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Jets cut G Kelechi Osemele after he elects to have shoulder surgery

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On 10/18/2019 at 4:13 PM, Counselor said:

If argue that tanking and not trying to win as best as possible is classless as well.

 

No, two totally different things.  Tanking has nothing to do with having class.  It is a method of rebuilding the team.  Just because it does not reach the highest ideals of the sport it can not be compared to fining a player who wants to have surgery.   Now I can understand fining a player for having surgery during the season, when the team advised him to get the surgery during the off season, and the player made the decision to try to let it heal on its own.  This coming from a team, whose team doctor led the nfl coverup on concussions, I would think the jets were to be more aware of the public reaction on this issue. 

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2 minutes ago, patman said:

 

No, two totally different things.  Tanking has nothing to do with having class.  It is a method of rebuilding the team.  Just because it does not reach the highest ideals of the sport it can not be compared to fining a player who wants to have surgery.   Now I can understand fining a player for having surgery during the season, when the team advised him to get the surgery during the off season, and the player made the decision to try to let it heal on its own.  This coming from a team, whose team doctor led the nfl coverup on concussions, I would think the jets were to be more aware of the public reaction on this issue. 

It’s still classless. Not comparable to the Jets. But in my mind that is what it is. Thank you.

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25 minutes ago, Daniel said:

 

Or if the docs "missed" something to a degree of negligence that falls outside of acceptable practice within the profession, though something that extreme in this case seems unlikely.  I could see an argument that mere underdiagnosis to help clear him for the team would be malpractice, but I doubt there's any case law on point.  

Now that we know more about how the Jets are fining him, I'd imagine if anyone would be more liable it'd be them versus the actual doctors.

This system is broken though. Doctors need to be completely independent, and there needs to be union representation in how they're selected.

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1 hour ago, sammymvpknight said:

@NJC33 what are your thoughts on the topic?

This is going to make the Jets look really bad. If I was Osemele, I would sue them. He'd probably win for before forced to play and potentially doing further harm to his shoulder. I've done this for a long time. You NEVER assume that a patient is malingering. Do patient's malinger (such as Ramsey)? Yes...but way more often than not they aren't. And it looks REALLY bad when you make that assumption and you end up being wrong.

The Saints made the same mistake a few years ago with Delvin Breaux. It was honestly the biggest embarrassment of Sean Payton's career.

I've said from the beginning that this pissing contest wouldn't be worth the PR look, that's proven to be true, nonetheless, it hasn't changed my originally opinion. 

Osemele was healthy enough to play before being relegated to the bench, at which point the pain became to unbearable. This is a clear example of malingering, despite the narrative being created in the media. Your 100% right to say you can never assume that a patient is malingering, which is why this is such an idiotic stance by the Jets and Joe Douglas in particular. But make no mistake about it, Osemele is not the victim he's working so hard to be portrayed as.

At the end of the day, the Jets need to put their stubbornness aside and try to neutralize some of damage that's already been done.  

 

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Just now, NJC33 said:

I've said from the beginning that this pissing contest wouldn't be worth the PR look, that's proven to be true, nonetheless, it hasn't changed my originally opinion. 

Osemele was healthy enough to play before being relegated to the bench, at which point the pain became to unbearable. This is a clear example of malingering, despite the narrative being created in the media. Your 100% right to say you can never assume that a patient is malingering, which is why this is such an idiotic stance by the Jets and Joe Douglas in particular. But make no mistake about it, Osemele is not the victim he's working so hard to be portrayed as.

At the end of the day, the Jets need to put their stubbornness aside and try to neutralize some of damage that's already been done.  

 

But you understand that you're wrong. Malingering is an actual diagnosis that is used when you don't have another more appropriate diagnosis, it's a diagnosis of exclusion. The guy has a torn labrum that could very easily cause his symptoms. That's his diagnosis, and it disqualifies him from being a malingerer. Just because it is common for NFL players to play through injuries that they shouldn't (cough, Mahomes, cough), doesn't mean you change diagnosis. 

It is very possible that he played through an injury that he probably should NOT have, and his condition and symptoms worsened. But that's what happens when you play through an injury. That's why when you or I go to the doctor with a torn labrum, we get instructed to stop doing what's hurting our shoulder. The moment that the Jets team physician medically owned Osemele, they owned the condition. They owned the possibility that his shoulder could worsen or limit him. They owned it. They don't want to own it...and there in lies the problem.

The fact that they are fighting back on this and that Jets fans are going along with it is disgusting. It's undoubtedly part of the reason you have a dysfunctional organization that has a long history of losing. If I wasn't a Jets fan, I'd be looking to get out of town. I wouldn't be especially interested in making the Jets a winner.

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18 minutes ago, NJC33 said:

I've said from the beginning that this pissing contest wouldn't be worth the PR look, that's proven to be true, nonetheless, it hasn't changed my originally opinion. 

Osemele was healthy enough to play before being relegated to the bench, at which point the pain became to unbearable. This is a clear example of malingering, despite the narrative being created in the media. Your 100% right to say you can never assume that a patient is malingering, which is why this is such an idiotic stance by the Jets and Joe Douglas in particular. But make no mistake about it, Osemele is not the victim he's working so hard to be portrayed as.

At the end of the day, the Jets need to put their stubbornness aside and try to neutralize some of damage that's already been done.  

 

Dude take the L.  Osemele has 3 opinions that confirm the labrum is completely torn.   It’s embarrassing to try and paint Osemele as the bad guy here.   This is like NO & Breaux.  Except NO had the good sense to admit when they’re wrong.  
 

Ppl and orgs make mistakes.  It happens.   Not owning said mistakes though is never justifiable.   Good orgs learn from mistakes.  Bad ones don’t.  

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6 minutes ago, Broncofan said:

Dude take the L.  Osemele has 3 opinions that confirm the labrum is completely torn.   It’s embarrassing to try and paint Osemele as the bad guy here.   This is like NO & Breaux.  Except NO had the good sense to admit when they’re wrong.  
 

Ppl and orgs make mistakes.  It happens.   Not owning said mistakes though is never justifiable.   Good orgs learn from mistakes.  Bad ones don’t.  

Quite honestly, the Breaux situation was the most embarrassing moment of my 20+ year history of being a Saints fan. I knew they were going to regret taking the malingering route, and it completely blew up in their face. Delvin Breaux was a local kid who did everything in his power to make it to the NFL, the guy was living his dream as guy from New Orleans...and he's going to fake his level of pain? It was embarrassing that the Saints coaching staff didn't trust their player. I was very vocal even before the news broke that they missed the diagnosis. Just a bit of common sense and humility would have gone a long way.

To the Saints credit...Payton later came out and apologized and did everything he could to make it right. They fired the Saints team physicians. But the damage was done...they hurt the career of Breaux, a kid who deserved so much better.

I was actually in residency at the time that it went down. I was strongly considering Sports Medicine and I would have been a complete LOCK to get a Sports Med fellowship. I decided to move my career in a different direction. Being the Saints team physician would have been a dream job 10 years ago...but it really was enlightening and heartbreaking. You should never have to make a decision that is not in the best interest of your patient, and I think that it happens way to often within the field.

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11 minutes ago, sammymvpknight said:

Quite honestly, the Breaux situation was the most embarrassing moment of my 20+ year history of being a Saints fan. I knew they were going to regret taking the malingering route, and it completely blew up in their face. Delvin Breaux was a local kid who did everything in his power to make it to the NFL, the guy was living his dream as guy from New Orleans...and he's going to fake his level of pain? It was embarrassing that the Saints coaching staff didn't trust their player. I was very vocal even before the news broke that they missed the diagnosis. Just a bit of common sense and humility would have gone a long way.

To the Saints credit...Payton later came out and apologized and did everything he could to make it right. They fired the Saints team physicians. But the damage was done...they hurt the career of Breaux, a kid who deserved so much better.

I was actually in residency at the time that it went down. I was strongly considering Sports Medicine and I would have been a complete LOCK to get a Sports Med fellowship. I decided to move my career in a different direction. Being the Saints team physician would have been a dream job 10 years ago...but it really was enlightening and heartbreaking. You should never have to make a decision that is not in the best interest of your patient, and I think that it happens way to often within the field.

I don’t think it’s even a conscious decision.  But I can’t deny that sports team MD’s make decisions that a 2nd opinion reverses far more than in general.   The incidence of 2nd opinions being different than the original one outside of sports is microscopic.  That’s no coincidence. 

It highlights the problem when a team is the employer.  It’s also why the 2nd opinion must be respected.  Get a 3rd if you must.  But that's the failsafe that is supposed to remove the threat of team bias from affecting medical decisions.  The moment teams outright ignore outside opinions, they destroy credibility inside their org and with prospective players / agents.   Without some level of mutual trust, there's no basis for an organization to recruit and retain their talent.  Regardless of any legal fallout, the inability to recruit and retain their best players is going to crush the Jets FO long-term if they don't do a complete 180 and stop this nonsense.  

The Jets FO is being incredibly stupid and short-sighted here.  It’s crazy that GM Joe Douglas is taking this stance.  He’s supposed to be brilliant, having been a Howie Roseman disciple.  This incident calls that take of Douglas being one of the brightest young minds for GM very much in question.  

Edited by Broncofan

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1 hour ago, Broncofan said:

Misdiagnosis or undercall of severity?   That latter being a judgment call, no chance IMO.  

I'll defer to the legal guys, but the issue is more the optics - the only MD to clear Osemele was the team MD.   The independent opinions, all 3 - said get surgery now.  It highlights the problem with the system using MD's who are tied to the team to make the call.   Which is what the 2nd opinion is the failsafe for.   That's why the Jets' inaction (at best) / deliberately ignoring or hiding (at worst) the extra opinions is an awful, awful look.   The extra opinions are the failsafe to team-bias in a decision.    

I doubt the team MD is going to get dinged legally, if there's any element of judgment (but again, I'm no legal expert).  But on the flip side, I don't know how anyone on the team (or any prospective FA) has any trust with their medical staff or FO after this, either.   From an org perspective, that's just as damaging, if not more so.

 

1 hour ago, ramssuperbowl99 said:

Now that we know more about how the Jets are fining him, I'd imagine if anyone would be more liable it'd be them versus the actual doctors.

This system is broken though. Doctors need to be completely independent, and there needs to be union representation in how they're selected.

I'm not saying the doctors would be solely liable or the best lawsuit to bring.  Obviously the grievance with the team would be first since they have deeper pockets, but the original question was about how viable a med mal case would be, and at least here in Tennessee, what you look for in a med mal case is a gross negligence that clearly falls short of the standard of care within the profession.  It's the same for legal malpractice, and though they're tough to win because a doc can just say his opinion is his opinion, and usually that's all, if three other doctors said that he needed surgery, and if one of them says that no doctor actually practicing to the degree of acceptability within the profession would say he didn't need surgery, you've definitely got a case (assuming that "he needs surgery now" also means he could suffer further harm if he doesn't--still need to show damages).

Plus, what the standard is doesn't matter as much as what you can get a jury to believe the standard is, because they're the factfinders.

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43 minutes ago, NJC33 said:

Osemele was healthy enough to play before being relegated to the bench, at which point the pain became to unbearable.

It is perfectly reasonable to think that the day to day pain simply became overwhelming. Pain is exhausting, treatment is exhausting, and without the motivation of starting, he might not have been able to go anymore. That's not him consciously choosing not to play or electing to time the surgery, so assuming there was any type of intent in his decision is wildly speculative.

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10 minutes ago, Daniel said:

 

I'm not saying the doctors would be solely liable or the best lawsuit to bring.  Obviously the grievance with the team would be first since they have deeper pockets, but the original question was about how viable a med mal case would be, and at least here in Tennessee, what you look for in a med mal case is a gross negligence that clearly falls short of the standard of care within the profession.  It's the same for legal malpractice, and though they're tough to win because a doc can just say his opinion is his opinion, and usually that's all, if three other doctors said that he needed surgery, and if one of them says that no doctor actually practicing to the degree of acceptability within the profession would say he didn't need surgery, you've definitely got a case (assuming that "he needs surgery now" also means he could suffer further harm if he doesn't--still need to show damages).

Plus, what the standard is doesn't matter as much as what you can get a jury to believe the standard is, because they're the factfinders.

Yeah, the grievance is definitely the first step.  And it's a slam dunk.

The issue with the 1st MD opinion is if his opinion is simply "needs surgery, but it can wait until the offseason".  That's actually a decision that's taken and accepted in many cases, so it's a judgment call.   That's where it will be difficult to prove a standard of care was set and missed.     You can definitely get medical experts to advocate that surgery isn't the immediate standard in labrum tears, while at the same time recognizing that with 3 outside opinions, the Jets should acquiese and don't have a case to fine/penalize him.   But, the last part of the jury is really the most important part in the US - in Canada, this goes to a judge, and it has little to no chance.  In the US, I totally get where you are coming from.

The fact the "standard of care" is fuzzier on timing of surgery (now vs. later), I don't put anything on the Jets initially - until they started ignoring the 2nd & then the 3rd opinion.    THAT is a major no-no.    The only way the 1st MD is liable is if they said "doesn't need surgery at all".    Again, though, your last point on a jury is why I defer to the legal guys.  

Edited by Broncofan

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4 minutes ago, Daniel said:

 

I'm not saying the doctors would be solely liable or the best lawsuit to bring.  Obviously the grievance with the team would be first since they have deeper pockets, but the original question was about how viable a med mal case would be, and at least here in Tennessee, what you look for in a med mal case is a gross negligence that clearly falls short of the standard of care within the profession.  It's the same for legal malpractice, and though they're tough to win because a doc can just say his opinion is his opinion, and usually that's all, if three other doctors said that he needed surgery, and if one of them says that no doctor actually practicing to the degree of acceptability within the profession would say he didn't need surgery, you've definitely got a case (assuming that "he needs surgery now" also means he could suffer further harm if he doesn't--still need to show damages).

Plus, what the standard is doesn't matter as much as what you can get a jury to believe the standard is, because they're the factfinders.

I do think that most physicians have the best interest of their patients in mind. But this is a high stakes game, and there is unquestionably pressure that is put on some of these physicians. So if there's a question of whether or not a player CAN play versus SHOULD play...some will opt for the can play option, especially if the those two two options are presented to the patient and the player wants to get back (this is likely the scenario with Mahomes). If Mahomes was in a different situation than he currently is in, he'd be receiving different treatment options right now. If he was a college QB, I'd be surprised if he wasn't out for at least 6 weeks. I personally think that rushing him back a week after a significant knee injury is stupid. He already has a gimpy ankle, and now he has a gimpy knee. Sure, you can protect the knee, but it will undoubtably make him less mobile and more likely to take big hits, and it also could screw with his biomechanics of throwing which could predispose him to other injuries. It's stupid...but whatever, I'm sure the Chiefs understand the risks.

 

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Jesus what a mess!

Just reading all those twitter reports gave me an headache!

 

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23 minutes ago, Daniel said:

I'm not saying the doctors would be solely liable or the best lawsuit to bring.  Obviously the grievance with the team would be first since they have deeper pockets, but the original question was about how viable a med mal case would be, and at least here in Tennessee, what you look for in a med mal case is a gross negligence that clearly falls short of the standard of care within the profession.  It's the same for legal malpractice, and though they're tough to win because a doc can just say his opinion is his opinion, and usually that's all, if three other doctors said that he needed surgery, and if one of them says that no doctor actually practicing to the degree of acceptability within the profession would say he didn't need surgery, you've definitely got a case (assuming that "he needs surgery now" also means he could suffer further harm if he doesn't--still need to show damages).

So, in practice, the way to prove a case against the doctor would be that he let the team influence his opinion by some written communication, that probably doesn't exist.

Showing damages would be a little easier right? The risk for future injury isn't needed when you have records of all the pain medication he's taking to play.

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