Medical Negligence

October 11, 2009

CBO Offers New Data on Cost of Medical Malpractice Lawsuits

Senator Orin Hatch (R-Nevada) asked the Congressional Budget Office to update its previous findings concerning the effect that restrictions on the rights of patients to hold the health care industry responsible for errors that kill or injure patients ("tort reform").

Here are some of the findings from the report:

"National implementation of a package of proposals similar to the preceding list would reduce total national premiums for medical liability insurance by about 10 percent, CBO now estimates. … CBO estimates that the direct costs that providers will incur in 2009 for medical malpractice liability—which consist of malpractice insurance premiums together with settlements, awards, and administrative costs not covered by insurance—will total approximately $35 billion, or about 2 percent of total health care expenditures. Therefore, lowering premiums for medical liability insurance by 10 percent would reduce total national health care expenditures by about 0.2 percent."
"Combining the effects on both mandatory spending and revenues, a tort reform package of the sort described earlier in this letter would reduce federal budget deficits by roughly $54 billion over the next 10 years. That estimate assumes that a change enacted in 2010 would have an impact that increased over time, achieving its full effect after four years, as providers gradually changed their practice patterns. Of course, the estimated effect of any specific legislative proposal would depend on the details of that proposal." Note: the proposals listed in the letter was a $250,000 cap on non-economic losses, abolition of joint and several liability, changes to the collateral source rule, caps on punitive damages, and reducing the statute of limitations to 1 year for adults and 3 years for children.
"Because medical malpractice laws exist to allow patients to sue for damages that result from negligent health care, imposing limits on that right might be expected to have a negative impact on health outcomes. There is less evidence about the effects of tort reform on people’s health, however, than about its effects on health care spending because many studies of malpractice costs do not examine health outcomes. Some recent research has found that tort reform may adversely affect such outcomes, but other studies have concluded otherwise."

Let us put these numbers in perspective. Americans spend over $45 billion per year on pet care.

October 6, 2009

An Appropriate Handoff

by The Law Offices of John Day, P.C.

Yes, handoffs occur in football. But they also occur in healthcare, when one professional transfers the responsibility for caring for a patient to another provider.

Here is how The Doctor’s Company explains handoffs when talking about hospitalists:

The primary objective of a handoff is to provide accurate information about a patient’s care, treatment, current condition, and any recent or anticipated changes. Handoffs are interactive communications allowing the opportunity for questioning between the provider and the recipient of patient information. For hospitals, the handoffs that occur during the time when a patient is moved to another unit, sent for a diagnostic test, or transferred to a new physician can create continuity of care issues.

September 18, 2009

President Orders Tort Reform Tests

by The Law Offices of John Day, P.C.

President Obama announced yesterday that the government will set aside $25 million to support state grants for pilot programs to reduce medical malpractice lawsuits.

ABC News describes the grant process this way:

The Department of Health and Human Services will oversee the process for states to launch and test initiatives that meet the following parameters:
• Put patient safety first and work to reduce preventable injuries;
• Foster better communication between doctors and their patients;
• Ensure that patients are compensated in a fair and timely manner for medical injuries, while also reducing the incidence of frivolous lawsuits; and
• Reduce liability premiums.

September 17, 2009

Washington Certificate of Merit Struck Down

by The Law Offices of John Day, P.C.

The Washington Supreme Court has struck down the filing of a certificate of merit in medical malpractice cases in Washington state. The certificate is required by RCW 7.70.150.

The opinion said that the statute was unconstitutional because it violated the separation of powers between the Legislature and the Judiciary and it denied medical malpractice victims equal access to the courts.

The Court said that

September 17, 2009

Georgia Supreme Court Considers Constitutionality of Damages Cap in Medical Malpractice Cases

by The Law Offices of John Day, P.C.

The Georgia Legislature imposed a cap on noneconomic damages in meritorious medical malpractice cases in 2005. The cap is $350,000. In a case tried in Fulton County several years ago, the jury’s verdict exceeded the cap, and the Georgia Supreme Court is now considering whether the cap is constitutional.

According to a press release from the Georgia Trial Lawyers Association and re-printed on the Atlanta Injury Lawyer Blog

“Betty Nestlehutt was the face of her real estate business,” said Malone. “Her face was so horrifically disfigured that she was no longer able to even leave her house. Photographs of her disfigurement are even too gruesome for public distribution. The damage is permanent. Years later she has to wear layers of special makeup to try to give the appearance of normalcy.”

September 11, 2009

Medical Malpractice Reform: Survey Manipulation

by The Law Offices of John Day, P.C.

Max Kennerly has done it again. Read this post on the Litigation and Trial bog which looks behind the allegation that the American people support medical malpractice reform. Before you do, read the following:

DO YOU AGREE OR DISAGREE WITH THIS STATEMENT: As part of any health care reform plan, Congress needs to change the medical malpractice system so that cases are resolved quicker, and more reliably, on behalf of those who are in the right.

Did you say "Yes?" I did.

September 3, 2009

Health Care Reform Everyone Can Support – The Use of Medical Checklists

by The Law Offices of John Day, P.C.

A reader sent me an article in September – October 2009 issue of Harvard Magazine that discusses the work of Dr. Atul Gawande. Dr. Gawande is very interested in patient safety. One of his interests is the use of medical checklists, a subject I have addressed in a previous post.

Apparently, Gawande and his colleagues developed a checklist for surgery patients. The list, described in the article as addressing "rudimentary tasks" (e.g. confirming the patient’s identity), had some amazing results. In one year of use in 8 different hospitals around the world, the rate of complications had dropped one-third; surgicial-site infections by half, and deaths of surgical patients by nearly half.

Seven countries and more than two dozen states require the use of surgical checklists. One wonders why every state in the Union does not require them.

August 25, 2009

Hospitals That Do It Right

by The Law Offices of John Day, P.C.

Some health care providers are starting to get it. When you mess up, fix it. Don’t hide. Don’t cover it up. Don’t blame the patient. Just do the responsible thing and fix it.

Today’s Wall Street Journal writes about the relatively recent phenomena of hospitals that not only step in and make a fair payment to a person who has been harmed by negligence but go a step further and (a) figure out how and why the error happened and (b) put measures in place to prevent future errors.

This is absolutely wonderful, and shows that the tort system works. The purpose of the system is not just to compensate victims of negligence but also to deter future harm. Other things being equal, wrongdoers who fail to take steps to deter future harm will be hurt in the marketplace. Thus, the reasonably prudent person who is in the position to cause harm takes steps to prevent harm from occurring. That means they take advantage of the every error to analyze what they can do to prevent future harm. And they try to work out something with the victim of that error before litigation, saving everyone transaction costs and potential harm to reputation.

August 25, 2009

Failure to Inform Patients of Abnormal Test Results

by The Law Offices of John Day, P.C.

An article in Archives of Internal Medicine (2009;169(12):1123-1129) reveals that about 1 in 14 abnormal outpatient test results are either not reported to the patient or the report to the patient is not documented. The article summarizes a study consisting "of a retrospective medical record review of 5434 randomly selected patients aged 50 to 69 years in 19 community-based and 4 academic medical center primary care practices."

Read an abstract of the article here.

August 17, 2009

The First Syllable of “Lawyer” is “Law”

by The Law Offices of John Day, P.C.

A Tennessee lawyer who purports to have knowledge and experience in Tennessee medical malpractice law recently wrote a blog post that advised the pubic about statutes of limitations in medical malpractice cases. His post was wrong, and it was obvious to me that he was unaware of the legislation passed in June and that went into effect on July 1, 2009.

Now, you might say, "well John, don’t be a jerk. The law has only been in effect for a little over a month." Sorry folks, in my opinion that doesn’t cut it. If you hold yourself out as having knowledge in a given area of law you have the responsibility to keep yourself reasonably current in that area. The proposed changes to the medical malpractice law have been talked about by those actively involved in the field for months before the legislation was signed by the Governor. The Tennessee Association for Justice list-serves have had numerous posts about the subject. I wrote several blog posts on the issue (here, here, and here.). I wrote a cover-story article for the July 2009 TBA Journal on the changes. In short, there were plenty of opportunities to learn that the law was changing and that it had in fact changed.

I don’t expect every lawyer to keep up with all changes in the law – that is impossible. I don’t expect every personal injury and wrongful death lawyer to keep up with changes in medical malpractice law, for the simple reason that many of these lawyers do not do medical malpractice law. I don’t expect anyone to keep all the details of law in his or her head even in a relatively narrow field like medical malpractice. And of course I am not saying that everyone who does tort work in Tennessee must read this blog.