Articles Posted in Medical Malpractice

How many times have you Googled for one purpose and then found something interesting unrelated to what you were looking for? This weekend, looking for something unrelated, I found a New Yorker article from two years ago on medical malpractice in the comments section of a blog. It is an interesting and somewhat balanced article by a doctor writing about the country’s medical malpractice problem. I disagree with his conclusions but it really is a wonderfully well-written article that points out the paradox inherent in medical malpractice cases. Three quotes in the article I found of particular interest:

“Malpractice attorneys are hardly the most impartial assessors of care, but medicine has offered no genuine alternative because physicians are generally unwilling to take financial responsibility for the consequences of their [medical malpractice]. Indeed, the one argument that has persuaded many doctors to be more forthright about mistakes is that doing so might make patients less likely to sue.”
“I watch a lot of baseball, and I often find myself thinking about the third baseman’s job. In a season, a third baseman will have about as many chances to throw a man out as I will to operate on people. The very best (players like Mike Lowell, Hank Blalock, and Bill Mueller) do this perfectly almost every time. But two per cent of the time even they drop the ball or throw it over the first baseman’s head. No one playing a full season fails to make stupid errors. When he does, the fans hoot and jeer. If the player’s error costs the game, the hooting will turn to yelling. Imagine, though, that if every time Bill Mueller threw and missed it cost or damaged the life of someone you cared about. One error leaves an old man with a tracheostomy; another puts a young woman in a wheelchair; another leaves a child brain-damaged for the rest of her days. His teammates would still commiserate, but the rest of us? Some will want to rush the field howling for Mueller’s blood. Others will see all the saves he’s made and forgive him his failures. Nobody, though, would see him in quite the same way again. And nobody would be happy to have the game go on as if nothing had happened. We’d want him to show sorrow, to take responsibility. We’d want the people he injured to be helped in a meaningful way. This is our situation in medicine, and litigation has proved to be a singularly unsatisfactory solution. It is expensive, drawn-out, and painfully adversarial. It also helps very few people. Ninety-eight per cent of families that are hurt by medical errors don’t sue. They are unable to find lawyers who think they would make good plaintiffs, or they are simply too daunted. Of those who do sue, most will lose. In the end, fewer than one in a hundred deserving families receive any money. The rest get nothing: no help, not even an apology.”
“What would most doctors do if someone close to them was hurt by a medical error? In a recent national survey, physicians and non-physicians were given the following case: A surgeon orders an antibiotic for a sixty-seven-year-old man undergoing surgery, failing to notice that the patient’s chart says that he is allergic to the drug. The mistake is not caught until after the antibiotic is given, and, despite every effort, the patient dies as a result. What should be done? Unlike fifty per cent of the public, almost none of the physicians wanted the surgeon to lose his license. Medical care requires that a thousand critical steps go right every day, and none of us would have a license if we were punished every time we faltered. At the same time, fifty-five per cent of the physicians said that they would sue the surgeon for malpractice.” Continue reading

The Washington Post and the Baltimore Sun wrote yesterday about a recent report that Maryland faces a doctor shortage that may well become severe by 2015.

We already have a shortage of doctors, and things will get worse? I don’t know anyone—family, friend, or client—who could not find a medical doctor when they needed one. Ever.

Who wrote the report? Well, if you go to the fourth paragraph of the Washington Post article, you learn that our good friends at MedChi, the Maryland State Medical Society, commissioned the report. These are the same folks who warned of impending doom for doctors as the result of escalating medical malpractice costs. The same folks that came out with data supporting the future abyss.

The Maryland Court of Special Appeals found in a 2-1 decision last month that a reduction of 30 percent in the survival chances of a woman with uterine cancer as the result of medical malpractice is not actionable as a matter of Maryland law.

Marcantonio v. Moen is a case about the delay in diagnosing cancer. Plaintiff claimed that his wife died as the result of her doctors misinterpreting a sonogram and failing to order sufficient tests to follow up on the woman’s symptoms. Because of this failure to diagnose, the Plaintiff claims that his wife’s chances of survival went down from 80% to 50%-60%. So while she was statistically likely to beat cancer even with the malpractice, she died.

The Maryland Court of Special Appeals found that the “major issue to be decided is whether proof that a health care provider was responsible for a twenty to thirty percent reduction in the decedent’s chance of survival suffices to prove that the malpractice caused the death. We shall hold that it is not,” wrote Judge James P. Salmon.

On Monday, the Supreme Judicial Court of Massachusetts overturned the dismissal of a lawsuit filed by a woman against a physician who had failed to warn his patient of the side effects of a medication. These side effects had caused the patient to lose consciousness at the wheel and kill the woman’s 10 year-old pedestrian son. The driver had recently had treatment for cancer and had been told by his doctor that he could safely resume driving while on his medication. (He had stopped driving for a period of time.) The mother sued, alleging that the doctor failed to warn his patient, the driver, of the possible side effects of drowsiness, dizziness, and altered consciousness.

The lower court had dismissed the lawsuit, claiming that the physician had a duty to his patient only, not to third parties. The Supreme Judicial Court disagreed and found that the doctor’s duty extended to anyone who could be harmed by his failure to warn his patient about the drug’s side effects. This ruling greatly widens the scope of duty of physicians when choosing treatment options for their patients and perhaps necessitates a wider discussion of possible side effects when prescribing medications. The case will now return to the lower court and be tried on the issue of the doctor’s negligence (the dismissal was on the basis of standing to bring the lawsuit in the first place).

This is a very sad case. The driver was 75 years old and suffered from lung cancer, chronic bronchitis, high blood pressure and emphysema. At the time of the crash, he had finished his cancer treatment but was still on many medications. He died of cancer shortly after the accident. A ten-year old boy lost his life when he was in the wrong place at the wrong time. It does not get much more awful than that.

I read this weekend a crazy story about a Tennessee medical malpractice case. The plaintiff sued a Tennessee lawyer for legal malpractice for botching a case which he supposedly should have won. The legal negligence case settled for $750,000 which means, if logic and reason were at all involved in the settlement process, it was a meaningful case with actual value. Incredibly, he was also successfully sued for bringing a groundless lawsuit–the same case he should have won. There can be only one cogent response to these facts: huh?

Here is what happened. The plaintiff has back surgery which left him blind in one eye and without peripheral vision in the other, rendering him legally blind and unable to work. Obviously, this was an awful outcome. Plaintiff brings a med mal claim against the doctor, claiming that they used incompatible blood control products together during the surgery which caused the Plaintiff’s injuries.

Plaintiff’s lawyer apparently starts screwing things up from there. The lawyer failed to find a medical expert that supported the claim before suing, although there is a requirement in Tennessee that he do so. Ultimately, he never obtained an expert. In the legal malpractice suit, Plaintiff contended that incompatible medications did not cause his injuries. Instead, he and his experts claimed that the actual cause of his injuries was the misplacement of his head during his seven-hour surgery. They settled the legal malpractice claim again for a substantial amount of money.

In the legal negligence case, the lawyer being sued steps into the shoes of the doctor being sued in the l malpractice case as a defendant for the “case within the case.” So someone will write a big check under the assumption that the doctor had committed medical malpractice, but the doctor’s insurance rates do not go up and he gets off scot-free. Continue reading

A few weeks ago, I wrote about a new product for malpractice lawyers called MedMal Reports. This company creates a report of the expected medical malpractice payout for a case based on the National Practitioner’s Data Bank. I received an email from MedMal Reports Chief Economist, Dr. David M. Frankel, asking if I might tell Maryland Injury Law Center readers about his new newsletter.

I get a lot of these emails and my first instinct was to press delete. But I took a quick look at the newsletter. If you are into the statistics of personal injury and medical malpractice cases like I am, you will love the newsletter. It answers the questions I have always wondered about: whether gender matters (it does not), and what is the optimal age of a plaintiff regarding settlement/trial value of the case (30-39).

As always, excellent information is power. This kind of information does two powerful things for medical malpractice lawyers. First, it gives you ammunition to use in settlement negotiations. Most good medical malpractice cases settle. The battleground is usually over price and detailed information that shows the value of your client’s case is helpful. The second thing it gives you is information to inform and educate the client in making the call whether they want to take their medical malpractice case to trial or whether to resolve it.

The West Virginia Supreme Court, applying West Virginia’s medical malpractice cap, affirmed the trial court’s decision to cut a $10 million medical malpractice verdict against a West Virginia hospital and one of its doctors down to $1 million.  (This is the same thing that happened to us in Maryland 10 years after this post.)

Malpractice?

medical malpractice capPlaintiff’s lawyers contended that the non-economic damages cap in medical malpractice cases in West Virginia did not apply to the jury’s verdict because their claim against the hospital did not arise out of the care and treatment of the Plaintiff but because of the hospital’s failure to control an environmental Serratia outbreak which the jury found caused Plaintiff to contract a nearly fatal infection during an otherwise routine anterior cruciate ligament (“ACL”) surgical reconstruction in 1995.

Doctors may have a new opponent in their battle for lower medical malpractice premiums: the state of Maryland. As I wrote last month, Maryland has been paying subsidies to doctors to the tune of $80 million over the past three years as a part of the medical malpractice “reform” bill that the General Assembly passed in 2004. The Baltimore Sun reports today that Maryland Insurance Commissioner Ralph S. Tyler ruled that a $68.6 million malpractice premium surplus, which Medical Mutual owed to the state of Maryland.

Back in 2004, doctors’ fervor for caps in medical malpractice cases reached a new high. To fan the flames, I’m convinced that Medical Mutual (easily the largest medical malpractice insurer in Maryland, covering about 75% of Maryland doctors) engaged in a little creative accounting and timely settlement negotiations that allowed Medical Mutual to pay out more during the time frame being examined by the Maryland legislature. The Maryland legislature was looking to determine how much medical malpractice premiums had risen.

After they got their wish and the Maryland legislature passed a bill to further cap medical malpractice damages, it quickly became apparent that the rise in premiums was artificial, evidenced by this $68.6 million surplus. For most insurance companies, this means they have a $68.6 million profit. But Medical Mutual’s policyholders own it, the doctors Medical Mutual covers. So this profit would have gone back to the doctors had the state of Maryland not intervened.

I have expressed my disdain for Maryland’s cap on non-economic damages many times on this blog. I read an interesting article in the University of Baltimore Law Forum on an issue to which I have never given much consideration: the impact of the cap on non-economic damages on women. In the article, Maryland Tort Damages: A Form of Sex-Based Discrimination 37 U. Balt. L.F. 97 (2007), University of Baltimore law professor Rebecca Korzec argues that the statutory cap on non-economic damages in Maryland, although facially neutral, has the unintended consequence that it disproportionately disadvantages women.

The essential premise is that limiting non-economic damages disproportionately affects female litigants, because women earn less, largely because they spend more time on unpaid child care around the house. Limiting pain and suffering damages does not allow juries to award fair compensation. Non-economic damage caps solidify bias by rewarding economic losses over non-economic ones, intensifying the gender bias of tort law.

Professor Korzec notes that physical injuries to women may not result in significant damages awards, because of some injuries specific to women. A “soccer mom” who suffers an injury requiring a hysterectomy, for example, may cause little economic harm. Restricting or limiting her non-economic damages may cause an insignificant award of damages.

A post on the Illinois Trial Practice Blog discusses a product for malpractice attorneys called>MedMal Reports. This company generates a report based on the payout reported in the National Practitioner’s Data Bank. Reporting of settlements and verdicts is mandatory, so the data is not skewed the way published verdict reports favor those medical malpractice lawyers who seek publication.

The theory is that payouts in these cases are predictable. The question is what variables should the calculus include. Interestingly, the company believes that there is not enough focus on the defendant in valuing medical malpractice cases, citing the following facts:

(1) The number of defendants affects value. The more defendants, the higher the total recovery in medical malpractice cases;

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