Medical Malpractice News and Views

Welcome to our blog where we discuss current issues in medicine and law. We welcome your comments.

Malpractice Can Happen At Even The Best Hospitals

July 15, 2019

Two of the best hospitals in the United States made headlines in the bad way recently when they were called out for deaths following what should have been routine blood transfusions.  The two hospitals were the University of Texas MD Anderson Cancer Center in Houston and its neighbor across the street, Baylor St. Luke’s Medical Center.

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In both cases, the events were what are termed “never events,” that is they should never happen in the absence of a medical error.  That was true in both cases here as well: human error on the part of nurses who were caring for the patients cost them their lives.  As is so often the case, it was not just a failure on the part of an individual nurse but the failure of the system to have the checks and balances in place to make sure these errors never occur.

At MD Anderson, the young leukemia patient was getting a transfusion.  Unbeknownst to her or to the medical personnel, the blood she was given had become contaminated with bacteria.  This is a rare occurrence, but it does happen.  When it does, the patient’s vital signs will begin to deteriorate.  If the nurses administering the transfusion are monitoring the patient’s vital signs, there should be ample time to stop the transfusion and administer antibiotics before any permanent harm is done.  The nurses at MD Anderson were only checking the patient’s vital signs shortly after the start of the infusion and after the infusion was complete.  This meant that hours went by when no one was monitoring the patient.  The nurses testified they had not been trained to continue to monitor the patient.

When they were interviewed after the death, some of the nurses blamed the patient.  They stated that patients were instructed to report if they developed problems and if the patient did not, it was the patient’s fault.  It is scary when nurses expect patients to do their job for them and blame the patient when she is injured by poor nursing care.  Patients are not the best persons to recognize a developing medical complication.  They do not have the same training as the nurses and their illnesses may impair their ability to be completely aware of what is going on.

At Baylor St. Luke’s a patient was given the wrong blood type.  How can this happen you might well ask?  The patient had been brought to the emergency department and needed a transfusion.  When the doctor ordered the transfusion, one of the nurses picked up a vial of blood from an earlier patient and put this patient’s identification sticker on the vial.  Not only did she put it on the wrong vial, she put it on top of the identification sticker of the earlier patient.  The lab analyzed the blood in the vial, matched it and send matching blood to the emergency department.  Unfortunately, while the blood that was sent up matched the blood in the vial, it did not match that of the patient, who died shortly after being given the wrong blood.

These two sad stories remind us that medical malpractice is not as uncommon as the medical profession would like you to think it is and that it can and does occur at even the best hospitals.  In both of these cases, the deaths prompted a review of procedures and changes to training and checklists to make it much less likely that these mistakes will be repeated.  If there is a good thing that resulted from these unnecessary deaths, the improvements in procedures would be that good thing.  It is too bad that patients have to die before hospitals recognize that perhaps their procedures are not adequate or that perhaps their nurses need more training.


Posted in Hospital Negligence, Hospitals, medical errors, Medical Malpractice, medical mistakes, Medical Negligence, never events, Nurses |

2018 Malpractice Payments

July 08, 2019

The National Practitioner Data Bank (“NPDB”) was established by Congress in 1986 to be a repository of information about malpractice payments and matters affecting the privileges and licensing of physicians and other health care professionals.  All malpractice payments made on behalf of a health care provider must be reported to the NPDB.  Hospitals, medical boards, insurers and certain others can query the NPDB about health care professionals who are applying for privileges, licenses or insurance.  The public may not review the information kept by the NPDB, except in the most general terms.

What is the NPDB?

LeverageRx is a digital lending and insurance broker for medical professionals.  Every year it analyzes the reports that have been made to the NPDB and produces a report of its own.  Here is a link to its report for payments made in 2018.  The data are quite interesting.

There are a few caveats, however, to the data.  The first is that, as noted, it is based upon reports to the NPDB.  Not all malpractice settlements or judgments are required to be reported to the NPDB.  For example, if a nurse at a hospital makes a mistake that causes an injury and the hospital settles the claim, that settlement need not be reported to the NPDB.  This creates a significant limitation on the ability of the NPDB reports to accurately capture all of the malpractice payments being made in a given year.  Especially in cases involving the most serious injuries, a hospital often plays a role and, given its larger financial ability and insurance, may be making the largest payment of all of the defendants.  It is impossible to determine how many more payments were made that were not reported but the total amount of those payments is likely to be a very large figure.

Another limitation to keep in mind is the effect of insurance limits.  Probably the most common amount of coverage for an individual physician is $1 million.  Certainly, this is the case in Arizona.  Occasionally, if the doctor is a member of a group, there may be a second million but very often $1 million is it.  Since it is almost unheard of for a doctor to make a payment out of his or her personal funds to settle a case, the malpractice policy limit is the maximum that an injured patient will recover, regardless of the magnitude of the injury or the clarity of the malpractice.

Lastly, some states have caps on malpractice recoveries while some do not.  The data does not distinguish between those states with caps and those without.  The caps most often take the form of limiting the amount of non-economic damages (read pain and suffering) a patient can recover.  There is substantial controversy over the fairness of caps (since it is the most seriously injured patients who have their recoveries capped) and the effect of the caps in keeping down costs and payments.

Without further ado, here is the information on reported payments in 2018 with some comparisons going back to 2004.

The total number of payments has been declining since 2004.  There were over 16,000 payments in 2004 and only 11,584 last year.  After gradually declining for a number of years, the total dollars paid out has been gradually rising since 2012.  Last year it was just a little over $4 billion.  In 2004, it had been about $4.6 billion.  The gradual rise in payments is at least in part due to inflation in general and in the cost of medical care in particular.

Total payments in Arizona were on a par with its population.  Last year there were 225 payments totaling almost $84 million.  The average payment in Arizona was $372,397.  This was only slightly over the national average payment of $348,065.

Across the nation, 96.5% of all payments were made by way of settlement.  Only 3.5% were the result of a case that went to trial and resulted in a verdict in favor of the patient.  The data does not tell us how many cases went to trial or how many of those that did resulted in a verdict for the doctor but national statistics are that doctors win about 75% of the cases that go to trial.

The data confirm my experience that the most seriously injured patients are the ones getting paid.  29.7% of the cases arose out of a patient death.  Of those which involved living patients, just over 81% involved a permanent injury.  Of those permanent injuries, only a few were minor in nature.  Most of the permanent injuries which resulted in payments were brain injuries, quadriplegia or other injuries requiring life-long care, or other major or significant permanent injuries.  Not surprisingly, the injuries requiring life-long care were the ones with the highest average payment: $961,185.  The average payment for a death was $386,317.  The smallest payments went to the patients with injuries which were not permanent.

The data show what any experienced medical malpractice attorney will tell you:  These are difficult, expensive cases in which only the most seriously injured are likely to receive significant payments.  Even then, the payments are far less than what one would expect for the serious nature of the injuries involved.  The low numbers reflect the strong bargaining power of doctors in these cases who know they are likely to win if the patient does not take what is offered in settlement.



Posted in Doctors, Health Care Costs, Hospitals, Lawsuits, Malpractice caps, medical errors, Medical Malpractice, Medical Malpractice Case Value, medical malpractice cases, medical malpractice claims, medical malpractice damages caps, medical malpractice lawsuits, medical malpractice lawyers, medical mistakes, Medical Negligence, plaintiff, tort reform, Valuing Damages in Medical Malpractice Cases, Verdicts |

Passing the Malpractice Buck in Florida

July 01, 2019

By 2004, Florida voters had had enough.  They passed a constitutional amendment to stop bad doctors from continuing to malpractice.  The idea was a simple one:  If there there three instances of malpractice, a doctor would not be allowed to practice medicine in Florida any longer.  Three strikes and they were out.  Turns out it was not so simple after all but no one will accept responsibility for the failure of the amendment to do what voters wanted.

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The constitutional amendment was put into the law books in the part of the Florida statutes dealing with the practice of medicine.  It required either a verdict or judgment or final ruling in an administrative proceeding that a doctor had committed medical malpractice.  It further required that the malpractice be proved by clear and convincing evidence.  The clear and convincing requirement was not in the amendment passed by the voters.  It was a gift to the doctors from the Florida legislature when it passed the amendment into law.  It made it much more difficult to use a finding of malpractice to get rid of a bad doctor.  Multiple studies and investigations have shown that little has changed since 2004 and that bad doctors continue to practice without fear of discipline in Florida.

One of the problems to rooting out bad doctors is that the law requires there be a final verdict, judgment or administrative decision.  The bad doctors of Florida get around this by settling the claims against them.  When a case is settled, it never goes to trial and there can be no verdict or judgment or final administrative decision.  No verdict, no judgment, no administrative decision, no strike against the doctor.

The Florida legislature has done other things to frustrate the will of the people.  It has passed a number of laws making it more difficult for patients to bring malpractice suits in the first place.  If there is no suit, there can be no verdict or judgment.

When there is a verdict or judgment or administrative decision, they are rarely based on a finding of clear and convincing evidence.  Most malpractice claims go to a jury or to the judicial fact finder on a preponderance of the evidence test.  If the evidence shows that the doctor more likely than not committed malpractice, the verdict is returned in favor of the plaintiff.  It is the province of the Florida Medical Board to determine if the malpractice verdict or judgment or administrative decision was supported by clear and convincing evidence.

To no one’s surprise, the Florida Medical Board has rarely found clear and convincing evidence that a doctor committed medical malpractice.  Many studies since the passage of the constitutional amendment have found few doctors affected by its terms.  Here is a study by the Board of Governors of the State University System finding little to no impact six years after passage of the amendment.

A recent investigation by Florida news organizations found that hundreds of Florida doctors had made multiple malpractice payouts and were still practicing.  They found at least 120 doctors with three or more malpractice suits in the last 10 years but only two had had their licenses revoked under the “three strikes” statute.  Astonishingly, they found one back surgeon who had paid out sixteen malpractice claims since 2000, six of which involved the death of the patient, and yet this man was still practicing.  Not only is he still practicing, the Florida Board of Medicine lists his license as “clear/active.”

The following quotation from the Chairman of the Florida Board of Medicine shows why it is failing the citizens of Florida so spectacularly,  “The concerns that the public has are perhaps more related to the policing of medicine and that is not the Board of Medicine’s responsibility.”   If the Board of Medicine does not believe it is responsible for policing the quality of medicine practiced by the doctors it supervises and licenses, it is no wonder doctors can malpractice with impunity in Florida.

Posted in Doctors, Lawsuits, medical errors, Medical Malpractice, medical malpractice cases, medical malpractice lawsuits, medical mistakes, Medical Negligence, Secrecy, Surgical Errors, Verdicts |

Generic Drug Betrayal

June 24, 2019

The promise of generic drugs is enticing:  quality replacements for name-brand drugs at a fraction of the price.  Regardless of whether that promise was ever anything more than an illusion, it is a proven lie today.

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I read two recent articles which deal with two separate ways in which generic drug manufacturers have betrayed patients.  In both cases, the betrayal is rooted in money.  The first betrayal is discussed in a book about generics and the ways in which it has betrayed its promise by cheating on quality.  Lightly regulated plants in India and China are paying off regulators, using substandard ingredients and cutting manufacturing corners to increase profits.

Most of the bad and dangerous drugs that are produced by these manufacturers end up in places like Africa and Asia but, beginning in the 1980’s, the United States began importing foreign generic drugs.  While the F.D.A. has done a masterful job of overseeing American drug production and made sure that quality control is high, the same is not true of its efforts to assure the safety of these Asian generics.  When the F.D.A. inspectors to get to these plants, and apparently their visits are few and far between, they announce themselves in advance, which gives the manufacturers plenty of time to cover their tracks.  This is not the case in the United States where no notice inspections are the rule rather than the exception.

Some of these dangerous drugs have made it to the United States.  In 2007 a number of dialysis patients died from allergic reactions to a contaminant in a generic blood thinner manufactured in China.  The F.D.A. had never inspected the Chinese plant and someone there had diluted the product to make it go further.

So one betrayal by the generic industry has been its production of poor quality, dangerous copies of name-brand drugs.  The other betrayal has been the generic industry’s price fixing.  Instead of providing low cost alternatives to name-brand drugs, the big boys in the generic industry have been engaging in schemes intended to drive up prices.   For example, the generic antibiotic, doxycyclene, cost about $20 for a prescription in 2013.  A year later, the price had risen over 8,000% to $1,829.  Similar, but not quite so outrageous, increases were seen in other generics.  Manufacturers would sometimes agree to raise prices in lock step.  Other times they would agree to assign certain drugs exclusively to certain manufacturers.

Now 43 states are part of a massive price fixing suit against 20 manufacturers alleging billions of dollars of harm to American consumers.  The likelihood of success seems high as the states have e-mails, text messages and testimony from insiders supporting the claim that the manufacturers were conspiring to raise prices.

There is another betrayal here as well.  It is the betrayal of the American citizen by the federal government.  The F.D.A. did not protect us from bad drugs made overseas.  The Congress did not protect us from generic price fixing at home.  It is a sad day when we must rely upon the attorneys general of the states to get together to address a national problem.  That is supposed to be the job of the federal government.  I am just happy that someone is doing the job.

Posted in drug companies, Fraud, health, Health Care Costs, Lawsuits, Medical Costs, medical ethics, Secrecy |

Misdiagnosis – A Leading Cause of Malpractice.

June 17, 2019

Some recent reports show that misdiagnosis is a leading cause of medical malpractice.  This is not news to me or to anyone who represents patients and families injured by malpractice.  Diagnosis is hard.  Diseases and illnesses don’t always present with the same signs and symptoms every time.  A good diagnosis takes work and patience.

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One medical malpractice insurance company reviewed 1,800 closed claim files involving the doctors it insured to see what was the cause of the claims against the doctors.  It found that 46% of the claims involved misdiagnosis.  In 45% of those cases, the patient died.  Another insurer reported on claims involving the treatment of children and reported that 38% of the claims against its doctors arose out of misdiagnosis.  Still another study concluded that the third leading cause of death in hospitalized patients resulted from misdiagnosis.

It is easy to understand how these figures come to be.  Diagnosis is one of the most difficult tasks a health care provider faces.  It usually involves a series of steps be taken to get to the correct result.  If any one of the steps is done incorrectly, the result may be a mistake in diagnosis.  To top it all off, sometimes the steps must be taken quickly and in emergency circumstances.

The first thing that must be done is to get some basic information.  This is called the “history” and it is an area with great potential for a mistake.  The provider usually asks the patient what is the problem.  Depending on the patient’s answer, the provider may go on to ask directed questions to elicit more information.

There may be a language barrier interfering with this question and answer process and, even if there isn’t, misunderstandings in communication are a common, everyday problem.  The patient may not understand what are the most important symptoms to tell the provider.  The provider may get misled by what the patient thinks is her primary complaint.  The patient may not remember to tell the provider about an earlier doctor visit or test result or diagnosis.  The provider may be in a hurry and not spend the time she should talking with the patient.  The provider may be impatient and this may cause the patient to hold back for fear of angering the provider.  The provider may not ask the appropriate follow-up questions.  In short, lots can go wrong at this stage.

Even if the history taken by the provider is complete and both provider and patient did a good job, there is still lots of opportunity for a misdiagnosis.  One of the sayings often repeated by medical malpractice defense lawyers at trial is, “When you hear hoofbeats, you think horses, not zebras.”  They say this when they are defending a doctor accused of failing to diagnose an illness or problem which is unusual.   They say this because providers will sometimes jump to conclusions about what the problem is without going through all the appropriate steps.  They get something in their heads and they fail to consider other possibilities.  Doctors are supposed to create what is called a “differential diagnosis,” which is a mental list containing all of the possible explanations for the patient’s condition.  They should then “rule out” the more serious of these possibilities until they get down to a shorter list of explanations and then order testing to reduce the list further.

Diagnosis is not an easy thing.  You can do your part by being sure to tell the provider about all of your health issues, your medications, your past doctor visits, hospitalizations and diagnoses.

My best advice to you is not to catch anything too rare.  If you do, the chances the doctor will think horses instead of zebras goes way up.

Posted in Doctors, Hospitals, Lawsuits, medical errors, Medical Malpractice, medical malpractice claims, medical mistakes, Medical Negligence, Misdiagnosis |

Warning: Your Surgeon May Be “All Thumbs”

June 10, 2019

It is human nature to criticize the younger generation.  What’s the matter with them?  They don’t do things the way we did when we were young, etc.  In the world of surgery, there may be valid reasons to be concerned about young people who are entering surgery residency programs.  According to a recent story in the New York Times, those who run these surgery residency programs are concerned that their new residents do not have the manual dexterity necessary in a good surgeon.  The most likely reason is that young people no longer sew, knit, build models, woodwork, play musical instruments or do the other things that children used to do and that build manual dexterity.  Nowadays, instead of developing dexterity of their fingers, young people use their thumbs to play video games or to text their friends.

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The successful surgeons interviewed for the article point out that by the time doctors complete medical school and enter a surgical residency program, it is too late to develop the same level of dexterity as someone who has been doing “hand things” all their lives.  They note that the earlier a person starts developing manual dexterity, the easier it is to develop and the better it becomes over time.  Late starters will rarely be as good as those who start early.  A suggestion has been made to consider manual dexterity among the factors considered in selecting surgical residents.

Another “problem” pointed out by those who run these programs is that there are now limits to the number of hours a resident can work.  For a long time there were no limits and some surgical residents would work as much as 120 hours in a week.  They would literally live at the hospital and operate at all hours, catching a nap here or there when they could.  This was not good for either the health of the resident or that of the patients upon whom she was operating at the end of a 120 hour week so limits were put in place to protect the residents and the public.

Paradoxically, these limits may be affecting the quality of those graduating from surgical residencies today.  One residency program director quoted in the Times’ article stated that today’s residents may complete the program with 900 operations under their belts.  He, on the other hand, had double that number by the time he completed his surgical residency.  The number of operations is important as “practice makes perfect.”  The more surgeries a resident has performed, the more she or he has seen and the more she or he has learned.

As usual, there are lessons for us to learn.  Always check the background and experience of your surgeon.  Always ask how many of your surgery he or she performs a year.  The more the better.  Always ask about your surgeon’s rates of complications.  Always check the medical board web site for information about your surgeon.  If your surgeon is not happy to be questioned by you about these issues, find yourself another surgeon.

Posted in Arizona Medical Board, Doctors, medical errors, science news, Surgical Errors |

Secrecy and More Secrecy

June 05, 2019

I swear it is not just me.  While I have been concerned about the effects of secrecy in health care and malpractice litigation for some time, the news lately is just full of stories about patients being kept in the dark.

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For example, in addition to Monday’s post about secrecy in pediatric heart surgery, I wrote recently about the problem of bad doctors, the ones who get sued over and over.  A study had found that most of them just kept practicing.  One of the main reasons they are allowed to continue to malpractice upon new patients is that their malpractice settlements are always confidential.  The injured patient, who just wants his or her money, is forced to agree not to reveal that they were paid by the doctor or his insurance company.  Everything is kept hush hush and the doctor goes on as before.  Other doctors know who these people are.  Hospitals know who these people are.  The medical board knows who these people are.  Malpractice lawyers know who these people are.  The only people who don’t know are the patients.  It is my strong belief that this is information patients looking for a doctor ought to have.  I don’t want to go to one of these doctors but there is little way for me to know who they are if I am not part of the system.

A physician who writes on medical issues read the same study I did and reached the conclusion that the fact these bad doctors kept on practicing showed the failure of the malpractice tort system.  This is a serious misunderstanding on the part of this physician.  The most the malpractice tort system can do is try to compensate the poor patient who has been injured.  There is no ability of the tort system to take a doctor’s license away.  That is the responsibility of the state medical board.  I respectfully submit that it is not the malpractice tort system that has failed when these doctors just keep on malpracticing, it is the state medical board which has failed in its duty to protect the public.  The medical board is informed of the fact of the settlement or judgment against the doctor and has the right and duty to investigate the facts underlying the malpractice claim.  When it lets the doctor go on practicing, it has failed to protect the public.

Another investigation of medical secrecy found that hospitals with outbreaks of dangerous infections almost always kept that information to themselves.  The story was captioned, “Culture of Secrecy Shields Hospitals With Outbreaks of Drug-Resistant Infections.”  If you hear about an outbreak of infections at a local hospital, you can be pretty sure the hospital did not voluntarily disclose the fact.  Either a whistleblower went to the press or to the local public health authority and the hospital got outed.

Hospitals have lots of reasons why they keep this information from the public.  They all sound nice and reasonable.  “We have to protect the privacy of our patients.”  “HIPAA requires us to keep this kind of information private.”  “If patients knew we were having these problems, they might avoid coming and getting needed medical care.”  “The risk that a patient will get an infection is low.”  “Disclosing this information might do more harm than good.”  All of this is BS.  Hospitals are concerned about one thing above all others: keeping the dollars flowing.  Telling prospective patients that you are having dangerous infections at your hospital is a good way to reduce that dollar flow.

You can pretty much forget about politicians forcing hospitals or medical boards or doctors to be more transparent.  Money talks and hospitals and doctors are savvy political players who spend a lot of money on lobbying.  They get the attention of the politicians in ways the public is rarely able to do.

My recommendation is to do the best investigation you can using the resources that are available to you.  Look at Medicare information about hospital performance.  Look at medical board information about your doctor.  If you have the desire, look at court dockets to see if your doctor has been sued.  Ask questions.  Be an informed consumer so you reduce the likelihood we will meet in my office to discuss your malpractice case.

Posted in antibiotic resistant bacteria, Arizona Medical Board, Defensive Medicine, disclosure of medical mistakes, Doctors, Hospital Negligence, Hospitals, Infection, Lawsuits, medical errors, medical ethics, Medical Malpractice, medical malpractice claims, medical mistakes, Medical Negligence, Medicare, Secrecy |

Secrecy Plus The Desire For Profits Equals Patient Deaths

June 03, 2019

Over the years I have discussed a number of topics which relate to patient safety.  These include secrecy, money, training, medical ethics, and surgical experience.  Every once in a while a story comes along which touches on all of these topics.  Last week such a story appeared in the New York Times.  I hope you can use this link to read the story.  Although it deals with pediatric heart surgery in North Carolina, it has application everywhere, including here in Arizona.

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In 2016, pediatric cardiologists at the University of North Carolina Children’s Hospital began to have grave concerns about the quality of the surgeries being performed at their hospital.  (Although cardiologists are heart doctors, they do not perform surgeries.  That is the role of pediatric heart surgeons.)  Children undergoing heart surgery at the their hospital were dying at an unacceptably high rate.  They complained about it and wondered if their medical ethics permitted them to continue to recommend their pediatric patients have surgery at the hospital, as opposed to sending them somewhere else where survival rates were higher.

Secrecy:  While the pediatric cardiologists had concerns and tried to do something about them, there is no indication in the Times story that the parents of their tiny patients were told of these concerns or of the higher than normal death and complication rates at the hospital.  To the contrary, the hospital refused to disclose to the public its mortality and complication rates, even though many of the best hospitals in the country do disclose this information.  Without the mortality and complication information, parents had no way of knowing that they were placing their children at risk by allowing their surgeries to be performed at this hospital.

Hiding information about surgical outcomes for Medicare patients does not happen as hospitals are required to provide it to Medicare, which publishes it.  This is not the case for non-Medicare patients and many hospitals, especially those with substandard outcomes, keep that information a closely guarded secret.  After all, who would want to come to one of these hospitals, if they knew there was a safer alternative nearby?  Who would want to come even if the safer alternative was in another city?  How far would you take your child to increase the chance he or she would have a successful surgery?

According to the Times’ article, two hospitals in Arizona do not report data on their pediatric heart surgeries.  They are both Banner Health hospitals.  The two are Banner University Medical Center Tucson and Banner Cardon Children’s Medical Center in Mesa.  Since the data is regularly reported by most successful hospitals throughout the United States, you have to ask yourself two questions:  Why won’t these two hospitals disclose their data and do I want to take my child for heart surgery to a hospital that won’t tell me how their patients do?  Given the propensity of hospitals to brag about whatever they do that is good, you have to be concerned about this refusal to provide the data.

Experience:  The Times’ story pointed out that the more pediatric heart surgeries a hospital did, the more successful its outcomes.  This is true across the board when it comes to surgery and is not limited to pediatric heart surgery.  Practice does indeed make perfect and the more operations a surgeon performs, the better she and her operating room team do.  The more surgeries done at a hospital, the better the post-surgical care is likely to be as well.

Money:  At the University of North Carolina Children’s Hospital, they were doing far fewer pediatric heart surgeries than the most successful hospitals in other states.  Why didn’t they let another hospital in the state take over these cases?  The answer is that surgeries and post-surgical care are big money makers for a hospital.  Having a pediatric heart surgery program is also a reputation builder for hospitals.  It is very difficult for hospitals to refuse these opportunities to make money, even when patient welfare suggests they should send these patients elsewhere.

After reading the Times’ story, it is hard to escape the conclusion that when the administrators at the North Carolina Children’s Hospital were faced with troubling problems in their pediatric surgery program that would take years to fix, they sacrificed patient safety to keep the money and prestige of the program.  They say their program is better now but still refuse to release all the data backing up their claim.  Even if the program is better now, that is cold comfort to the parents whose children died while undergoing heart surgery during the troubled period at the hospital.

After reading this story, I am left with feelings of helplessness and anger.  Money and secrecy took precedence over patient safety and there is little the government, the hospitals, or the medical community are willing to do to put an end to it.  There is little patients can do when hospitals hide their data.  I guess the best advice is to go only to hospitals that are transparent about their surgical successes and failures and choose those which are most successful.  Good luck.

Post Script:

June 17, 2019

After word leaked out about the problems it was having with its pediatric heart surgery program, the North Carolina Children’s Hospital has announced that it will suspend heart surgeries for the most complex cases in an effort to restore the confidence of the public in its program.





Posted in Doctors, Hospital Negligence, Hospitals, Medical Malpractice, medical mistakes, Medical Negligence, Medicare, Secrecy, Surgical Errors |

When Will Congress Protect The American People?

May 27, 2019

If you needed any further proof of the corrosive effect of unlimited corporate money in politics, look no further than the scandalous profits being made by the big drug companies.  Drug companies are rolling in profits.  They make these profits the old fashioned way.  They make them the same way the robber barons and monopolists of the Nineteenth Century made their great profits:  They gouge the public.  Meanwhile, Senators and Congresspeople wring their hands and hold hearings at which they “grill” drug company executives and tell us how tough they intend to be on them.  And then?  And then? And then, nothing happens.  Nothing happens because campaign contributions are the life’s blood of every politician who wants to be re-elected, and they all do.  Pharmacy giants don’t contribute to the campaign coffers of politicians who won’t support them in keeping profits up.

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We pay more for the same drugs than any other country on the planet.  If this were the result of great innovation by which drug companies were bringing new and wonderful cures to us, the high prices would be worth it.  That is definitely not what is happening.  Instead, drug companies are buying the rights to old drugs that are still patent protected and jacking up the price.  Or drug companies are taking one of their drugs that is coming off patent protection, making some minor changes and getting a new patent on what is essentially the same drug.  Or the drug companies pay generic drug manufacturers to hold off on introducing a generic alternative to their big moneymakers.  Or the drug companies sue the generic manufacturers and claim some sort of patent violation to slow things down.  The list of dodges the drug companies use to gouge us goes on and on.

Congress has the power to get drug prices down but it won’t use it.  First and foremost, it can permit Medicare to negotiate prices with the drug companies.  Undoubtedly at the suggestion of the drug companies, Congress has specifically prohibited Medicare from doing that.

Congress could allow importation of drugs from other countries where the governments keep the prices down.  The imports could and should be overseen by the Food and Drug Administration to assure the quality and safety of the imports.

Congress could change the patent laws to keep the drug companies from applying for and receiving multiple patents on their drugs.  Congress could tighten up the patent laws and assure that patents are given, as intended, only for true innovation.  For essential drugs, Congress could eliminate patent protection completely so that generics could compete with the drug companies and let the market set a fair price for the drugs.

Congress could stop the drug companies from paying off generic manufacturers to keep them out of the market.

Congress could stop the drug companies from using the courts to intimidate and delay their competitors.

Congress could just say “No” to drugs and the drug companies.

Americans are dying because they can’t afford the medicines they need.  The American taxpayer is footing the bill for treatment of patients who become critically ill because they could not afford their medications.  Meanwhile the drug companies don’t know what to do with all the money they are making in this country.

It is time for Congress to stop the madness and get drug prices down now!

Posted in drug companies, General Health, Health Care Costs, Medical Costs, Medicare, Type 1 Diabetes |

Medical Malpractice Victims in Canada Face Many of the Same Problems You Do.

May 20, 2019

As any observer of medical malpractice in the United States knows, there is a lot of malpractice out there but few of the victims make a claim and fewer still make a financial recovery.  Turns out things aren’t much better north of the border.

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The Canadian Broadcasting Company, known as the CBC, is the national broadcaster for Canada.  The CBC recently did an investigation into malpractice claims that revealed many trends similar to those seen in the United States.  The researchers discovered that, even though the number of doctors and patients has been growing, there are fewer claims being made by patients than in the past.  And when patients do make a claim, they are less likely than in the past to be successful in making a recovery.

In the 1970’s, the CBC reports that in cases that went to trial, patients were successful roughly one-third of the time.  In the last five years, however, that success rate has dropped to one in five.  This is roughly similar to success rates for patients in the United States.

Overall, of cases filed in the last five years, just over 55% were either dropped, dismissed or abandoned.  At least some of this may be due to the aggressive defense by the taxpayer subsidized Canadian Protective Medical Association, which insures most doctors in Canada.  Of the filed cases, 36.7% were settled.  This number is also similar to practice in the United States.  The remaining 8% of the filed cases went to trial.  Overall, only 1.6% of the patients who filed suit in the last five years, were successful at trial in obtaining a verdict against the doctor.

According to the CBC investigation, many of the same factors which work against patients in the United States, are also at work in Canada discouraging patients from making claims.  One of the most important factors is cost.  As in the United States, these cases are vigorously defended by the insurance company, which hires excellent, aggressive attorneys to represent the physicians.

As here, patients need to present expert witness testimony to prove their cases and this is a substantial expense with many experts charging over $500 per hour.

According to a lawyer who used to represent Canadian doctors but now represents injured patients, most lawyers won’t consider a case that has a value less than $250,000.00.  That again is very similar to practice in the United States.  The vast resources of the Canadian Medical Protective Association allow it to mount an aggressive and well-financed defense which few patients can afford to match.

Canadian victims of medical malpractice, we feel your pain and know just what you are going through.

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