Posts Tagged ‘Michael Jackson’

Rising to the Top: What Does it Take? by Pat Iyer

Monday, July 6th, 2009
The Beatles practiced over 10,000 hours

The Beatles practiced over 10,000 hours

Are people born lucky? Is success a fluke? Malcolm Gladwell’s Outliers book exposes the myth that some people are successful because they are born lucky, intelligent or ambitious. This has direct applicability to the success of attorneys and legal nurse consultants. One chapter of the book traces the success of New York Jewish lawyers born in the 1930s. Many of them were children of garment manufacturers, who came to Manhattan at a time when their specific skills were needed.  Their children observed the successes that came from being smart, ambitious and hardworking.

Gladwell argues that success is not a random act. It arises out of a predictable and powerful set of circumstances and opportunities. The New York Jewish lawyers who rose to the top of the New York legal profession were born in the 1930s. They received the best attention from uncrowded public schools and had the easiest time in the job market. They learned about the connection between effort and reward from their hardworking parents. The doors were closed to them at the big gentile downtown law firms so they were overwhelmingly sole practitioners who worked hard, learned their craft, and were ready to take advantage of the rising tide in litigation that began in the 1970s.

Gladwell’s book identifies the 10,000 hour rule. This concept shows that the more time a person puts into learning a craft, the better the skills and the higher the chance of success. Gladwell described Bill Joy, who wrote much of the software that allows you to access the internet. He spent eight to ten hours programming a day while he was in college. Bill Gates spent about seven years in nonstop programming before he dropped out of Harvard after his second year. Early in their career, the Beatles spent eight hours a day, seven days a week performing in Germany. All of these efforts resulted in at least 10,000 hours of experience perfecting knowledge. Consider Michael Jackson’s career began when he was 5-years-old. Berry Gordy said of Michael Jackson: “He had a hunger to be the best and was willing to work as hard as long as it took.

Gladwell’s thesis is that people are not successful because of luck. The brightest people are not always successful. Outliers are those who have been given opportunities- and who have had the strength and presence of mind to seize them. It is dedication, determination, and problem solving that adds up to success.

FYI- Med League began in 1989, although I began reviewing cases as an expert witness in 1987. I can say we’ve passed the 10,000 mark long ago.

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Posted in Business skills, Trial lawyer skills | 2 Comments »

Michael Jackson: A Demerol Death? by Pat Iyer

Monday, June 29th, 2009
Michael Jackson- Demerol Overdose?

Michael Jackson- Demerol Overdose?

Reports state Jackson stopped breathing shortly after receiving an injection of Demerol. Attempts to resuscitate him were not successful. Was it the combination of medications or the Demerol which caused him to stop breathing? Toxicology reports are pending.

Recent reports reveal that Michael Jackson took an unusual combination of drugs:

Demerol and Vistaril twice a day- Demerol is a pain reliever, and Vistaril potentiates or accentuates the effects of Demerol.
Dilaudid 3 mg twice a day- Dilaudid is one of the strongest narcotics on the market.
Vicodin- an oral narcotic
Prozac 20 mg –antidepressant
Zoloft -antidepressant
Xanax -treats panic or anxiety disorders
Ritalin -for attention disorders
Prilosec-reduces stomach acid

It is unusual to see a patient taking two antidepressants and even more unusual and dangerous to take three narcotics. The danger lies in the accumulation of the medications in the body. Reports on the Internet also emphasize that the singer had lost weight and was skeletal-thin. The risk of overdose increases as weight loss occurs if the dosage is not also decreased.

Demerol is a narcotic pain reliever that used to be given with regularity in hospitals. (It is still acceptable to use Demerol in the recovery room for shivering.) It has fallen out of favor for a few reasons – there are more effective and safer pain relievers on the market and secondly, it is poorly tolerated by elderly people. Visual hallucinations may occur in this population. I recall my mother telling me that when she received Demerol after surgery when she was in her mid 70s. I advised her to request a different medication. She saw moving figures on the hospital room wallpaper. Days after her last Demerol shot, as she was being driven home, she saw icicles hanging in the sky. Another danger: the metabolites of Demerol can accumulate, and cause oversedation and death.

What you can do as an attorney involved in a medical or nursing malpractice case involving a potential overdose from Demerol (or another narcotic): Look at the weight and age of the patient. Ask a legal nurse consultant to do a timeline. This person will need to review the medication administration records and the narcotic sign out logs to determine how much Demerol the patient was given for pain control. Get a pharmacologist and possibly a toxicologist involved to look at the connection between the Demerol and the death.

I have lectured about the dangers of oversedation. Several years ago I was an expert witness for the plaintiff in a case that revolved around oversedation from Demerol. The case resulted in a settlement for the family of the patient. The article on Med League’s blog includes the actual facts of the overdose.

Susan Hill (fictitious name) was wheeled up to her postoperative medical surgical room at 11:30 AM. Mrs. Hill weighed 120 pounds; she was recovering from a hysterectomy. Her postoperative medications included Demerol (meperidine) 50-100 mg IM every 3-4 hours PRN (as needed), and Phenergan 12.5 mg IV every 6 hours PRN for nausea. The nurse assigned to the patient until 7 PM administered 50 mg of Demerol at 12:30 PM and 100 mg at 2 PM and 5 PM. Phenergan 12.5 mg was given IM at 12:30 PM, 2 PM and 5 PM. The nurse administered Phenergan to potentiate the action of Demerol. Read more.

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Posted in Damages, Legal nurse consulting, Medical malpractice, Medical records, Medication errors, Nursing malpractice, Patient safety | 4 Comments »