changes, if any, come in tiny increments at a snail’s pace.

In concept, market forces were expected to encourage manufacturers to produce vehicles that exceeded the minimum safety standards. Sadly, this has not occurred with enough frequency and consistency to be considered a success story. Rather than battle for a competitive advantage, most manufacturers settle for the least common denominator in safety and performance.
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In its infinite wisdom (sarcasm intended), the Florida Legislature, in 2003, placed arbitrary caps on the amount of money persons harmed by medical negligence may recover for noneconomic damages. (Noneconomic damages are defined in Florida Statute 766.202(8) as follows: “Noneconomic damages” means nonfinancial losses that would not have occurred but for the injury giving rise to the cause of action, including pain and suffering, inconvenience, physical impairment, mental anguish, disfigurement, loss of capacity for enjoyment of life, and other nonfinancial losses to the extent the claimant is entitled to recover such damages under general law, including the Wrongful Death Act.) This blog will attempt to summarize the caps, as set forth in Florida Statute 766.118:

IF THE NEGLIGENCE IS COMMITTED BY A “PRACTITIONER” (“Practioners” include MDs, DOs, chiropractors, podiatrists, naturopathists, optometrists, dentists, midwives, physical therapists and nurse practioners as well as their employers (i.e. hospitals, private practice groups). See 766.118(1)(c)):

  • For personal injury: $500,000 per claimant, regardless of the number of practitioner defendants, and no practioner shall be liable for more than $500,000, regardless of the number of claimants.
  • For negligence resulting in a permanent vegetative state or death: $1,000,000 is the total amount recoverable from all practitioners, regardless of the number of claimants.
  • In cases that do not involve death or permanent vegetative state, if the trial court determines that the patient has sustained a catastrophic injury and the noneconomic harm sustained by the injured patient was particularly severe: $1,000,000 total by all claimants from all practitioner defendants.

IF THE NEGLIGENCE IS COMMITTED BY A NONPRACTITIONER:

  • Personal injury: $750,000 per claimant regardless of the number of nonpractitioner defendants.
  • Permanent vegetative state or death: $1.5 million per claimant.
  • In cases that do not involve death or permanent vegetative state, if the trial court determines that the patient has sustained a catastrophic injury and the noneconomic harm sustained by the injured patient was particularly severe: $1.5 million.

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The outcome of the 2010 Florida Governor’s race will have a profound impact on the rights of individuals to pursue remedies against big business. Alex Sink will preserve those rights. Rick Scott, of Medicare fraud fame, will work to curtail them.

When Jeb Bush became Florida’s Governor, in 1998, Florida politics took a radical (not to be confused with conservative) turn to the right. With Florida’s House and Senate chambers controlled by Republicans, draconian laws designed to limit the ability of individuals from obtaining relief through the court system were passed with little resistance. (It was not unusual for these laws to gain passage with little to no Democratic support.) This was the Golden-Period in Florida for big business, the dark days for fairness and justice.

After 8 years of Jeb Bush, Floridian’s elected Charlie Crist as its governor, in 2006. He proved to be Jeb-light. Beholden to the radical-right, but kinder than his predecessor, Governor Crist encouraged and signed into law many anti-consumer, anti-individual rights laws, but also vetoed some egregious bills that Jeb Bush would have gladly approved. Compared to Jeb Bush, Crist respected the the rights of individuals.

Emboldened by high approval ratings, when Republican Mel Martinez retired from the U.S. Senate, Governor Crist decided to run for the office. This opened the door to career politician Bill McCollum and political neophyte Rick Scott to seek the Republican nomination as his replacement.

In the year of the Tea Party, Rick Scott pulled off a mild upset in the primary election by defeating McCollum. On the Democratic side, Alex Sink handily won her party’s nomination. Hence, the battle lines are drawn: Sink/Individuals v. Scott/Big Business.

Who Floridians elect as their next Governor will determine the type of state Florida will be for generations to come. Will Florida be a state that values and respects the rights of individuals above all else, as in “of the people, by the people, and for the people” (The Gettysburg Address), or will it be a state that places profits over people?

Republicans remain firmly in control of both chambers of the The Florida Legislature. As a group, they are more radically-right than the body in power during Jeb Bush’s rule, more determined than ever to prevent big business from being accountable to individuals. If Rick Scott is elected, Florida’s legislature will be able to operate without restraint. Every draconian bill passed by the legislature will be rubber-stamped into law by a Governor Scott. Not so a Governor Sink.

One example of the sharp differences between the candidates concerns the duty owed by insurance companies to their policyholders. Candidate Sink believes that insurance companies have a fiduciary duty to act in the best interests of their policyholders. This means that insurance companies must act in good faith to pay legitimate claims in a timely manner. This principle is supported by well-established Florida law. When an insurance company violates the principle, hence, acts in bad faith, it faces serious consequences. These consequences have done more than anything else to keep the insurance industry in line. Because Florida’s bad faith laws cut into insurance company profits, Rick Scott wants to eliminate them. (Do not believe the propaganda that payments made by insurance companies for acting in bad faith will be passed on to consumers. Bad faith payments are not allowed to be taken into consideration when determining rate premiums.)

Consider this: Even with strong bad faith laws, it is always a battle to resolve claims fairly with insurance companies. Imagine how much more difficult it will become if the bad faith hammer is taken away from the people. It is not a pretty picture.

Alex Sink, a successful yet compassionate businesswoman, will protect the rights of individuals by proposing positive and helpful legislation, while vetoing negative legislation which is surely to come from our Florida Legislature.

Please click here – ALEX SINK – to learn more about her.

(If Rick Scott’s policies aren’t enough to scare you, consider this segment: Rick Scott and the 5th Amendment.)
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In a previous blog, I wrote about the “enhanced injuries” doctrine in Florida. The doctrine stands for the proposition that a wrongdoer can be liable for damages extending beyond those resulting from the initial negligence. The example I used was of a simple car accident that triggered a defect in the victim’s vehicle, which caused a fire and catastrophic injuries well beyond the minor injuries resulting from the initial impact alone. Today’s blog is about the common characteristics associated with enhanced injury cases in the context of motor vehicle accidents and the various defects leading to those accidents.

Common characteristics include:

  • One or a few occupants are catastrophically or fatally injured while others have minor or no injuries;
  • Minor collisions resulting in catastrophic injury or death – see example in first paragraph;
  • Severe damage to or failure of a localized area of the vehicle (examples: roof crush or seat belt collapse);
  • Seat-belted occupants who are seriously injured or who are partially or fully ejected.

Typical Reasons for Enhanced Injuries:

Post-Impact Fuel Fed Fire Defects
Auto engineers agree that an occupant who survives the crash forces should not be injured or killed by a subsequent fire. Fire causing defects include:

  • Fuel Tank Location & Shielding. Fuel tanks placed in positions of risk to crushing or compromise, or not adequately protected against puncture damage.
  • Siphoning, Filler Tube & Fuel Line Failure: Excessive post-accident fuel leaks caused by failing to install inexpensive check-valve devices.

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tire_blowout.jpgThere is more to tire safety than adequate tread depth and proper inflation levels. Age alone is a major factor in tire safety. As tires age, the rubber dries out and makes them more prone to blowouts and tread separation. This applies to new-old-stock tires as well as to used tires.

No laws in the United States restrict the age of tires. In states with inspection laws – Florida is not one of them – all that is tested is tread wear. A tire has a useful life of six years. Accordingly, for consumers to get at least two years of useful life from a tire, it should be no more than four years old at the time of purchase.

Unfortunately, retailers can sell tires that are more than six years old. Many are much older, sometimes 15 years and above. These tires are accidents waiting to happen.
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We are frequently asked if insurance premiums will be increased or policies canceled or non-renewed because of a motor vehicle accident. If the insured was not substantially at faulpretty answer is No. See Florida Statute 626.9541(1)(o)3. An insurance company’s violation of this statute may subject it to a civil lawsuit and government fines for engaging in an unfair and deceptive act.

Further consumer protection is afforded by Florida Statute 626.9702, which provides as follows:

(1) No insurer shall impose or request an additional premium for automobile insurance, or refuse to renew a policy, solely because the insured or applicant was convicted of one or more traffic violations which do not involve an accident or do not cause revocation or suspension of the driving privileges of the insured, without adequate proof of a direct, demonstrable, objective relationship between the violation for which the surcharge was imposed and the increased risk of highway accidents.
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Email: jgale@jeffgalelaw.com

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