This Makes Me Sick

Hospital: Let the State Pay

Ohio State University Hospital has admitted its responsible for catastrophic errors committed while Kerri Swain was recovering from Guillain-Barre syndrome, an inflammatory disorder of the peripheral nerves. But while the family is looking for upwards of $10 million, the hospital wants her to join the state's Medicaid rolls. Huh?  OSU has accused the Swains of failing to minimize their expenses by withdrawing Kerri from the Medicaid waiver home-care program after obtaining the settlement. Read [Cleveland Plain Dealer]

 

Buh-Bye Co-Pays and Rates-a-Risin'

A doc in Santa Cruz has erased insurers and co-pays from her office vocabulary. She's been able to lower her fees for patients—they pay by cash or card—and now she has a better handle on her own costs, like malpractice insurance. Read [Santa Cruz Sentinel]

Kansas: Though tort reform was passed last year, health insurance costs are still rising. Sweet. Read [Kansas City Star]

Warm Up The ER: Sandoval County in New Mexico can't get new malpratice insurance, so county jail inmates will go to the ER for doc visits. Lean government lives! Read [Rio Rancho Observer]

Left Hand, Right Arm: Florida state licensing board opts for a system of double-checks over an increase in penalties for wrong-site surgery. Read [Sun-Sentinel]

'I believe in the American jury system'

When we launched ThisMakesMeSick, we hoped not only to inform our audience about medical liability issues, but also to provide a forum that sparked rants and dialogue and questions and concerns. We know thousands of people check out the site, but we want more reaction and commentary. One avid reader throughout has been a firebrand of sorts named Matt. He offers up regular retorts to our so-called “liability crisis” and drinks from a glass that is most definitely half-full. We asked him to spell out his thoughts on health courts, as he doesn’t seem to have bought into the system. 

I believe in the American jury system.  Nowhere else in the world do you have a situation where people with no conceivable vested stake in the outcome are making the call based on the best case of both sides put before them.  In many inquisitorial systems, popular in Europe, you have one judge as the fact finder.  Imagine that in America, given the influence of lobbyists on our politicians.  And I don't just mean corporate lobbyists, but ATLA as well.  Can you think of something that would more undermine our process?  Even tort reformers are reluctant to attack juries too strongly, but judges?  No restraint for judges - consider the Schaivo rhetoric.

The health courts are nothing more than backdoor damage caps, as I've frequently said.  Take that provision out, and we're not having a discussion about them.  They're dead in the water.  And, they solve neither of the problems identified by the Studdert study - cost and ease of access.  They are still adversarial, and they still require expert witnesses.

Even if one were to stipulate they were easier to access, then that just means you'll have more unmeritorious claims. Lawyers right now, at their own expense, serve as gatekeepers to the system.  To the public's detriment at times, because low cost cases aren't taken, but they do weed out a lot of frivolous cases.  Ask any lawyer how many calls he/she gets a day from someone wanting a million dollars for some ridiculous slight, and they'll regale you with story after story.  I, for one, attribute this to the PR efforts of the tort reformers, who actually have people believing that for little to no injury you can become wealthy quite easily.

More tomorrow on the costs of special health courts.

News Roundup

A South Carolina doc who gave steroids to NFL players has agreed to pay $200,000 to the family of a man who died after receiving his controversial treatments.  Read [WIS-10 TV]

A lesbian couple filed a medical malpractice lawsuit Tuesday claiming botched cancer treatments damaged their love life. Their attorneys say it is the first of its kind under Connecticut's civil unions law. Read [Stamford Advocate]

The Seattle Post-Intelligencer has an interesting piece on the exposed practice of folks shuttling abroad to get cheaper medical care. What caught our eye was the very last sentence of the article: Legal recourse could be difficult if things go wrong. Read

Liability Fears Cloud Use of Stroke Drug

A stroke victim arrives at Massachusetts General Hospital in Boston. She can't speak or move and is given a CT scan and then a clot-busting drug (Tissue plasminogen activator - tPA). Ninety minutes later, she's able to move and talk again. Unfortunately, tPA is rarely used, though it's been approved by the FDA for ten years. "The number of acute stroke victims who are given tPA is very low -- 94 to 97 percent of stroke patients do not get the drug," said Dr. Eric Smith. Two reasons: tPA can only be given within three hours of the onset of stroke, because the risk of hemorrhage is too high after that time; patients must have a CT scan before receiving the drug because tPA is only effective in treating ischemic strokes, which are caused by a blood clot. And that sneaky third factor: some doctors fear potentially fatal hemorrhaging in about 5% of those patients who get the drug. What can be done about this? Read [Atlanta Journal-Constitution]

A Doctor Speaks

We invite those suspicious of a doc’s stand on the medical malpractice situation to take a read of the November 14, 2005 issue of The New Yorker. Surgeon and author Dr. Atul Gawande pens a remarkably candid piece, “Bad Medicine: Who Pays the Price When Patients Sue Doctors?" Check it out as he follows Barry Lang, a malpractice attorney who was a pediatric orthopedic surgeon for 23 years. Though the article is only available in the mag, Dr. Gawande sits down for a Q & A that’s available on-line.  You’ll be surprised. Excerpt below.

What is the toll of malpractice on doctors?

.... Almost every case, when it’s settled, is sealed, and it can become hard to know what the patterns of failure in medicine are. In the airline industry, if there’s an accident, they can do an investigation and share information and figure out when there are certain patterns that suggest what things can be done to improve safety. We really haven’t been able to do that.

More [The New Yorker]