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Medical Malpractice

 

Third-leading cause of death in America.  “It seems that every time researchers estimate how often a medical mistake contributes to a hospital patient’s death, the numbers come out worse.”

“In 1999, the Institute of Medicine published the famous “To Err Is Human” report, which dropped a bombshell on the medical community by reporting that up to 98,000 people a year die because of mistakes in hospitals.”

“In 2010, the Office of Inspector General for Health and Human Services said that bad hospital care contributed to the deaths of 180,000 patients in Medicare alone in a given year.”

“Now comes a study in the current issue of the Journal of Patient Safety that says the numbers may be much higher — between 210,000 and 440,000 patients each year who go to the hospital for care suffer some type of preventable harm that contributes to their death, the study says.”

“That would make medical errors the third-leading cause of death in America, behind heart disease, which is the first, and cancer, which is second.”

Excerpted from: How Many Die From Medical Mistakes in U.S. Hospitals? By Marshall Allen, ProPublica 9-19-13


If the board had moved faster, my daughter would still be alive. “Dr. Greggory Phillips was a familiar figure when he appeared before the Texas Medical Board in 2011 on charges that he'd wrongly prescribed the painkillers that killed Jennifer Chaney.”

“Over a decade, board members had fined him thousands of dollars, restricted his prescription powers, and placed his medical license on probation with special monitoring of his practice.”

“They also let him keep practicing medicine.”

“Despite years of criticism, the nation's state medical boards continue to allow thousands of physicians to keep practicing medicine after findings of serious misconduct that puts patients at risk, a USA TODAY investigation shows. Many of the doctors have been barred by hospitals or other medical facilities; hundreds have paid millions of dollars to resolve malpractice claims. Yet their medical licenses — and their ability to inflict harm — remain intact.”

Excerpted from: Dangerous doctors allowed to keep practicing, by Peter Eisler and Barbara Hansen, USA TODAY 8-20-13


Hats off to Sully!  “Capt. Chesley “Sully” Sullenberger in 2009 coolly landed his jet safely on the Hudson River in what was dubbed as the Miracle on the Hudson. He has refashioned himself as an expert on reducing medical errors, which by some estimates kill up to 200,000 people a year — “the equivalent of 20 jetliners crashing per week,” he told POLITICO.”

“If tens of thousands of people died in plane crashes, he says, “There would be a national ground stop. Fleets would be grounded. Airports would close. There would be a presidential commission. The NTSB would investigate. No one would fly until we had solved the problems.”
“But patients die needlessly every day, and it’s barely a blip on the national radar.”

“Sullenberger has become a fixture on the health care circuit, where comparisons to airline accidents and calls for pilot-like safety checklists have become clichés. He crisscrosses the country, pleading with policymakers to embrace practices to reduce medical errors and save lives.”

Excerpted from: ‘Miracle’ pilot on mission against medical errors, by KYLE CHENEY, Politico, August 1, 2013.


Most alarming. “The Texas Medical Board has temporarily suspended the license of a Plano neurosurgeon whose practices have led to "significant risk of harm and resulted in at least two patient deaths" over the past 18 months.”

“The order issued this week against Dr. Christopher Daniel Duntsch, 42, cites numerous mistakes in four surgical cases, from diagnostic breakdowns to failures to recognize and respond to complications. It also said he is unable to practice medicine with "reasonable skill and safety due to impairment from drugs or alcohol."

“Duntsch, who was practicing at University General Hospital Dallas… injured one patient earlier this month after he demonstrated "poor judgment and insufficient knowledge of the regional anatomy'' involving a spinal procedure, the order said.”

Excerpted from: Plano neurosurgeon suspended after patient deaths by MILES MOFFEIT, The Dallas Morning News 6-28-13


The TBME is supposed to be policing doctors and protecting the public but... “Top secret meetings, back-door deals and confidential complaints are all a part of the Texas Board of Medical Examiners. The state board is supposed to be policing doctors and protecting the public but some patients complain the system is a prescription for failure.”

“In 2003 Texas lawmakers put caps on medical malpractice lawsuits but promised to keep a tight rein on doctors by beefing up the Texas board.”

“Since 2003 the number of complaints rolling into the board has skyrocketed from 4,900 to more than 8,000 last year. But investigations are down to only 25 percent.”

“Cases are also taking much longer to resolve. That number is up to 328 days.” Excerpted: News Station Investigation: Medical Board by Becky Oliver, FOX DFW, May 8, 2012


Dentists drilling for gold.  “Texas toddlers being held in restraints as dentists at corporate-run clinics performed unnecessary root canals were among the dental horror stories told Wednesday at a House Public Health Committee hearing at the state Capitol.”

“The Texas State Board of Dental Examiners… was the subject of criticism by members of Texans for Dental Reform and unaffiliated residents, who called for legislative reform while levying accusations of ineptitude, a pattern of withholding or obscuring negative information about dentists, and failure to act against corporate-run dental clinics committing Medicaid fraud and harming patients.”

“The clinics in question often serve only Medicaid patients and pay one dentist to act as a prop by claiming ownership. The real owners of the clinics — usually private equity firms — are in the dental business for profit…” Excerpted from: Texas Dental Board is Accused of Ineptitude, by Becca Aaronson, Texas Tribune, April 12, 2012


Closing the gap. “Methodist officials said they did not know that Rivera-Alsina was under investigation until the Texas Medical Board made its disciplinary action public last week. That is entirely possible — and that’s where the problem exists.”

“This gap in the medical reporting process — in which the medical board is aware of investigations but hospitals are not alerted case by case — needs to be closed.”

“ doctors should be presumed innocent until all the facts are in. But for the safety of patients, hospitals should have a better way to find out about complaints than hoping that patients, internal whistle-blowers or the doctors themselves come forward.”

“Patient safety requires a system that efficiently alerts hospitals to doctors’ potential mistakes and makes sure those in a position to act have no excuses for inaction.” Excerpted from: Editorial: Better reporting of medical reviews is needed, Dallas Morning News 3-1-12


Some things are better left unsaid?  “In a nationwide survey of 1,800 physicians, 17 percent had some level of disagreement with the notion that they should "never tell a patient something that is not true." Not only that, but 11 percent of those surveyed acknowledged that they had told a patient "something that was not true" in the past year.”

“The survey found that 34 percent did not completely agree that "all significant medical errors" should be disclosed to patients, with 20 percent saying they had withheld information about medical mistakes in the past year.”  Excerpted from: Many doctors hide the truth about medical errors, study finds, McClatchy/Tribune 2-9-2012


Wish I’d never said that. “…AMA News continues reporting on some fascinating statements coming out of the Texas “tort reform” movement in response to Public Citizen’s recent report called "A Failed Experiment; Health Care in Texas Has Worsened in Key Respects Since State Instituted Liability Caps in 2003… “

"The Texas Medical Assn. called the report misleading. ‘First of all, we never promised the tort reform bill would lower the cost of medical care. We said it would increase access to medical care,’ said TMA President C. Bruce Malone, MD.” Ooh, sound familiar?”

“Of course they claimed that. (Straight from their materials: "More patients will be able to afford health insurance;" "Passage of Prop 12… would keep medical care affordable and accessible for all Texans.") But that’s not even the point. The point is that these folks now say, "don't expect 'tort reform' to lower your healthcare costs." Finally, consensus!”
Excerpted from: "Tort Reformers" Caught in Texas, www.thepoptort.com, October 31, 2011, (Center for Justice & Democracy blog)


Debunking another TX urban legend. “A common perception among policymakers and pundits is that medical malpractice litigation is significantly, or even chiefly, to blame for skyrocketing health care costs and steadily diminishing access to care. But analysis of data in Texas, which in 2003 imposed some of the strictest liability caps in the country, tells a far different story. While litigation over malpractice in Texas has plummeted dramatically since the caps were imposed, residents of Texas (except for people with financial connections to liability insurance companies and, to a lesser extent, doctors) have realized few, if any, benefits. Instead, the health care picture in Texas has worsened significantly by almost any measure.” Public Citizen Report: A Failed Experiment - Health Care in Texas Has Worsened in Key Respects Since State Instituted Liability Caps in 2003, October 12, 2011.


The Welcome Wagon.  “The fabulous group Texas Watch has been closely following the case(s) of Dr. Stefan Konasiewicz, Texas brain surgeon.”

“In Dr. Konasiewicz’s former state, Minnesota, he was…only the second neurosurgeon to be disciplined…as a result of charges prompted by allegations of harming patients…Konasiewicz was also disciplined by the Minnesota Board of Medical Practice for ‘unprofessional and unethical conduct’… “

“Dr. Konasiewicz made a bee line for [Texas], where in 2008 he joined the South Texas Brain and Spine Institute in Corpus Christi…Apparently, Texas was so happy to have him operate on the brains of Texans…the Texas Medical Board has taken no such action against him, meaning his license is not restricted and he does not need to have his work supervised.” Excerpted from: Where do Incompetent and Unethical Doctors Go?, www.thepoptort.com (Center for Justice & Democracy) 9-27-11


Chilling effect. “A law that took effect this month bars the Texas Medical Board from considering complaints against doctors if they come from anonymous sources like the complaint from two Winkler County nurses who lost their jobs after anonymously urging the board to investigate a doctor in 2009.”

“Since a 2003 tort law made it tougher for consumers to sue doctors, the Texas Medical Board has become the sole recourse for some patients who can't find lawyers to take their malpractice case because of damage limits. Those patients might not get justice — or money — in court, but they still want the doctor punished and the public to know about it.”

“Alex Winslow, executive director of Texas Watch… called the law "a step in the wrong direction" that "could endanger the safety of patients."  Excerpted from: New law bans anonymous complaints about doctors, by Mary Ann Roser Austin American Statesman, Sept. 18, 2011


Exactly.  “A West Virginia judge who helped West Virginia’s Supreme Court hear a recent medical malpractice case is blasting the outcome.”

“First Circuit Judge Ronald Wilson dissented sharply on Friday with last month’s ruling that upholds limits on jury verdicts...”

“His dissent said that the courts should instead be protecting malpractice victims as well as doctors who are overcharged by insurance companies.” Excerpted from: Judge Blasts West Virginia Medical Damages Cap, Insurance Journal 7-25-11


The Jury has spoken… “Advocates for nurses and a top state medical official praised the conviction Tuesday of the Winkler County sheriff for retaliating against two nurses who complained to state regulators about a physician who is a friend of his.”

“Robert L. Roberts Jr. automatically lost his job as sheriff when jurors returned the guilty verdicts on four felony counts and two misdemeanor charges.”

"The verdict sends a message that nurses, patients and family members can bring a complaint about a doctor to the Texas Medical Board without fear of retaliation," said Mari Robinson, the board's executive director. Robinson testified at Roberts' trial.”

“Roberts was found guilty of retaliating against Anne Mitchell and Vickilyn Galle, nurses at Winkler County Memorial Hospital, after they sent an unsigned letter to the Medical Board in 2009 about Dr. Rolando Arafiles Jr.”  Excerpted from: Nurse advocate, state medical official happy with verdict against sheriff, by Betsy Blaney (AP) Ft. Worth Star Telegram, 6-16-11


Less lawsuits does not equal less malpractice. “But not everyone agrees that tort reform was good for patients.”

“Just because there are fewer lawsuits doesn't mean there's any less malpractice being committed,” said Alex Winslow, executive director of Texas Watch, an Austin-based consumer advocacy group. “It simply made it more difficult for patients who are harmed to exercise their rights and hold the doctor accountable.”   Excerpted from: Malpractice lawsuits plummet by Don Finley, San Antonio Express News, 5-30-11
 


Depends on your definition of frivolous.  “The lawmaker and retired obstetrician [Representative Phil Gingrey, R-GA] sponsoring a Congressional bill to sharply cut medical malpractice awards was involved in a $500,000 settlement of a malpractice lawsuit. The action was brought by a pregnant woman who charged that inappropriate care caused the loss of her fetus and other complications.”

"Since then, the Georgia Republican has introduced earlier versions of the bill and has been among the leading Congressional advocates of efforts to limit malpractice awards, arguing that such cases are often frivolous.”

“In a pretrial deposition, Dr. Gingrey testified that he had been sued at least three other times over malpractice during his long career. In one case, a jury found against him; in another case, there was a settlement; and in another case, the patient dropped the action, he testified.” Excerpted from: Malpractice Bill Raises Issues About a Lawsuit By Barry Meier, New York Times, 2-8-11


Baiting-and-switching. “The Toyota situation should be a wake-up call for Texas policymakers: The decades-long campaign by insurance companies and multinational corporations to shift responsibility for consumer protection away from independent judges and common-sense juries…has put families at risk in their workplaces, on the highways and in our healthcare system”.

“…when patients' legal rights were severely restricted…by the [Texas]Legislature in 2003, an office of patient protection was created. It was a bait-and-switch. The agency's funding never materialized, and two years later the office was shut down entirely before it ever had a chance to help a single patient”.
Excerpted from: Op-ed - Texas must stop protecting public safety on the cheap by N. Alex Winslow (Texas Watch), Fort Worth Star Telegram 3-11-10


The Fox is Guarding the Hen House. "Seven years ago...the Texas Medical Board promised to crack down on bad doctors.

It hasn't turned out that way.

After its last meeting...the board announced decisions on four sex-related cases. Two involved doctors whom judges had already sentenced for crimes against children. Two involved psychiatrists found to have had affairs with adult patients...

The child abusers were allowed to go on practicing medicine, though not with kids. The other two are working without restrictions.

...Others who kept their licenses...include two doctors convicted of lucrative federal crimes that put patients in harm's way; a neurosurgeon who operated on the wrong body part four times; a cardiologist found to have performed dozens of invasive procedures with little or no cause; and at least seven physicians linked to a death."
Excerpted from: Physician misconduct often tolerated by state medical board, analysis finds, by Brooks Egerton, Dallas Morning News 10¬12-09


Malpractice-related hooey. "So while Texas patients lost significant legal rights and many unsafe health care providers are now unaccountable, rural communities that were exploited during the "tort reform" campaign have seen no improvement in access to physicians." Excerpted from: Medical Malpractice Myths Debunked TXs, California and Some Michigan Thrown In, www.poptort.com 9-15-09


Barely merits discussion: "After reviewing thousands of patient records, medical researchers have estimated that only 2 to 3 percent of cases of medical negligence lead to a malpractice claim. For every notorious error - the teenager who died in North Carolina after being given the wrong blood type, the 39-year-old Massachusetts mother killed by a chemotherapy overdose, the newborn twins (children of the actor Dennis Quaid) given too much blood thinner - there are dozens more. You never hear about these other cases."

"Medical errors happen more frequently here than in other rich countries, as the Robert Wood Johnson Foundation recently found. Only a tiny share of victims receive compensation."

Excerpted from: Medical Malpractice System Breeds More Waste by DAVID LEONHARDT, New York Times 9-23-09


Unacceptable. "And what about us-the patients? How does a nation that might close down a business for a single illness from a suspicious hamburger tolerate the carnage inflicted by our hospitals? And not just those 100,000 deaths. In April, a Wall Street Journal story suggested that blood clots following surgery or illness, the leading cause of preventable hospital deaths in the U.S., may kill nearly 200,000 patients per year. How did Americans learn to accept hundreds of thousands of deaths from minor medical mistakes as an inevitability?"
Excerpted: How American Health Care Killed My Father, The Atlantic by David Goldhill, September 2009


Dentophobia on steroids. "An American-Statesman review of disciplinary records found that despite years of critical audits and complaints of lax oversight, the dental board... is less likely to take disciplinary action, slower to act and far less likely to impose the most severe sanction, loss of a license, than the state medical board."

"The dental board...routinely suspends dentists' licenses, then probates those suspensions in full...Since January 2007, probated suspensions have been meted out to dentists who have a license revoked in another state or who plead guilty to crimes such as Medicaid fraud or assault."

"...the dental board requires members of the public to file an open records request to see a dentist's disciplinary record."
Excerpted from: Oversight of dentists lacks strength, by Mary Ann Roser, Austin American Statesman, July 20, 2009


Target practice. "[Dr. Gary D. Kao] whom regulators accuse of mishandling scores of radioactive seed implants at the Philadelphia veterans' hospital told a Congressional panel...he "could have done better" with some implants, his patients over all received effective treatment for their prostate cancer.'

"...investigators for the Nuclear Regulatory Commission and V.A. officials had identified Dr. Kao as the doctor who did all but a handful of the ...92 substandard seed implants out of 116 cases..."

"An N.R.C. consultant...concluded that "erratic seed placement caused a number of cases to have elevated doses to the rectum, bladder or perineum."...Dr. Kao confirmed that he had on occasion implanted seeds in the bladder.""Did you notify the patient?" Mr. Specter [Senator Arlen Specter] asked."

"No, sir," Dr. Kao replied."
Excerpted from: Oncologist Defends His Work at a V.A. Hospital By WALT BOGDANICH, New York Times 6-30-09


Medicine's Culture War. "I went to dinner with six McAllen doctors...Some were dubious when I told them that McAllen was the country's most expensive place for health care...costs have grown faster than any other market...ultimately soaring by more than ten thousand dollars per person."

"Maybe the service is better here," the cardiologist suggested...."

"Others were skeptical. "I don't think that explains the costs he's talking about," the general surgeon said."

"It's malpractice," a family physician said."

"McAllen is legal hell," the cardiologist agreed...That explanation puzzled me...Texas passed a tough malpractice Iaw...Didn't lawsuits go down?"

"Practically to zero," the cardiologist admitted."

"Come on," the general surgeon finally said. "We all know these arguments are bullshit. There is overutilization here, pure and simple." Doctors, he said, were racking up charges with extra tests, services, and procedures..."the way to practice medicine has changed completely. Before, it was about how to do a good job.

Now it is about `How much will you benefit?"
Excerpted from: The Cost Conundrum: What a Texas town can teach us about health care by Atul Gawande The New Yorker, June 1, 2009


Pick your adjective: PREVENTABLE or NEEDLESS or AVOIDABLE. "Despite a decade of promises, little has been done to fix the problem of preventable medical errors that kill nearly 98,000 people in the United States each year..."

"Consumers Union... said lawmakers largely have failed to enact patient safety reforms recommended by a 1999 report by the Institute of Medicine or IOM that found that medical errors cost the United States $17 billion to $29 billion a year."

"...the group now projects that preventable medical errors now account for more than 100,000 deaths each year..."
Excerpted from: U.S. group sees little progress on medical errors, Reuters 5-19-09


This Just In: Damage Caps Have NOT Brought Down Healthcare Costs for Consumers. Film at 11. "Their [a team at the University of Alabama] survey of studies related to malpractice insurance, defensive medicine and consumer health insurance premiums looked at 27 states with limits on non-economic damages..."

"Their conclusion - `Tort reforms have not led to health care cost savings for consumers'..." "Tort reform is not a panacea for health care costs," said Morrisey" [Michael Morrisey, professor of health economics/health insurance and director of Lister Hill Center for Health Policy]

"But it's important to keep in mind who gains and who loses...As Morrisey and his colleagues put it: "The results of this study suggest that there are no insurance premium savings that accrue to consumers. Are there other benefits to consumers? If these cannot be identified, it is difficult to see a justification for the loss of legal rights."
Excerpted from: Malpractice damage caps not a cure for high health care costs by Jim Landers (Business Columnist), Dallas Morning News, April 21, 2009


*"we are programmed to receive, you can check out any time you like, but you can never"...whine or criticize. "Across Texas over a recent three-year period, hospitals reported that 53 newborns with no obvious birth defects died unexpectedly. Medical blunders killed or crippled another 78 patients."

"Foreign objects... left in 218 patients. More than 120 times, surgeons cut into the wrong body part or wrong patient."

"Which hospitals bungled their jobs? The state knows, but, by law, you can't find out...the state no longer requires hospitals to own up to their mistakes, even anonymously. The Legislature let the law expire."

"Hospitals have been able to avoid making more than their errors public. Complaints, accreditation inspections, staffing numbers, infection rates - information that could help the public evaluate patient care - are also off limits."

"Public reporting sometimes "has a chilling effect," said Charles Bailey, general counsel for the Texas Hospital Association. So while hospitals are starting to open up, he said, "there's some reluctance because they're worried about getting sued or other implications."
Excerpted from: Texas hospitals wary of making complaints, errors public, by Darren Barbee, Ft Worth Star Telegram, 7-1-08, *Hotel California, The Eagles 1977


Lone Remaining Remedy: File a Complaint. "After the Texas Legislature gave the board additional funds for enforcement in 2005,...the board [Texas Medical Board] has stepped up its investigations. By the end of fiscal year 2007, the board was investigating 1,300 cases...opened about 2,600 more, compared to 694 investigations and 1,900 open cases in 2004, according to TM B's Web site."

"The number of complaints the board receives from patients and family members also has increased dramatically, said Mari Robinson, the agency's director of enforcement. In the last two years alone, complaints have increased by 62 percent... "Most of the complaints are about quality of care," she said."

"Robinson said several factors could be contributing to the increase... the number of doctors in Texas is on the rise,...because the Legislature has imposed caps on medical malpractice damages in Texas, more patients and family members are filing grievances with the board rather than filing lawsuits. And finally, more patients know about the complaint process than in the past, she said."
Excerpted from: Complaints against doctors increase By MELISSA McEVER, Valley Morning Star, June 11, 2008


Newsflash: Prop 12 Didn't Deliver, 'Ya think? In its' October 19th issue, The Texas Observer provides an accurate and thorough assessment of the the distribution of doctors in Texas since the passage of Proposition 12. Below are a few highlights:

•    "As of September 2007, the number of counties without obstetricians is unchanged - 152 counties still have none..."

•    "Nearly half of Texas counties...have no obstetrician, neurosurgeon or orthopedic surgeon."

•    "...21 Texas counties have no physician of any kind."

•    "The TMA counts 186 new obstetricians in Texas since Proposition 12 passed.... Collin County...gained the most obstetricians." (34)

•    "The pattern of doctors' opting to practice in more affluent, urban areas holds true for Texas' overall gains in neurosurgeons (36) and orthopedic surgeons (185) since 2003." Excerpted from: Baby, I Lied, The Texas Observer, October 19, 2007


A Few Bad Apples... Did you know that only 5.9 percent of doctors are responsible for 57.8 percent of medical malpractice payments? The largest majority of doctors - 82 percent - never make a malpractice payment.

Two-thirds of doctors who made 10 or more malpractice payments were not disciplined at all by their state medical boards. Only 8.61 of doctors who made two or more malpracticepayments were disciplined by their state board.
Source: Center for Justice & Democracy Spotlight on Justice


D'oh! It's Medical Errors, Stupid... "Medicare will no longer pay the extra costs of treating preventable errors, injuries and infections that occur in hospitals, a move they say could save lives and millions of dollars."

"If a patient goes into the hospital with pneumonia, we don't want them to leave with a broken arm," said Herb B. Kuhn, acting deputy administrator of the Centers for Medicare and Medicaid Services.The Centers for Disease Control and Prevention estimates that patients develop 1.7 million infections in hospitals each year, and it says those infections cause or contribute to the death of 99,000 people a year - about 270 a day."

"Dr. Kenneth W. Kizer, an expert on patient safety who was the top health official at the Department of Veterans Affairs from 1994 to 1999, said: "I applaud the intent of the new Medicare rules, but I worry that hospitals will figure out ways to get around them. The new policy should be part of a larger initiative to require the reporting of health care events that everyone agrees should never happen. Any such effort must include a mechanism to make sure hospitals comply."
Excerpted from: Medicare Says It Won't Cover Hospital Errors by Robert Pear, The New York Times, 8-19-2007