Malpractice and medical liability

1,592 articles · Since 2004

Articles, page 17

The legal system has serious problems, but who are we to complain?

February 9, 2014Feb 9, 201417

I have never been involved in a medical malpractice case, but I have recently been the victim of a sociopathic legal abuse situation entirely not related to medicine. It involves a no-good attorney with the ethics of a camel, a multiply convicted felonious sociopath, and his long series of victims including his own prison guards who he is suing because his feelings were hurt.

As my small part of it, I …

Physician voices

After a medical mistake: Honesty is the best policy

Jim deMaine, MD

January 23, 2014Jan 23, 20149

Elton John had it right: “It’s sad, so sad. Why can’t we talk it over. Oh, it seems to me that sorry seems to be the hardest word.” Mistakes are all to common in medicine, but can we say the…

Example 1: There’s a diagnosis of recurrent lymphoma in the ICU. The oncologist gives a phone order for cytoxan, prednisone, and vincristine. The recorder, working a double …

Physician voices

Doctors often don’t have the time to address social slander

James C. Salwitz, MD

January 17, 2014Jan 17, 20143

Not long ago a woman in my community, who was a patient of an esteemed local oncologist, died. Let us call her “Beverly” and let us say she died of “breast cancer.” I am familiar with the details of the case because one of my partners saw her in consult, but HIPAA and common courtesy forbid me to be any more transparent. Beverly was very popular in our town and …

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Physician voices

A patient falls off the OR table: Who’s to blame?

Skeptical Scalpel, MD

January 9, 2014Jan 9, 20145

An anesthetized patient fell to the floor headfirst from an operating room table during a laparoscopic appendectomy in Scotland. The table had been tilted into an extreme head down position to facilitate the operation. Fortunately, no injury occurred. The Edinburgh…

The Edinburgh Evening News account says that there were 10 staff members in the room at the time the case started, but no one had placed a safety restraint on the patient.

A …

Physician voices

When does false hope become malpractice?

James C. Salwitz, MD

January 1, 2014Jan 1, 201412

10:11am Tuesday, June 5, 2006: This was the moment Marge was told the mammogram showed a mass, which was probably breast cancer. “But, don’t worry, the tumor is very small and with surgery and radiation, you will be fine.” 1:55pm…

1:55pm Wednesday, March 25, 2009: This was the moment Marge was told that the breast cancer had spread to her ribs. “But, don’t worry, the tumors are small, and with hormones, you …

Physician voices

Can defensive medicine ever be stopped?

Skeptical Scalpel, MD

December 25, 2013Dec 25, 201356

You may have missed this when it first appeared. Experts from Harvard and the University of Southern California say assumptions made by some analysts that defensive medicine is not an important facet of the high cost of health care may…

You may have missed this when it first appeared.

Experts from Harvard and the University of Southern California say assumptions made by some analysts that defensive medicine is not an important facet of the high cost of health care may be wrong.

Those assumptions were based on data showing that malpractice reforms instituted in some states did little to reduce health care spending.

According to the report from the National Center for Policy …

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Can defensive medicine ever be stopped?

Physician voices

How should a physician apologize after a medical error?

Michael Kirsch, MD

December 18, 2013Dec 18, 201318

I had thought that apologizing was a straightforward act, but I now realize that it is a nuanced art form. We’ve all heard the "mistakes were made" version, usually issued by politicians who attempt to insert a layer of passive…

I had thought that apologizing was a straightforward act, but I now realize that it is a nuanced art form. We’ve all heard the “mistakes were made” version, usually issued by politicians who attempt to insert a layer of passive voice insulation between themselves and their screw-ups.

There is also the ever present conditional apology which by definition falls short of complete responsibility acceptance. The template here is: “I’m sorry for …

Physician voices

Don’t resign your professional license in the midst of an investigation

George F. Indest III, JD

November 23, 2013Nov 23, 20137

Do you have a medical, pharmacy or nursing license in several different states? Do you have a license in more than one health profession? Have you been notified that an investigation has been opened against you? Are you thinking about resigning your professional license or voluntarily relinquishing such a license? Then you must be aware of the following.

First, you should never voluntarily relinquish or resign your license after you know …

Physician voices

Use awareness intervention to improve physician behavior

Paul Levy

November 11, 2013Nov 11, 20138

Here’s a familiar story in America’s hospitals. An “old fashioned” surgeon decides that the protocols and procedures put in place by the medical executive committee or other governing body don’t apply to him. “I’ve done it this way for 30…

People in the risk management field will advise …

Physician voices

Everything’s my fault: How a surgeon says I’m sorry

Lara Devgan, MD, MPH

November 9, 2013Nov 9, 20136

When I started my surgical internship, my chief resident told me some magic words: Whenever something bad happens, stay calm and say, "I assume full responsibility. It won't happen again." As a young surgeon at the bottom of the totem…

When I started my surgical internship, my chief resident told me some magic words: Whenever something bad happens, stay calm and say, “I assume full responsibility. It won’t happen again.”

As a young surgeon at the bottom of the totem pole, those words were my mantra for the times when someone’s head was going to roll. In those nascent days of my …

Health policy

It’s hard to get a handle on the true costs of defensive medicine

Peter Ubel, MD

November 4, 2013Nov 4, 201312

Ask physicians if our messed up malpractice system causes them to practice “defensive medicine,” and most will probably say yes -- hard not to be paranoid with so many lawsuits affecting so many physicians. Some experts even contend that major…

Ask physicians if our messed up malpractice system causes them to practice “defensive medicine,” and most will probably say yes — hard not to be paranoid with so many lawsuits affecting so many physicians. Some experts even contend that major reforms of our malpractice system could go a long way towards controlling spiraling healthcare costs. On the other hand, if you ask physicians whether they ever order unnecessary tests …

Physician voices

A physician expert witness speaks out

Anonymous

November 2, 2013Nov 2, 2013

I have been actively engaged in the clinical practice of radiation oncology for the last 40 years, and over the last 10 years have been asked to participate as a radiation oncology expert witness in a variety of medical malpractice cases. Radiation therapy, together with surgery and chemotherapy, is one of the major cancer treatment methods. It is estimated that 50-60% of all cancer patients seen in the USA receive treatment with …

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A physician expert witness speaks out

Physician voices

We need better measures of diagnostic accuracy

Robert Wachter, MD

October 18, 2013Oct 18, 2013

In 2008, I gave the keynote address at the first “Diagnostic Errors in Medicine” conference, sponsored by the Agency for Healthcare Research and Quality (AHRQ). The meeting was filled with people from a wide variety of disciplines, including clinical medicine, education, risk management, cognitive science, and informatics, all passionate about making diagnosis safer. The atmosphere was electric. My lecture was entitled, “Why diagnostic errors don’t get any respect” (I wrote up the …

Physician voices

Not all adverse events are preventable

Skeptical Scalpel, MD

October 16, 2013Oct 16, 201357

Medical errors are a real problem. I won't deny that. It was bad enough when the often-quoted Institute of Medicine figure that 98,000 deaths per year in the US are caused by medical errors was in vogue, but now a…

Medical errors are a real problem. I won’t deny that.

It was bad enough when the often-quoted Institute of Medicine figure that 98,000 deaths per year in the US are caused by medical errors was in vogue, but now a paper in the Journal of Patient Safety states that adverse medical events result in 210,000 to 400,000 deaths per year and 10 to 20 times those numbers of serious …

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Not all adverse events are preventable

Physician voices

6 thoughts after testifying at a medical malpractice trial

Robert Centor, MD

October 3, 2013Oct 3, 20137

A few weeks ago I was an expert witness in a malpractice trial. In this post I will use generalities and specifically not reveal any details of the patient or the court case. I first became involved in this process several years ago. My involvement included a deposition, reviewing medical records, reviewing other expert depositions, discussing the patient’s most unfortunate story with lawyers for two different defendants, and finally testifying. …

Physician voices

What to do after you make a medical error

Brian J. Secemsky, MD

September 21, 2013Sep 21, 20135

Ms. A was a sweet older lady with a bad heart who was transferred all the way from Montana in order to get expedited workup for cardiac (heart-related) surgery. Her story of her symptoms and disease course was the story…

Ms. A was a sweet older lady with a bad heart who was transferred all the way from Montana in order to get expedited workup for cardiac (heart-related) surgery.

Her story of her symptoms and disease course was the story told by hundreds of patients seen at any given hospital every year. It started with a few weeks of chest discomfort while walking, followed by a day of chest pain, nausea, …

Physician voices

Would every profession consent to returning fees for mistakes?

Michael Kirsch, MD

September 20, 2013Sep 20, 201314

Though I have been accused by various commenters as protecting my own specialty when I point out excesses, flaws and conflicts of interest in the medical profession, this accusation would be handily dismantled after a fair reading of prior posts. Indeed, my own specialty of gastroenterology and my own medical practice has felt the effects of the honed Whistleblower scalpel. If an individual or an institution will not willingly engage …

Physician voices

The lessons of Annie Dookhan can apply to every laboratory

The Pathology Blawg, MD

September 15, 2013Sep 15, 201313

The attorney appointed by Massachusetts Governor Deval Patrick to investigate the case of Annie Dookhan, the Massachusetts state drug lab chemist who allegedly faked test results, tampered with evidence and neglected protocols over a several year period, now states more…

So far the state has released 330 inmates and dismissed or declined to prosecute more than 1,100 other cases as …

Physician voices

Lawyers are a big impediment to disciplining bad doctors

Skeptical Scalpel, MD

September 12, 2013Sep 12, 2013198

If you are interested in patient safety and medical errors and haven't read the story in the Texas Observer about a spectacularly incompetent neurosurgeon, you should. It is long but worth it. It will make you cringe. The story includes…

If you are interested in patient safety and medical errors and haven’t read the story in the Texas Observer about a spectacularly incompetent neurosurgeon, you should. It is long but worth it. It will make you cringe.

The story includes many details about operations done poorly and patients suffering paralysis and death at the hands of Dr. Christopher D. Duntsch.

The Texas Medical Board is over-worked, slow to act and …

Physician voices

Urging doctors to take responsibility for their mistakes

Manoj Jain, MD, MPH

September 8, 2013Sep 8, 201314

In 2007, I published a story in my local paper in which I confessed to having made a medical error years earlier. I’d mistakenly prescribed an antibiotic for a patient whose chart indicated an allergy to the drug. Thankfully, the…

Thankfully, the story had a happy ending. My patient recovered and took no legal action after I explained to her what had happened. I ended my article vowing to take greater care to prevent errors …

Malpractice and medical liability

Articles, page 17

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