The circus that is the aftermath of the St. Joe’s stent debacle just added a new act. A Baltimore cardiologist has filed a lawsuit against St. Joseph’s claiming the hospital harassed and discriminated against him for his role in a whistle-blowing action by, in part, refusing to refer patients to him.
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 credentialling, 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.
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.
Jury Verdict Research reports on recovery probabilities in the following types of medical malpractice case:
Foreign Objects Left in Body 66%
Postsurgical Infection 43%
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 hospital setting. But doctors do not have a monopoly on arrogance and abusive behavior, as many who have worked for some Maryland malpractice lawyers can attest.
Hospital infections are becoming more of an issue both within hospitals and in the media in recent years. The Center for Disease Control in Atlanta makes clear the reason: infections at hospitals cause 90,000 deaths in the U.S. every year. Infections result in an estimated 205,000 additional hospital days for infected patients and $2 billion in hospital charges.
Most infections are not the result of hospital malpractice. But consider these facts. In Central New York, University Hospital had, according to one study, an infection rate of 0.669 percent. Other New York Hospitals had lower rates: St. Joseph’s and Crouse had infection rates of 0.405 percent and 0.364 percent, respectively. But Community General’s infection rate was 0.017 percent and Oswego’s rate was absolutely zero.
Now, hospital quality data is not standardized and there are different reports that measure hospitals in different ways. But can this degree of variance in hospital infection rates be the product of mere probability or the way the hospitals report the data? I don’t think so.