Posted On: December 22, 2008

Burden of Proof for Emergency Room Doctors in a Hosptial

An Arizona state senator renewing plans to introduce a bill to make it harder to successfully sue emergency medical providers for alleged malpractice by raising the burden of proof in hospital cases against emergency room doctors.

Governor Janet Napolitano vetoed 2006 legislation and the House narrowly rejected a 2007 version. But there is new optimism because Republican Secretary of State Jan Brewer will replace Governor Napolitano because she is taking over Homeland Security in the Obama administration.

Having spent far more time writing this blog post than reading the Arizona Constitution, I can't speak with authority on this. But I can't imagine such a bill would pass constitutional muster. Moreover, it is just a bad idea that is absolutely unfair to medical malpractice victims.

You can read the short article on the proposed legislation here.

Posted On: December 16, 2008

Electronic Medical Records

Kevin MD raises concerns that electronic records will actually increase the cost of health care in the United States.

I think this is an important question but, in the end, the critical question is whether it will save a signifcant number of lives and prevent human suffering.

Posted On: December 12, 2008

Medical Malpractice Panels in New Hampshire

Interesting article in the Insurance Journal on medical malpractice panels in New Hampshire. The idea is that medical malpractice panels, which are chaired by a retired judge and include a doctor and lawyer -- screen every medical malpractice case that's filed in New Hampshire. If the verdict of the panel is unanimous, this information is given to the jury. We do not have this system in Maryland although some variation is regularly raised by medical malpractice tort reformers from time to time.

The problem with medical malpractice panels is that they add to the cost to the already significant cost of bringing a medical malpractice lawsuit. Accordingly, Plaintiffs' medical malpractice lawyers in Maryland and elsewhere generally dislike the notion of medical malpractice panels. Conversely, defendants' medical malpractice lawyers love the system: more hours to bill.

Update: here is another article (January 11, 2009) on effort to modify or eliminate this medical malpractice in New Hampshire.

  • Health Courts in Maryland (an idea that failed in Maryland)
  • Health Courts (Common Good's view, differing from ours, on health courts)
  • Posted On: December 11, 2008

    Wrongful Death Claim Against Massachusetts Doctors

    Four Massachusetts doctors are asking that a wrongful death lawsuit against them be dismissed because the claim should be handled as a medical malpractice claim. The family of a man who killed in a motor vehicle accident claims these doctors failed to warn the at-fault drive that her medication may have rendered her unable to drive. Defendants in the case ask that it be reviewed by a medical malpractice tribunal consistant with a medical malpractice case.

    This claim would not fly in Maryland under a new case decided this year. (The name escapes me.)

    Posted On: December 4, 2008

    Medical Malpractice Lawsuits in Maryland: How to Reduce Litigation Costs

    The Volokh Conspiracy has a blog post from David Hyman discussing the logic behind caps on non-economic damages in medical malpractice cases. Apparently, a Harvard Law School student writing a paper on caps asked the principal legislative sponsor of California's (draconian) medical malpractice cap why they settled on $250,000. This was the response:

    The theory was that you could never really and adequately compensate for pain and suffering, no matter how much money you provided. Money just doesn’t do it. But $250,000 (in addition to meeting the medical and other needs of the patient), properly invested to the extent that it elevated the quality of life over and above the post-injury status, was thought to be enough to do that job.

    One of the comment to the post made a very insightful comment:

    Malpractice litigation is very labor-intensive, and sensible attorneys won't commit to a case which will require many hours of labor unless they can anticipate a reasonable return on their investment of time. Malpractice insurance carriers know this, and they systematically drag out most cases so that the lawyers have to work more hours. (Unlike other tort cases, which might settle at any stage of the litigation, medical malpractice settlements are typically reached just before -- or even during -- trial, after the lawyer has done virtually all of the work.) These tactics further dissuade attorneys from taking on such cases. As a result, they further tilt the playing field in favor of the defense and made it harder for victims of malpractice to get their day in court.

    Medical malpractice defense lawyers in Maryland always claim that meaningful settlement negotiations cannot begin until discovery is completed. Most malpractice lawyers - even us - have come to buy into this principle over time. But what separates malpractice claims from any other complex tort claim, many of which settle long before a lawsuit is filed?

    The author of this comment goes on to suggest a creative out-of-the box resolution:

    If lawmakers are really trying to reduce the cost of malpractice litigation, it would seem more sensible to put an identical cap on the attorney fees which can be earned by defense counsel. Of course, lawmakers have never seriously considered doing anything of the sort. Med-mal defense lawyers are paid by the hour, and their bills -- sometimes in the millions of dollars in very serious cases -- are typically paid by an insurance carrier. Limiting their fees would dissuade the sort of scorched-earth tactics malpractice defense attorneys often employ. As it is, though, defense attorneys can often earn many times the maximum fee which the plaintiff's attorney can earn in the same case, and have every incentive to put more hours into a given case in order to wear down their opponents. If this doesn't qualify as preferential treatment for the defense, I don't know what would.

    This suggestion would not get 10 votes in any state legislature in the country. But I love the idea.

    Posted On: December 3, 2008

    Obama Tort Reform Views

    There is a lot of speculation about Barack Obama's tort reform views. This nugget came out of an article in the Wall Street Journal on the battle now going on over the Illinois cap: Obama voted for the medical malpractice cap in Ilinois. It is such an obvious clue to Obama's thinking on tort reform that no one is taking about. I don't think Obama supports extreme measures, particularly on the federal level, for medical malpractice tort reform. But he is no Joe Biden, who I think is fully committed to protecting tort victims.

    June 11, 2009 Update: Maybe I'm wrong and Obama put medical malpractice reform directly on the table. But I don't think that reform is going to include caps. But what he will do is anyone's guess at this point.

    Related Posts


    Posted On: December 2, 2008

    Mean Doctors = Medical Malpractice

    The New York Times reports today that badly behaved doctors, specifically arrogant, abusive and disruptive behavior, can contribute to low morale, stress and high turnover among hospital staff and can lead to medical malpractice. A recent survey of medical providers found that an alarming percentage of workers believed that disruptive behavior could lead to medical malpractice.

    Certainly, this is true and systematic changes can be made to improve what is tolerated in a hosptial setting. But doctors do not have monopoly on arrogance and abusive behavior as many who have worked for some Maryland malpractice lawyers can attest.