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Finding a suitable nursing home for an older loved one is an arduous and time-consuming process.  Nursing homes can be the best fit for an elderly family member’s care but fears of elder abuse, medical mistakes, and the recent problem of MRSA infections make the choice even more difficult.   Very difficult.

First, what is MRSA?  MRSA is well known as a deadly problem for hospitalized people with open wounds or those recovering from surgery.  This type of MRSA is known as hospital-acquired MRSA.

A new study from the University of California, Irvine shows that the vast majority of surveyed nursing homes tested positive for the drug-resistant MRSA bacteria.   Researchers surveyed 22 facilities and found 20 to have strains of methicillin-resistant Staphylococcus aureus (MRSA).  MRSA is the bacterial strain that no longer responds to the antibiotics used to treat staph infections.   Once it gets going,  it s a beast of a task to fight it off.  What we now know – and suspected all along – is that nursing home patients are particularly at risk, even more so than others patient of the same age who are not in nursing homes.

Here’s an interesting case that the Nebraska Supreme Court decided yesterday.  Plaintiff volunteers to donate a kidney to his dad.  Doctor removes plaintiff’s kidney and gives it to the father.    Sadly, father has complications with the kidney, requiring further surgery.   According to plaintiff’s complaint, the doctor mistakenly stitched the renal artery during the father’s exploratory surgery, which lead to the loss of the donated kidney.  Really just a tragedy – son tries to help father which is how the world should work.  Malpractice or not, it is just a shame.

But here’s the wierd part.  Isn’t this Dad’s malpractice claim?  Instead plaintiff – actually plaintiffs, inexplicably his wife was also a plaintiff, filed suit instead of the father.  Defendants, understandably, filed a motoin for summary judgment.  Plaintiffs’ response was telling, asking for a continuance to pursue further discovery on whether doctor-patient relationship existed between plaintiff and the doctors.  The court granted defendants’ motion for summary judgment.

So the Nebraska Supreme Court had to decide whether doctor owes a duty of care to a kidney donor during the post-transplant treatment and care of the donee.  Is this really a question?  I don’t think so and the Nebraska high court didn’t think so either.  I’m not even sure why I’m blogging about this except the facts are interesting.  I just wish we had the bad story.  Why didn’t dad sue in his own right?

On our website, we have put up pages that provide information about bringing medical malpractice claims against hospitals in Maryland, including these four Baltimore City hospitals:

• Harbor Hospital
• Johns Hopkins

Medical malpractice attorneys that defend doctors love medical malpractice caps.  They just think they are the greatest invention since the iPhone.  Or something like that.  I always thought it was misplaced because what defense lawyer want more than anything else is more cases and I assumed that malpractice caps meant less money in legal fees for them.

For reasons I can’t explain, the opposite may well be true.  In a study in the Journal of Health Politics, Policy and Law titled “Medical Malpractice Reform and Insurer Claims Defense: Unintended Effects?”, the authors looked at the impact of malpractice tort reforms on the cost of defending medical negligence cases.  What they found really surprised me: defense expenses were actually higher in those states where noneconomic damage caps, punitive damage limits, and attorney fee limits had been implemented.

The law of intended consequences is really something.  I honestly cannot think of a reason why this would be true.  And it is just one study.  But it does throw another monkey wrench into one of the rationales for medical malpractice cap.

The Maryland Injury Lawyer Blog has a post on a disconcerting defense strategy one hospital has used to try to get two depositions from the plaintiffs’ expert.

Federal Judge Ellen Huvelle denied a motion to dismiss a class action suit that was brought on behalf of nearly 3,000 nursing home residents in Washington, D.C.

Plaintiffs’ class action nursing home lawsuit is not a classic personal injury claim. Instead, the suit alleges that approximately 3,000 city residents with disabilities are institutionalized in nursing homes when they don’t have to be, because they have the ability to live independently if provided information about and access to home- and community-based services. The lawsuit is not asking for the stars and the moon. The suit simply seeks to order the city to provide these services and inform residents of their rights and choices.

The judge rejected the District’s claim that it has complied with the American with Disabilities Act (ADA) by providing services to nursing home patients who want to live in the community. The ADA requires states and local governments to make their best effort to provide services to people with disabilities in an integrated setting.

• Oregon high court overrules intermediate appellate court that reduced malpractice verdict for patient’s comparative fault
• Criminal problems for former medical consultant accused of collaborating with local doctors and lawyers to fraudulently manipulate medical malpractice cases
• More competition for medical malpractice insurance?Capson Medical Malpractice Insurance is now available in 12 states.

The median medical malpractice jury award in Maryland, according to Jury Verdict Research, was $500,000 in 2003, the last year for which I could find data. Verdicts that year ranged from $54,521 to $7,708,064. One study indicates that the average award in Maryland malpractice claims (presumably claims that are reported to the national data bank) is $319,977, which is about what I would have predicted.

Studies in other jurisdictions give interesting data on median verdicts in other states: Florida – $1,257,386; Ohio – $850,000; New York – $1,100,000; Pennsylvania – $1,000,000; Texas – $880,000 (average, not median which makes a big difference) Indiana – $750,000; Missouri – $694,000; West Virginia – $1,100,000 (average) North Carolina – $500,000.

Keep in mind, these comparisons are out of context. The publication dates, in particular, vary wildly for the states I picked, and the methodology probably varies but I still think this provides an interesting means of comparison for medical malpractice lawyers.

These New York Times letters to the editor are of some interest on the issue of the efficacy of electronic medical records.

I watched this weekend the Maryland Court of Appeals oral argument in University of Maryland Medical Systems v. Waldt. (click here, it is a few cases down). I read this case and wrote a treatise of a post on the Maryland Injury Lawyer Blog about the case. But watching the oral arguments – for whatever reason – just gives you a different level of understanding about the issues. It is time consuming but really worth the time.