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.
Malpractice lawsuits are a necessary evil in our society. At times, they are frivolous, often resulting from a patient’s or family’s anger at a result that was not what they had hoped. Some are actually designed just to try to get a financial settlement. When doctors are sued for malpractice, it is a searing process, isolating and painful. I have known several excellent doctors who have given up established practices …
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The scope of the standard of care in medicine has changed
Suppose your malpractice insurance company wants to settle a medical malpractice case against you – even though the case has no merit.
In many cases, insurance policy language may allow the insurance company to do just that.
In the 2011 case of Mohan Papudesu, MD v. Medical Malpractice Joint Underwriting Assn. of Rhode Island, the Rhode Island Supreme Court allowed an insurer to settle a case on behalf of the defendant physician …
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When doctors are forced to accept malpractice case settlements
Several years ago I was hired by a plaintiff’s attorney as an expert witness on a personal injury case. He paid the fee in advance but the night before the trial, his co-counsel called me to review the case. It was clear that she did not have a thorough understanding of the case and I spent two hours with her on the phone trying to bring her up to speed. …
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Lessons learned when a doctor sues an attorney
The following column was published on March 25, 2012 in the Nashua Telegraph.
Medical malpractice historically has been a contentious issue. Doctors have argued that the system is broken, promotes multi-million dollar awards disproportionate to the injuries suffered, and encourages the ordering of unnecessary tests to avoid being sued, a practice known as defensive medicine. Trial attorneys, on the other hand, …
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Patients deserve a medical malpractice early offer
Back in 2000, a group of experts convened by the Agency for Healthcare Research and Quality (AHRQ) reported that, although substantial medical error and injury was occurring in the ambulatory setting, very little research had been done to understand the reasons why.
To address what they recognized as a serious issue, this expert panel made 11 specific recommendations that were intended to stimulate research in this area.
Fast forward to the present …
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Improving patient safety in ambulatory care
The mother of the dead baby sat in her husband’s arms and simply asked “why?” over and over through the Vietnamese interpreter. I had no way to answer the question. I didn’t know why. There was nothing to point to. No defect in the child or mother or the actions taken in L&D.
All I could do was say “I am so sorry” … for your baby, for you … for …
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The double tragedy of medicine’s battlefield mentality
Unlike most other industries, safety in healthcare has a unique set of circumstances to overcome: 1) patients die from errors one-at-a-time, and 2) we rarely find out exactly why. The “sensationalism” from a front-page disaster is completely absent. And, due to a myriad of factors, the underlying hazards usually remain a secret.
As we ride the crest of a current wave of interest in “patient safety,” is the refreshing new focus blinding …
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The necessary steps healthcare must take for patient safety
A version of this op-ed was published on January 17, 2012 in USA Today.
Ask doctors about what concerns them the most, and chances are they’ll say, “medical malpractice.” Indeed, most physicians will be sued sometime during their careers. A recent New England Journal of Medicine study found that 75% of doctors who practice psychiatry, pediatrics or family medicine will be …
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Reducing the emotional impact of medical malpractice
Back in the 1990’s, my husband and I spent a year working at one of the largest hospitals in West Virginia. The patients were the nicest people in the world, and the hospital staff was terrific—kind, generous, and hard working. Some of the surgeons were excellent, but others definitely were not. My husband (a cardiac anesthesiologist) and I had to cope with surgical complications the likes of which we had …
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When is it better for doctors to make mistakes?
It’s unclear how many non-legal persons actually understand how different civil trials are from criminal proceedings. Most people have heard that juries in criminal trials are told that they can only find a defendant guilty if their belief that the defendant is guilty is beyond a reasonable doubt. Federal courts define this term further as, “proof of such a convincing character that a reasonable person would not hesitate to act …
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Why the civil litigation system is unfair to physicians
Billionaire Teddy Forstmann had been diagnosed with a serious form of brain cancer. There’s a tragic twist to the story: according to Fox Business News, Forstmann believes that for more than a year, he had been misdiagnosed with meningitis.
ABC News wonders, “How could such a misfortune befall a billionaire —- a man able to afford the best doctors, best technology and the most sophisticated diagnostic tests?”
They’re missing the point. …
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5 ways to avoid a misdiagnosis
In October 2011, the Centers for Disease Control and Prevention reported a 60% increase in “emergency department visits for sports– and recreation–related traumatic brain injuries, including concussions, among children and adolescents” over the past decade. That’s good news: as the CDC’s press release said, they believe the increase was due in part to “growing awareness among parents and coaches, and the public as a whole, about the need for individuals with a suspected …
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Avoid malpractice while treating minor head trauma in children
“I wouldn’t hesitate to sue you.”
I’m sorry, what?
That is what I heard from the mother of one of my patients. I was evaluating a high school athlete who had recurrent stingers (nerve injury that affects an upper limb, usually resolves with time) and a possible episode of transient quadriparesis (affecting all limbs this time). I wasn’t on the sidelines for these injuries, so I had to go on the reports …
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The fear of malpractice will always be in the back of my mind
It was 1976 and I was a junior resident in urology at Baylor College of Medicine in Houston, Texas. I was assigned to a rotation in pathology where my job was to process specimens taken at surgery, dictate a gross description of the specimen and then place the specimens into the cassettes that would be used to make the permanent sections. I was transferring a prostate biopsy, approximately 0.5mm x …
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Patients will understand an honest mistake if the doctor tells the truth
What if we had considered the following items within health care reform?
What if physicians were able to practice medicine with reduced fear of malpractice litigation? Some estimates believe the cost of defensive medicine approaches 30%.
What if patients were to be offered a different process for conflict resolution before litigation, one that is partially driven by greed? What if this process provided a remedy which met all our future financial and …
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Health reform that offers relief from fear and greed
I’ve been involved in clinical medicine for more than 20 years and during this time I’ve come across numerous situations that created stress, or emotional upheaval within myself, and even times of burnout. At one point, I came close to permanently leaving my chosen profession. The culture of medicine is not geared towards allowing health care providers to de-stress, acquire emotional support, or discuss in an encouraging environment various conflictive …
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The culture of medicine needs to change
