Posts Tagged ‘medical’

Cruise ship should have stocked opiate-antagonist meds

That’s attorney Gloria Allred’s complaint on behalf of the survivors of Ashley Barnett, who appears to have ingested Vicodin, methadone or some combination of the two while onboard the ship. Carnival says the late Ms. Barnett “was deceased well before medical assistance was summoned”. (Lisa Richardson, “Death on Ship Prompts Lawsuit”, Los Angeles Times, Oct. 13). Commenters at KevinMD do not appear impressed with the suit (Oct. 13).

“The End Result of a Lawsuit”

From House of Caduceus, a disturbing story if true:

The court case lasted a couple years, he was humiliated in court b/c that is what a good lawyer will do, spent thousands of his own money, and eventually won the case. You would think that this win would boost his confidence, but instead, he felt betrayed by the patient and the patient’s family, abused by the court system, and worried about a another possible future lawsuit. This doctor then quit the practice of medicine and refused to keep his job, despite the begging of his employer.

My congrats to those patients and lawyers out there destroying American medicine. You’re doing a fine job of wasting our time and talent.

More on the Allan Navarro $217M verdict

Kevin MD reviews the medicine behind the Navarro stroke case (which we covered Oct 5/6), and finds a lot of 20/20 hindsight second-guessing. One commenter adds:

The scary thing to me and many ER physicans about cases like this is that outside of the diploplia I probably see 3-4 patients like this a week and usually send them home with or without a Head CT. When we read cases like this we thing “Thank God it wasn’t me” and realize these cases are bound to eventually happen to us too. I see 3-4 patients an hour I CANNOT decrease that to 0.5-1.0 patient an hour and get a specialty consult on every single patient.

Once again, a verdict that deters practice, rather than malpractice.

(Update, August 2007: case settles.)

Jackpot justice: $217M for misdiagnosed stroke in Florida

[Bumping October 5 9AM post to reflect new details.]

$100.1 million in punitive damages, and the “compensatory” award is almost certainly mostly non-economic damages, though the press coverage does not distinguish. (Thomas W. Krause, “Jury Puts Punitive Award At $100 Million”, Tampa Tribune, Oct. 3). TortsProf blog, Peter Lattman, Kevin MD, and Greedy Trial Lawyer comment. So no one accuses us of unfairness, we’ll repeat the GTL summary of the case:

ProAssurance’s subsidiary, ProNational Insurance Co., was the malpractice insurer for a doctor’s group running a Tampa area hospital emergency room where patient Allan Navarro’s stroke was misdiagnosed by an unlicensed physician’s assistant as a headache and sinus infection.

[Plaintiffs’ attorney Steve] Yerrid told the Tampa newspaper he tried to get the insurance company to settle for the maximum allowed under the policy – $1 million for the doctor and $1 million for the physicians’ group. Instead, he said, the insurance company wanted to settle for $300, offering $100 for Navarro, $100 for his wife and $100 for his 10-year-old son.

Update: Daily Business Review has a more detailed summary than the mainstream press:

On Aug. 9, 2000, Navarro, who was a professional basketball player in his native Philippines, entered University Community Hospital-Carrollwood with a headache, nausea, dizziness, confusion and double vision. He described a personal medical history of hypertension, diabetes and elevated cholesterol plus a family history of strokes to the triage nurse. A different nurse than the triage nurse also noted he was unsteady on his feet.

When Navarro spoke with Herranz in the examination room, he mentioned the sudden onset of a headache earlier that day and that he had felt a “pop” in his head.

According to the 2005 second amended complaint, Herranz did not complete an adequate medical history of Narvarro, nor did he do a complete or adequate neurological exam.

Navarro spent about 5 1/2 hours at UCH-Carrollwood, during which time he had two CT scans of his brain and was diagnosed with “sinusitis/headache” by Austin, prescribed Vicodin for the pain and an antibiotic by the doctor and sent home. He was not told to watch for any stroke symptoms.

The suit alleged that Navarro presented classic stroke symptoms that Austin should have noticed. It further said that CT scans are not adequate diagnostic tools for ruling out the type of stroke Navarro had.

Early the next morning, Navarro woke with a severe headache, slurred speech, nausea, confusion and trouble walking. He was readmitted to the UCH-Carrollwood Emergency Room at 6:05 a.m. Upon his return, he was labeled “urgent,” but doctors still had not diagnosed a stroke. It wasn’t until he was transferred to Carrollwood’s sister hospital, UCH-Fletcher, that afternoon that surgery was finally performed. By then, the stroke had already left him paralyzed with mental disabilities. During surgery, he slipped into a four-month coma. He is now confined to a wheelchair.

(Rebecca Riddick, “Judge Halts Defendants’ Bid to Avoid $116M Med-Mal Verdict”, Oct. 6).

Multiple issues here:

Read On…

Medical tourism

Bumrungrad International Hospital in Bangkok, Thailand, treated 58,000 American patients in 2005, and looks to treat 20 percent more this year. Why?

At Bumrungrad Hospital, [spokesman Ruben] Toral said, the lower cost of living is a major factor in the savings, but so are differences in how the medical system operates.

Doctors in Thailand pay about $5,000 a year for malpractice insurance, compared with more than $100,000 for some specialties in the United States.

Thai courts will adjudicate malpractice claims, but the largest award ever issued was about $100,000 and the law there doesn’t permit damages for pain and suffering.

(Mark Roth, “Surgery abroad an option for those with minimal health coverage,” Pittsburgh Post-Gazette, Sep. 10). Apparently the Thais haven’t heard the propaganda from the American trial bar that caps on non-economic damages don’t lower malpractice insurance premiums or medical expenses. And apparently, thousands of Americans prefer cheaper healthcare to the opportunity to recover pain-and-suffering damages: unfortunately, plaintiffs’ organizations fight very hard to ensure that American consumers don’t actually get that choice. (Via, of all places, Bizarro-Overlawyered, where one can almost see the smoke coming out of the ears of the posting blogger because of the “Does-Not-Compute” cognitive dissonance.)

Read On…

“Death after two-hour ER wait ruled homicide”

In Waukegan, Ill., 49-year-old Beatrice Vance died of a heart attack after waiting two hours in a hospital waiting room. A coroner’s jury has declared her death a homicide. (Lake County News-Sun, AP, Chicago Tribune). Medical blogs are discussing: GruntDoc, MedPundit, KevinMD. Plus a discussion at Prof. Bainbridge’s. (cross-posted from Point of Law).

Caesarean sections: ooooops…

A whole field of malpractice litigation has been based on contentions that babies could have been spared injury if doctors used Caesarean sections more often, and doctors, in part responding to the incentives sent by the legal system, now order the procedure at high rates even when it is not clearly indicated. But what if C-sections themselves turn out to be much more dangerous to babies than we had realized? (Nigel Hawkes, “Babies ‘are more likely to die’ after an elective Caesarean”, The Times (U.K.), Sept. 7)(via the returned MedPundit).

A dose of reality

September 1 UPI interview with William Plested III, president of the American Medical Association (via Kevin MD):

Q: Ken Suggs, head of the Association of Trial Lawyers of America, recently told UPI that doctors and lawyers should stop fighting each other and unite against the medical malpractice insurance companies who keep hiking insurance premiums to push their profits higher. How would you respond?

A: Do you have any idea what happened with medical malpractice insurance? It’s almost totally in the hands of doctor-owned companies; doctors who put together their finances to get a company to give them insurance, because the for-profit insurers all ran. There is no profit in this; (the insurers) left it. And people who are not out to make a profit, they’re just out to protect doctors (via) their own insurance companies, they’re the one who are left.

Related.