What About Small Cases?

How can patients without million dollar injuries find justice?

Defense firms, presumably billing the deep pockets of insurance companies hourly, can drag a case on and wear down a plaintiff attorney, who is funding the case from his/her own pocket. Having watched these cases play out over years in most cases, it costs at least $25,000 for a plaintiff case to make it to settlement. Costs for just the defense of such cases going all the way to trial are reported by insurers (such as Washington’s Physicians Insurance) at up to half a million dollars, before the plaintiff receives a nickel.

As a result there is often little recourse for the patient whose doctor’s care resulted in an unfortunate outcome but who suffered little more than a few days of additional hospitalization, a few weeks or months of discomfort, or a bit more time loss from work than his/her sick leave or vacation benefit would cover. There may even be an additional required procedure to correct the “mistake,” but overall it may be viewed by everyone but the patient as “no harm, no foul.”

For example, if I botch the repair of an extensor tendon laceration, leaving a construction worker with a finger that hangs down and requires an extra 2 weeks off work and a surgical correction, how is that person (or his insurer) to be compensated. Who should pay for the second procedure, my malpractice insurer or the patient’s health insurer (if he has one)? Sure his hand still works fine, but he is out time and money, and of course “pain and suffering.”

Thanks to the high esteem in which most physicians are held, and the slack cut them by understanding patients, such errors are often chalked up to “well, sometimes bad things happen.” But the tort system we have may not easily come to the aid of the “little guy.”

Sure, sometimes a hospital or an insurance company receiving a complaint on such a case from a patient will “do the right thing” and make the patient whole for a few thousand dollars. Most of the time, however, neither hospitals, nor physicians, nor insurance companies will act unless and until they receive notice of legal action. That requires the patient to contact an attorney.

And that raises the ante.

In a case like this, where the value may be less than $10,000, can an attorney afford to get involved? If he/she does, the costs associated with the case escalate, the time to settlement grows from weeks to years, the patient and defendant physician suffer additional stress, and both the plaintiff attorney and the defense insurance company incur huge costs.

It strikes this writer as a whole lot of posturing for little gain. Perhaps there’s an answer out there somewhere, something better than what appears to some patients, insurers and attorneys as our “lottery system”? Shouldn’t the “little guy” get a better shot at the system as well?