Saturday, November 11, 2006

Lawyers

All of the older docs that I work with have a story of being named in a lawsuit. Most of them told to prove an educational point and are usually about documentation.

One of the doctors I know who is the most meticulous about documenting his conversation with patients and their family members regarding the risks of surgery was once sued by a family. The basis of the lawsuit was that they hadn't been told that the patient could die as a result of the surgery. He unfortunately did die. The lawyer who filed the lawsuit apparently didn't do a good job reading the medical chart, because right there in the preoperative note was a list of potential complications explained to the patient and his family that included death. The lawsuit was dropped.

One of the funnier stories, but with very unfortunate consequences for the resident involved, was a lawsuit over a foreign body left in a patient's abdomen. The patient came to the ER with cholecystitis, and had a laparoscopic cholecystectomy done without incident. He came back to the emergency room about 6 months later with abdominal free air and required emergency surgery. On the abdominal X-ray, there was a metallic object that the radiologist said might be intra-abdominal. Those who examined the patient knew that it was a ring associated with a skin piercing. However, the patient got a lawyer and a lawsuit was filed alleging that the skin ring was something left inside his abdomen at the time of the first operation. The lawsuit was eventually dropped when the lawyer realized that he didn't have a case. However, the resident involved in the first surgery had just matched to do his fellowship in heart surgery. He had been approved for a mortgage to buy a house in the city he was moving to. When he went to close on the house, they found out that he had a lawsuit pending against him, and denied him the mortgage. He was unable to get another bank to give him a mortgage at that time and lost the house that he had been attempting to buy.

Another surgeon I know had a bogus lawsuit filed against him. A month before the case, the lawyer called and offered to settle for a million dollars. He refused. A week later the lawyer called again and offered to settle for $500,000. He again refused. A week before the trial the lawyer called and offered to settle for a five figure sum which he said were his costs to date for filing the case. The surgeon again refused and at this point told the lawyer that he would not settle for $5 if that was offered as he was not guilty of malpractice in the case. The case was dropped by the lawyer prior to going to trial.

Another resident was sued by the family of a patient who claimed that the patient died after a gunshot wound because the resident didn't plug the skin holes through which the patient was exsanguinating. In reality, plugging the holes would have meant that the blood would have exsanguinated anyway, but just would have been inside of him rather than on the floor. The end result would be the same either way. That case was also dismissed

A couple of years ago I had a case filed against me and a number of other doctors and nurses who had taken care of a certain patient. It was eventually dropped, in my opinion because the allegations were ridiculous and false, but I of course am biased when it comes to evaluating a case filed against me. What amazed me about the whole process was reading the deposition. It basically made it sound like all of the medical people involved in the care of the patient spent their time figuring out how creative ways to harm him and make sure that he never recovered. I was hurt that someone whom I, among others, had tried so hard to help was bitter enough toward me to make those allegations. The case has been closed for quite some time now. I recently came across some of the associated legal documents when I was cleaning. I'm getting ready to send out Christmas cards, and have felt compelled to send them one. If I have a current address for them, I probably will send them one and not say anything about their lawsuit but just wish them a good Christmas season.

The legal system in the US is out of control. A recent study published the worst five states for medical malpractice insurance for surgeons. They were Florida, Pennsylvania, Ohio, Michigan, and Illinois with annual malpractice insurance rates of $150-200,000 per year. That means that a surgeon wishing to practice there has to shell out a six figure sum each year just to have insurance. That doesn't include office costs, salaries and benefits for office staff, etc.

Then people wonder why medical care is so expensive.

Its like Dr. Barker, our senior trauma surgeon, says. "All you are is a walking lottery ticket to these folks."
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