CONTENTS:
- Perspective: Stroke, Part 2: Stroke/TIA evaluation and treatment both a medical and legal quagmire
- PSA test is not the standard of care. Discussing it with patients is.
- Texas liability reforms spur plunge in premiums and lawsuits
- Can I please have my bullet back? Court request leads to lawsuit against physician
- Does a patient near death as the result of suicide qualify as “terminally ill?”
- Medical bloggers lack quality control
- Seattle/King County still the worst place to try to die
- $38.5 million settles 6 malpractice cases for OHSU
Perspective: Stroke, Part 2: Stroke/TIA evaluation and treatment both a medical and legal quagmire
Stroke evaluation, diagnosis and treatment was briefly addressed in last issue’s “Perspective” titled “Is thrombolytic therapy for stroke the standard of care?” Recent articles highlight the need for more information for attorneys on this subject.
PSA test is not the standard of care. Discussing it with patients is.
A urologist was successfully sued for delayed diagnosis of prostate cancer, not for failing to order a PSA test, the value of which is controversial, but for failing to discuss the option of the test with his patient.
Texas liability reforms spur plunge in premiums and lawsuits
In 2003 Texas voters approved a constitutional amendment limiting noneconomic damages in medical liability cases to $250,000. Since then, access to care has markedly improved as physicians return to the Lone Star state. Insurance rates have dropped by 25%, lawsuit filings by 50% and more than 30 new competitors entered the state, up from just four in 2003.
Can I please have my bullet back? Court request leads to lawsuit against physician
A search warrant from the court ordered a physician to remove a bullet from an accused armed robbery suspect. The bullet would have linked the suspect to the crime. The suspect sued the physician for battery in the unsuccessful attempt at removal. The question of public policy, unreasonable search, patient privacy, and physician statutory obligation will be fascinating to watch play out in the courts.
Does a patient near death as the result of suicide qualify as “terminally ill?”
That’s the question being asked of a Nevada court in the case of an elderly patient who took an overdose of pills. In Nevada and 20 other states, physicians can make the determination of terminal illness when the patient has voiced a refusal of life-sustaining care. Physicians can risk a claim of battery should they not honor the patient’s request, but can be accused of negligence if they do.
Medical bloggers lack quality control
Blogs are a growing part of the public face of the health professions. They offer physicians and nurses the opportunity to share their narratives. They also risk revealing confidential information or, in their tone or content, risk reflecting poorly on the blog authors and their professions. Over half (56.8%) of blog authors provided sufficient information in text or image to reveal their identities. Of blogs that described interactions with individual patients, 45 (16.6%) included sufficient information for patients to identify their doctors or themselves. An AMA News article on this is available here.
Seattle/King County still the worst place to try to die
Two articles and an editorial in JAMA, September 24, 2008, once again illustrate the success of Seattle/King County’s Medic I program. In this area 16.3% of patients with cardiac arrest survive to discharge. In the case of ventricular fibrillation, the figure is 39.9%. Both are the highest in a study of 10 North American communities, and as much as 4 times better than the lowest performers. Portland and Vancouver, B.C., both fared well also.
$38.5 million settles 6 malpractice cases for OHSU
In Oregon Health Science University’s first malpractice settlement since a court removed its state protection from large damage awards, the university agreed Friday to pay $38.5 million to bring an end to six long-standing cases.