Very articulate 60-Minutes interview of actor Dennis Quaid regarding his first-hand experience with preventable medical errors. The video is a bit long, but it is a compelling piece.
Quaid’s twin infant children both received the wrong dose of Heparin, a blood thinner, while hospitalized at Cedar Sinai Hospital in Los Angeles. There were actually two separate overdose incidents for each baby. In each instance, hospital staff gave the drug in doses a thousand times stronger that what is appropriate for an infant.
The description is graphic. Every parent’s worst nightmare. Mr. Quaid explains what those of us who handle these cases have known for a long time. Preventable medical errors commonly kill patients.
The problem is worse because patients are at the mercy of providers. When you’re driving your car, you can drive defensively. But when your child is hospitalized, all you can do is hope and pray that everyone is being attentive.
David F. Sugerman
Interesting report on MSNBC today about doctors in rehab in California who are allowed to obtain confidential drug and alcohol treatment while continuing to provide patient care. Here’s the link: www.msnbc.msn.com/id/22314486/
Oregon has a similar program of confidential drug and alcohol treatment for physicians. Here is the url for the Board of Medical Examiners summary of the program: oregon.gov/BME/healthprog.shtml. The statutes codifying the Oregon program are ORS 677.615-677.677.
The MSNBC article notes that many drug and alcohol treatment professionals and the American Medical Association support these types of programs. According to the AMA, allowing an impaired physician to continue treating patients encourages impaired doctors to seek treatment. Of course, the article also notes that California is ending its program because a review revealed that the confidential program failed to protect patients. And it also failed to encourage doctors to receive treatment.
The California experience provides hard data that undermines the AMA’s position. My perspective is surely colored by representing patients, but even so, there is something horrifying about a patient not knowing about a doctor’s impairment.
If you have any doubt about this in the abstract, consider a fairly simple hypothetical question. Would you want a surgeon who is addicted to drugs performing surgery on your child? If the answer is, “Of course not,” then it’s easy to see the problem with letting impaired doctors continue treating patients.
The AMA should be advocating for quality of care, and the California experience makes clear that the current system delivers lower quality care. An impaired doctor can be dangerous to patients. If the impairment is kept confidential, the very least that should happen is that the doctor should take a leave so that patients have confidence in their physician. Alternatively–and it’s a radical alternative–remove the confidentiality so that patients can choose. I imagine the radical alternative would horrify the AMA and the Oregon Board of Medical Examiners. I could see that reaction. But if you’re not going to give patients the information they need to protect themselves, then you surely should take the impaired physician out of circulation.
David F. Sugerman
A recent news report reveals that at one prominent Rhode Island hospital, three different brain surgeries performed by three different surgeons involved surgery on the wrong side of the head. Same hospital. All in one year. Here’s the link: www.msnbc.msn.com/id/22263412/
The report details how surgeons and nurses failed to comply with safety procedures designed to ensure that surgery is done at the correct site. The regulating agency, Joint Commission on Accreditation of Hospitals gets 8 reports a month of wrong-site surgery, but the Commission notes that hospitals are not required to report these incidents. As a consequence, the rate of error from this type of medical mistake is believed to be 10 times higher than the reported rate.
If you think about it, surgery is a fairly intense way to treat a big medical problem. To cure, the surgeon is literally cutting into the human body and removing and restructuring the body. That’s a bit obvious, of course, but it’s an important concept when thinking about what it means to do surgery at the wrong site. It’s another form of unnecessary surgery, and that’s no small thing for the patient.
When we undergo surgery, patients literally surrender all control to the doctor and medical staff. We’re put under and have no way to gently say, “Excuse me, doctor, but it’s the other hip.”
The best outcome would be that the surgical team review and re-review the patient’s chart to make sure that surgery is being performed where it is needed. Failing that, the patient’s only recourse is the civil justice system. This is the only place where ordinary people have the ability to call wrongdoers to account. This is true even when the wrongdoer is rich and powerful.
So next time you hear a politician ranting about the “malpractice crisis” or “frivolous” lawsuits, it might be wise to remember that serious mistakes happen, and the system needs to remain open to address those errors.
David F. Sugerman
The Washington Post reports today that Maryland is demanding repayment of $84 million from a physician insurer because–here’s some news–the medical malpractice “crisis” wasn’t actually a crisis.
Back in 2004, then Gov. Ehrlic convened a special session to deal with what he termed the malpractice crisis. Maryland began to provide subsidies.
The insurer recently announced that it had a surplus and would pay some of the money back to the State and the rest to doctors in the form of a rebate for next year’s coverage. State regulators weren’t thrilled and instead demanded repayment of the $84 million which had been raised by a surcharge on HMO subscribers.
It’s nice to see a state government stand firm and demand return of public money. It might be interesting to take a look back at who was fanning the flames on the non-crisis.
David F. Sugerman
Ah yes, it’s campaign season again. And we have another politician calling for, “federal caps on non-economic and punitive damages related to malpractice” because, “lottery-sized awards and frivolous lawsuits may enrich the trial lawyers but they put a heavy burden on doctors, hospitals and, of course through defensive medicine, they put a burden on the entire health care system.”
This time it’s Mitt Romney. Link: www.salon.com/wires/ap/2007/11/20/D8T1MFNO2_romney_health_care/index.html
I don’t know where to start. First, with the irony. I thought Gov. Romney was a conservative, but here he wants regulation and a one-size-fits-all federal standard for all patients injured by physician neglect.
The bigger problem is that Gov. Romney either knows nothing about profound injury or–worse–he knows it well, but wants to treat patients’ rights as a political issue. There are bigger policy problems. To begin with, punitive damages in medical cases are so rare as to be almost non-existent. They are awarded in the rare case when a surgeon–who is drunk–commits a surgical error or when a doctor who is a pervert sexually abuses a patient. Most doctors and nurses are honorable and good people, and that is why the punitive damage problem is rare.
And then there’s the lottery argument. For a buck or two, you can play the lottery in most states. You’re likely to lose but if you win, you’ll be a multi-millionaire. To “play the lottery” in a medical malpractice case, you need a profound injury–often it’s as serious as death, or a life in a wheelchair. No matter what happens you will be that way for life because of a mistake made by an inattentive doctor. That’s a tragedy, not a lottery. Anyone who confuses the two does not understand the devastation caused by profound injuries.
And then there’s frivolous lawsuits. This is a phrase that really means, “We don’t trust juries.” For according to Gov Romney and others, juries can’t tell when a lawsuit has merit, and they will literally shower the fraudulent party with a torrent of cash. I’ve been trying cases for over 20 years. Maybe I’m just not a very good lawyer, but it’s pretty clear that juries have plenty of sense when it comes to ferreting out good claims and bad ones. Or maybe Gov. Romney and those who rant about the “crisis” have a different agenda.
In the end, it’s easy to trust the jury. Our ancestors set up the jury trial system to protect us against politicians and titans. Let’s not mess with it, as they knew what they were doing.
David F. Sugerman
Today, an Oregon anesthesiologist, Dr. David Burleson, pleaded not guilty to felony sex abuse charges. Dr. Burleson is charged with fondling two patients who had been sedated. The case represents the next step in a long process that included a legal showdown in front of the Oregon Supreme Court.
Apparently, employees of a clinic where Dr. Burleson provided care witnessed him fondling sedated patients. When subpoenaed to a grand jury, a witness refused to provide medical records identifying the victims.
The State appealed to the Oregon Supreme Court. Here is a link to the opinion: State of Oregon v. Burleson, http://www.publications.ojd.state.or.us/S54377.htm The short version is that the Supreme Court ruled that the witnesses must identify the victims.
It’s nice to see that the system is taking Dr. Burleson’s conduct seriously. In earlier times, sexual misconduct by professionals was swept under the rug. Patients suffered, and so did the profession. Bringing professional misconduct into the light of day provides important protection to future patients. Weeding out the bad doctors helps all of us.
David F. Sugerman