Articles Posted in Medical Negligence

Four professors have written an article titled "Do Poor People Sue Doctors More Frequently? Confronting Unconscious Bias and the Role of Cultural Competency."

The article concludes that "Contrary to popular perception, existing studies show poor patients, in fact, tend to sue physicians less often. This may be related to a relative lack of access to legal resources and the nature of the contingency fee system in medical malpractice claims."

Quite frankly, there is no original research in this article, but it is a good collection of research that has been out there for several years.

State Volunteer Mutual Insurance Company, the Tennessee medical malpractice insurer owned by the doctors themselves, has had another profitable year even with its significant rate decrease.

The company, which insures about 75% of the doctors in the state, has announced the following financial results and other data for the year ending December 31, 2011:

• Net income – $28,012,000.
• Policyholder’s Surplus (equivalent to net worth): $436,424,000
• 2011 Dividend – $20,100,000
• Total Dividends paid during company existence – $300,000,000
• Rate of return on investments – 5.3%
• Average decrease in premiums over last 3 years – 31%  (mature, base premiums)
• Insured physicians – 14, 476

The gross premiums written have decreased since 2007 for two reasons. First, SVMIC has lost almost 1600 doctors as clients during that period.  Second, rates have declined substantially during that period.  The combination of the two factors has resulted in a decreased of gross premium written of a little over $90,000,000.  Profits remain high because investment income has remained about the same (actually, it is a little higher) and net paid loss and loss adjustment expenses have increased only about 5% in five years.  Surplus during the 5 year period has increased over 80% despite payment (through premium credits) of $48,000,000.

Insurance Journal reports that the parents of a child born with cystic fibrosis sued various Montana  health care providers,  saying that had they known of the genetic disorder they would have terminated the pregnancy.

Cystic fibrosis causes sticky mucus buildup in the lungs and other organs, leading to infections, digestive problems and death in young adulthood. The typical life expectancy is about 37 years, according to the Cystic Fibrosis Foundation.

The couple alleges that genetic testing the mother underwent in the first trimester failed to explore whether the child was likely to have cystic fibrosis. The parents would have terminated the pregnancy because they claim they were not emotionally or financially equipped to care for a child with that illness.

One of the defenses commonly asserted in an Erb’s Palsy medical malpractice case is the "natural forces of labor defense."   The Appellate Division of the Supreme Court of New York recently ruled that a trial judge did not abuse his discretion by ruling that the defense could not be presented to the jury because "defendants failed to rebut plaintiff’s showing that [the] theory was not generally accepted within the relevant medical community" and  that the theory "lacked an adequate foundation for its admissibility."

 Mark Bower, guest blogger at the New York Personal Injury Law Blog, does an excellent job explaining the injury and the creation of a defense to it:

Erb’s Palsy is a neurological injury that is commonly the subject of birth trauma litigation. For over 100 years, it was generally accepted that Erb’s Palsy happens when a baby’s shoulder gets caught in the mother’s birth canal during delivery. If the delivering doctor pulls on the baby’s head in order to dislodge the stuck shoulder, the nerves running down from baby’s neck to the shoulder and arm (the “brachial plexus”) can be stretched or torn, resulting in a crippled arm. That the newborn has a non-functioning arm is usually recognized at the time of birth, or very shortly thereafter.

The Arkansas Supreme Court has rejected an effort by the Arkansas Legislature to define who is permitted to give testimony as an expert witness in a medical malpractice case.

Broussard’s medical malpractice case was dismissed on summary judgment after her expert witness was excluded under Arkansas Code Annotated section 16-114-206 (Repl. 2006). Broussard argued that the requirement in section 16-114-206(a) that proof in medical-malpractice cases must be made by expert testimony by “medical care providers of the same specialty as the defendant” violates section 3 of Amendment 80 of the Arkansas Constitution.

This article by an emergency room physician in Texas providers a good summary for the evaluation of chest pain in the emergency room.  

The article explains that "The decision to discharge a patient who presents with chest pain as the primary complaint should be made only after careful consideration of potential consequences. Patients with myocardial ischemia (MI), angina, pulmonary embolism, dissecting aortic aneurysm, or pneumothorax all can present with chest pain. Your evaluation and documentation should take into consideration all of these high-risk conditions."

The author explains the importance of documentation with these words:

This article from www.claimsjournal.com reveals data from the Physician Insurer’s Association of America on the monies spent on defense costs in medical malpractice cases.

The PIAA reviewed closed claim data for 2009 and found that the average defense costs for medical malpractice lawsuits was $69,244 for cases that settled and ranged between $140,000 and $170,000 for cases that were tried.

The rates paid were not disclosed.  The article did not discuss whether "defense costs" included expenses such as court reporter fees, expert witness fees, etc.  Given the numbers that were disclosed, I assume that such expenses were not included in the amounts.