Dr. Benjamin Brewer, who writes the Wall Street Journal’s “The Doctor’s Office” column, discusses the OB shortage caused in Illinois by the medical malpractice problem. Trial lawyers like to blame the insurance industry’s investments and “business practices,” but the leading insurer in Illinois, ISMIE, has only 3% of its funds in the stock market. (Moreover, ISMIE is a mutual insurer–profits go back to its member doctors. The doctors aren’t conspiring to charge themselves too much; ISMIE’s rates reflect the payouts it makes in malpractice cases.) Large swaths of southern Illinois and nearly half the counties in the state have no obstetrical hospital services at all. Brewer concludes “it may take a federal law to stimulate the reform process in Illinois, where entrenched proponents of our broken system hold political and judicial sway.” (“When a Pregnant Patient Struggles to Find Care”, Jan. 4). Our sister site, Point of Law, comments on tomorrow’s Presidential visit to Madison County, where Bush will discuss his litigation reform agenda for the upcoming Congress. (Krysten Crawford, “Bush heads to ‘Judicial Hellhole'”, CNN/Money, Jan. 4; Ryan Keith, “Bush to Highlight Tort Reform in Ill.”, AP/Newsday, Jan. 4; Caleb Hale, “Doctors Are Eager To Hear What Bush Will Say About Crisis”, The Southern, Jan. 4; Mark Silva, “Bush’s tort reform efforts to start at ‘judicial hellhole'”, Chicago Tribune, Jan. 3).
Posts Tagged ‘medical’
Hospital sued over lack of neurosurgeons
Coming full circle: in Florida, the family of the late Barbara Masterson is suing West Boca Medical Center because hospital staff was unable to locate a neurosurgeon willing to come to the scene to perform life-saving surgery after a stroke. “The incident occurred in February, when Palm Beach County neurosurgeons were refusing to perform emergency services for fear of skyrocketing malpractice costs. The Mastersons’ lawyer, Gary Cohen, said the hospital was aware of the unavailability of neurosurgeons for emergency work “and should have never taken her in.” (John Murawski, “West Boca Medical Center sued over woman’s death”, Palm Beach Post, Dec. 23).
“The county had no neurosurgeon, and the boy died”
Chester County, Pennsylvania:
The boy [a 17-year-old who had sustained head trauma in an auto accident] could not be treated at Brandywine Hospital in Coatesville because the trauma center had closed, so he was transferred to Crozier-Chester Medical Center in Delaware County….
‘The last neurosurgeon in Chester County was Sam Lyness, a world-class neurosurgeon,” [Robert] Surrick said, but Lyness left Pennsylvania when his malpractice premiums reached $383,000. With no neurosurgeons, Brandywine shut down its trauma center in 2002.
(Paul Carpenter, Allentown Morning Call, Nov. 28).
Australian med-mal crisis
It’s now abated, following states’ enactment of laws limiting recovery, and “the country’s biggest medical indemnity company has emerged from near collapse to reveal it will be able to cut premiums by an average 20 per cent”. (Mark Metherell, “Indemnity crisis heads for recovery” Sydney Morning Herald, Nov. 5). The government also threw some subsidies at the problem. For more on medical liability and legislated reform Down Under, see Jul. 16, 2003 and May 30, 2004.
Medical Protective
One company that sells medical malpractice insurance — Medical Protective, owned by General Electric — angling for a rate increase in Texas, recently claimed to regulators that it didn’t expect to save much money from the state’s recently enacted liability caps. Trial lawyer allies of course immediately ran to the press claiming this proves something or other (though what it most obviously proves is that some companies have an incentive to poor-mouth their future expectations, especially when angling for rate increases). Other medical insurers have cut rates in Texas or announced plans to re-enter the state. MedPundit Sydney Smith tries to sort things out (Nov. 26). More: see Point of Law, Mar. 2, 2005.
“Repeat Caesareans Becoming Harder to Avoid”
“Women around the country are finding that more and more hospitals that once allowed vaginal birth after Caesarean, or VBAC (commonly pronounced VEE-back), are now banning it and insisting on repeat Caesareans. About 300,000 women a year have repeat Caesareans. The rate of vaginal births in women who have had Caesareans has fallen by more than half, from 28.3 percent in 1996 to 10.6 percent in 2003. …
“On a practical level, many women prefer vaginal birth because they recover more quickly and with less pain than they do from a Caesarean. In addition, each Caesarean increases the risk of complications in the next pregnancy, so women who want more than two or three children often hope to avoid the operation.
“Some doctors and hospitals freely acknowledge that fear of being sued has driven their decisions. Hospitals say they cannot comply with guidelines issued in 1999 by the American College of Obstetricians and Gynecologists, which call for a doctor to be available ‘immediately’ throughout active labor during such a birth, to perform an emergency Caesarean if needed. Previous guidelines had called for them to be ‘readily’ available.” (Denise Grady, New York Times, Nov. 29)(via Lone Star Times). We covered the issue Jul. 18, 2003.
Update: “Judge reinstates $30 million verdict”
Geoffrey Fieger’s $30 million verdict in the cerebral-palsy case Hollins v. Jordan (Oct. 11), thrown out by one judge, has been reinstated by a second judge. The press coverage isn’t clear why Judge Lawther “voluntarily removed himself” from the case; Fieger had earlier threatened to file a motion to remove the judge (Aug. 31). Fieger isn’t satisfied with $30 million; he’s going to ask the court for an additional $50 million in “pre-judgment interest.” The defendants have not had an opportunity to comment, but they’ll presumably appeal to a higher court on the grounds that led the first judge to throw out the verdict. (James F. McCarty, Cleveland Plain-Dealer, Nov. 20).
Legal hazards of medicine-by-phone
Many physicians in Alaska sighed with relief this summer when a jury for the second time ruled in favor of Anchorage general surgeon James O’Malley, finding that O’Malley “had given enough information to patient Vicki Marsingill over the phone for her to make an informed decision about whether to go to the hospital emergency department. Marsingill experienced complications after she decided not to follow Dr. O’Malley’s advice.” An initial verdict in Dr. O’Malley’s favor was thrown out because of improper jury instructions. The case raised questions about how forcefully doctors are expected to respond when counseling a potentially noncompliant patient to seek treatment. In Alaska, a state where consultation-by-phone is common given the great geographical distances, the case also “sparked debate …over how much information doctors should give patients over the phone and how much responsibility falls to patients. Some physicians have stopped taking phone calls after hours and instead instruct patients to go to an emergency department or call 911.” (Tanya Albert, “Alaska physician wins case on ignored medical advice”, American Medical News (AMA), Jun. 7; “Alaska bill offers immunity when advice is ignored”, Mar. 22-29; more on case).
Sports medicine: a view from Pa.
Independent team doctors getting scarcer: “The rising cost of medical malpractice insurance, and the proliferation of sponsorship arrangements between teams and large medical groups, have changed the landscape for team physicians in recent years — particularly at the major pro level, but also reaching down to college and high school sports. As part of the sponsorship deals, health care groups provide the team physicians, who have come to realize they need the umbrella of a large health care system to provide malpractice insurance. The combination of the rising cost of malpractice insurance in states such as Pennsylvania that don’t have tort reform and the potential for large judgments going to high-paid athletes has increased the risk for team doctors and made it nearly impossible for independent doctors to work in the field. … Although malpractice lawsuits filed by athletes against team physicians aren’t common, there have been several multimillion-dollar judgments and settlements, and that’s enough to cause a lot of concern.” (Shelly Anderson, “Is there a doctor in the clubhouse?”, Pittsburgh Post-Gazette, Oct. 10). For more, see Apr. 7-8, 2003, Jun. 13, 2002 and Dec. 7, 2000.
“New Evidence on Main Cause of Cerebral Palsy”
Another blow to the theories that have proved such a fertile source of litigation over the past few decades: “A new study undermines the long-held belief among obstetricians that oxygen deprivation, or hypoxia, is the main cause of cerebral palsy in premature infants. The study, published in the October issue of The American Journal of Obstetrics & Gynecology, found that the brain injury that leads to cerebral palsy was much more commonly associated with infection than with hypoxia.” (Nicholas Bakalar, New York Times, Nov. 2). Virginia Postrel comments (more on stored Google search page — note the nature of most of the advertising).