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'''Kristjan T. Ragnarsson, M.D.''', is a [[Physical medicine and rehabilitation|physiatrist]] with reputation for being pompous . [[central nervous system]].<ref>[http://www.rehab.research.va.gov/mono/sci/ragnarsson.pdf United States Department of Veterans Affairs]</ref> He is currently the Dr. Lucy G. Moses Professor and Chair of Rehabilitation Medicine at The [[Mount Sinai Hospital, New York|Mount Sinai Medical Center]] in [[New York City]].<ref name=MSH>[http://www.mountsinai.org/Find%20A%20Faculty/profile.do?id=0000072500001497274332&officeDrawer=biz The Mount Sinai Medical Center – Doctor Profile]</ref>
'''Kristjan T. Ragnarsson, M.D.''', is a [[Physical medicine and rehabilitation|physiatrist]] with an international reputation in the rehabilitation of individuals with disorders of the [[central nervous system]].<ref>[http://www.rehab.research.va.gov/mono/sci/ragnarsson.pdf United States Department of Veterans Affairs]</ref> He is currently the Dr. Lucy G. Moses Professor and Chair of Rehabilitation Medicine at The [[Mount Sinai Hospital, New York|Mount Sinai Medical Center]] in [[New York City]].<ref name=MSH>[http://www.mountsinai.org/Find%20A%20Faculty/profile.do?id=0000072500001497274332&officeDrawer=biz The Mount Sinai Medical Center – Doctor Profile]</ref>


Ragnarsson is the author of multiple book chapters and more than 100 articles. He was listed among [[New York (magazine)|New York Magazine]]’s Best Doctors of 2009 and among [[Castle Connolly]]'s "Top Doctors in America" every year since 2002.<ref>[http://www.castleconnolly.com/doctors/full.cfm?doctorID=81CC003804 Castle Connolly Top Doctors]</ref>
Ragnarsson is the author of multiple book chapters and more than 100 articles. He is listed among [[New York (magazine)|New York Magazine]]’s Best Doctors of 2009 and among [[Castle Connolly]]'s "Top Doctors in America" every year since 2002.<ref>[http://www.castleconnolly.com/doctors/full.cfm?doctorID=81CC003804 Castle Connolly Top Doctors]</ref>


==Biography==
==Biography==
Ragnarsson was born in 1943 in [[Reykjavík]], [[Iceland]]. He graduated from the [[University of Iceland]] School of Medicine in 1969 and completed a residency in physical medicine and rehabilitation and a clinical research fellowship in [[Spinal cord injury|spinal cord injury (SCI) medicine]] at the [[Rusk Institute of Rehabilitation Medicine]] at [[New York University School of Medicine|NYU]]. He was appointed to the faculty of the Department of Rehabilitation Medicine of the NYU School of Medicine in 1976 and served as director of the New York SCI Model System of Care from 1981 to 1986. In 1986, he was appointed Professor and Chair of the Department of Rehabilitation Medicine at The Mount Sinai Medical Center.<ref>{{cite book |title= This House of Noble Deeds|last=Aufses, Jr. |first=Arthur H |coauthors=Barbara Niss |year= 2002|publisher= NYU Press |isbn= 0814705006|page=358 |pages=|url=http://www.amazon.com/This-House-Noble-Deeds-1852-2002/dp/0814705006/ref=sr_1_2?ie=UTF8&s=books&qid=1260893929&sr=1-2 |accessdate=December 29, 2009}}</ref>
Ragnarsson was born in 1943 in [[Reykjavík]], [[Iceland]]. He graduated from the [[University of Iceland]] School of Medicine in 1969 and completed a residency in physical medicine and rehabilitation and a clinical research fellowship in [[Spinal cord injury|spinal cord injury (SCI) medicine]] at the [[Rusk Institute of Rehabilitation Medicine]] at [[New York University School of Medicine|NYU]]. He was appointed to the faculty of the Department of Rehabilitation Medicine of the NYU School of Medicine in 1976 and served as director of the New York SCI Model System of Care from 1981 to 1986. In 1986, he was appointed Professor and Chair of the Department of Rehabilitation Medicine at The Mount Sinai Medical Center.<ref>{{cite book |title= This House of Noble Deeds|last=Aufses, Jr. |first=Arthur H |coauthors=Barbara Niss |year= 2002|publisher= NYU Press |isbn= 0814705006|page=358 |pages=|url=http://www.amazon.com/This-House-Noble-Deeds-1852-2002/dp/0814705006/ref=sr_1_2?ie=UTF8&s=books&qid=1260893929&sr=1-2 |accessdate=December 29, 2009}}</ref>

Deane v. Mount Sinai Hospital, 114984/07
Ragnarsson served as president of the American Spinal Injury Association from 1993 to 1995. From 1995 to 1997 he served as president of The Mount Sinai Hospital Medical Board, and from 1997 until 2003 he chaired the Board of Governors of The Mount Sinai Faculty Practice Associates. He was a member of the board of the American Paraplegia Society from 1997 to 1999 and a member of the [[United States Department of Veterans' Affairs]] Scientific Merit Review Board from 1984 until 2000. In 1998, he chaired the [[National Institutes of Health]] consensus conference on "Rehabilitation of Persons with Traumatic Brain Injury".<ref name=MSH/> He has been a member of the [[American Medical Association]] since 1976. Currently he serves as President of the Association of Academic Psysiatrists<ref>[http://www.physiatry.org/AboutUs_Board_Committees.cfm AAP]</ref> and Vice President of the Foundation for Physical Medicine and Rehabilitation.<ref>[http://www.physiatry.org/AboutUs_Board_Committees.cfm Foundation for PM&R]</ref>
Decided: August 27, 2009
Justice Joan B. Carey
NEW YORK COUNTY
Supreme Court
Justice Carey
Click here to see Judicial Profile
On or about April 1, 2007, Kevin Deane was injured while skiing in
Colorado. Mr. Deane suffered a spinal cord injury, and, as a result, was
experiencing paralysis. He was first taken to Vail Valley Hospital and was
then transferred to Denver Hospital. An MRI and a CT scan were
performed, and showed the following: "[m]ultiple vertebral segmentation anomalies with hyperextension injury at
C3-C4 and C4-C5 and moderate spinal cord contusion at C3-C4. There is a moderate broad-based disc protrusion at
C3-C4, right greater than left, which produces mild anterior spinal cord indentation." On or about, April 2, 2007, Kevin
Deane underwent an anterior cervical discectomy and fusion of C3-C5, as well as posterior fusion. The aforementioned
surgery involved the placement of a plate and screws into Mr. Deane's cervical spine to provide stabilization. The
surgery was performed without complication, and Mr. Deane began to experience neurological improvement. The plan
was for Mr. Deane to undergo rehabilitation, with the hope of regaining full function and returning to his job as a fire
fighter.
Thereafter, on April 6, 2007, Mr. Deane was discharged from Denver Hospital in stable condition and was transported
by air ambulance to the Mount Sinai Hospital (hereinafter "Mt. Sinai"), in New York, where he was to receive
rehabilitation services. At the time of his discharge from Denver Hospital and during the flight to Mt. Sinai, Mr. Deane
was having difficulty swallowing, requiring suctioning of his secretions. Upon arrival at Mt. Sinai late in the afternoon on
April 6, 2007, Adam B. Stein, M.D., a rehabilitation attending physician, admitted Mr. Deane under his services, meaning
that he was primarily responsible for Mr. Deane's care. Dr. Stein took a history and performed a physical examination
of Mr. Deane, his impression following this examination was that Mr. Deane had decreased mobility, decreased
activities of daily living, and difficulty swallowing. Dr. Stein believed Mr. Deane's prognosis for a substantial neurological
recovery was quite good, and estimated his legnth of stay at the rehabilitation facility to be six (6) weeks. However,
Dr. Stein had concerns relating to Mr. Deane's difficulty swallowing and ordered a consultation by an ear nose and
throat (ENT) specialist. It is noted that Dr. Stein indicated, at his deposition, that he was aware of potential
complication of the type of surgery that Mr. Deane underwent that is caused by erosion of hardware placed in the neck
Dr. Stein's shift ended at approximately 7:30 p.m. on April 6, 2007. The weekend on-call attending, Dr. Bryce, was to
take over Mr. Deane's care from Dr. Stein the next morning. The attending physician on-call is expected to be
physically present at Mt. Sinai on Saturday and Sunday. Notwithstanding, it appears that Dr. Bryce failed to report to
work on the morning of Saturday, April 7, 2007. It was later learned during discovery that Dr. Bryce's name was
omitted from the list containing the e-mail addresses of physicians receiving the on-call schedule, and, thus, Dr. Bryce
was unaware that he was the on-call attending that weekend. According to the deposition of Dr. Steven Flanagan, who
was the Vice-Chairman of the Department of Rehabilitation at Mt. Sinai from January of 2000 to March 2008, it was
his responsibility to establish schedules for coverage of the physicians in the rehabilitation department. Dr. Flanagan
testified that it is expected that two attending physicians be on-call each weekend, and that both on-call attendings are
expected to be present at the hospital on Saturday and Sunday. It appears that the other attending on-call that
weekend was Dr. Herrera, who was unaware that Dr. Bryce had failed to show up for work, and apparently unaware
that half the patients in the rehabilitation facility were not under the care of an attending physician. Dr. Flanagan also
testified that it is his expectation that every patient be seen by an attending physician at least once a day, and that the
attending physicians make a note of such examination. Dr. Flanagan testified that the physicians in his department are
aware of these expectations. With respect to the on-call schedule for attending physicians setting forth their
responsibility for weekends, Dr. Flanagan testified that other than sending out the e-mail to the physicians, nothing
more is done to make sure that the physicians know when they are required to be at the hospital.
Nurse Awo Sam was the nurse who admitted Mr. Deane on the evening of April 6, 2007. As the admitting nurse, Nurse
Sam did an assessment of Mr. Deane at approximately 7:00 p.m., and, at the time of her deposition, she recalled that
Mr. Deane was tired, had swelling in his neck, was anxious, had an elevated fever, a high pulse rate and was in pain.
During her assessment of Mr. Deane, he was having respiratory difficulties and receiving supplemental oxygen. He also
had a cough that was productive of yellow secretions, which, according to Nurse Sam's testimony, could suggest
pneumonia or respiratory infection. According to Nurse Sam, during her assessment, Mr. Deane advised her that he
was having difficulty swallowing. Nurse Sam testified at some point during her shift, which ended at 7:00 a.m. on the
morning of April 6, 2007, she alerted the on-call resident that Mr. Deane had abnormal vital signs, such as an
abnormally high fever, high pulse, and high blood pressure.
Dr. Rebecca Brown was the resident on call from 7:00 p.m. on April 6, 2007, until 7:00 a.m. on April 7, 2007. She was
a fourth year resident in rehabilitation medicine. During this shift, Dr. Brown was responsible for covering all of the
patients on all four floors of the rehabilitation facility, which included spinal chord injured patients, such as Mr. Deane, as
well as brain injured patients. She was the only resident physician assigned to the entire rehabilitation facility for that
day, where there are approximately 100 patients. These same hundred patients would be cared for by eight or nine
attending physicians during the week, in addition to whatever residents, nurses and patient care associates were
working in the facility. It is important to note that immediately prior to beginning her shift at the rehabilitation clinic on
the evening of April 7, 2007, Dr. Brown worked a 12 hour shift in the outpatient clinic at Mt. Sinai.
Dr. Brown first encountered Mr. Deane when he was examined upon admission by Dr. Stein. At that time, Dr. Brown
became aware of Mr. Deane's difficulty swallowing, and was also aware of his respiratory difficulties. At approximately
12:30 a.m. on April 7, 2007, Dr. Brown observed that Mr. Deane had increased difficulty breathing, so she doubled the
amount of oxygen he was receiving. At that time, Mr. Deane also had an elevated fever, hoarse breath, and was
requesting to sit up to have his chest suctioned to clear out secretions. Additionally, Mr. Deane was also tachycardic,
i.e., his heart rate exceeded the normal range. Dr. Brown ordered a stat complete blood count, chem profile and chest
x-ray. It appears from the records, and the deposition testimony of Dr. Brown, that she did not see Mr. Deane after
approximately 12:30 a.m. on April 7, 2007, and she never notified an attending physician with respect to Mr. Deane's
condition. It is noted that the stat chest x-ray that Dr. Brown ordered at approximately 12:30 a.m. on April 7, 2007,
was not performed prior to the completion of Dr. Brown's shift. The chest x-ray was ultimately performed at
approximately 12:40 p.m. on April 7, 2007. It appears that the x-ray results were not reported, and such results were
never sought by any medical provider at Mt. Sinai.
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1 of 4 9/17/2009 4:36 PM
Dr. Nutini,


==Honors and awards==
==Honors and awards==
Line 149: Line 60:
==Publications==
==Publications==
Partial list:
Partial list:
*with traumatic brain injury". Ragnarsson KT. Restor Neurol Neurosci. 2002;20(3-4):103-8. Review. PMID 12454359
*Functional electrical stimulation after spinal cord injury: current use, therapeutic effects and future directions. Ragnarsson KT. Spinal Cord. 2008 Apr;46(4):255-74. Epub 2007 Sep 11. Review. PMID 17846639
*Traumatic brain injury research since the 1998 NIH Consensus Conference: accomplishments and unmet goals. Ragnarsson KT. J Head Trauma Rehabil. 2006 Sep-Oct;21(5):379-87. PMID 16983223
*Reliability of the Bryce/Ragnarsson spinal cord injury pain taxonomy. Bryce TN, Dijkers MP, Ragnarsson KT, Stein AB, Chen B. J Spinal Cord Med. 2006;29(2):118-32. PMID 16739555
*Spinal cord injury clinical trials for neurologic restoration: improving care through clinical research. Ragnarsson KT, Wuermser LA, Cardenas DD, Marino RJ. Am J Phys Med Rehabil. 2005 Nov;84(11 Suppl):S77-97; quiz S98-100. PMID 16251838
*The effect of electrically induced lower extremity ergometry on an ischial pressure ulcer: a case study. Pollack SF, Ragnarsson KT, Dijkers M. J Spinal Cord Med. 2004;27(2):143-7. Erratum in: J Spinal Cord Med. 2005;28(1):19. Djikers, Marcel. PMID 15162886
*Quality of life in patients with spinal cord injury--basic issues, assessment, and recommendations. Wood-Dauphinée S, Exner G, Bostanci B, Exner G, Glass C, Jochheim KA, Kluger P, Koller M, Krishnan KR, Post MW, Ragnarsson KT, Rommel T, Zitnay G; SCI Consensus Group. Restor Neurol Neurosci. 2002;20(3-4):135-49. Review. PMID 12454362
*Results of the NIH consensus conference on "rehabilitation of persons with traumatic brain injury". Ragnarsson KT. Restor Neurol Neurosci. 2002;20(3-4):103-8. Review. PMID 12454359
*Rehabilitation of the patient with chronic critical illness. Thomas DC, Kreizman IJ, Melchiorre P, Ragnarsson KT. Crit Care Clin. 2002 Jul;18(3):695-715. Review. PMID 12140920
*Rehabilitation of the patient with chronic critical illness. Thomas DC, Kreizman IJ, Melchiorre P, Ragnarsson KT. Crit Care Clin. 2002 Jul;18(3):695-715. Review. PMID 12140920
*Diagnosis and Treatment of Traumatic Brain Injury. Ragnarsson KT. JAMA. 2000 May 10;283(18):2392. PMID 10815080
*Diagnosis and Treatment of Traumatic Brain Injury. Ragnarsson KT. JAMA. 2000 May 10;283(18):2392. PMID 10815080

Revision as of 17:49, 12 April 2010

Kristjan T. Ragnarsson, M.D., is a physiatrist with an international reputation in the rehabilitation of individuals with disorders of the central nervous system.[1] He is currently the Dr. Lucy G. Moses Professor and Chair of Rehabilitation Medicine at The Mount Sinai Medical Center in New York City.[2]

Ragnarsson is the author of multiple book chapters and more than 100 articles. He is listed among New York Magazine’s Best Doctors of 2009 and among Castle Connolly's "Top Doctors in America" every year since 2002.[3]

Biography

Ragnarsson was born in 1943 in Reykjavík, Iceland. He graduated from the University of Iceland School of Medicine in 1969 and completed a residency in physical medicine and rehabilitation and a clinical research fellowship in spinal cord injury (SCI) medicine at the Rusk Institute of Rehabilitation Medicine at NYU. He was appointed to the faculty of the Department of Rehabilitation Medicine of the NYU School of Medicine in 1976 and served as director of the New York SCI Model System of Care from 1981 to 1986. In 1986, he was appointed Professor and Chair of the Department of Rehabilitation Medicine at The Mount Sinai Medical Center.[4]

Ragnarsson served as president of the American Spinal Injury Association from 1993 to 1995. From 1995 to 1997 he served as president of The Mount Sinai Hospital Medical Board, and from 1997 until 2003 he chaired the Board of Governors of The Mount Sinai Faculty Practice Associates. He was a member of the board of the American Paraplegia Society from 1997 to 1999 and a member of the United States Department of Veterans' Affairs Scientific Merit Review Board from 1984 until 2000. In 1998, he chaired the National Institutes of Health consensus conference on "Rehabilitation of Persons with Traumatic Brain Injury".[2] He has been a member of the American Medical Association since 1976. Currently he serves as President of the Association of Academic Psysiatrists[5] and Vice President of the Foundation for Physical Medicine and Rehabilitation.[6]

Honors and awards

Partial list (since 2002):

  • American Spinal Injury Association (ASIA) Lifetime Achievement Award. Presented at joint meeting of ASIA and the International Spinal Cord Society. Vancouver, Canada, May 4, 2002.[7]
  • Best Doctors in New York, New York Magazine, since 1991
  • Top Doctors in America. Castle-Connolly, 2002, 2003, 2004, 2005, 2006, 2007, 2008, 2009
  • New Jersey Medical School Excellence in Teaching Award in Recognition of Outstanding Contribution to the Education of Medical Students and Residents, June 12, 2002.
  • Ellis Island Medal of Honor, May 15, 2004[8]
  • Standing Tall Award – Alan T. Brown Foundation to Cure Paralysis, August 9, 2004
  • Distinguished Public Service Award, American Academy of Physical Medicine and Rehabilitation. November 10, 2006.[9]
  • Sir Ludwig Guttmann lecturer at the 46th Annual Scientific Meeting of the International Spinal Cord Society and the 10th Scientific Meeting of the Nordic Spinal Cord Society, Reykjavík, Iceland, June 28, 2007.
  • Gold Key Award of Merit – “The highest honor given by the American Congress of Rehabilitation Medicine for members of the medical and applied professions in recognition of extraordinary service to the cause of rehabilitation”. Washington, DC, October 5, 2007.

Grants

Partial list of active grants:

Title Source
FES Ergometry after SCI NIDRR Grant 88-431RM
An Evaluation of the Medtronic Synchromed Infusion System for Intrathecal Infusion of Baclofen Fan Fox and Leslie R. Samuels Foundation
Evaluation of the Benefits of FES Ergometry in Spinal Cord Injured Individuals Therapeutic Technologies, Inc.
Mount Sinai Spinal Cord Injury Model System NIDRR Grant #H133N00009

Publications

Partial list:

  • Functional electrical stimulation after spinal cord injury: current use, therapeutic effects and future directions. Ragnarsson KT. Spinal Cord. 2008 Apr;46(4):255-74. Epub 2007 Sep 11. Review. PMID 17846639
  • Traumatic brain injury research since the 1998 NIH Consensus Conference: accomplishments and unmet goals. Ragnarsson KT. J Head Trauma Rehabil. 2006 Sep-Oct;21(5):379-87. PMID 16983223
  • Reliability of the Bryce/Ragnarsson spinal cord injury pain taxonomy. Bryce TN, Dijkers MP, Ragnarsson KT, Stein AB, Chen B. J Spinal Cord Med. 2006;29(2):118-32. PMID 16739555
  • Spinal cord injury clinical trials for neurologic restoration: improving care through clinical research. Ragnarsson KT, Wuermser LA, Cardenas DD, Marino RJ. Am J Phys Med Rehabil. 2005 Nov;84(11 Suppl):S77-97; quiz S98-100. PMID 16251838
  • The effect of electrically induced lower extremity ergometry on an ischial pressure ulcer: a case study. Pollack SF, Ragnarsson KT, Dijkers M. J Spinal Cord Med. 2004;27(2):143-7. Erratum in: J Spinal Cord Med. 2005;28(1):19. Djikers, Marcel. PMID 15162886
  • Quality of life in patients with spinal cord injury--basic issues, assessment, and recommendations. Wood-Dauphinée S, Exner G, Bostanci B, Exner G, Glass C, Jochheim KA, Kluger P, Koller M, Krishnan KR, Post MW, Ragnarsson KT, Rommel T, Zitnay G; SCI Consensus Group. Restor Neurol Neurosci. 2002;20(3-4):135-49. Review. PMID 12454362
  • Results of the NIH consensus conference on "rehabilitation of persons with traumatic brain injury". Ragnarsson KT. Restor Neurol Neurosci. 2002;20(3-4):103-8. Review. PMID 12454359
  • Rehabilitation of the patient with chronic critical illness. Thomas DC, Kreizman IJ, Melchiorre P, Ragnarsson KT. Crit Care Clin. 2002 Jul;18(3):695-715. Review. PMID 12140920
  • Diagnosis and Treatment of Traumatic Brain Injury. Ragnarsson KT. JAMA. 2000 May 10;283(18):2392. PMID 10815080
  • Pain after spinal cord injury. Bryce TN, Ragnarsson KT. Phys Med Rehabil Clin N Am. 2000 Feb;11(1):157-68. Review. PMID 10680163
  • Medical rehabilitation length of stay and outcomes for persons with traumatic spinal cord injury--1990-1997. Eastwood EA, Hagglund KJ, Ragnarsson KT, Gordon WA, Marino RJ. Arch Phys Med Rehabil. 1999 Nov;80(11):1457-63. PMID 10569441
  • Physical medicine and rehabilitation at the Mount Sinai medical center during the 20th century. Ragnarsson KT. Mt Sinai J Med. 1999 May;66(3):139-44. PMID 10377544
  • Restorative treatment of persons with spinal cord injury: current trends. Ragnarsson KT. J Rehabil Res Dev. 1998 Oct;35(4):xi-xiv. Review. PMID 10220214
  • Three women with lupus transverse myelitis: case reports and differential diagnosis. Inslicht DV, Stein AB, Pomerantz F, Ragnarsson KT. Arch Phys Med Rehabil. 1998 Apr;79(4):456-9. PMID 9552115

References

  1. ^ United States Department of Veterans Affairs
  2. ^ a b The Mount Sinai Medical Center – Doctor Profile
  3. ^ Castle Connolly Top Doctors
  4. ^ Aufses, Jr., Arthur H (2002). This House of Noble Deeds. NYU Press. p. 358. ISBN 0814705006. Retrieved December 29, 2009. {{cite book}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  5. ^ AAP
  6. ^ Foundation for PM&R
  7. ^ American Spinal Injury Association
  8. ^ Library of Congress
  9. ^ a b American Academy of Physical Medicine and Rehabilitation
  10. ^ New York 2009 Super Doctors
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