Roanoke Personal Injury Lawyer - Medical Malpractice

Too Many Malpractice Lawsuits or Too Much Malpractice?

Dan Frith — Thu, 02 Apr 2009 15:15:41 GMT

We've listened to George Bush, various national, state, and local medical organizations, and the insurance industry cry long and hard about the need to reform medical malpractice laws in the United States. Frivolous lawsuits they claimed...running doctors out of the practice of medicine they claimed. My response...BS!

I challenge anyone to deny the reality that:

Most Americans injured by medical malpractice do not sue.
Most lawsuits are not frivolous and courts efficiently weed out weak claims.
Jury awards have not spiraled out of control, and lawsuits have not reduced access to doctors.

Here are the facts:

In a landmark study, the Institute of Medicine of the National Academy of Sciences estimated that medical errors kill up to 98 000 US hospital patients each year (Kohn LT, Corrigan JM, Donaldson MS, editors. To Err is Human: Building a Safer Health System) In 2004, Healthgrades, an independent health care ratings company, reported nearly double that figure. Its examination of 37 million patient records from all 50 states, representing 45% of all U.S. hospital admissions, found 195 000 hospital deaths from preventable medical errors annually between 2000 and 2002.
Evidence that medical malpractice in the U.S. greatly exceeds malpractice lawsuits has been available since 1974, when California's medical and hospital associations sponsored a study intended to support their efforts to get lawmakers to pass tort reform. Instead, it found that doctors and hospitals negligently injured 0.8% of hospital patients (Mills DH, editor. Report on the Medical Insurance Feasibility Study. Sacramento: California Medical Association and California Hospital Association; 1977). A later analysis of the data found that, at most, only 1 in 75 of those injured were compensated (Danzon, Patricia A. Medical Malpractice: Theory, evidence and public policy. Cambridge: Harvard University Press; 1985).
The notion that frivolous lawsuits abound is also unsubstantiated. A 2007 study by Public Citizen showed the court system was "on the whole, a rational one that provides money for valid claims and dismisses invalid ones." Using data from the U.S. government's National Practitioner Data Bank, the consumer nonprofit group concluded that complaints by "the business and medical lobbies are exaggerated and unsupported by the facts."
The evidence is that jury awards are simply keeping up with the costs of medical care, rather than being out of line. In 2005, Dartmouth College economists studied payments made to patients between 1991 and 2003. Actual payments, not jury awards, grew an average of 4% annually — slowing to 1.6% a year since 2000 — or 52% since 1991, roughly equivalent to increases in health care costs. A 2004 RAND study examining 40 years of jury verdicts concluded that average payouts grew by less than real income, with more costly medical care responsible for more than half the growth in jury awards.
Malpractice insurance and claims account for, at most, 2% of U.S. health care spending, according to the U.S. General Accounting Office, the investigative arm of Congress.

Who is willing to take on my challenge?

Originally posted at InjuryBoard by Dan Frith

Hospital ICU's: Wrong Drug...Wrong Dose...Wrong Route

Dan Frith — Mon, 30 Mar 2009 08:37:39 GMT

What am I talking about? A newly released (multinational) report from the British Medical Journal which concludes medication errors are common in intensive care units and may result in permanent harm or death.

The findings include:

1. The total prevalence of medication errors at the administration stage in intensive care units was found to be 74.5 errors per 100 patient days.

2. Errors were most frequently associated with the wrong time of administration (386) followed by missed medication (259), wrong dose (118), wrong drug (61), and wrong route (37).

3. Workload, stress, and fatigue were reported as the most frequent contributing factors to medication errors (32%). Other contributing factors included changes in drug names; written or oral miscommunication; lack of experience, knowledge, or supervision; violation of protocol; shift change; and equipment failure. More than half of the errors (53%) that resulted in permanent harm or death occurred in situations in which trainees were involved.

Wonder how the ICU units in following Southwest Virginia hospitals perform?

Carilion Roanoke Memorial Hospital, Lewis-Gale Hospital, Memorial Hospital of Martinsville and Henry County, Danville Regional Medical Center, Stonewall Jackson Hospital, Carilion New River Valley Hospital, Montgomery Regional Hospital, Wellmont Bristol Regional Hospital, Carilion Giles Memorial Hospital, Alleghany Regional Hospital, Carilion Franklin Memorial Hospital, and Tazewell Community Hospital

Originally posted at InjuryBoard by Dan Frith

Ask Tough Questions Before Choosing a Doctor

Dan Frith — Thu, 05 Mar 2009 11:40:18 GMT

It amazes me to see how many people chose a doctor based solely upon "word of mouth" or convenience. That doctor, whose office is just down the street, may have 5 pending medical malpractice cases against her and the state board of medicine may be getting ready to suspend her medical license...but that co-worker told you how nice she is so you just decide to place your health (and life) in her hands. Happens all the time.

Be an informed consumer of medical care. If you are in Virginia, check out the doctor's credentials with the Virginia Board of Medicine. At least you will know if the doctor graduated from the Southwest Antigua School of Art and Medicine. The site will also disclose whether the physician is board certified in a recognized specialty like cardiology, internal medicine, geriatrics, etc. You see anyone can "focus" their practice in certain areas of medicine but what you need to know is whether they passed a certification test which examines the depth and extent of their knowledge in a certain medical area.

Are you considering surgery? If so, why not ask your surgeon how many times has he performed the recommended procedure? What is his complication rate (not what is the national complication rate)?

My Take: If your doctor doesn't look good after checking him/her out...go somewhere else! If your doctor refuses to answer questions about his/her complication rates...it is probably because the answer will not make him/her look good...go somewhere else!

Originally posted at InjuryBoard by Dan Frith

Midwives in Virginia: Part Two

Dan Frith — Wed, 04 Feb 2009 11:45:22 GMT

Yesterday I wrote a blog on midwives in Virginia...and boy did I raise some eyebrows! I do appreciate my readers' comments and, although I cannot respond to everyone, I do want to follow up on my post with the following comments:

1. I spend a great deal of my professional time representing pregnant mothers and other consumers of medical care in medical malpractice cases. As a result, I have seen (specifically, in-depth review of medical records) more deliveries than any of my critics, except for those in the health care profession who delivery babies on a regular basis.
 

2. I am not a proponent or supporter of the Medical - Industrial Complex. America's system of providing medical care is too expensive and makes too many mistakes, costing billions of dollars and the loss of thousands of lives.

3. I am an advocate for personal choice and if a woman wants to deliver at home it should be her decision. However, it is because I believe in personal choice, it is important for the consumer to fully understand the consequences of making this important decision.

4. I've heard from many people about their wonderful experience delivering their child at home. Those responses do not surprise me. If there are no complications experienced during a home delivery, I am sure everyone is pleased with the outcome...its less expensive...more personal...and more intimate and special than delivery at the local hospital.

5. My concern, and the purpose behind my post, is to make sure all pregnant mothers think about what happens if there is an unanticipated medical emergency or crisis which occurs at the time of delivery at home. What happens when the umbilical cord becomes wrapped around the fetuses' neck and her heart rate plummets? What happens when the fetus' shoulder cannot pass the pelvis resulting in a brachial plexus injury? What happens when the mother experiences DIC (disseminated intravascular coagulopathy) and risks bleeding to death? I have seen and litigated cases with these very facts. All occurred in the hospital setting and I can tell you that either the mother or infant (or both) run the risk of death unless prompt surgical intervention (often with the involvement of multiple medical specialists) is provided. This type of care cannot be provided in mother's home.

For example, the standard of care in Virginia for the speed at which an emergency Cesarean section is performed is 30 minutes from "decision to incision." Do you think a mother who encounters a life-threatening unanticipated complication can be transferred from her home to the local hospital and for an emergency c-section in 30 minutes? I doubt it!

Originally posted at InjuryBoard by Dan Frith

Midwives in Virginia: A Bad Idea

Dan Frith — Tue, 03 Feb 2009 10:57:29 GMT

Virginia is seeing an explosion in the number of midwives....and this is a bad trend!

I see many complicated deliveries where a fetus becomes entangled in the umbilical cord or caught in the birth canal due to the large size of the fetus or the smallness of the mother's pelvis. Both of these situations are medical emergencies and require the immediate attention of well-trained obstetrician or maternal-fetal specialist in a hospital setting. These life or death situations do not, in my opinion, call for delivery by a midwife in the patient's home...where there is often inadequate time to transfer a patient to the hospital after a delivery becomes complicated.

Is the increase due to lack of health insurance? Maybe. Is the increase due to outrageous hospital and physician bills for deliveries? Probably. Is the American system for the provision of health care the best in the world? Absolutely not!

I just reviewed the National Association of Certified Professional Midwives (NACPM) website which states as follows about how the state of Virginia is approaching the issue of midwives, "Midwives, consumers and supporters in the legislature had the amazing foresight to include an explicit reference to the NACPM Standards of Practice in the legislation to license CPMs in Virginia." The NACPM website goes on to state that Virginia did a good thing by making specific reference to NACPM standards, because otherwise the Virginia Board of Medicine would not know what standards are applicable.

What a bunch of hooey! Want to know what the NACPM's first identified "Philosophy and Priciples of Practice is? How about, "NACPM members respect the mystery, sanctity and potential for growth inherent in the experience of pregnancy and birth."

My Take: Virginians deserve better medical care...it's not a mystery people....its medicine!

Originally posted at InjuryBoard by Dan Frith

What Happens When Damages Exceed the Cap in Medical Malpractice Cases

Dan Frith — Wed, 28 Jan 2009 09:31:50 GMT

I practice law in Virginia...a beautiful state with much to offer...unless you are the victim of a serious medical error which renders you a quadriplegic...or comatose for life...or incapable of earning an income for your family.

In Virginia all damages against a health care provider (doctor, hospital, nursing home, etc.) are "capped" or limited to $2 million for claims arising after July of 2008. A lot of money indeed, but lets look closely at Virginia's medmal cap. What if a patient is the victim of medical negligence and is so injured as a result that she will require medical care costing $150,000 per year for the rest of her 30 year life expectancy? My math indicates that, despite not even counting damages for pain and suffering, that patient will incur $4.5 million in just monetary damages. Does anyone pay the rest and, if so, who?

I recently had the opportunity to speak with some of the professional and business pillars of my city (Roanoke, Virginia). This topic came up and it appeared the answer to the above question was a surprise to some. The answer: The portion of the patient's monetary damages above the cap are paid by YOU....the taxpayer...in the form of Medicaid or Medicare benefits.

Is that fair? I do not think so...someone tell me I'm wrong and why!

Originally posted at InjuryBoard by Dan Frith

Is Your Surgeon a "Temp"?

Dan Frith — Thu, 15 Jan 2009 06:00:00 GMT

Yes...I am afraid this is a serious question. It appears that many hospitals have decided to meet the need for general surgeons by hiring temporary surgeons to work a day or two or maybe a week. I am not making this up.

According to an article in the Wall Street Journal (Surgeon Shortage Pushes Hospitals to Hire Temps, January 13, 2009) the practice is becoming widespread. I don't know about you but I want a surgeon who is going to stick around after surgery in case there are post-operative problems and complications. I don't want a surgeon who it going to remove my gallbladder today and leave for California tomorrow so she can remove an appendix.

The American College of Surgeons have long condemned this practice...and for good reason. Patient's experiencing post-operative complications is routine and the doctor who performed the surgery is the best person to address those complications.

My Take: Itinerant surgeons is a very bad idea!

Originally posted at InjuryBoard by Dan Frith

Be an Informed Consumer of Health Care

Dan Frith — Wed, 14 Jan 2009 10:11:46 GMT

Information is power. I don't know who first said it, but this little 3 word sentence packs a wallop!

Nowhere in our lives is information more important than when it comes to making health care decisions. Everything from who is the best doctor to treat my condition to what hospital has the best results for the surgery I need. I spend a great deal of time searching for good sources of "medical information" and would like so share my list of the TOP 10 sources of medical information with you:

1. The Centers for Disease Control.

2. WebMD.com.

3. Revolution Health.

4. EveryDayHealth.

5. ConsumerMedSafety.org.

6. WhyNottheBest.org.

7. VisualDxHealth.com.

8. QualityHealth.com.

9. Healthline.com.

10. The Merck Manuals.

Originally posted at InjuryBoard by Dan Frith

Medical Information and Privacy

Dan Frith — Wed, 12 Nov 2008 13:59:21 GMT

I received a telephone call the other day from a woman whose adult mother was in the hospital. The woman is a single (working) mother and had just been told by her mother's nurse that she (the nurse) could not provide the daughter with information about her mother's medical condition. The nurse said that federal law (called HIPAA or the Health Insurance Portability and Accountability Act) prohibited her from telling the daughter about her mother's medical condition.

The nurse was wrong...but her mistake is made by many healthcare providers who just don't know what they are talking about. According to guidelines issued by the Department of Health and Human Services, if the patient doesn't object to the disclosure of medical information, the healthcare provider is permitted to share the information with family, friends, and others involved in the patient's care.

HIPAA doesn't require the patient to give written permission to disclose private medical information.

HIPAA doesn't require family members to "prove" their relationship to the patient via a driver's license or other form of identification.

For more information on the privacy of your medical records read this notice from the Department of Health and Human Services.

Originally posted at InjuryBoard by Dan Frith

Virginia Hospital Can't Avoid Responsibility for Emergency Room Problems

Dan Frith — Tue, 21 Oct 2008 09:57:09 GMT

Danville (VA) Regional Medical Center has been sued for medical negligence. The hospital is being sued in federal court for its Emergency Room staff"s failure to provide competent medical care. The case, Everett W. Scruggs v. Danville Regional Medical Center, involves among other issues, an allegation that the hospital Emergency Room did not provide competent medical care as required by federal law called the Emergency Medical Treatment and Active Labor Act (EMTALA).

The EMTALA statute imposes two primary obligations on hospitals. First, it requires that when an individual seeks medical treatment in a hospital’s emergency room, the hospital must provide for an appropriate medical screening examination . . . to determine whether or not an emergency medical condition exists. Second, if the screening examination reveals the presence of an emergency medical condition, the hospital must stabilize the medical condition before transferring or discharging the patient.

The lawsuit alleges a patient arrived at DRMC Emergency Department at 1:50 a.m. on September 3, 2006 complaining of prolonged dry heaves over the previous two days. Upon arrival, the patient was triaged by a registered nurse and prioritized as a "non-urgent" patient based upon the nurse's triage screening examination. The nurse’s triage report did not include Scrugg's diabetic ketoacidosis condition or his history of diabetes.

The Emergency Room doctor did not examine the patient for over 11 hours after he arrived in the ER. That physician ordered various tests but, unfortunately, the patient was found unresponsive and in cardiac arrest approximately 20 minutes later.

Almost unbelievably, the hospital argued the emergency room nurse's brief assessment of the patient met the requirements of a "medical screening examination" required by EMTALA. However, sound reason prevailed and the judge did not agree.

Originally posted at InjuryBoard by Dan Frith