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Has Florida’s “Pill Mills” Problem Really Been Solved?

“Pain management” has become a common practice among doctors, some of whom even specialize in it. Patients are routinely asked to rate their pain on a scale of 1-10 at every doctor’s visit, and based on their answer the doctor will prescribe narcotics or other potentially addictive drugs to help the patient treat the pain.   But all too often, “pain management practices” are really just another way of describing “pill mills,” which prescribe high doses of narcotics to anyone who asks – for a fee, of course. Many of these doctors also filled the prescriptions that they wrote, leading to more convenience for the patients and higher profits for the doctors.

From Legitimate Pain Management to Medically Licensed Drug Dealing

Until late in the 20th century, narcotic pain relievers were generally reserved for short-term use after surgery or serious injury. If a patients’ pain could not be controlled, the theory went, they would be unlikely to move around freely during their recovery and would be more likely to develop blood clots or pneumonia. In a controversial move, some doctors decided to prescribe these drugs to patients with terminal cancer, believing that even if some patients became addicted to the drugs, their life expectancies were short and on balance it was more merciful to manage their pain than to worry about the side effects of addiction.

About twenty-five years ago, there was a change in many doctors’ thinking about the proper use of narcotics. Research showed that chronic pain could actually change the brain over time. Controlling patients’ pain was seen as an important part of medical practice, and research – some of which was paid for by pharmaceutical companies – purported to show that the risk of any one particular patient becoming addicted was low, if the patients were monitored.

Florida became the epicenter of an explosion of death from overdoses of drugs that had been duly prescribed by a doctor. When the Drug Enforcement Administration (DEA) implemented a new system in 2010 to track prescriptions for narcotics in an effort to find and control the most notorious pill mills, 98 of the 100 doctors in the US who wrote the largest number of prescriptions for oxycodone were located in Florida.

Florida Attorney General Pam Bondi said in a campaign commercial in September, 2014 that today, the number of top pill mills in Florida is zero. While Bondi’s claim is controversial in its specifics, there is no doubt that Florida’s “narcotourism industry” has been dealt a severe blow in recent years. The number of deaths from overdose has decreased in Florida in recent years, while at the same time the problem has been growing significantly in the US as a whole.

There are many patients who rely on oxycodone and other narcotics for a few days or weeks, and these drugs can make their recoveries easier and safer. Some people may need to stay on these drugs long-term. But we believe that narcotics should be the last choice for these patients, not the first one, because of the risk of abuse and the fact that mixing narcotics with alcohol or other drugs is a common method of suicide. Patients who are in chronic pain should talk to their doctors about ways to decrease their need for these drugs, such as physical or occupational therapy, a supervised medical exercise program, or the possibility of substituting at least part of their dosage with less dangerous drugs.

If you or a family member are taking narcotics on a long-term basis, know the risks. Count your pills to make sure that they are not being pilfered by someone in the household, or someone who works there or visits frequently. If you see that the dosage is increasing over time, don’t be afraid to talk to the patient about it. He or she may know that they are in trouble, but don’t know how to ask for help. And if you or a loved one have been injured by a narcotics prescription that you believe may have been written too hastily or poorly monitored, you should speak to an attorney.   No one wants their loved ones to suffer unnecessarily, but doctors need to remember that the first rule of the Hippocratic Oath is “do no harm.”

Is Your Loved One a Victim of Nursing Home Abuse or Neglect?

When elderly loved ones get to the point where they cannot be left alone safely, most families have no alternative to placing them in a nursing home or other institution, especially when physical limitations are combined with signs of dementia. While many elder-care institutions provide good care, the vulnerability of the elderly patient population and the constant pressure on for-profit institutions to cut costs results in a system in which neglect and abuse are unfortunately not uncommon.

One in Three Nursing Homes Investigated for Abuse

The National Center on Elder Abuse has reported that one in three nursing homes in the U.S. had been investigated for cases of reported abuse or neglect during a specific two-year period. Fifty percent of nursing home staff admitted that they had personally abused or neglected a resident during the previous year. Most cases of abuse were committed by staff, but in over 20 percent of the reported cases, the abuser was another resident of the facility.

Nursing home patients are especially vulnerable because they often cannot clearly describe what has happened, and they often fear retaliation from staff members. Even if the patient is able to clearly describe the incident, the home’s staff and even the patient’s own doctor may explain that confabulation – making up stories about things that never happened – is in itself a symptom of dementia. Even if a person has a history of confabulation, this does not mean that the incident did not happen. In these circumstances, it is even more important to look for other evidence that may support a claim of abuse or neglect.

It is important to keep the following signs of possible abuse or neglect in mind when you visit a nursing home patient:

  • Significant weight loss. While many patients will lose weight in their final months, a sudden loss of interest in food may signal problems with teeth or dentures, difficulty with self-feeding, or a patient who needs to be hand-fed not being given the necessary opportunity to eat enough to maintain health
  • Signs of dehydration (dry mouth or eyes, dark urine, a patient who drinks thirstily when liquids are made available).
  • Poor patient hygiene or unsanitary living conditions in areas of the home, especially in bathrooms and food preparation areas.
  • Repeated infections, especially of the skin and urinary tract.
  • Bedsores – while superficial bedsores are not uncommon in patients who cannot walk well, deep or infected sores are a sign that proper medical care is not being provided.
  • Cuts, bruises, welts or other signs of physical injury that could have been caused by a fall.
  • The use of physical or chemical restraints — giving patients high dosages of drugs or drugs that have not been approved by the FDA for the use of keeping dementia patients calm. While these drugs are sometimes necessary, they are often used as a substitute for proper staffing levels and staff training in how to communicate with patients.
  • Any other unexplained deterioration in a patient’s condition, which could be the result of missed medication doses or mistakes in calculating the correct dosage, or lack of medical attention that allows new symptoms to go unnoticed until they become dangerous or even fatal.

The following are some of the most common signs that a patient may have been physically or emotionally abused:

  • Unexplained changes in behavior, including agitation, withdrawal or crying spells.
  • A sudden increase in complaints about living conditions and staff in general or specific staff members.
  • Signs of fear including avoiding physical contact or eye contact with a specific staff member, agitation when left alone with staff during or at the end of a visit.
  • Signs of sexual abuse, including unexplained vaginal infections.
  • Any unexplained physical injuries, including bruises, broken bones, strains or sprains, or head or spinal injuries. Any new source of pain should be considered a sign of abuse until it has been adequately explained.

No one wants to think that a staff member or an institution that is supposed to protect and care for an elderly person could be neglecting or abusing them. If you believe that your loved one may be showing signs of abuse or neglect, it is imperative that you call the Florida Abuse Hotline at 1-800-96-ABUSE immediately. As soon as your loved one is safe, the next step is to consult with an experienced nursing home attorney. When a family member can no longer protect themselves, their only hope to prevent future victimization may be your continued vigilance.



Cheerleading Injuries Lead the Pack in Sports Injuries for Young Athletes

For as long as there have been sports leagues for children and teens, there have been concerns about the effects of injuries on young athletes’ developing bodies. In recent years there has been more awareness about the possible long-term effects of concussions on athletes at every age and skill level. Some parents are so concerned that they are rethinking their children’s participation in certain sports. But if you ask American parents which sport has the highest rate of catastrophic injuries, the right answer would not even occur to most of them.

Cheerleaders at the Greatest Risk for Catastrophic Sports Injuries

According to the American Academy of Pediatrics (AAP), cheerleading caused more catastrophic injuries to female high school and college athletes during the period from 1982 to 2009 than all other sports combined. The study found a total of 110 closed head injuries, skull fractures and spinal injuries that resulted in permanent brain injury, paralysis and death during this period – not a large number, if you consider that some 3.6 million girls participating in cheerleading programs during the same period. But the proportion of the most severe type of injuries is striking when you compare cheerleading to other sports, leading the National Center for Catastrophic Sports Injury Research to call cheerleading “without a doubt, the most dangerous female sport.” (While about 4 percent of cheerleaders are male, the study did not address the incidence of injury in male participants.)

President Obama has remarked that if he had a son, he would think twice about allowing him to play football, but he has not been asked how he would feel if one of his daughters wanted to cheer. If he were asked, he might well not realize that cheerleading has changed significantly in recent decades. Today, it is not unusual to see girls who are too young to drive being thrown tens of feet into the air, with nothing but other participants of the same age between the “flyer” and a life-changing injury.

The AAP did find that the incidence of catastrophic injury has been falling ever since 2005, partly due to new recommendations that certain higher-level skills only be performed on mats, a ban on one particular trick in high school programs, and requirement that cheerleaders master more basic tricks before they attempt more dangerous ones. The recommendations seem like common sense, but many coaches for school teams are not specifically trained to teach young athletes, a problem that extends far beyond cheerleading. While the sport’s governing body has emphasized increased training for coaches, cheer programs sometimes are victims of a Catch-22 situation. Only 29 states recognize cheerleading as a sport, and the NCAA does not include competitive cheerleading in its list of sponsored sports. The lack of agreement on treating cheerleading as a sport can lead to more lax attitude toward required physical exams, access to a trainer, and documented emergency plans.

Parents know that good sports programs can confer a wide variety of benefits to children and teens that last far longer than the playing season. But parents have to ask the right questions and not blindly trust a school or a private gym to protect their children from injury. Don’t be afraid to ask about the coach’s training and experience, and refuse to allow your child to participate if you are not comfortable with the answers.

If your child has suffered an injury while participating in any sports program, you should make sure to take the child to the doctor, even if he protests that he is fine. Do not allow the child to return to practice until the doctor has certified that the injury has fully healed. If your child has suffered an injury to their head or spine or another type of serious injury that may lead to permanent disability, you should discuss the situation with an experienced sports injury attorney. A mistake in this area can cost your child not only their sports career, but also their health and in some cases, could even threaten their life.


When Laundry Detergent Looks Like Candy, Tragedy Can Result

Seven-month-old Michael Williams was living in a Kissimmee shelter for battered women when his mother left a laundry detergent pod on top of a load of laundry on a bed while Michael slept. When she returned to her room after stepping out of the room to speak to a staff member for a moment, she saw that Michael had the pod in his mouth. The mother called 911 and Michael was rushed to the hospital, but he died shortly thereafter.

Convenience – but at what price?

Laundry detergent pods only became available on the American market in 2012, and they rapidly became popular. Michael’s death was the first reported fatality caused by the pods, but Florida authorities reported that there have already been over 300 exposures to the product in Florida alone. Many exposures were described as a child tasting or licking the product, which does not normally cause a life-threatening reaction, but officials estimate that hundreds of children have ended up in intensive care or on ventilators nationwide.

A toxic product in a small, attractive package

The problem is with the laundry pods is twofold, according to the National Capitol Poison Center. One is that the detergent is much more concentrated than traditional liquids or powders. Many parents do not think of detergent as a major danger to children compared to other household products, because children who have tasted laundry detergent tend to spit it out.

The second problem is that the pods are packaged in a way that is very attractive to children. They are often brightly colored, and a young child could easily think that it is a piece of candy. When a child puts it into their mouth, the coating quickly dissolves, as it is designed to do in the washing machine. The contents inside the coating are under some pressure, so the detergent squirts into the child’s mouth, and the fast-acting poison causes the victim’s blood oxygen levels to plummet, causing them to become lethargic – which then further disrupts their efforts to breathe.

Should parents buy laundry detergent pods?

Some experts urge parents of children under the age of five to consider not buying the pods because they are simply too dangerous to have in the house. But no matter what form of laundry detergent you buy, all household cleaners should be kept in a locked cabinet out of the child’s reach, and parents must remember that a child can be seriously injured as a result of a momentary lapse. At least one manufacturer has changed to opaque packaging and has added a double lock to discourage children from opening the package, but as of this writing there are no regulations designed to make the pods less attractive to children or harder to access.
If your child has become sickened by exposure to a detergent pod, we recommend that you consult your pediatrician, even if the child seems to be unharmed. Because this is a new product, there is no data on the long-term effects of this type of accident. You should also call a Florida attorney who is experienced in products liability cases. These pods may be convenient, but the way in which they are designed and packaged is an accident waiting to happen.

Generic Drugs: Are You Risking Your Health to Save a Few Dollars?

Ever since the federal Food and Drug Administration (FDA) approved the use of generic drugs in 1984, the controversy over whether they are just as good as the brand-name drugs that they were designed to mimic has not been resolved. Generic drugs contain the same amount of the same active ingredient as the brand name equivalent, but they may use different binders and inactive ingredients and be manufactured in different ways. The FDA’s requirement of “bioequivalency” requires that they contain the same amount of the active ingredient, and that patients should show similar levels of the drug in their blood.

Generic prescription drugs save American patients and their insurance companies some $200 billion dollars a year, and eighty percent of prescriptions are now filled with generic drugs. Drugstore shelves are also filled with generics next to their patented counterparts, with the generics’ labels inviting consumers to “compare” the store brand to the drug that they have taken since childhood, at a fraction of the price of the original drug. But thirty years after the first generic substitutes were approved by the FDA, many doctors still question whether generics really work as well as their original counterparts. In some cases, there is little doubt that switching can be dangerous for patients.

A long-time proponent of generic drugs now advises caution

Pharmacologist Joe Graedon, the author of the best-selling “The People’s Pharmacy” and the host of a popular radio show, was forced to examine his long-standing support for generics after he was contacted by Robin Lynn. In 2007, Lynn had been taking Wellbutrin XL, a long-acting version of a popular antidepressant when her doctor wrote her a prescription for a generic instead. At first, Lynn thought nothing of the change, but after a period of time she realized that her medication was not working as well as it did previously. She also felt as if she had received “a shot of adrenaline” when she took her pill each morning.

Graedon began to hear similar stories from hundreds of other patients who had switched from Wellbutrin XL and had experienced similar side effects and loss of efficacy. He contacted the FDA and asked them to investigate, but the agency did not respond. So Graedon brought the generic version to, which independently tests generic drugs for universities, hospitals, government agencies and other clients. Graedon asked the lab to research how the generic drug dissolved, and whether it dissolved in the same way that the brand-name drug did.

When bioequivalency is a myth

The results were shocking. After two hours, 34 percent of the active ingredient had already dissolved. Wellbutrin XL pills had only released 8 percent of the ingredient in the same amount of time. This means that patients were getting a jolt of the medication, and could easily explain the complaints about jitteriness and insomnia. It would also mean that patients were getting a much lower amount of the drug later in the day, which could account for the patients’ perception that the drug was no longer working.

Trusting the FDA’s data

When Graedon confronted the FDA with his results, the agency did not want to discuss the results of its own tests. Finally, the agency had a confession to make – it had actually never tested this particular generic formulation in humans at all. Although the package insert stated that “equivalence had been demonstrated” in a study in patients, in fact the FDA had never tested the drug in humans at this dosage. It had relied on tests on a lower dose to “prove” that the higher dose generic was safe to use. The FDA’s rationale was bizarre: The higher dose had shown a risk of causing seizures, and the agency was not sure that it was ethical to test the drug in healthy volunteers. Seven years after it was approved, the generic version was taken off the market in 2012. (There are other generic versions of Wellbutrin XL still on the market, and none of them have the same problem). Graedon still believes that most generics are safe, but he now believes that there are dozens, if not hundreds, of generic drugs that are not bioequivalent as they are currently formulated.

You should always ask your doctor about any changes in your prescriptions, and call back promptly if you notice any changes in how you feel on the new drug. If you or a family member switched from a brand-name drug and noticed any change in your health, you should consult your doctor immediately. You should also consult with an attorney who is familiar with the complicated laws that govern prescription drugs. Saving a few dollars is never a good reason to take chances with your health.



Distracted Driving Kills, and Florida Police Can’t Do Much About It

Florida was one of the last states to ban texting while driving with a new law that took effect in 2013. But one veteran police officer has stated that the law as written is “almost unenforceable”, and police estimate that fewer than 1,800 tickets will issue in the laws’ inaugural year.

The Florida law allows a police officer to issue a citation only as a “secondary offense,” which means that a driver can only be ticketed if the officer also observed another violation, such as speeding or weaving between lanes – the officer cannot stop a driver simply because they see the driver texting. The prohibition only extends to the time when the car is in motion; when the car is stopped at a light or in traffic, the driver is allowed to text. Other uses of a cell phone, including making voice calls, listening to music and checking maps are not covered by the new law. Finally, the fine for violating the texting ban is only $30.00 – hardly a serious disincentive for most drivers.

If a driver is involved in an accident that causes death or serious injury, police will be able to subpoena cellphone records, which may help victims to prove their claims in civil court. But the real reason to avoid texting while driving is not the fear of a $30.00 fine – the most important reason to avoid distraction behind the wheel is that distracted drivers kill.

Studies Show Cellphone Use Impairs Driver Reaction Times More Than Alcohol

The National Safety Council released findings in 2012 that shows that there is no such thing as multitasking. Your brain will switch frequently between scanning the road for hazards and carrying on a conversation, but you simply cannot perform both functions at once. The report estimated that a driver who is talking on a cellphone has a four-fold increase in the chances that they will be involved in an accident. A controlled study using driving simulators found that drivers’ reaction times were more impaired by using a cellphone than by a blood alcohol level of .08 percent – the same level that constitutes driving under the influence in Florida.

Cellphone use is a common target of distracted driving advocates, since the proliferation of smartphones has changed how we think about what we can safely do while driving. But there are many other activities that can be just as dangerous, and many of us have been guilty of at least some of them from time to time:

  • Eating or drinking
  • Brushing hair, putting on makeup, and other grooming tasks
  • Disciplining children, including in the back seat, or being distracted by their behavior
  • Searching the floor for dropped items
  • Reading a map or looking at a GPS
  • Adjusting the radio or CD player, or watching a video
  • Rubbernecking

When you are driving, remind yourself that your only priority is to guarantee your safety and that of your passengers until the car is parked and the ignition is switched off. If you must deal with a situation in the car, find a safe place to pull over.

If you have been involved in an accident and you believe that the other driver might have been distracted, you need to consult with a law firm that has the experience and the resources to investigate your case and bring your case to trial if necessary. You need to understand that if even the other driver could not have been ticketed for texting under those specific circumstances, this does not mean that they are not liable for your injuries. The requirement to pay attention to the road and react to hazards is far broader than any one law can enumerate.

The All-Too-Real Nightmare of Waking Up During Surgery

It sounds like the plot of a horror film or a nightmare. You are scheduled for surgery, and the anesthesiologist tells you to “have a good sleep.” But rather than regaining consciousness in the recovery room, you realize at some point that you are awake, but you are still on the operating table. And when your ordeal is over, you find out that your experience was not unique, but anesthesiologists cannot agree on whether there is anything that can be done about it.

Can you really wake up in the middle of surgery?

In the largest study ever of its kind, anesthesiologist Jaideep Pandit of Oxford University Hospitals collected the stories of patients who had told a staff member that they had experienced awareness during their surgery anywhere in the UK or Ireland in 2012. In some 300 cases, both the patient and the doctors were interviewed in an attempt to understand what had happened and to look for common factors.

The study reported a rate of about one case of consciousness for every 19,000 uses of general anesthesia. However, the researchers did not speak to a patient unless they had already brought up the topic with another staff member, so it is impossible to know how many cases may have been missed. The researchers said that most of the occurrences were brief, and that in 51 percent of cases, they occurred before or after the surgery, rather than during it.

The most common experience reported by patients was one of complete paralysis and accompanying panic – which is understandable since many patients are given drugs to relax muscles and prevent reflexive movements. Pandit noted that people are familiar with the experience of pain, but very few know what it is like to be paralyzed. “I thought I was about to die,” said a 12-year-old who regained consciousness during a dental procedure. Some patients also reported pain or the feeling of choking.

Can awakenings during surgery be prevented?

Some doctors advocate the use of a device called a nerve stimulator that could allow them to give lower doses of paralyzing drugs. If the patient woke up enough to feel pain or panic, they would be able to move and alert the doctors. Critics say that in certain types of surgeries, complete paralysis is very important, and they suggest the use of a system using scalp electrodes. Pandit argues that interpreting the signals from the electrodes is difficult and that there is no one reading that shows that a patient is conscious.

The researchers found that 41 percent of patients had ongoing effects from their experiences, including episodes of intense fear and panic, and with some patients comparing their symptoms to those of post-traumatic stress disorder. If you have had general anesthesia and you remember waking up during the procedure, it probably was not in your imagination. You should consider speaking to an attorney, especially if you have symptoms that affect your daily life and your level of functioning. The only thing worse than having a nightmare is waking up and realizing it wasn’t a dream at all.


Barking Dogs DO Bite: Misconceptions About Dog Bite Injuries

According to the U.S. Centers for Disease Control, almost 5 million Americans are bitten by dogs every year, and over 800,000 of them are injured seriously enough to require medical treatment. These figures exclude victims who do not see a doctor, as well as those who are left with a permanent fear of dogs but no physical scars.
Can I be held liable if my dog isn’t dangerous?

Under Florida law, a dog owner is liable if the dog was on public property, or on private property at the invitation of the owner, even if the dog has no history of aggression. (In some cases, such an “invitation” is created by law, and the fact that you were not directly invited may not bar recovery).

A Florida dog owner can protect himself from liability for attacks on his private property if he displays a sign containing the words “Bad Dog,” unless the owner is otherwise negligent or the victim is under the age of seven. Even if there was not a sign, the owner can claim that the victim’s behavior was partially responsible for the bite. If the judge agrees that there is evidence that the victim may also have been at fault, the jury can reduce the amount of the damage award by the percentage of fault attributed to the victim. (For example, if the jury decides that the victim’s damages are $100,000 but the victim was 25 percent at fault, he would collect $75,000).

If you own a dog, you should be aware that under Florida law, you might be liable even if your dog has never bitten anyone before. The Insurance Information Institute found that one-third of claims under homeowners’ and renters’ policies are for dog bites, and the average claim paid was for nearly $30,000. The dog does not even have to bite the victim for the owner to be liable; in one case, a woman was allegedly chased by a neighbor’s dog, and she fell and broke her wrist. The owner was fined and classified as a “dangerous dog” even though there was no evidence that the dog even tried to bite the victim.

A “dangerous dog” classification results in lifetime registration with the local animal control authority, and results in a long list of requirements, including that the dog be leashed and muzzled unless it is within an enclosure and that it not be transferred to another owner without notification to the animal control authorities. If the dog is involved in another alleged attack, there is a sliding scale of fines and other penalties, including euthanasia. However, unlike many other states, Florida does not have statewide breed-specific legislation that bans or restricts Florida residents from owning specific breeds.

I have been bitten, what should I do?

The most important thing is to seek medical care promptly. Dog bites can become infected because the wounds can be deep and the dog’s mouth can contain many types of bacteria. Some skin wounds are shallow but there are signs of a crush injury, because the bones and soft tissues can be damaged without regard to the depth of the bite itself. Follow the doctor’s advice and keep any follow-up appointments. It may take months until you learn that you will be left with a permanent disability. Dog bites on the hand are not uncommon, and any limit on hand function can have serious consequences.

Many dog bite victims do not consider consulting an attorney, believing that the dog’s owner does not have any money to pay a judgment or that any recovery would be less than the amount of legal fees. Most people do not realize that if the dog’s owner has a homeowner’s or renter’s insurance policy, the insurer can be liable for the amount of any judgment. Also, some attorneys will advise dog bite victims without any payment up front; if the victim does collect money for their injuries, the attorney will then collect the fees and costs from the damage award.
If you have been traumatized or otherwise injured by a biting dog, you should consult with a Florida attorney who is knowledgeable about dog bite injuries. If you wait too long to act, you may lose your rights to collect for the cost of your medical bills, lost time at school or work, and other losses that were caused by someone else’s lack of care.



Whiplash is Not a Joke

When most people hear the term “whiplash”, they associate it with car accidents. Accidents, especially those in which a car is hit from the rear, are one of the most common causes of whiplash injuries, but there are many others. And although medical practitioners are often correct when they say that the injury will heal with no permanent disability, they do not have the ability to predict which patients will heal quickly, which will need months of therapy and rehabilitation, and which will be left with permanent pain and loss of motion.

What is Whiplash?

Whiplash is a non-medical term for several different kinds of neck injuries that occur when your body suddenly accelerates and then decelerates without warning, and then decelerates. In the classic case of a whiplash injury, your neck moves backwards and then forwards, quickly and violently, pushing your neck muscles, ligaments and tendons beyond their normal range of motion.

While whiplash injuries are a common result of a car accident, you can be injured in exactly the same way by anything that causes your neck to go through a similar sequence of motions. Thrill seeking activities like roller coasters and bungee jumping have been associated with whiplash injuries, but you can also suffer whiplash from more pedestrian situations such as being struck by falling objects or an assault.

The fact that you do not feel pain immediately after the incident does not mean that you have not been injured. Many whiplash victims wake up the next morning and realize that they are in pain. The first treatment that you should try is an over-the-counter medication (Advil, Aleve, Tylenol etc.) and ice. Many people believe that heat is good for whiplash, and this can be true after a day or two, but in the immediate aftermath of the accident, ice is normally more helpful because it can reduce swelling and inflammation.

Common symptoms of whiplash

Whiplash can cause a variety of symptoms besides localized pain and stiffness. Some other common signs of a whiplash injury can include:

  • Headaches, especially those originating at the base of your skull.
  • Dizziness.
  • Blurred vision.
  • Fatigue.
  • Difficulty concentrating, problems with your memory or irritability.
  • Insomnia, which can either make it difficult for you to fall asleep in the evening or to return to sleep in the middle of the night.

Possible signs of an emergency

If you have any of these symptoms you should not wait to see if your condition improves. If you cannot get a same-day appointment with your doctor, you should go to the emergency room:

  • Pain on moving your head
  • Pain radiating down one or both arms
  • Numbness, tingling or weakness in your arms

What should I do if my condition doesn’t improve?

You may find that your pain makes it impossible for you to continue with your daily activities or that it is not improving after a few days. In this case you should see your doctor and ask whether you might benefit from a prescription pain reliever or muscle relaxant. Your doctor may also recommend that you use a cervical collar or that you see a physical therapist.

Many victims of whiplash will heal with no serious or permanent effects, but if you have been injured in a car accident or in another circumstance that could have caused a serious whiplash injury, you should consult with an experienced attorney. Many of the activities that doctors recommend to whiplash patients (rest, modification of daily activities, and professional therapy sessions) are expensive, and they need to be continued until you are fully healed. A consultation with a personal injury attorney may help you to discover ways to pay for your therapy and to give yourself the best chance to make a full recovery.



Ride-Sharing Goes High-Tech, But is it Safe?

A new business model that claims to save customers money while also preserving the environment has nevertheless ended up in regulatory hot water in Florida. UberX and Lyft are both ride-sharing companies that function on the smartphones of anyone who downloads each company’s app. In both cases, a prospective rider can summon a driver who is going to a nearby destination. Lyft allows its passengers to also become drivers by posting the details of a planned trip. (It is worth noting that UberX is a different service than Uber, which functions more like a traditional taxi by allowing passengers to summon a nearby vehicle owned by Uber, rather than a ride-sharing model using private cars.) Bothcompanies have begun serving customers in Fort Lauderdale and West Palm Beach in recent weeks.

Miami-Dade: initial lawlessness, a temporary truce

Established taxi vendors and other local interests fought back when the two companies tried to break into the market in Miami-Dade earlier this summer. Miami-Dade police issued citations to drivers and even impounded several private cars, alleging that they were operating as taxis without the required permits and licenses. UberX and Lyft both claim that they are not in fact taxi companies and that the relevant county ordinances did not apply, since neither company owns vehicles or employs drivers.

After a period of a month during which the two services were operating illegally, Miami-Dade county commissioners passed a temporary amendment to the relevant regulations that allowed the citations and the vehicle seizures to stop. The issue is scheduled for further debate in October, but permanent approval is far from certain, since the county’s transportation committee is deadlocked on any changes that would allow the new companies to continue to operate.

Existing transportation companies are asking that Uber and Lyft drivers be required to obtain the same chauffeur’s licenses as other drivers for hire. The established businesses want to maintain legal limits on the number of taxi medallions and limousine permits, while UberX and Lyft want the limits dropped, and the two sides also differ on insurance requirements. UberX and Lyft provide drivers with commercial insurance policies that cover them when they are carrying passengers, but opponents of the new services say that the only way to protect the public is to require full-time commercial coverage.

What will Fort Lauderdale and West Palm Beach do?

As of this writing, the legal status of UberX and Lyft vehicles outside of Miami-Dade is not yet clear. There is no concrete evidence that these drivers are breaking the law, but the question of whether they have clean driving records or criminal convictions, and whether the driver’s regular auto insurance policy and/or the ride-sharing company’s part-time commercial policy will pay if you are injured in an accident has not been conclusively decided.

If you have been in an accident while riding in a commercial vehicle, whether it is an old-school taxi, a private car service limousine or a car working within the Lyft or UberX systems, you need to be represented by an attorney who is familiar with these claims. All of the usual issues of the fault of the drivers will have to be examined, but the question of who will end up paying the passengers’ medical bills and other damages is handled very differently in a vehicle-for-hire scenario. An attorney who is not knowledgeable about these differences may end up leaving money – your money – on the table.