Total ankle replacements (TAR) have been available to patients in the United States since the early 1970’s. Naturally, these implants have undergone various design evolution phases. A review article published in the September 2008 issue of the Journal of the American Academy of Orthopedic Surgeons (http://www.jaaos.org/) discusses the different types of total ankle replacement implants currently available.

“When we started off, the ankles we used in this country included just two components and we had to use bone cement to fix them and basically they all failed,” said Andrea Cracchiolo, MD, lead author of the article and Director of the Adult Foot and Ankle section at UCLA Medical Center. “The difference between the first generation implants and those today is that you don’t need to use bone cement. The surfaces are such that the bone will grow into the joint much like in total hip replacement.”

As of present, there are four designs that are approved by the Food and Drug Administration for use in the United States. All four designs consist of the two-component designs which are considered fixed implants. Yet, for numerous years now, many surgeons outside of the United States have been using a new three-component ankle design. According to Dr. Cracchiolo, a three-component ankle could possibly allow for additional movement, mobility, and flexibility in the joint. Additionally, it may also be easier for orthopaedic surgeons to implant. Although here in the U.S. a three-component device has been recommended for approval by the Food and Drug Administration, it could take until late 2008 (or longer) before it would be made accessible to U.S. patients.

Although total ankle replacement offers many patients more mobility compared to the option of fusion to repair the injured joint, not every patient is an ideal candidate. As Dr. Cracchiolo explains, patients need a detailed evaluation from a qualified orthopaedic surgeon who feels the procedure may be suitable. “Some patients have such deformity of the ankle or have an ankle that is so unstable that total ankle replacement is not indicated,” explains Cracchiolo.
According to the American Association of Orthopaedic Surgeons there are signs that you may be a candidate for a total ankle replacement. These signs include:

• Having a destroyed ankle, meaning the surfaces of the ankle are gone
• Having advanced arthritis of the ankle
• The condition of your ankle is interfering with daily activities and causing pain
Total ankle replacements can offer patients:
• Better motion of the ankle compared to fusion
• Protection in the small joints below and in front of the ankle from developing arthritis
• Relief of ankle pain

There are approximately 20 total ankle replacement implants worldwide that are currently available or in their final stages of design. Nonetheless, there have only been a limited number of clinical studies involving such implants. Dr. Cracchiolo says, “Great care must go in to selecting not only the ideal patient, but also the implant that should be used. We need more long-term follow up clinical studies on implants here in the U.S. In addition, if patients are young, they should understand that the ankle replacement, just like the hip and knee, is not going to last a life time.”

“As improvements in design continue to evolve, the goal is to develop total ankle replacements that are comparable to hips and knees in terms of quality and longevity,” noted Dr. Cracchiolo.

SOURCE: American Academy of Orthopaedic Surgeons

See our website for information on what to do in the event of an accident involving serious injuries or death: www.hickeylawfirm.com. See also www.cruiseshipassault.com. The bottom line is get medical care immediately, take photos of the area where you were injured, get the names and contact information of witnesses, and report the accident at once. Also, CALL HICKEY LAW FIRM, P.A., TOLL FREE AT: 1.800.215.7117. Our consultations are always free. We work on a contingency basis. Personal injury, wrongful death, sexual assaults, and medical malpractice. We have handled these types of claims for 28 years.

Hickey Law Firm, P.A. is headed up by John H. (Jack) Hickey. Hickey was born and raised in Miami, Florida. For the first 17 years of his career, Hickey represented the railroads, cruise lines, and insurance companies. Now he represents you, the seriously injured, the family of a loved one who has died as a result of someone else’s negligence, the victim of a sexual assault, or the victim of medical malpractice.

Hickey is Board Certified as a Civil Trial Lawyer by The Florida Bar and by the National Board of Trial Advocacy. He is a Past President of the Dade County Bar Association and is on the Board of Governors of The Florida Bar. Hickey has been named by his peers as a “SUPERLAWYER” in the Superlawyer.com publication (the top 5% of all lawyers); as a “Top Lawyer in South Florida” in the areas of personal injury and maritime in the South Florida Legal Guide (2004 to present); and as a “Legal Elite” member in Florida Trend Magazine (2006) (top 1.7% of all lawyers). He is listed in Who’s Who in America, Who’s Who in American Law, and Who’s Who in Emerging Leaders in America. Hickey is rated A/V by Martindale Hubbell, the international directory of lawyers, a rating achieved by only 5% of all attorneys. CONTACT US AND SEE OUR RESULTS AT: www.hickeylawfirm.com and CALL US TOLL FREE AT 1.800.215.7117.

On Monday, May 12, 2008, the United States Coast Guard called off the search for a passenger of a cruise ship who fell overboard. The passenger was a woman who had been on the Norwegian Dawn cruise ship. The Coast Guard called off the search because of weather conditions.

The details at this point are lacking in regard to: how the passenger went overboard, whether the cruise line’s lack of security onboard contributed to the incident in the first place, whether the cruise line reacted quickly enough (under international maritime law, the cruise line is obligated to conduct an immediate search), whether the cruise line reacted appropriately in for example calling in the Coast Guard quickly enough and in conducting the search long enough.

This is the last in a series of events for Norwegian Cruise Lines. Just this month, this same cruise line was found criminally negligent in the maintenance of the SS Norway which led to a boiler room blow up over 5 years ago. The explosion on that Norwegain Cruise Ship caused the death and horrific injuries to several crew members. In that case, the cruise line avoided any severe liability to the families of the seaman by invoking a little used and little known clause in the seaman’s contract which said that the seaman were required to arbitrate in their home country, in that case the Philipines. In other words, the United States Congress has enacted the Jones Act for seaman but these seaman cannot utilize it because the cruise lines put a clause in their contract to keep the cases out of U.S. courts.

In the case of the SS Norway, the boilers had cracks caused by age and by infiltrates in the water used in the boilers. The cruise line said that they should not be blamed for the shoddy maitenance because their classificatoin society, a private company hired by the cruise lines to perform periodic inspections, had inspected and passed the engine room. The report upon which the indictment relied said that the class society inspection did not matter. After all, these class societies are paid by the shipowners to perform these inspections. In any event, it is the cruise line which is ultimately responsible for maitenance.

This is the same cruise line and the same cruise ship which was involved in the so called “rogue wave” incident off of the coast of North Carolina 3 years ago. In that case, the ship diverted early to go back to New York so they could film a TV show on the ship. In doing so, the captain went headlong into a storm with gigantic waves. The captain admitted in deposition that there was no “rogue wave” although at trial he recanted this. Numerous people suffered injuries on that cruise.

I keep track of the cruise lines; I know their history; I used to represent the cruise lines for over 15 years; I now represent only the passengers who have suffered severe injuries and the families of passengers who had died as a result of the negligence or medical malpractice of the cruise line.

See our website for information on what to do in the event of an injury in a cruise ship: www.hickeylawfirm.com. See also www.cruiseshipassault.com. The bottom line is get medical care immediately. Take photos, and document and report everything. This includes reporting it to the cruise line, taking photos, and going to your doctor and whatever specialist he/she sends you to.

Also, CALL HICKEY LAW FIRM, P.A., TOLL FREE AT: 1.800.215.7117. Our consultations are always free. We work on a contingency basis. Personal injury, wrongful death, sexual assaults, and medical malpractice. This all happens on cruise ships and we have handled these types of claims for 27 years.

Hickey Law Firm, P.A. is headed up by John H. (Jack) Hickey. Hickey was born and raised in the cruise line capital of the world, Miami, Florida. For the first 17 years of his career, Hickey represented the cruise lines and insurance companies. Now he represents you, the seriously injured, the family of a loved one who has died as a result of someone else’s negligence, the victim of a sexual assault, or the victim of medical malpractice.
Hickey is Board Certified as a Civil Trial Lawyer by The Florida Bar and by the National Board of Trial Advocacy. He is a Past President of the Dade County Bar Association and is on the Board of Governors of The Florida Bar. Hickey has been named by his peers as a “SUPERLAWYER” in the Superlawyer.com publication (the top 5% of all lawyers); as a “Top Lawyer in South Florida” in the areas of personal injury and maritime in the South Florida Legal Guide (2004 to present); and as a “Legal Elite” member in Florida Trend Magazine (2006) (top 1.7% of all lawyers). He is listed in Who’s Who in America, Who’s Who in American Law, and Who’s Who in Emerging Leaders in America. Hickey is rated A/V by Martindale Hubbell, the international directory of lawyers, a rating achieved by only 5% of all attorneys. CONTACT US AND SEE OUR RESULTS AT: www.hickeylawfirm.com and CALL US TOLL FREE AT 1.800.215.7117.
We also represent passengers who have been sexually assaulted on cruise ships. John H. (Jack) Hickey Hickey Law Firm, P.A. www.hickeylawfirm.com. CALL US TODAY FOR A FREE CONSULTATION: 1.800.215.7117.

Recently, I got an email from someone in New York asking if we represent people, namely cruise line passengers, who live out of state, in that case New York. The answer is YES!

The would-be client asked if she needed a New York attorney. The answer is NO!

At HICKEY LAW FIRM, P.A., we represent people, cruise line passengers, who live all over the United States and in fact the world. Why? How? THE BOTTOM LINE: You the passenger are required to file suit where the ticket requires, not where you live, not where you got on the ship. So, you need a maritime law specialist in the place where the ticket requires. If you sailed on a ship of Carnival Cruise Lines, Norwegian Cruise Lines, Celebrity Cruise Lines, or Royal Caribbean Cruise Lines, you are required to file the suit in Miami, Florida.

Writing a letter is not filing suit. Only filing suit will stop the clock on the time limit to file suit which usually is one year from the date of the accident. If you go beyond that limit without filing suit, you will be out of luck; you will have no claim. Only an attorney licensed to practice in Florida can file suit here. Only an attorney who knows maritime law-and who knows the cruise lines- should represent you and file suit against the cruise lines.

If you were a passenger on a cruise ship and were injured on the ship or on the tender going to or from shore, as a result of the negligence of the ship or cruise line or their employees, call us toll free today at: 1.800.215.7117. We will talk to you and all consultations are free.

We can help you and we are the ones who are qualified to help. We are here in Miami, Florida, the cruise line capital of the world and the place where most passengers will have to file suit.

I know. I used to represent the cruise lines, for 17 years. I am a maritime law specialist. I am the lawyer who your local lawyer will call for advice and help when the cruise lines deny your claim or refuse to settle with you.

Do not waste anymore time. Call us today. It is toll free: 1.800.215.7117. www.hickeylawfirm.com.

NTSB HOLDS HEARING ABOUT PRINCESS CRUISE SHIP TILTING

The National Transportation Safety Board will hold a hearing about the cause of the accident where a Princess cruise ship tilted or listed on July 18, 2006. This is possibly a significant step in the resolution of this accident. The incident occurred when the cruise ship Crown Princess left Cape Canaveral on its way to Brooklyn, N.Y. This ship is owned and operated by Princess Cruise Lines which in turn is owned by Carnival Corporation which owns Carnival Cruise Lines.

About an hour after the Crown Princess left Port Canaveral, someone in the bridge disconnected the automatic pilot system. He then turned the ship and allowed it to list, i.e., tilt, to starboard, the right side. This list was 24 degrees which is huge. Imagine taking a 13 story building and leaning it over all of a sudden so that everything inside of it comes crashing to one side. The list threw chairs, couches, ice machines, lamps, furniture of all types, glasses, trays, food, hundreds if not thousands of passengers and crewmembers to one side of the ship. The people onboard were hit by and entangled with the wreckage. 298 passengers and crew suffered personal injuries. See more information about the hearing and about the NTSB at www.ntsb.gov.

Hickey Law Firm, P.A. represented many of the passengers who suffered personal injuries from this accident. See our website for information on what to do in the event of an injury in a cruise ship: www.hickeylawfirm.com. See also www.cruiseshipassault.com. The bottom line is get medical care immediately. Take photos, and document and report everything. This includes reporting it to the cruise line, taking photos, and going to your doctor and whatever specialist he/she sends you to.

Also, CALL HICKEY LAW FIRM, P.A., TOLL FREE AT: 1.800.215.7117. Our consultations are always free. We work on a contingency basis. Personal injury, wrongful death, sexual assaults, and medical malpractice. This all happens on cruise ships and we have handled these types of claims for 27 years.
Hickey Law Firm, P.A. is headed up by John H. (Jack) Hickey. Hickey was born and raised in the cruise line capital of the world, Miami, Florida. For the first 17 years of his career, Hickey represented the cruise lines and insurance companies. Now he represents you, the seriously injured, the family of a loved one who has died as a result of someone else’s negligence, the victim of a sexual assault, or the victim of medical malpractice.
Hickey is Board Certified as a Civil Trial Lawyer by The Florida Bar and by the National Board of Trial Advocacy. He has been named by his peers as a “SUPERLAWYER” in the Superlawyer.com publication (the top 5% of all lawyers); as a “Top Lawyer in South Florida” in the areas of personal injury and maritime in the South Florida Legal Guide (2004 to present); and as a “Legal Elite” member in Florida Trend Magazine (2006) (top 1.7% of all lawyers). He is listed in Who’s Who in America, Who’s Who in American Law, and Who’s Who in Emerging Leaders in America. Hickey is rated A/V by Martindale Hubbell, the international directory of lawyers, a rating achieved by only 5% of all attorneys. CONTACT US AND SEE OUR RESULTS AT: www.hickeylawfirm.com and CALL US TOLL FREE AT 1.800.215.7117.

STATUTES OF LIMITATIONS: WHAT IS THIS AND WHEN DO I HAVE TO ACT?

I got a call the other day from an attorney in Pennsylvania. He said that his client was raped (“sexually assaulted”) on a cruise ship and that she-the client- had reported it to the FBI. So far, the client did what she should have done.

Then he said that the sexual assault took place about 2 ½ years ago. Oops. I told the lawyer that the one year statute of limitations in her ticket (the cruise line “passenger contract ticket”) had passed and there is nothing I could do now. It is too late to bring a claim.

The cruise lines have included in the fine print on all of the passenger tickets the terms under which you have to bring a claim against them. They say when (usually within one year of the accident or incident) and where (Miami, Florida if it is Carnival Cruise Lines, Norwegian Cruise Lines, Royal Caribbean Cruise Lines, or Celebrity Cruise Lines). By the way, in order to bring a claim in Florida, it is best to contact a Florida attorney. Each state licenses attorneys to practice only in that state.

Then I asked why she waited so long. He said that the passenger was told by the FBI agent investigating the rape that the statute of limitations was 3 years. Oh well. So much for advice from someone who is not a maritime lawyer. (It is true generally that the statute of limitations for maritime claims is 3 years. However, the cruise lines can limit that to one year, and of course they do in the ticket terms).

This is not meant to be legal advice or to explain everything about statutes of limitations or something you can rely on to determine what your statute of limitations is. To know about that, call a lawyer who knows about the field in which you have a claim.

But here are some of the concepts: The “statute of limitations” for a claim is a general term which means the time within which you have to file a lawsuit. First, it is not always expressed in a statute. Sometimes it is in a contract like a passenger ticket. And there are provisions in some statutes, commonly in medical malpractice statutes, that it starts (“begins to run”) from when you knew or should have known about the medical malpractice. This does not apply to claims for medical malpractice against the cruise lines.

Second, there are different periods of time or statutes of limitations for different types of claims, and the statute can be different in each state. Generally, for maritime seaman’s claims the statute is 3 years; for passengers it is 1 year. Generally, in Florida, for general negligence it is 4 years; for wrongful death it is 2 years; for medical malpractice it is 2 years; for product liability it is 2 years.

Third, the only way to stop the clock, beat the deadline, or as the law says “toll the statute” is to file a lawsuit. The clock is not stopped just by reporting the accident. You have to file suit. That means that you have to contact an attorney in time for him or her to evaluate and investigate the claim and to prepare and file a complaint in court. If you wait until the day the statute runs out or the day before it may be too late to do anything.

The best way to determine the statute of limitations is to call an attorney and to tell him or her about your case. The attorney will tell you. Do not rely on someone else or the internet or this blog even. Call the attorney’s office today. You can call us here at Hickey Law Firm, P.A. toll free at 1.800.215.7117. Barbara Hernandez, Karla Huertas, Sandy Talavera, Darby Mitchell, and attorney John H. (Jack) Hickey are here to take your call, get your information, and listen. Thanks.

Just one week before the Food and Drug Administration is to hold hearings on the safety of over the counter cough and cold medications for children, the industry has finally reacted. The cold medicine industry trade group, the Consumer Healthcare Products Association, has announced that major drug manufacturers will pull off the market 14 cough and cold remedies for children. This is because what they did not tell you is that coughing can be good; it is the mechanism by which the body gets rid of mucous. If you inhibit coughing, you inhibit this mechanism and the mucous stays in the lungs. The results: The Centers for Disease Control and Prevention said that about 1500 children across the nation were treated in emergency rooms for bad reactions to over the counter cough and cold medicines from 2004 to 2005. From 1969 to 2006, the FDA found at least 54 children died after taking decongestants, and 69 children died after taking antihistamines. That is a total death toll of 123. That means 123 wrongful deaths of children including infants. According to Dr. Peter Antevy, a pediatric emergency medicine physician at Joe Dimaggio Children’s Hospital in Hollywood, Florida, “This is a long time coming”.

The medicines include various medicines for children or infants under the names of Dimetapp, Little Colds, Pediacare, Robitussin, Triaminic, and Tylenol.