Medical Malpractice Bulletin, July/August, 2010

In this issue:

  • Miscellaneous quick links:

Perspective: Avandia – What’s the risk?

Rosiglitazone (Avandia – GSK), an oral hypoglycemic agent (OHA) used in treating diabetes, has been in the news recently because of concern that it is associated with an excessive number of adverse events in users of the drug.

After a week of media hype with headlines such as “Avandia users experience 30% more heart attacks,” the FDA on July 14 determined that existing warnings regarding the drug are sufficient and that the drug does not need to be removed from the market.

So what’s the truth? Why the hype? Why the confusion? More ->

Washington dumps notice for malpractice lawsuits
In a July 1 ruling, the Washington State Supreme Court said that it is unconstitutional to require a 90 day notice of intent to sue in a medical malpractice case. The ruling sides with two separate plaintiffs who had medical malpractice cases thrown out by lower courts over notice issues. See Seattle Times article here.

Conflict of interest: Can a defense attorney’s former client testify as a plaintiff expert in a later case he is defending?
Ten years ago a plastic surgeon was defended by an attorney in a malpractice case. Now he is serving as a plaintiff expert. Can he do so if the current defendant’s attorney is the same one who previously defended HIM? The plastic surgeon now acting as the plaintiff’s expert submitted a declaration stating that he understood he might be subject to cross-examination in the current proceeding, and that he—as the holder of the attorney-client privilege—waived it “as it applies to any relevant information to be presented in this matter.” However, a California Court of Appeals recently ruled that the plaintiff expert must agree to sign an “unqualified waiver of attorney client privilege.” The rationale? The current case might expose the expert to cross-examination by the defense about his own case ten years previously, so an unqualified waiver is needed.

Prostate cancer and PSA: If and when to test
A great deal of controversy exists in the medical literature about the value and timing of PSA testing as a predictor or preventer of cancer of the prostate. This publication previously reported on a case in which a defendant physician lost his case because he did not do a PSA test. Here’s one in which the defendant physician won his case despite not doing a PSA test. Bottom line: Prostate cancer cases can be a crap shoot.

The “how” matters when gauging risk after suicide attempt
The method used in an unsuccessful suicide attempt may indicate the risk of a fatal attempt in the future, according to a Swedish study published in BMJ. Hanging, strangulation, or suffocation in a first attempt were associated with a 6.2 fold higher risk of later suicide completion than with poisoning

Calling plaintiff’s attorney a “slick lawyer” not enough to reverse defense verdict
An Illinois jury rendered a defense verdict after the defense attorney labeled the plaintiff attorney a “slick lawyer.” Based on this allegedly prejudicial remark, the plaintiff (or could it have been her “slick” attorney?) appealed. An appellate court affirmed the verdict.

New York project seeks to cut malpractice costs, compensate victims faster.
Five major New York City hospitals are joining a 3 year federally funded pilot program to encourage early reporting of medical errors and early settlement. The program involves the state health department and court system, and will utilize specially trained judges and health courts. The model is based on methods devised by State Supreme Court Justice Douglas McKeon of Bronx County Supreme Court. McKeon has presided over all malpractice cases involving Health and Hospital Corporation, the entity that runs New York’s municipal hospitals, which has saved HHC an estimated $50 million annually in defense fees and payouts. Settlement agreements will be mediated by judges. Victims and hospitals can still opt for a jury trial.

Judge disqualifies expert for failing to rebut claims of “hired gun.”
A Maryland judge disqualified a defense expert neuroradiologist for failing to disclose financial records, finding his testimony about those records “disingenuous” and his honesty questionable. The plaintiff had accused the expert of being a “hired gun” whose opinions were suspect. A $5.6 million verdict resulted. Reality check: The verdict might be fair if this is the best expert the defense had,

Miscellaneous quick links:

  • Las Vegas Sun publishes a list of Nevada hospital medical errors, 10 years and 2.9 million inpatient visits. Pressure is on low-performing hospitals.
  • CBS investigators have found that copiers remember more than we know. Many copiers have hard drives just like a computer. Tossing one out, recycling it, or trading it in can expose client records to identity theft.
  • Scheduling meetings can be a pain, especially for attorneys. Take a look at “Meeting Wizard,” a free web service that is unbelievably easy to use.
  • Cases against a Physician Assistant in Tennessee must utilize PA experts, not physicians, according to the Tennessee Supreme Court.
  • New medical malpractice insurer in Florida bypasses brokers, claims to save physicians 20% on insurance costs by “buying direct.”