MEDICAL MALPRACTICE BULLETIN for Februrary, 2008

CONTENTS:

  • What about small cases?
  • Physicians report far fewer errors than actually occur
  • When the plane crashes, where’s the NTSB? Another take on error reporting.
  • Replace torts with contracts…in my lifetime???
  • Can a physician self-insure for malpractice? Possibly
  • Can stupidity be regulated? Long Island medical malpractice cases spark call for ban on multi-dose vials
  • Twin Falls, Idaho, legal malpractice suit: A Gordian knot of issues for healthcare lawyers
  • ACEP publishes standards for review of questionable testimony by expert witnesses
  • Expert opinion not-required before filing malpractice claim: Maryland
  • Addicted doctors [and attorneys?] still practice while in rehab

What happens with small cases?
How can the patient without the million dollar injury find justice? << CLICK HERE >>

Physicians report far fewer errors than actually occur
Does this surprise anyone? With most medical errors being subjective rather than objective, failure to report such events is probably common across all professions. Were there a truly “safe” way to report errors, even events where a physician thinks “I could have done this a better way,” we could all learn from the experience. Many “errors” do not necessarily have bad outcomes. All would be good teaching cases. Maybe it’s time for the AMA, in the genre of Lemony Snicket, to publish a “Journal of Unfortunate Events” and show us all what we can learn from them. An abstract of this report from Archives of Internal Medicine can be found << HERE >>


When the plane crashes, where’s the NTSB? Another take on error reporting.

When a pilot drops his plane into the Cascades in icing conditions, there is an NTSB investigation. When a pilot screws up and flies into icing conditions, but turns around and saves his butt, then reports the “near miss” to the NTSB, that pilot is immunized against adverse licensure action. No such mechanism exists in medicine. If there were, our health care system would benefit. “Shadowfax,” a well-respected PNW area medical blogger and ER doc, compares the two systems in this << HERE >>


Replace torts with contracts… in my lifetime???

The biggest advantage to reform of the current tort approach to malpractice would be an opportunity to compensate the large majority of patients harmed by malpractice whose cases are too small to make the economic cut that allows an attorney to take the case. This comes from the National Center for Policy Analysis, a rather libertarian “think tank.” [Editor’s note: I googled “libertarian attorney.” It looks like they could all meet in my kitchen.] << CLICK HERE >>


Can a physician self-insure for malpractice? Possibly

Charleston, SC, vascular surgeon R.E. Hamrick proposed establishing his own $1 million malpractice insurance fund. The hospital where he practiced said “No,” and revoked his privileges. Hamrick sued the hospital and recently won a $25 million settlement. << CLICK HERE >>


Can stupidity be regulated? Long Island medical malpractice cases spark call for ban on multi-dose vials

NY State Health Commissioner Richard Daines proposes banning multi-dose syringes as a result of medical malpractice scandals in which two physicians repeatedly re-used syringes on multiple patients. In asking the FDA to force a stop to the manufacture and distribution of medications in multi-dose vials, Daines seems to be attacking the product rather than the user. His proposal would punish the innocent as well as the guilty, make medicine more rather than less complex, and drive up the cost of care. Using his logic, why don’t we just ban large aircraft because terrorists could use them as weapons? << CLICK HERE >>


Legal malpractice suit: A Gordian knot of issues for healthcare lawyers

Currently in court in Boise, this case involves enough issues of healthcare law to keep several firms busy for years:

  • the hospital’s purchase of a therapy clinic, keeping the clinic’s owners as hospital employees
  • accusations by these new employees (former clinic owners) of Medicare billing fraud on the part of the hospital
  • termination of the new employees by the hospital, with claims of unlawful termination by the fired employees
  • allegations by the hospital that the attorney for the hospital’s insurance company put the insurer’s interests ahead of the hospital’s during negotiations on the Medicare billing issues
  • and now a legal malpractice suit against that attorney and the Washington State firm(s) with whom he has been associated. And so far, the original allegations of Medicare fraud have not been proven.


ACEP publishes standards for review of questionable testimony by expert witnesses

This article summarizes the “Standard of Care Review Procedure” established by the American College of Emergency Physicians. It includes links to four great reviews discussing questionable testimony by medical experts. Many other specialty societies have similar panels of reviewers and means of reporting. << CLICK HERE >>


Expert opinion not-required before filing malpractice claim: Maryland

The Maryland Supreme Court ruled that the expert-certification requirement regarding the merits of a medical negligence claim deprives low-income plaintiffs of both equal protection and due process. << CLICK HERE >>


Addicted doctors [and attorneys?] still practice while in rehab

Our current system allows physicians, and presumably other professionals, who voluntarily enter a monitored treatment program for substance abuse, to continue to work. Imagine what would happen if instead treatment options were off the table and licenses were summarily revoked if a professional were “caught.” This physician thinks the current system works well, and eliminating it or forcing disclosure will drive the issue underground and be dangerous to patients, clients, colleagues and the addicted individual. No profession is immune. << CLICK HERE >>