Malpractice and Medical Liability

Physicians writing on KevinMD about being sued and about making mistakes: the summons, the deposition, and the verdict that does not feel like winning, whether damage caps and safe harbors work, frivolous claims argued from both sides, expert witnesses, nuclear verdicts and premiums, apology laws, and how physicians say errors happen and what it is like to make one. Two maintained records draw on this archive: Medical malpractice: what physicians say, in their own words and Medical errors: what physicians say, in their own words.

How a Trump presidency may affect physicians

David Mokotoff, MD

Physician

April 1, 2016

For a moment, let’s forget about his unfiltered voice, bullying, flip-flops, ego, and violence-focused rhetoric. I know suspending this discussion might be interpreted as some as my supporting Donald Trump. I do not.

I would rather, however, look at how Donald Trump in the White House might affect the day-to-day lives of physicians. And by this I am not referring to his support or opposition to universal health care, for I …

Engage patients to improve outcomes and reduce risks

David B. Troxel, MD and Robin Diamond, JD, RN

Physician

March 24, 2016

A 42-year-old patient arrived for her annual gynecologist appointment complaining of a self-detected breast lump. She had several questions about her condition and wanted to tell her doctor about a family history of breast cancer. The doctor was in a hurry and advised her to ask the staff, but the staff was busy with other patients and told her to call them later. The patient did not call.

The gynecologist ordered …

Medical mistakes happen. It’s what doesn’t follow that is unforgivable.

Lisa Goodman-Helfand

Patient

March 4, 2016

38 states currently have an apology act. This means that if doctors feel they owe a patient an apology, they may provide one without any ramifications, if future legal actions are taken by the patient/patient’s family.

In 2006, I spent 218 days in the hospital after the healthy birth of my daughter. My chronic autoimmune disease, scleroderma, masked certain signs of preeclampsia, which went undiagnosed. This led to a massive infection …

Doctors and nurses need better support when they make errors

Nina Shapiro, MD

Physician

December 28, 2015

In September 2010, a seasoned pediatric intensive care unit nurse administered an accidental overdose to a critically ill baby, giving ten times the amount of calcium that was prescribed. Five days later, this baby, with an already tenuous heart condition, died. The nurse recognized her mistake immediately, informed her superior, and also told the family and physicians. She was, however, escorted out of the hospital, put on administrative leave, and …

If surgery is a team sport, should surgeons bear sole responsibility for errors?

Skeptical Scalpel, MD

Physician

December 25, 2015

A Kentucky appeals court ruled that a surgeon was not responsible for a burn caused by an instrument that had been removed from an autoclave and placed on an anesthetized patient’s abdomen.

According to an article in Outpatient Surgery, the surgeon was not in the room when the injury occurred and only discovered it when he was about to begin the procedure.

An insufflator valve had been sterilized and was apparently still …

Why doctors will continue playing defense in the clinic

Kevin R. Campbell, MD

Physician

December 17, 2015

For decades, many physicians have been pushing for comprehensive tort reform on the national level. Malpractice claims in the U.S. are twice those of other developed countries such as England, Canada, and Germany. Payouts in a U.S. claim can easily reach 3 million dollars or more; in Germany most claims are around $30,000 or less.

A survey conducted by RAND in 2011 estimates that 99 percent of American physicians in high-risk …

Doctors are thanked by the false positives but sued by the false negatives

Dr. Saurabh Jha

Physician

October 24, 2015

Diagnostic tests such as CT scans are not perfect. A test can make two errors. It can call a diseased person healthy: a false negative. This is like acquitting a person guilty of a crime. Or a test can falsely call a healthy person disease: a false positive. This is like convicting an innocent person of a crime that she did not commit. There is a trade-off between false …

Tips for patients to help ensure an accurate diagnosis

Martine Ehrenclou, MA

Patient

October 14, 2015

If you weren’t aware of the prevalence and severity of diagnostic errors, (misdiagnosis, missed diagnosis, delayed diagnosis) maybe you should be now.

The Institute of Medicine (IOM) released a new report called, Improving Diagnosis in Health Care. The report cited that most people will experience one or more diagnostic errors over their lifetimes. It also revealed that diagnostic errors contribute to 10 percent of patient deaths and account for up …

It’s time for health care to stand up to medical errors. Will we?

Carol E. Gunn, MD

Physician

October 6, 2015

It’s been over a year since my older sister Anna died, so I choke up less readily while speaking about it. The raw anger is less, but the frustration of losing someone to a preventable medical mistake will always remain with me. Anna was five years older than me, my only sister, and the one I often turned to for advice. We were close despite living 600+ miles apart. She …

The time for medical liability reform is now. Here’s why.

Tom Murphy, MD

Physician

September 4, 2015

Have you been injured? Call us at this number! You may be entitled to a reward!

We have all seen these advertisements on TV. Our society has become conditioned to expect perfection. If a patient suffers a known complication from a condition or dies, there is a feeling that someone must be held accountable — even if everything was done perfectly from a medical standpoint. Medical malpractice litigation has exploded over …

How to survive the stress of a medical liability lawsuit

David P. Michelin, MD, MPH

Physician

August 9, 2015

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Imagine the scene: You’re in your busy office on a typical day when a letter arrives — a letter of intent. A patient is suing you for malpractice.

From the moment you receive that letter, everything changes. The malpractice claim begins to affect all aspects of your life. You don’t sleep well. You don’t interact well with family members, friends, or colleagues. You …

The sad story of how “never events” prevent obese patients from getting new hips

Thomas D. Guastavino, MD

Physician

July 30, 2015

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Daytime TV advertising is dominated by two players. Pharmaceutical companies with direct to consumer pitches and the so-called “toxic tort.” How confusing it must be to the average person to see a new drug pushed by one commercial, to be immediately followed by another commercial from a lawyer trying to sue for the known side effects of the exact same drug. It …

How I got 86% off my malpractice insurance. Now, you can too!

Pamela Wible, MD

Physician

July 29, 2015

I’m a physician entrepreneur. In 1998, I opened my first clinic. My malpractice: $500 per year. Then I tried life as an employed physician. Hated it. So in 2005, I opened my ideal clinic. Best. Job. Ever. My malpractice: $1,230 per year. Want low premiums? Here’s how I did it.

A quick tutorial. New malpractice policies mature over five years. So the first …

A patient secretly records his colonoscopy. It cost this doctor her job.

Admin

Video

June 23, 2015

A patient undergoing a colonoscopy pressed “record” on his smartphone before being sedated, hoping to capture instructions from his physicians after the procedure. What he heard instead was shocking: “In addition to their vicious commentary, the doctors discussed avoiding the man after the colonoscopy, instructing an assistant to lie to him, and then placed a false diagnosis on his chart.”

The incident cost his …

Following evidence-based guidelines won’t protect you from malpractice

Karen S. Sibert, MD

Physician

June 15, 2015

The best way to avoid being sued for malpractice is to make certain that all your patients are happy and all their outcomes are good.

Reality is seldom so rosy. Patients aren’t necessarily happy even when their clinical outcomes are as good as they can get. In the event of an undesired outcome, an unhappy patient may easily become a litigious one. A 2011 study in the New England Journal …

We’re losing the war on error. And here’s why.

Michel Accad, MD

Health Policy

May 28, 2015

The war on medical error was officially launched in 1999, when the Institute of Medicine (IOM) published its landmark report To Err is Human, alleging that up to 98,000 yearly deaths in US hospitals were due to human missteps.

Despite significant ambiguities in the definition of a medical error, numerous militias known as patient safety organizations …

Tips to avoid medical errors in the emergency department

Roneet Lev, MD

Physician

May 12, 2015

Emergency medicine physicians: Could these be your cases?

A 35-year-old presents with shortness of breath and numbness to the legs. CXR and EKG are normal. She is discharged to see her doctor in two days, but is found dead at home. Autopsy reveals a dissecting aortic aneurysm.
A 15-month-old is triaged to fast track and seen by a physician assistant for fever, lethargy, …
Read more…

Tips to avoid medical errors in the emergency department

Why safe harbors for medical malpractice are DOA

Skeptical Scalpel, MD

Physician

April 21, 2015

Several months ago, Physician’s Weekly featured an article describing a bill that was introduced into the House of Representatives called H.R. 1406: The Saving Lives, Saving Costs Act. It would create a “safe harbor” for physicians who could show that they followed best practice guidelines when faced with a malpractice suit. At the end of the piece, a question was asked, “Do you think this bill will help safeguard physicians against …

After a verdict: Doctors need to be taught a lesson. Really?

Dr. Saurabh Jha

Physician

April 12, 2015

Recently, a jury awarded a young California resident $28.2 million for a delayed diagnosis of a pelvic tumor. The jury found Kaiser Permanente (KP) negligent. Doctors in the system, touted to be one of the finest systems by the president, allegedly refused an immediate MRI for back pain in a 17 year old. The patient eventually received an MRI three months after …

Medical malpractice reform won’t save money

Peter Ubel, MD

Health Policy

February 25, 2015

Two problems loom large over the American medical care system. First, we spend outrageous amounts of money on health care, with too many patients receiving too many services at too high a price. Second, our malpractice system is an international embarrassment, with too many health care providers sued by too many patients for too little reason.

Many experts have pointed out that these problems are two sides of the same coin. …