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.

Why health IT won’t help with medical risk management

Satish Misra, MD and Iltifat Husain, MD

Health Technology

January 28, 2010

The march is on across the American healthcare landscape to implement electronic health records that also function as decision-support systems.

These “advanced” electronic health records will both provide centralized records and assist providers in making care decisions such as implementing therapy and utilizing evidence-based practice on the individual patient level. And anyone that has had the opportunity to work with some of the systems out there knows that they can be …

How root cause analysis can improve patient safety

Robert Wachter, MD

Physician

January 19, 2010

Hospitals face so many urgent tasks in safety – computerize, promote teamwork, implement evidence-based safety practices, discover unsafe conditions – that it’s hard to know where to start. If you’re struggling, I recommend that you put your Root Cause Analysis enterprise on steroids. This is what we did at UCSF Medical Center, and it was the most important change we’ve made in our safety journey. Here’s the story, …

Good doctors sometimes may make patients unhappy

Edwin Leap, MD

Physician

January 18, 2010

Most of us went into medicine because, in addition to being good students, we wanted to help people. How many oceans of ink and forests of paper have been used explaining that point to admissions committees we’ll never know. Suffice it to say, it felt very good when our professors wrote us glowing letters of recommendation. Of course, we were also saying, “I want to feel good about helping people. …

Don’t use kitchen spoons to measure drug dosages

Kevin

Medications

January 15, 2010

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

Individuals using standard spoons from their home kitchen to dispense liquid medications may be pouring too little or too much of the drugs, researchers found.

Among volunteers trying to pour a teaspoonful of cold and cough medicine, using a slightly larger spoon resulted in underdosing and using a much larger …

Will physician and hospital penalties improve patient care?

Kevin

Health Policy

January 5, 2010

Originally published in HCPLive.com

by Alan Berkenwald, MD

In 1904, the Scottish author Sir James Matthew Barrie sent Peter Pan off to Never-Never Land to escape growing up and to enjoy many-many adventures. As children, we all hoped it really existed. In truth, many of us fantasized, one day, to make the trip ourselves.

Well, good news for physicians – that day has arrived!

A cockpit checklist to improve patient safety

Kevin

Physician

December 29, 2009

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

Medical teams should take a lesson from airplane crews, a new study concludes.

Medical personnel who used procedural checklists modeled after preflight checklists used by airplane crews were more likely to report safety-related incidents and feel empowered to address safety issues, according to an online report in the Dec. 21 …

Issues surrounding videotaping surgeries in the operating room

Dr. Martin Young

Physician

December 23, 2009

The rapid advance in digital video and still camera technology has found its way into the operating room.

There is the potential to capture and record just about every minute of every surgical procedure in some way. The newest endoscopic camera systems and operating microscopes have integrated systems to record video footage. Storing all that data is just the press of a button away.

The advantages for surgeons are obvious, like the …

How only lawyers can determine medical standard of care

Michael Kirsch, MD

Physician

December 20, 2009

by Michael Kirsch, MD

A medical malpractice case was recently filed against me.

I received the thick envelope from noble and altruistic Cleveland barristers about 6 weeks ago. Once again, I saw my name in the good company of many other physicians and our local hospital. I reviewed my medical records and felt comfortable with the care I had provided. In a medical malpractice case, quality of medical care is important, …

Some patients won’t accept a conservative approach to medical treatment

Michael Kirsch, MD

Conditions and Diseases

December 12, 2009

by Michael Kirsch, MD

Who says one person can’t make a difference? This past week, I personally set back health care reform. No, I wasn’t attending a ‘tea party’ or decrying Obamacare in a venomous letter to the editor. I single-handedly bent the health care cost curve in the wrong direction. I performed an unnecessary medical test on a hospitalized patient, which exposed her to risk and cost the system money. …

Should health care workers go to jail for medical errors?

Robert Wachter, MD

Physician

December 11, 2009

Two years ago, I wrote about the case of Julie Thao, the Wisconsin nurse sent to prison for a medication error. I argued then that – although Julie bypassed some safety rules – she most certainly did not deserve jail time.

Along comes another case involving jail time for a medical mistake, this one featuring an Ohio pharmacist named Eric Cropp. I became aware of Eric’s case through the efforts of …

Will electronic records raise the legal standard of care and increase malpractice risk?

Kevin

Physician

December 10, 2009

Originally published in HCPLive.com

by Robert J. Mintz, JD

As EHRs are widely adopted and the quantity of information about a patient expands dramatically, does provider liability increase even if the quality of care is vastly improved?

What happens if the quality of care really does get better but because of all the new and easily accessible information, the standard of care for …

How a personal injury lawyer views the medical malpractice system

Eric Turkewitz

Physician

November 18, 2009

Personal injury lawyer Eric Turkewitz responds to my recent USA Today piece on fixing the medical malpractice system.

In a USA Today op-ed, Kevin Pho tackles the medical malpractice liability system. Some stuff I agree with, but suggestions regarding improvement of the current system are unlikely to work.

Kevin correctly states that malpractice legal fights often go on for years. In New York, it could easily take three years to get …

Will video cameras in the OR decrease the rate of wrong-site surgery?

Kristina Fiore

Conditions and Diseases

November 12, 2009

by Kristina Fiore, MedPage Today Staff Writer

Rhode Island Hospital, located in Providence, will pay $150,000 and install video cameras in all of its operating rooms after performing its fifth wrong-site surgery since 2007, according to the state’s Department of Health.

The hospital will also have to open its ORs to an inspector who will observe surgical procedures and protocols for at …

Op-ed: Injured patients deserve medical malpractice reform

Kevin

Physician

November 7, 2009

A version of this op-ed was published on October 26th, 2009 in the USA Today.

President Obama has acknowledged that changes in the medical malpractice system must be considered with other health reforms, and recently ordered that pilot projects to improve the way we compensate injured patients be implemented.

Reforming medical liability has historically been a source of major contention. Physicians argue that the system is expensive, promotes multi-million dollar awards …

Does the tort-based medical malpractice system improve patient care?

Michael Kirsch, MD

Physician

November 2, 2009

by Michael Kirsch, MD

Physicians and plaintiff attorneys have philosophically divergent views on our tort system. I know the attorneys’ views on this issue well. There are lawyers in my family who have prosecuted physicians for alleged medical malpractice. Sometimes, there hasn’t been enough antacids in our house to douse my flaming heartburn after some of our discussions.

Obviously, one reason that lawyers support the current system is because it enriches them. …

Does the Max Baucus health reform plan do enough for doctors?

Glenn Laffel, MD, PhD

Health Policy

October 10, 2009

Max Baucus’ decision to release his solo album—subtitled the Senate Finance Committee’s proposal on health reform—was timed with the precision of a 4th grade marching band.

Physicians could live with that, but the bill contained gornisht on tort reform and not much more than that on Medicare reimbursement. Upon seeing that, the Long White Coats reacted as if they’d seen earwax on their stethoscopes.

“The feeling of most doctors is that …

A formula to help Congress with health care costs

Kevin

Health Policy

September 30, 2009

by Gary R. Gibson, MD, FACP

In his 2007 book Critical, Tom Daschle said lawmakers were “flummoxed” when attempting to craft specific reform legislation. They seem flummoxed again as they fail to recognize the primacy of the patient-physician covenant and try to analyze a complex problem without a suitable conceptual model.

The formula below represents a valid conceptual model describing health care costs.

“E” is expressed in monetary units …

Does the bulk of excessive medical care happen in the ER?

Michael Kirsch, MD

Physician

September 25, 2009

by Michael Kirsch, MD

The concept of medical excess is very difficult for ordinary patients to grasp. The medical community has worked hard for decades teaching them that more medicine meant better medical care. The public has learned these lessons well. Physicians who sent their patients for various diagnostic tests or specialty consultations were regarded as conscientious and thorough. Patients approved of doctors who prescribed antibiotics regularly for colds and other …

Medical malpractice reform by President Obama and the White House

Emily P. Walker

Physician

September 19, 2009

by Emily P. Walker, Washington Correspondent, MedPage Today

The White House today announced details of a $25 million grant program to test alternatives to the tort system for medical liability cases.

In his Sept. 9 speech before Congress, the president announced he would direct Kathleen Sebelius, Health and Human Services secretary, to launch pilot programs meant to cut down on physicians …

A patient dies after doctors fail to communicate in the operating room

Kevin

Physician

September 10, 2009

by Jerry I. Meyers, Esq.

Communication is essential between health care providers but sometimes communication fails because of the arrogance or carelessness of the persons involved in the needed medical communication.

Several years ago, a female client about to enjoy an important anniversary was admitted to a University affiliated hospital for the purpose of having a colostomy wound debrided.

This was to be a one-day inpatient hospital procedure and was associated with little …