Medical Malpractice Bulletin for August/September, 2009

Perspective: Service

Service. My parents exemplified it and passed the value down to me. Since my first job delivering newspapers in Federal Way for the Seattle Times, I have enjoyed serving others. On rainy days it was important to me that the papers I delivered did not get wet. “Any job worth doing is a job worth doing well,” my Dad would say. I learned early that “going the extra mile” pleases others and is its own reward. Click here to see where this led ->

Pharmacist pleads “No Contest” to involuntary manslaughter for medication error, receives 6 month jail sentence
An Ohio hospital pharmacist supervising the compounding of a chemotherapy drug was charged with criminal negligence, pled “no contest,” and was sentenced to 6 months in jail and had his license revoked. This followed an incident in which a 2 year old died after being given a drug containing a lethal concentration of saline solution. We normally consider medication errors a form of civil negligence with monetary penalties, but this case shows that jail time is possible.

Certificate of Merit: Certifying expert apparently need not testify
The editor of the Malpractice Bulletin checked the RCW’s in the past month to determine if there is any requirement in Washington State that an expert providing a plaintiff with a “Certificate of Merit” is then required to be one of the plaintiff experts in subsequent litigation. According to RCW 7.70.150 it appears that the answer is “No.” Section 3 states only:

The certificate of merit must contain a statement that the person executing the certificate of merit believes, based on the information known at the time of executing the certificate of merit, that there is a reasonable probability that the defendant’s conduct did not follow the accepted standard of care required to be exercised by the defendant.

If any reader has a different take on this based on another portion of the RCW or on case law, please email  the editor.
FYI, “Putman v. Wenatchee Valley Medical Center,” a case previously mentioned in Malpractice Bulletin, remains active before the Washington Supreme Court. The suit challenges RCW 7.70.150, claiming it violates the guarantee of equal access to the courts.

Tasers safe, study shows
Bozeman et al., in an August, 2009, article, report the results of their EKG monitored study of the effects of tasers (Conducted Electrical Weapons or CEW’s) on cardiac rhythm. The study concluded they are safe, as did a previous study of 105 volunteers. (How researchers recruited volunteers to subject themselves to taser shocks is an even more interesting question.)

Defensive medicine less of a cost driver than alleged
In an article in WSJ, Searcey and Goldstein recently reviewed the role played by defensive medicine in the overall cost of health care. Their conclusion is that the impact is modest. There are many other drivers, as shown in a recent survey.

Third parties out of luck in Wisconsin and Massachusetts lawsuits
Proving that the law can only be stretched so far, two plaintiffs recently lost third party claims in medical negligence cases. In the first case, a father who witnessed the death of one of his twin sons during their delivery sued for his own emotional distress. Though he was awarded $200,000 by the Court of Appeals, the Wisconsin Supreme Court overturned the award. And in the second case, a Massachusetts police officer responding to a car-pedestrian accident was injured in another accident while enroute. Because the pedestrian in the first accident had just been discharged after a colonoscopy at a nearby hospital, the officer sued the hospital, arguing apparently that had the pedestrian not been negligently discharged by the hospital, the first accident would not have happened and the officer himself would then have not been injured responding to it. The Massachusetts Supreme Court disagreed.
Had either of these cases ended differently, what would be the implications for medicine? Or for lawyers, for that matter? Could a mere witness to a murder sue the murderer?

Super-obese will be next fertile ground for trial lawyers
Dr. David Baehren, one of my favorite columnists, writes in ACEP News that the care of the super-obese will be a source of significant litigation in coming years. With patients frequently topping 300 pounds and sometimes topping 500 pounds or more, hospital equipment such as an MRI is unable to accommodate their  weight. As a result, an increasing number of lawsuits claiming discrimination based on obesity are being filed by super-obese patients. Check out “In the Arena: Heavy Stuff” for the full story

Arizona Enacts Law Raising ED Malpractice Standard
Effective September 30, a new law in Arizona raised the burden of proof for medical malpractice lawsuits against ED doctors from “preponderance of evidence” to “clear and convincing evidence.” The purpose of the law is to encourage more doctors to practice emergency medicine in the state. Critics of the new law say the measure unnecessarily gives privileged status to ED doctors, since other physicians are still held to the “preponderance of evidence” standard. These critics say that the elevated burden of proof will simply make it harder for plaintiffs who were injured out of negligence to prove their already-difficult claims.

Trial of Dr. Whitecoat: A physician blogs about his malpractice trial
For those with some time on their hands, this previously mentioned 19 episode series is a fascinating look at a malpractice trial from a physician’s perspective. It takes only about 4 minutes to read each episode.

Facebook: Friend or foe in a malpractice trial?
Facebook posts can be viewed by a surprising number of people who may not be one’s “friends.” This article from NY law firm Ziff Law shows what can happen when one’s life looks much better on Facebook than it is made to appear during a malpractice trial. Facebook is just one of many internet sites where both plaintiff and defense attorneys can check out litigants. Simply Googling a name often yields fascinating results.

Determining When An Expert Witness Is “Expert Enough”
The 5th Circuit Court in June ruled as qualified a defense expert with less training in the specific question at trial than the plaintiff expert had in toxicology and cardiology.  In Huss v. Gayden the plaintiff expert had been ruled unqualified by the trial court. The Circuit Court ruled that the defense expert did indeed have the credentials to provide rebuttal testimony on the scientific methodology and the medical literature cited by the plaintiff expert based on the defense expert’s qualifications as a physician in internal medicine. The 1993 Daubert case standard was frequently cited.