Articles Posted in Hospital Malpractice

I’m reading a book called Why We Make Mistakes by Joseph T. Hallinan. The premise of the book is that we, as a species, have shortcomings that make us prone to mistakes. It is a pretty decent book.

In a footnote on page 193, Hallinan makes reference to a study that was done that asked pilots the question: “Even when fatigued, I perform effectively during critical [times].” Only 26% of pilots agreed with that statement. Yet 70 percent of surgeons agreed with that statement.

People wrestle hard with the question of whether to contact a malpractice lawyer about their potential claim? They might like their doctor, fear retribution… there are a whole host of considerations people undertake.

You would expect the malpractice lawyer’s answer to be pick up the phone and find out if you have a malpractice case. But we get that it is not that easy. Nor should it be. A lot of very reasonable people have viable malpractice claims that they choose not to bring. This is not necessarily a bad choice. It is a deeply personal choice.

CNN provides today some balanced insight on the decision of whether to file a malpractice lawsuit.

I’m a big fan of the law of unintended consequences. Here’s one: better medical care because of a bad economy.

Why? I’m glad you asked. The economic downturn has helped the quality of nursing. During good times, every nurse (and their mother) was selling real estate on the side or involved in some other economic opportunity that provided economic growth. So nursing vacancies were high. In today’s economy, nurses are losing those opportunities and are retreating to the hospitals and nursing homes, which increased the number of full-time permanent nurses. This is cheaper for the hospitals and allows them to be choosier about the nurses they pick, immediately improving patient care.

Does a bad economy really decrease incidence of medical malpractice? I don’t know. I’ll leave that to the Freakanomics guys and their progeny. I just think this is interesting.

Surgical mistakes that seem like ‘once in a lifetime’ errors – such as operating on the wrong patient or amputating the wrong body part – occur more frequently than previously believed, a new Archives of Surgery study reports this month.

The study looked at surgical mistakes in Colorado over a six-and-a-half year period. The study found surgeons operated on the wrong patient at least 25 times and on the wrong part of the body in another 107 patients. Wrong-patient and wrong-site procedures accounted for approximately 1 in 200 medical malpractice errors in the study. While this sounds awful, one of the lead researchers believes this understates the number of “no-brainer” medical malpractice errors.

Doctors and hospitals are doing more to try to double check and triple check to reduce the number of these errors. Although the study does not say, I’ll bet the number of these errors trends down during the 6.5 years evaluated. That said, the authors and others quoted in USAToday and CNN underscore that this is a public health problem we still have not solved.

In Maryland hospital malpractice lawsuits, the Court of Appeals has followed the apparent authority theory of agency. Under this theory, if a Maryland hospital represents that a doctor is its servant or agent and thereby causes a patient to justifiably rely upon the care or skill of that doctor, the hospital is subject to liability to the patient for the doctor’s medical malpractice. The Maryland courts have historically understood that it would be unreasonable to expect that an emergency room patient, with no understanding about the business of how hospitals are set up with respect to independent contractors, should have to inquire as to whether the doctor is an employee of the hospital.

When a malpractice lawyer in Maryland brings a vicarious liability claim against a hospital, it typically includes claims of failure to develop or follow policies and procedures that could have avoided or limited the plaintiff’s injuries from the malpractice. Lawsuits against Maryland hospitals also include, where appropriate, claims that the hospital negligently failed to properly train the agents or servants responsible for the negligence. Another potential claim against the hospital, although it applies less frequently, is negligent credentialing, which means the hospital was negligent in allowing the doctor (or nurse) to work in the hospital.

If you are bringing a malpractice claim against the doctors and the hospital in Maryland, it is often wise to determine if there was a corporate entity that employed the defendant doctors. This may provide additional insurance coverage for claims that are not available against the hospital and give the jury a corporate defendant to make it feel better about a plaintiff’s verdict.

Cedars-Sinai Medical Center announced Monday that more than 200 patients received excessive doses of radiation because of a programming error in a CT scanner. Incredibly, the medical center said affected patients received eight times the normal dosage of radiation and that the error went unnoticed for about 18 months. Exposure to excessive amounts of radiation has been linked to cancer and other health problems.

Exposure to normal dose of radiation to treat or diagnose disease comes with serious health risks to patients that are already vulnerable. So this is awful news but, hopefully, the victims will tolerate this excessive radiation well.

Recently-passed laws in several states, including Maryland, Virginia, and Washington, D.C., require hospitals to detail serious injuries; this reveals the frequency and variety of so-called “never events” which should never happen. The laws are different in each state. Virginia’s public records identify the hospitals by name, but Maryland and Washington, D.C.’s don’t name names.

Five years ago, a Maryland law was passed requiring Maryland hospitals to report errors that led to death and serious harm. This month, the Maryland commission that sets hospital rates is using a new system that ranks hospitals on how often they commit 52 specific mistakes, from preventable obstetrical complications to infections of wounds that develop after surgery. Maryland hospitals that report the most mistakes from that list will be required to bill insurers at a lower reimbursement rate. In other words, good hospitals will make more money.

I think most Maryland malpractice hospital lawyers support this idea. The better hospitals get more money, which motivates them to get better. I worry, though, about any hospital that is last on this list. No real motive for the hospital to get better because they are too far from the higher reimbursement. But the rich Maryland hospitals get richer while the poor hospitals get poorer with no motivation to get better.

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.