December 15th, 2006

Are Electronic Health Records Coming Soon?

Often, medical malpractice occurs for the simplest of reasons: One health care practitioner did not effectively communicate a problem to another. And often, this is simply because of sloppy record keeping or illegible handwriting.

So it is worthy to note from this AP story last week, that the era of electronic medical records may well be here:

WASHINGTON – Five of the nation’s largest employers plan to soon give their workers an unusual health-care benefit: their very own electronic medical records that they can take when they travel, change jobs, or see a new doctor.

About 2.5 million workers and their dependents would have access to their health records through their computers. The records would be compiled by an independent, nonprofit organization. The information would be stored in a database that only the employee would supposedly be able to access.

The companies providing the electronic health records are Applied Materials Inc., BP America Inc., Intel Corp., Pitney Bowes Inc., and Wal-Mart Stores Inc.

The companies hope that cutting out the paperwork in health care will reduce administrative costs, duplicative care and medical errors.

Of course, this will raise another problem, that of privacy if too many folks can snoop through the records. But if that issue can be addressed, we may solve one of the many problems that bedevil our healthcare system.

Links to this post:

are electronic health records coming soon?
cross-posted from ny personal injury attorney blog. often, medical malpractice occurs for the simplest of reasons: one health care practitioner did not effectively communicate a problem to another. and often, this is simply because of

posted by Eric Turkewitz @ December 20, 2006 12:32 PM

 

December 11th, 2006

The Myth of Frivolous Litigation

Some accept as gospel that frivolous lawsuits are a big part of medical malpractice litigation: Baseless claims brought by uninjured people, or whose injuries were not caused by negligence. Not so, according to “Claims, Errors, and Compensation Payments in Medical Malpractice Litigation,” a study by the Harvard School of Public Health and the Harvard Risk Management Foundation that was published earlier this year in the New England Journal of Medicine.

The results, in fact, are the opposite of what the tort “deformers” claim, based on results from 1,452 randomly selected, closed medical malpractice files. The reviewers found that 97 percent had indeed suffered harm. In about one-third of these patients, the damage wasn’t clearly attributable to negligent medical treatment, a wrong prescription, or a misdiagnosis. Most of those claims were correctly denied compensation, the team reports.

According to the study, 73 percent of plaintiffs whose claims had merit received compensation.

The study also found that just six people had received compensation that were uninjured and 145 had injuries that had not been convincingly linked to medical error. On the other hand, 236 plaintiffs who did suffer an injury from medical error received no compensation. The authors wrote:

One in six claims involved errors and received no payment. The plaintiffs behind such unrequited claims must shoulder the substantial economic and noneconomic burdens that flow from preventable injury. Moreover, failure to pay claims involving error adds to a larger phenomenon of underpayment generated by the vast number of negligent injuries that never surface as claims.

Eighty percent of the claims involved injuries deemed to have caused significant or major disability or death. In only 3% of the claims, no adverse outcomes from medical care were evident.

Since the majority of payments from insurance companies went to people who had been harmed by medical errors and not to people with baseless claims, the authors said that the “moves to combat frivolous litigation will have a limited effect on total costs.”

Taking direct aim at politicians and business lobbyists, the authors wrote that:

“The profile of non-error claims we observed does not square with the notion of opportunistic trial lawyers pursuing questionable lawsuits in circumstances in which their chances of winning are reasonable and prospective returns in the event of a win are high. Rather, our findings underscore how difficult it may be for plaintiffs and their attorneys to discern what has happened before the initiation of a claim and the acquisition of knowledge that comes from the investigations, consultation with experts, and sharing of information that litigation triggers. Previous research has described tort litigation as a process in which information is cumulatively acquired.”

It is not the first time that a Harvard study has debunked the popular myths spread by insurance companies or politicians with respect to medical malpractice. It had happened back in 1991 by the Harvard Medical Practice Study that found that only eight percent of those injured by medical negligence brought lawsuits. But that is a post for another day.

[Addendum, 1/29/07 — This blog was cross-posted to TortDeform on January 25, 2007, resulting in much spirited commentary]

Links to this post:

why new york medical malpractice insurance jumped 14%
you may have seen the screaming new york headlines: doctors hit with 14% increase in medical malpractice rates! doctors in high risk specialties paying 6-figure insurance premiums! insurance reserves so low carriers may become insolvent

posted by Eric Turkewitz @ July 31, 2007 9:05 AM

why new york medical malpractice insurance jumped 14%
you may have seen the screaming new york headlines: doctors hit with 14% increase in medical malpractice rates! doctors in high risk specialties paying 6-figure insurance premiums! insurance reserves so low carriers may become insolvent

posted by Eric Turkewitz @ July 31, 2007 8:52 AM

health court legislation again introduced to congress
cross-posted from new york personal injury law blog. legislation that would provide federal funding for experimental “health courts” for medical malpractice cases has once again been introduced in both houses of congress.

posted by Eric Turkewitz @ May 30, 2007 9:55 AM

the myth of frivolous litigation
cross-posted from ny personal injury law blog. some accept as gospel that frivolous lawsuits are a big part of medical malpractice litigation: baseless claims brought by uninjured people, or whose injuries were not caused by negligence.

posted by Eric Turkewitz @ January 25, 2007 2:26 PM

 

December 7th, 2006

Judge Rejects Secrecy in Med-Mal Settlement Involving Public Funds

The following comes from the December 2006 issue of Trial Magazine, put out by the Association of Trial Lawyers of America. I would provide a link, but it is members only so this synopsis will have to do:

Following the lead of at least one other judge in his state, a Pennsylvania trial court judge recently refused to seal a settlement in a medical malpractice case, citing the public’s right to know that money from a state fund would be used to pay the widow of the patient who died. (Bryk v. Wilcox, No. 9254 (Pa., Luzerne Co. Com. Pleas settled Aug. 30, 2006).) Amanda Bryk considered filing a claim after her husband, Walter, died shortly after undergoing aortic valve replacement. The surgeon allegedly failed to properly tie off sutures in Walter’s heart, causing a fatal rupture. Before she filed suit, the case was settled, with part of the settlement to be paid from the state’s Medical Care Availability and Reduction of Error Fund (Mcare Fund). The fund provides excess medical malpractice coverage through the state’s insurance department and is financed by fees assessed on health care providers, moving-violation surcharges, and cigarette tax monies.

In an interview, the judge explained that, since this was public money, the public had a right to know how it was being spent. In addition, he indicated that doctors had complained that the system wasn’t open enough to know what was going on. So, the judge reasoned, if they want to have public disclosure, then it should not be limited to only what the doctors want disclosed, but should instead be full public disclosure.

 

December 7th, 2006

Tort "Reform", Trent Lott, and Changing Fortunes

I learned at Tortdeform.com that Senator Trent Lott, a long time proponent of reducing the rights of consumers, may be having a change of heart.

The reason? Seems his home got wiped out by Katrina and State Farm won’t pay him what he thinks he is owed after they took his premiums. The shoe, it appears, is suddenly on the other foot for Senator Lott, as he now must do battle with his insurance company. He was victimized once by the storm, and doesn’t want to see it happen again.

He therefore hired high-profile plaintiff’s attorney Richard Scruggs.

The turnabout in personal fortune reminds me of Frank Cornelius, who wrote an op-ed piece for the New York Times back in 1994. Mr. Cornelius tells his story in this excerpt better than I could:

Crushed By My Own Reform By Frank Cornelius
In 1975, I helped persuade the Indiana Legislature to pass what was acclaimed as a pioneering reform of the medical malpractice laws: a $500,000 cap on damage awards, and elimination of all damages for pain and suffering. I argued successfully that such limits would reduce health care costs and encourage physicians to stay in Indiana — the same sort of arguments that now underpin the medical industry’s call for national malpractice reform.

Today, from my wheelchair, I rue that that accomplishment. Here is my story.

On February 22, 1989, I underwent routine arthroscopic surgery after injuring my left knee in a fall. The day I left the hospital, I experienced a great deal of pain and called the surgeon several times. He called back the next day and told my wife to get me a bedpan. He then left on a skiing trip. I sought out another surgeon, who immediately diagnosed my condition as a reflex sympathetic dystrophy — a degenerative nervous disorder brought on by trauma or infection, often during surgery. * * *

At the age of 49, I am told that I have less than two years to live.

My medical expenses and lost wages, projected to retirement if I should live that long, come to more than $5 million. Claims against the hospital and physical therapist have been settled for a total of $500,000 — the limit on damages for a single incident of malpractice. The Legislature has raised that cap to $750,000, and I may be able to collect some extra damages if I can sue those responsible for the August 1990 incident that nearly killed me. But apparently because of bureaucratic inertia, the state medical panel that certifies such claims has yet to act on mine.

The kicker, of course, is that I fought to enact the very law that limits my compensation. All my suffering might have been worthwhile, on some cosmic scale, if the law had accomplished its stated purpose. But it hasn’t.

Indiana’s health care costs increased 139.4 percent from 1980 to 1990 — just about the national average. The state ranked 32nd in per capita health spending in 1990 — the same as in 1980.

It is understandable that the damage cap has done nothing to curb health care spending; the two have almost nothing to do with each other. In 1992, the Congressional Budget Office reported that medical malpractice litigation accounted for less than 1 percent of total healthcare spending. I doubt that the percentage in Indiana is much different.

Make no mistake; damage caps are arbitrary, wholly disregarding the nature of the injury and the pain experience by the plaintiff. They make it harder to seek and recover compensation for medical injuries; extend unwarranted special protection to the medical industry; and remove the only effective deterrent to negligent medical care, since the medical profession has never done an effective job of disciplining negligent doctors.

Medical negligence cannot be reduced simply by restricting consumers’ legal rights. That will happen only when the medical industry begins to effectively police its own. I don’t expect to see that day.

 

December 4th, 2006

Waiver of Claims, Before Negligent Act, Is Not A Bar To Lawsuit

In medical malpractice cases a person often signs a waiver of any claims when they agree to undergo surgery, at the same time they sign a consent. In the medical malpractice setting, this is usually one of a batch of forms shoved in front of a patient before surgery that few people even read. So the question becomes, does signing such a waiver prevent a lawsuit from being brought based on negligent conduct?
The short answer is no. New York, as well as other states, has long held that such an agreement to waive a claim of negligence is against public policy. And if the agreement is against public policy, the court won’t try to enforce it. One can not simply have a person waive a claim to future acts of negligence.
However, if a waiver is drafted smartly by a defendant it will describe various injuries or events that can happen during surgery, as part of the consent. If this is done it makes it easier for the defendant as they can point to the waiver form and claim that the person knew this was a risk of the event.
The question here is not whether the risk was known, but rather, whether due care used to avoid that known risk.