Medical Malpractice Bulletin for Nov/Dec, 2009

In this issue:

Perspective: I got elected. Now what?

It’s been a real honor working with the readers of this newsletter during the past few years. I look forward to continuing our relationship and wish all of you a happy and prosperous new year.

As I mentioned in the August issue, I believe in community service. In June, area leaders approached me to challenge an incumbent commissioner for a seat on the Board of our public hospital district. I agreed, and on November 3 was elected with a humbling 72% of the vote. On January 5, I will join the 5 member governing Board of Evergreen Hospital where I have focused my professional career for the past 35 years.

I look forward to continuing to hear from you whenever you need an objective opinion from a credible expert. As I said last month, if you want something else, you can probably find it. More…

Woman with DNR order given 20 mg IV morphine, dies. Family wins $3 million.
Does this sound like euthanasia to you? Read the article and draw your own conclusions.

Defense verdict in Bellingham brain injury trial
A Bellingham neurosurgeon, an assisting anesthesiologist, and St. Joseph’s Hospital were found not guilty of malpractice in a trial concluded October 8. The case went to the jury sometime after noon and a verdict reached in about 3 hours. What was apparently at issue was delay in the management of a neck hematoma following a cervical spine procedure. Four items caught my eye: 1) The case was filed September 28, 2007, a date that appears to be one week short of the statute of limitations. 2) The case lasted 2 years and one week later (about average?). 3) The major expert for the plaintiff was an orthopedic surgeon from Rhode Island. And 4) the court docket lists 238 separate line items, an average of 2 events (motions, etc.) each week (some with multiple entries) showing the immense amount of effort involved in a malpractice lawsuit. Key questions: Could the verdict have been predicted? Might a different pre-trial review have led to different decisions or a different outcome?

Feedback to hospitals on performance fails to improve quality of cardiac care
The value of hospital incident reports submitted to the State of Washington has been questioned and was reported in the October issue of this newsletter. Now, a study by Tu et al. posted in JAMA November 18 indicates that, on average, 86 hospitals in Ontario, Canada, which received a “public report card” failed to improve areas of cardiac care found to be deficient. The study adds fuel to the fire of the plaintiff attorneys who claim that their approach, i.e. lawsuits, is one, if not the only, way to impact improvements in the quality of patient care. Also, the Connecticut AG is calling for sweeping changes in that state’s “adverse event” reporting law. Presently, reports of errors are most often simply filed and closed without an investigation or report, according to an article in the Hartford Courant. AG Blumenthal stated, “We now have a culture of secrecy and concealment that is completely unjustified.” Key question: What good are error reports if no one learns anything from them, possibly not even the hospital filing the report?

Plaintiff attorney may advertise for patients similar to his client.
An Arkansas judge ruled that a plaintiff attorney could not be prevented from advertising for additional patients potentially injured by a defendant physician, denying an objection by the defense attorney in a case against that physician. Multiple claims and counterclaims in this situation make it well worth reading for both plaintiff and defense attorneys.

Georgia high court to weigh in on medical liability lawsuits.
American Medical News reported that Georgia’s “high court will determine the constitutionality of the 2005 reform measure, which mandated a higher burden of proof… in medical liability lawsuits concerning emergency care.” A trial court had turned down a request by the plaintiffs to declare the statute an unconstitutional special law, leading to the current appeal. Reality check: Sounds very little different from the arguments regarding the overturning of Washington State’s Certificate of Merit law.

Is a physician’s disciplinary history pertinent? Nebraska says “Yes.”
A physician’s disciplinary history may have no direct link to a medical liability lawsuit. But plaintiffs can still delve into such discipline to develop their cases, the Nebraska Supreme Court ruled this summer. In Washington State, anyone can access a physician’s disciplinary history at a DOL website.

Killer in your office? So what?
Despite homicidal threats, psychiatrists owe no duty to their patients’ potential victims
Key question: Is this the ruling you would want if you were the potential victim?