This Makes Me Sick

Say Sorry and Face the Piper?

Wisconsin Governor Jim Doyle vetoed a bill passed by the state Assembly that would have made a doctor's apology inadmissible as evidence in medical malpractice cases. Thoughts? Is this different than a confession? Iowa Governor Tom Vilsack just singed such a bill into law.

Learn to Use That Fax Machine

A man who is HIV positive has sued his Charlotte doctor, saying he was denied a promotion after the doctor faxed confidential medical records to his office. He contends that his boss found the report and then proceeded to discriminate against him at work. Nice execution. Read [Winston-Salem Journal]

The Big Payback

Dr. Frank Bonnarens was sued for malpractice four times and each of the lawsuits were dismissed. So after a fifth suit was filed and later dropped, the Louisville orthopedic surgeon fought back‑-filing his own suit against the moonlighting state government attorney who had sued him in the fifth case. The jury recently found that attorney Walter Bedford Jr. sued Bonnarens for the sole purpose of harassing him into paying a settlement. Classy. Read [The Courier Journal]

Anyone Can Be A Physical Therapist

Caryn Dinetz wanted to and all she had to do was lift Karen Levine's licensing information off of a New York State Web site. Then she polished up a resume with Levine’s name, presented the required medical malpractice insurance forms using Levine's policy number and voila. Yikes! Talk about liability nightmare. Read [Newsday]

An Inmate's Rx and Lawsuit Fears

Guy gets tossed in the slammer. Says he's got a toothache. The nurse thinks lawsuit first and passes the pills. The county pays.

"The ailments may just be outlandish, but we can’t afford to tell them they’re crazy. We have to err on the side of caution because if they really are sick, and we don’t provide care, we’re opening ourselves to a lawsuit." Don't you love the liability climate. Read [Alton Telegraph]

State Defers and Health Care Plan Dies?

The plan was novel: an employer, an employee and the state would join forces to insure that affordable health care was available for the poorest Tennesseans. But then Republicans in the Statehouse said they wanted the participating insurance companies to assume all the liability risk. Suddenly the dance floor was empty and only the crickets were chirping. Read [Nashville City Paper]

Medical School for Lawyers

Ah, a romance born in the college lecture hall. Well, not exactly. But docs are giving malpractice lawyers one-day sessions on the physiology, diagnosis and treatment of medical conditions frequently encountered by trial attorneys. Deeper med knowledge=fewer frivolous lawsuits? Read [UPI]

Do the math. But do it right.

Jeffrey Segal, M.D, a board-certified neurosurgeon and the founder and president of Medical Justice Services, Inc., weighs in on the study that 37% of malpractice lawsuits involved no medical error.

We know that taking frivolous and unfounded medical malpractice cases out of the courts, before they are filed and cost money, is a way to reduce the cost of healthcare.

The recent New England Journal of Medicine study found the same thing. The study said that many—37 percent—malpractice cases did not involve errors and three percent did not involve any injuries. And most of the claims that were not the result of errors or injuries did not result in compensation.

When compensation was paid, 54 cents of every dollar spent in cases that did not involve error went to administrative expenses, including those involving lawyers, experts and courts.

To me, perhaps the study’s greatest use is that it will spark further discussion that can lead to a realistic solution. But I have some concerns about the sample that the Journal employed.

The study’s authors note that 30 percent of the defendants were trainees, including residents, fellows and interns. But according to the National Practitioner Data Bank 2004 Report, interns and residents accounted for less than 1 percent of all malpractice payment reports. The authors admit that academic institutions were overrepresented in the sample and created an inherent limitation in the study.

But, given the preponderance of physicians-in-training in the sample, it is difficult to make a conclusion about the true error / total claim rate across the country. Those with the least amount of training would be more likely to make more true errors both in planning and execution.

Next, the data appears to be based on a claim as defined from the plaintiff's perspective; that is, there is one claim no matter how many defendants. That’s not the way typical medical malpractice cases work. A legitimate claim is actually more likely to have multiple defendants, for example, the referring physician, the emergency room physician, the surgeon, the radiologist, the anesthesiologist, etc.

Malpractice Suits By the Numbers

"I do not defend the present system at all," said Cliff Rieders, a personal injury lawyer. "I think money is wasted unbelievably." Smart man? A new study in the New England Journal of Medicine looked at 1,452 closed medical malpractice lawsuits and found 37 percent involved no medical error, and an additional 3 percent included no proof of injury. They also noted that the courts usually ruled against the plaintiffs in those cases and they didn't account for a large portion of medical malpractice costs. Read more. [The Patriot-News]

The Root of the Liability Problem?

An article in the American Prospect says forget legislative solutions to the liability mess; why not just end the medical errors? We missed this study from the Wall Street Journal, but it seems “Over the past two decades patient deaths due to anesthesia have declined to one death per 200,000 to 300,000 cases from one for every 5,000 cases.” ?$%#$ Anesthesia is 40 times safer today than it was 20 years ago! Thoughts, people? Read