Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Nurse practitioner hit with $1.4m verdict: the hidden truth behind the lawsuit

Howard Smith, MD
Physician
October 13, 2024
Share
Tweet
Share

In the August 2023 issue of MD Linx, Stephanie Srakocic writes about a Philadelphia jury that awards a $1.4 million verdict against a nurse practitioner for failing to treat hyperthyroidism. The patient, who is hyperthyroid, is admitted to the hospital for acute abdominal pain, nausea, and vomiting. The patient subsequently dies. The implication is that the patient is under the care of a nurse practitioner, and there is no supervision. Instead of implicating a nurse practitioner, or even the physicians who supervise, or fail to supervise, the nurse practitioner in the management of hyperthyroidism, the take-home message is really one about the nature of a medical malpractice lawsuit.

This article is “fact-checked,” and still, the author misses the point.

First, in Pennsylvania, nurse practitioners have a collaborative agreement with physicians. Lack of supervision was never a question in this case, and the doctors and the hospital are co-defendants.

Second, there are 85,000 medical malpractice lawsuits per year. All are predicated on a complication, which can be a medical error, an error of nature, or even a fabrication.

No health care provider is immune from complications. Death, acute abdominal pain, nausea, and vomiting are complications in a long list of comorbidities that can accompany hyperthyroidism. Most of these conditions, however, are surgical emergencies. Near the bottom of the list are abdominal pain, nausea, and vomiting caused by hyperthyroidism by itself.

Yet, according to the author, thanks to the shenanigans of a plaintiff attorney, likely coupled with the unartfulness of a defense attorney, the jury is left with the Hobson’s choice between departing from standards of care regarding hyperthyroidism or not departing from them. Worse yet, this choice is made with no more confidence than the burden of proof, which is 50 percent probability plus a scintilla—just enough to win. This underlies all medical malpractice lawsuits.

In truth, this case likely represents negligence, but not because of mismanagement of hyperthyroidism; rather, because of mismanagement of, or the misdiagnosis of, a surgical emergency.

Thanks to the author, an erstwhile health law authority herself, the reader is never exposed to the real point, which is that plaintiff attorneys, defense attorneys, malpractice carriers, and self-professed health law authorities all make their livings from fabricated claims of negligence or errors of nature that appear as medical errors. They are the medical liability litigation industry, and they profit from such tragedies.

I, too, am an erstwhile health law authority, but I do not miss the point. Instead, I have a solution. It adapts the scientific method to a lawsuit. The scientific method tests a null hypothesis with 95 percent confidence. The null hypothesis is always that the treatment in question is the standard of care. Ninety-five percent confidence, rather than 50 percent probability plus an ill-defined scintilla, makes the truth stand out in stark contrast to the alternative. The null hypothesis is either retained or rejected. Furthermore, with 95 percent confidence, the chance of erroneously rejecting a true null hypothesis, called a type 1 error, is only 5 percent. With traditional decision-making, type 1 error is closer to 49 percent.

Hyperthyroidism alone does not cause these presenting symptoms. An acute abdomen does. However, with hypothesis testing, this verdict may never have been delivered. More likely, as a meritorious claim with 95 percent confidence, the case would have conveniently settled. Avoidable costs to the carrier would have been reduced. Malpractice premiums would be lower. Health care is more affordable, available, and safer. As importantly, justice is served.

Tort reforms have not done this, and neither have other health law authorities, to whom we entrust the future of health care.

Ms. Srakocic’s article may have drawn the attention and even the disdain of readers, but for the wrong reasons. They are looking for a solution, and instead, this author provides a more provocative subject—a nurse practitioner who is entrusted with the care of a patient with hyperthyroidism, who subsequently dies on this provider’s watch. If this case had been settled, the article would never have been written.

Howard Smith is an obstetrics-gynecology physician.

ADVERTISEMENT

Prev

The enduring cycle of violence: lessons from history's darkest moments

October 13, 2024 Kevin 0
…
Next

The overwhelming reality of primary care: Why doctors still persevere

October 13, 2024 Kevin 5
…

Tagged as: Malpractice

Post navigation

< Previous Post
The enduring cycle of violence: lessons from history's darkest moments
Next Post >
The overwhelming reality of primary care: Why doctors still persevere

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Howard Smith, MD

  • The hidden cost of malpractice: Why doctors are losing control

    Howard Smith, MD
  • Why no medical malpractice firm responded to my scientific protocol

    Howard Smith, MD
  • The shocking silence of top law firms on frivolous medical lawsuits

    Howard Smith, MD

Related Posts

  • Nurse practitioner reveals startling flaws in APRN education: Is patient safety at risk?

    Joseph Lanctot, FNP-C
  • A comic reveals the terrifying truth about fentanyl

    Emily Watters, MD
  • Why a nurse should not go to jail

    Barbara L. Olson, RN
  • It’s the Year of the Nurse

    Sarah E. Jorgensen, RN
  • The work of an emergency department nurse through the eyes of a medical student

    Jennifer Geller
  • The triad of health care: patient, nurse, physician

    Michele Luckenbaugh

More in Physician

  • Love on life support: a powerful reminder from the ICU

    Syed Ahmad Moosa, MD
  • Why we fear being forgotten more than death itself

    Patrick Hudson, MD
  • From basketball to bedside: Finding connection through March Madness

    Caitlin J. McCarthy, MD
  • The invisible weight carried by Black female physicians

    Trisza Leann Ray, DO
  • A female doctor’s day: exhaustion, sacrifice, and a single moment of joy

    Dr. Damane Zehra
  • The hidden cost of malpractice: Why doctors are losing control

    Howard Smith, MD
  • Most Popular

  • Past Week

    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • Why shared decision-making in medicine often fails

      M. Bennet Broner, PhD | Conditions
    • “Think twice, heal once”: Why medical decision-making needs a second opinion from your slower brain (and AI)

      Harvey Castro, MD, MBA | Tech
    • Do Jewish students face rising bias in holistic admissions?

      Anonymous | Education
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
    • Are quotas a solution to physician shortages?

      Jacob Murphy | Education
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
  • Recent Posts

    • Love on life support: a powerful reminder from the ICU

      Syed Ahmad Moosa, MD | Physician
    • Surviving kidney disease and reforming patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why we fear being forgotten more than death itself

      Patrick Hudson, MD | Physician
    • My journey from misdiagnosis to living fully with APBD

      Jeff Cooper | Conditions
    • Antimicrobial resistance: a public health crisis that needs your voice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why a fourth year will not fix emergency medicine’s real problems

      Anna Heffron, MD, PhD & Polly Wiltz, DO | Education

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • Why shared decision-making in medicine often fails

      M. Bennet Broner, PhD | Conditions
    • “Think twice, heal once”: Why medical decision-making needs a second opinion from your slower brain (and AI)

      Harvey Castro, MD, MBA | Tech
    • Do Jewish students face rising bias in holistic admissions?

      Anonymous | Education
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
    • Are quotas a solution to physician shortages?

      Jacob Murphy | Education
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
  • Recent Posts

    • Love on life support: a powerful reminder from the ICU

      Syed Ahmad Moosa, MD | Physician
    • Surviving kidney disease and reforming patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why we fear being forgotten more than death itself

      Patrick Hudson, MD | Physician
    • My journey from misdiagnosis to living fully with APBD

      Jeff Cooper | Conditions
    • Antimicrobial resistance: a public health crisis that needs your voice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why a fourth year will not fix emergency medicine’s real problems

      Anna Heffron, MD, PhD & Polly Wiltz, DO | Education

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...