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.

Surgical error: The difference between mistake and complication

Dr. Martin Young

Physician

March 3, 2011

One of the benefits, or aberrations, depending on your point of view, of the fee-for-service model is that we surgeons are remunerated for correcting our mistakes and complications.

At first glance this seems wrong. But perspectives differ, and when a doctor has to deal with serious, undeserved complications and is self-employed he deserves to be compensated adequately. So what really is the difference between the two?

A complication may be described as …

Medical students should not be liable for malpractice

Kevin Pho, MD

KevinMD

February 21, 2011

Should medical students receive immunity from malpractice liability?

That’s an interesting question that’s raised in a bill from Arizona.

According to the Arizona Daily Sun,

State lawmakers are moving to keep patients injured by medical students from being able to sue them.

But proponents said that won’t leave victims without recourse.

SB1429, awaiting full Senate action, would spell out that students are not liable for malpractice if they are under the supervision of a …

Read more…

Medical students should not be liable for malpractice

Radiation treatment errors with Intensity-Modulated Radiation Therapy (IMRT)

Richard Leff, MD

Physician

February 4, 2011

In a recent series of articles in the New York Times, Walt Bogdanich uncovered an alarming series of radiation treatment errors associated with implementation of new computerized treatment technologies such as Intensity-Modulated Radiation Therapy (IMRT).

Based on this article, reporting hundreds of cases, some of them fatal, it appears that a variety of causes are associated with errors, including inadequate training of physicists and radiation therapists, difficulty physically validating computer-generated treatment …

The threat of malpractice means doctors cannot acknowledge their fallibility

Maggie Kozel, MD

Physician

February 2, 2011

An excerpt from The Color of Atmosphere: One Doctor’s Journey In and Out of Medicine (Chelsea Green Publishing, 2011).

We all make mistakes. To err is human—unless you are a doctor. This is a lesson that began in med school. If something went wrong, someone else was to blame. Attending physicians blamed the residents, who blamed the interns, who blamed whomever else was within range—med student, nurse, patient. We gave …

Patient-physician relationships in medical malpractice

Kathleen Clark, PhD

Physician

February 2, 2011

I recently read a post from Jan Gurley, MD on here on KevinMD.com.

Her opinion is that medical malpractice lawsuits are a “crap-shoot”; she notes that “malpractice lawsuits fail when it comes to medical errors-in both directions. People who’ve suffered from errors both don’t sue, and lose suits, in the same percentages that people who sued have no suffered from errors.”

Assuming that information is correct for purposes of this …

Patient safety lapses in the hospital

David B. Nash, MD, MBA

Physician

January 31, 2011

Earlier this month, at the third annual American Medical Student Association Patient Safety and Quality Leadership Institute, I listened with sympathy — and, frankly, a certain amount of discomfort — to a fourth-year medical student’s account of his grandmother’s recent hospitalization at a well regarded inpatient facility in New York City.

Admitted with an initial diagnosis of pneumonia, Cole Zanetti’s grandmother languished in the hospital for almost four weeks.

As the medically …

Read more…

Patient safety lapses in the hospital

Malpractice attorneys shouldn’t rely on clinical guidelines

Charles A. Pilcher, MD

Physician

January 26, 2011

The Institute of Medicine has been an advocate for clinical guidelines for many years.

Although the value of guidelines has never really been established, both clinicians and medical malpractice attorneys often want to ascribe greater credibility to them than they deserve. The issue was raised again in the past few months and I review it briefly here.

A few years ago Dr. Robert Ewart discussed the ethics of using guidelines to screen patients …

Malpractice fails when it comes to medical errors

Jan Gurley, MD

Physician

January 21, 2011

Here’s your multiple choice question to set the stage: what percentage of all physicians do you think should be sued for malpractice?

Would you say one-in-ten doctors ought to be sued? Or one-third? How about every single one of them? Let’s make it one claim per doctor, nationwide. Does that sound reasonable? Keep in mind that even defending yourself against a suit will cost on average $40,649 per claim, ranging from …

Are malpractice lawsuits really responsible for the rise in C-sections?

Kevin

Physician

January 16, 2011

by Louise Marie Roth, PhD

About one third of all births in the contemporary United States occur via c-section. Physicians and the public at large often attribute this to a “malpractice crisis,” whereby obstetricians perform c-sections routinely to avoid malpractice litigation. Over the last couple of years, I have been conducting research on obstetric practices and malpractice.

One of the things that I have learned …

Doctors can reduce malpractice by being better people

Aaron E. Carroll, MD

Physician

January 5, 2011

My father, although retired, is a general and thoracic surgeon, triple boarded in critical care, who ran a trauma unit. My brother is a pretty successful lawyer. Whenever I visit them, inevitably at least one night ends with the three of us around a table, and the two of them going at it about who is to blame for the malpractice system.

My father, of course, blames the lawyers; my brother …

How you can reduce preventable mistakes in your medical care

Neil Baum, MD

Patient

January 5, 2011

There are nearly 1.5 million Americans who suffer each year from preventable mistakes. A report by the Institute of Medicine estimates that as many as 98,000 people die in U.S. hospitals each year as the result of medical errors.

Most of these errors are related to drug mistakes. That’s the bad news. The good news is that your doctors and hospitals are trying to reduce these errors by using by using …

Patient complaints do not fit the primary care office visit

Kevin Pho, MD

KevinMD

December 28, 2010

Primary care physicians often have to see patients with a litany of issues. Often within a span of a 15-minute office visit.

This places the doctor in the middle of a tension — spend more time with the patient to address all of the concerns, but risk the wrath of patients scheduled afterwards, who are then forced to wait.

And, in some cases, it’s simply impossible to adequately address every patient question …

Posts of the year on KevinMD.com, 2010 edition

Kevin

Potpourri

December 25, 2010

Merry Christmas!

I’d like to thank everyone for your continued readership.

Doctors, patients and other health care professionals need to be heard, and there’s no better place to do so than here, on social media’s leading physician voice.

This year, KevinMD.com had a regular rotation of 175 guest contributors, and surpassed 1.75 million visits, 2.95 million pageviews, 33,000 followers on Facebook and Twitter, and 40,000 RSS subscribers.

I am truly …

A nurse and the system to deal with medical errors

Kevin

Physician

December 15, 2010

by Mary Lynn Summer

I am a nurse. Like most medical practitioners, I am afraid of malpractice attorneys and view them as a threat to my nursing license. Every hospital has a system in place to deal with medical errors and patient complaints. I used to think they worked, but now I don’t.

My mother, in her late 80s, recently broke her hip. She has dementia so is unable to appropriately express …

Medical errors that involve handwritten prescriptions

Kevin

Physician

December 14, 2010

by Daphne Swancutt

Two people in the United States just died in the last hour. Seventeen more will die in the next 7 to 8 hours. Over a year, that number will accumulate to about 7,000.

The reason? Medical errors that include misread or otherwise misinterpreted handwritten prescriptions. Believe it. This means that doctors are being sloppy, pharmacies are making mistakes and people are getting dead.

Even more …

A postmortem on the patient safety movement

Robert Donnell, MD

Patient

December 8, 2010

Are patients better off than they were ten years ago?

Just over a decade ago the Institute of Medicine (IOM) released its celebrated report on patient safety, To Err is Human. Many credit that report, which was released with great fanfare, with launching the patient safety movement. So it’s appropriate to assess the movement’s impact eleven years later. How did we do?

On November 25 the New England Journal of Medicine published …

Open dialogue on medical malpractice and patient safety

Kevin

Physician

December 7, 2010

A response to my recent post, The malpractice system doesn’t improve patient safety.

by Brian Nash

In his blog, Dr. Kevin acknowledges that in the “world of medical error, truth is often clouded in secrecy.” He then points out that “… taking the bold step of publicly describing your mistake is a brave one. Some would say it’s long overdue.”

Well so far, Dr. K, we’re on …

The malpractice system doesn’t improve patient safety

Kevin Pho, MD

KevinMD

November 29, 2010

There has been significant media attention on a New England Journal of Medicine case report where a surgeon, Massachusetts General Hospital’s David Ring, described how he operated on the wrong hand of a patient.

Here’s a summary of the case:

Ring, along with colleagues at Massachusetts General and Harvard Medical School, detailed the series of missteps that led to the wrong operation in the patient whose ring finger on her …

Read more…

The malpractice system doesn’t improve patient safety

Our malpractice system needs to focus on patient safety

Donald H. Taylor, PhD

Physician

November 18, 2010

A malpractice lawsuit claims that a doctor treated a patient negligently and that this treatment caused harm, and it seeks monetary compensation. Negligence means that a physician failed to provide the standard of care expected by the prevailing medical custom. Juries decide cases that are tried, but most cases are settled or dropped. Lawyers get paid (typically 35 percent) only when they win or settle a case.

A successful malpractice system …