Cherry Hill, New Jersey Personal Injury Lawyer - Medical Malpractice - Most Commented

Texas Tort Reform is NOT a Model for Nationwide Health Care Reform

Mike Ferrara — Mon, 07 Sep 2009 20:24:15 GMT

Tort reformers like to talk a lot about how the threat of malpractice suits raises health care costs by forcing doctors to practice “defensive medicine”—the ordering of unnecessary tests, procedures, and prescriptions in an attempt to protect themselves against a possible negligence lawsuit.

In a 2008 AMA survey, they remind us, a majority of the doctors who responded admitted to practicing defensive medicine—a number that translates, the AMA calculated, to $1.4 billion more spent annually on health care. If our doctors weren’t threatened into doing this, we’d all save loads of money and our national health crisis would be over.

Are the tort reformers right? Well, let’s look at Texas. Several years ago, the state passed a stringent medical malpractice law that capped awards for pain and suffering at $250,000, and brought the number of malpractice lawsuits down dramatically.

So the cost of health care in Texas must also be down, you suppose, since doctors don’t face the same malpractice threats as the rest of the country. Eh, No. In fact, Texas is home to three of the top ten most expensive cities in the country to receive health care: McAllen, Harlingen and Corpus Christi. In each of these cities, every Medicare patient is costing the country more than $10,000 a year (a couple thousand more than the national average).

So if defensive medicine against the threat of malpractice suits isn’t driving up costs, what is?

Harvard Medical School surgeon Atul Gawande got a candid answer to this question from a general surgeon in McAllen, Texas:

“Come on,” the general surgeon finally said. “We all know these arguments are [BS]. There is overutilization here, pure and simple.” Doctors, he said, were racking up charges with extra tests, services, and procedures.

The surgeon came to McAllen in the mid-nineties, and since then, he said, “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?’ ” –Atul Gawande, The NewYorker

While tort reform like Texas' won't improve the cost of our health care, changing our charge-per-service structure just might.

Originally posted at InjuryBoard by Mike Ferrara

Just How Much do Malpractice Suits Raise Health Care Costs?

Mike Ferrara — Thu, 16 Jul 2009 22:22:45 GMT

A succinct op-ed in The New York Times earlier this week by UPenn Law School professor Tom Baker made some terrific points about medical malpractice, and the expensive malpractice insurance that everyone is always blaming for the skyrocketing costs of health care.

Eighty percent of malpractice claims involve significant disability or death, a 2006 analysis of medical malpractice claims conducted by the Harvard School of Public Health shows, and the amount of compensation patients receive strongly depends on the merits of their claims. Most people injured by medical malpractice do not bring legal claims, earlier studies by the same researchers have found.

In other words, patient claims, and accordingly, the malpractice insurance to cover them, are not that large unless patients can prove significant injury or death due to medical negligence. This means that claims are not draining our pocketbooks; medical negligence is.

On the other hand, medical liability has improved patient safety — by leading hospitals to hire risk managers, for example, and spurring anesthesiologists to improve their safety standards and practices. Even medical societies’ efforts to attack the liability system have helped, by inspiring the research that has documented the surprising extent of preventable injuries in hospitals. That research helped start the patient safety movement.

Disturbingly, findings have shown that hospitals in New Jersey, Pennsylvania, and in fact all over the country are still vastly underreporting preventable errors, even serious ones, that occur on their watch, despite state laws requiring them to do so. On the consumer level, patients have no way of knowing how well local hospitals are performing. State agencies do not release reports from individual hospitals regarding their rate of medical errors. Oftentimes, it is not until the health department cites a hospital for breaking state laws that the public even hears of the hospital’s failing.

Take away medical liability and you take away the only meaningful check and balance a patient has on the impossible monstrosity of a system that American health care has become.

As Baker notes, “there’s a better answer for doctors worried about high malpractice insurance premiums.” And this answer is:

…[m]edical providers should be required to disclose injuries, provide quicker compensation to deserving patients and — here’s the answer for doctors worried about their premiums — shift the responsibility for buying malpractice insurance to hospitals and other large medical institutions. Evidence-based liability reform would give these institutions the incentive they need to cut back on the most wasteful aspect of American health care: preventable medical injuries.

It’s so crazy it just might work.

Originally posted at InjuryBoard by Mike Ferrara

Huge Medical Malpractice Study: Liability Should Not be More Limited.

Mike Ferrara — Thu, 23 Jul 2009 21:50:12 GMT

Americans for Insurance Reform released a study earlier this week showing that in recent years, doctor premiums and medical malpractice claims have overwhelmingly dropped, while the profits of the medical malpractice insurance industry have soared. Significantly, the study concludes that placing further limits on the liability of negligent doctors and unsafe hospitals would be unjustifiable, and would put almost no dent in our country’s health care costs.

AIR’s report, True Risk: Medical Liability, Malpractice Insurance and Health Care, is by Gillian Cassell-Stiga and Joanne Doroshow of the Center for Justice & Democracy, and actuary J. Robert Hunter, who is Director of Insurance for the Consumer Federation of America (CFA), former Commissioner of Insurance for the State of Texas, and former Federal Insurance Administrator under Presidents Carter and Ford.

In describing the study’s findings, Hunter said, “Thirty years of inflation-adjusted data show that medical malpractice premiums are the lowest they have been in this entire period. This is in no small part due to the fact that claims have fallen like a rock, down 45 percent since 2000. The periodic premium spikes we see in the data are not related to claims but to the economic cycle of insurers and to drops in investment income. Since prices have not declined as much as claims have, medical malpractice insurer profits are higher than the rest of the property casualty industry, which has been remarkably profitable over the last five years. -AIR

The findings apply equally to states that have placed major tort restrictions on victims of medical malpractice and to states that have not.

The study adds that because medical malpractice premiums amount to less than 0.5% of overall health care costs, with medical malpractice claims amounting to 0.2% (yes, these are tiny decimals) of health care costs, limiting liability any more will simply not have a significant effect on these health care costs. “If Congress completely eliminated every single medical malpractice lawsuit,” it says, “including all legitimate cases, as part of health care reform, overall health care costs would hardly change, but the costs of medical error and hospital-induced injury would remain and someone else would have to pay.”

All of this only confirms the position we’ve been taking, which is that removing or further limiting medical liability would mean robbing patients of the only meaningful check and balance they have on the impossible monstrosity of a system that American health care has become. Limiting liability is not a way to save the country money, and it’s not fair for patients who are wrongfully injured or who lose their lives due to negligence.

Read AIR’s full study here.

Originally posted at InjuryBoard by Mike Ferrara

Medical Malpractice Cases Decline - No Need For "Tort Reform"

Mike Ferrara — Tue, 15 Apr 2008 01:04:51 GMT

Those who favor restricting the rights of those harmed by careless doctors have one less weapon to use in their PR campaign. The latest figures just released by the Pennsylvania Supreme Court show that the number of medical malpractice cases have been declining over the past three years. Those who feel doctors should be held personal responsible for the harms they cause are vindicated by these findings. Most of the PR from the doctors has not withstood the scrutiny of careful analysis. The solution is to weed from the profession those doctors who cause the most harm, not restrict the rights of those who have been harmed.

The number of medical malpractice lawsuits filed in Pennsylvania declined for a third consecutive year in 2007. The number of suits, 1,617, represented a 4.5 percent decline from 2006 and a 40.8 percent drop from an annual average of roughly 2,700 malpractice lawsuits filed from 2000 to 2002.

Chief Justice Ronald D. Castille attributed the decline to key changes made several years ago - a court requirement in 2003 that an independent physician or expert certify the viability of a medical malpractice lawsuit and other changes. Since attorneys only recover a fee if they are successful, and since they need affidavits of merit before filing suit, critics are hard pressed to identify any so-called frivolous medical malpractice suits. Frivolous suits just aren't brought because they make no economic sense whosoever.

Originally posted at InjuryBoard by Mike Ferrara

Health Care Reform - Not Enough Attention to Medical Error Prevention

Mike Ferrara — Tue, 20 Oct 2009 22:38:27 GMT

According to a report just released by the NJ Department of Health and Senior Services, in 2007, hospital doctors, nurses and other medical workers committed nearly 9,400 "serious medical errors'' that threatened patient health by leading to infections, blood clots, and other unnecessary complications.

The report is the first in the state to compare hospitals with one another, showing exactly where the errors are occurring. Together, New Jersey’s hospitals fared worse than the national average on numbers of post-surgical infections and frequency of wounds re-opening. In other areas, such as surgical equipment being left inside patients after surgery or the wrong blood type being given, New Jersey fared better than other states.

AARP'S Kelmar said matching the national rate in mistakes is not good enough. She noted there were 63 incidents statewide of a foreign object left in the body after surgery -- a rate that is about the national norm.

"The expected rate of occurrence for this incident is zero,'' Kelmar said.

"Disconcerting numbers of preventable medical errors are occurring in our health facilities. Now consumers will know these results,'' said Patricia Kelmar, associate state director for advocacy for AARP-New Jersey, which pushed for the tougher reporting requirements. "Equally important, every hospital can see their own levels of mistakes compared to others, which we hope will encourage them to make the changes necessary to improve patient safety throughout the state." -The StarLedger

While state hospital “report cards” are a great step on the road to reducing medical errors, there is still not enough focus on preventable medical errors in the national health care legislation. All the talk of medical malpractice reform and tort reform has taken attention away from the real issue, which is that more than 100,000 patients die every year from preventable medical errors. Tort reform will do nothing to prevent this, and will only make it more difficult for patients who are needlessly harmed to get the compensation they deserve.

Originally posted at InjuryBoard by Mike Ferrara

Wisconsin Nurse Laid Off Mid-Surgery

Camryn Hansen — Tue, 14 Apr 2009 23:44:50 GMT

As if it isn’t enough that health care costs are draining patients’ wallets dry, last week, in a violation of hospital protocol, a Dean Health System manager at Dean West Clinic in Wisconsin called out a nurse in the middle of assisting in surgery—in order to lay her off.

The abrupt removal, which spokesman Paul Pitas said posed no danger to the patient, came after the Madison-based health care provider announced Wednesday that it planned to “immediately” lay off 90 employees.

Pitas, director of corporate communications, labeled the action “clearly ... an error in judgment on the part of the manager conducting the layoff.” He declined to name the manager but described her as “an otherwise good employee with more than 30 years of nursing experience who made a regrettable decision.” -Dee J. Hall, Wisconsin State Journal

According to spokesmen, the procedure interrupted for the layoff was not serious, and the patient is currently “doing fine.” The type of procedure it was, however, is being kept secret for now, as are the names of everyone involved in the incident.

The abrupt layoff caused there to be a period of time during surgery in which there was no RN present—a breach of Dean Health procedure. Had an injury to the patient resulted from this “error in judgment,” the hospital would be facing some serious malpractice charges. Even without injury, the patient has a right to be furious. Every surgery, no matter how minor, carries a risk of complications, and removing key health care personnel from the operating room in the middle of one is not just bad judgment; it’s medical malpractice.

Dean is planning to investigate the circumstances of the error, but refuses to discuss possible outcomes. I suppose we can be grateful they didn’t decide to “immediately” lay off their emergency room staff as well.

Originally posted at InjuryBoard by Camryn Hansen

Patients Contracted HIV from Contaminated Medical Equipment at Veterans Affairs Hospitals

Mike Ferrara — Sun, 19 Apr 2009 12:49:03 GMT

According to spokespersons at Veterans Affairs hospitals, three patients exposed to contaminated medical equipment at VA facilities in Murfreesboro, Tennessee; Augusta, Georgia; and Miami, Florida have now tested positive for HIV.

Over 10,000 patients at these facilities are currently getting tested for HIV after it came to light that doctors had used endoscopic (colonoscopy) equipment on them that hadn’t been sterilized properly, and had exposed them to the body fluids of other patients.

At the three facilities, there have also been a total of six positive tests for hepatitis B and 19 positive tests hepatitis C. While it’s fairly clear that the VA facilities were responsible for the HIV cases, it’s not yet clear whether patients were exposed to these other viruses here.

The VA has said it does not yet know if veterans treated with the same kind of equipment at its other 150 hospitals may have been exposed to the same mistake before the department had a nationwide safety training campaign.

An agency spokeswoman has said the mistake with the equipment was corrected nationwide by the time the campaign ended March 14. The problems discovered in December date back more than five years at the Murfreesboro and Miami hospitals. (…)

All three sites used endoscopic equipment made by Olympus American Inc., which has said in a statement it is helping the VA address problems with "inadvertently neglecting to appropriately reprocess a specific auxiliary water tube." -AP

Friday’s statement by VA officials tallies a total of 10,797 "potentially affected" patients, including 6,387 who had colonoscopies at Murfreesboro, 3,341 who had colonoscopies at Miami, and 1,069 who received treatment at Augusta’s ear, nose and throat clinic.

More than 100 VA employees have been assigned to "ensure that affected veterans receive prompt testing and appropriate counseling."

It’s a sad day for our country when our veterans can’t receive medical care without worrying about contracting life-threatening diseases through medical negligence.

Originally posted at InjuryBoard by Mike Ferrara

Malpractice Reform will Save the Country Almost Zero, Study Finds

Mike Ferrara — Sun, 11 Oct 2009 17:12:57 GMT

Advocates of medical malpractice reform have been claiming that reform would save the federal government (and taxpayers) between $100 billion and $200 billion a year. These figures have stood at the forefront of the debate on malpractice reform, and have come to be taken for granted as true. Purportedly, saving the country a great deal of money has been one of the tort reformers’ key objectives.

So what do the tort reformers say when they discover that this week, the Congressional Budget Office reported that, contrary to previous claims, malpractice reform is highly unlikely to have a significant impact on government health care spending? That in fact, caps on pain-and-suffering and punitive damages will only lower spending by three tenths of one percent?

Unbelievably, they say Wow, great. That’s really a lot. A whole three tenths of one percent! That’s $11 billion!

Lisa Rickard, president of the U.S. Chamber of Commerce's Institute for Legal Reform, called the analysis "momentous." "Today's CBO analysis should underscore what two-thirds of voters have said: Congress should include meaningful medical liability reform in the healthcare reform bill," she said. –LA Times

Malpractice reformers need to stop spinning the numbers pretending to fight for the noble taxpayer, and be honest about their true motives for reform: they want less corporate accountability and more corporate control over the lives of individual Americans. They want corporations like insurance companies and drug manufacturers to reap endless profits while patients who are truly injured during treatment have no legal recourse. Why do they want this? Because corporations fund their political careers.

Malpractice reform will not save the country a significant amount of money, and will only contribute to the number of people who are killed every year by preventable errors.

Originally posted at InjuryBoard by Mike Ferrara

Texas Tort Reform is STILL NOT a Model for Nationwide Health Care Reform

Mike Ferrara — Wed, 09 Sep 2009 22:17:57 GMT

I’m sure that everyone who was listening noticed the section in Barack Obama’s address to Congress tonight where he talked about trying out some more caps on medical malpractice suits. He mentioned the recent tort reforms in Texas as a potentially viable example of successful reform that could be tried in other states in an attempt to save on health care costs.

I’d like to repeat something I mentioned here two days ago: despite the stringent medical malpractice law Texas passed several years ago to cap awards for pain and suffering at $250,000, bringing the number of malpractice suits as well as the threat of malpractice down dramatically, Texas is now home to one of the most expensive health care systems in the country. Three of the top ten most expensive cities to receive health care in are Texas cities.

Propaganda issued in 2003 by tort reformers in Texas to limit malpractice suits claimed that Texas had a dangerous shortage of doctors due to skyrocketing malpractice premiums caused by the threat of lawsuits, and that tort reform would bring more doctors to Texas. At the time, the truth was that only the poorer, more rural counties in Texas lacked adequate doctors; since tort reform, this is still the case. While Texas has attracted more doctors, it has only been to wealthy counties with well-equipped, well-paying hospitals; the situation in rural counties remains unchanged.

[In 2003, a] flier printed by the TMA in English and Spanish and posted in waiting rooms across the state told patients that “152 counties in Texas now have no obstetrician. Wide swaths of Texas have no neurosurgeon or orthopedic surgeon. ... The primary culprit for this crisis is an explosion in awards for non-economic (pain and suffering) damages in liability lawsuits.”

As of September 2007, the number of counties without obstetricians is unchanged—152 counties still have none, according to the Observer’s examination of county-by-county data at the state Medical Board.

Nearly half of Texas counties—124, or 49 percent—have no obstetrician, neurosurgeon, or orthopedic surgeon. Those specialists aside, 21 Texas counties have no physician of any kind. That’s one county worse than before Proposition 12 passed, when 20 counties had no doctor. -The Texas Observer

Caps on patient awards will not lower health care costs, and will not attract more good doctors to the areas around the country that really need them. All it will do is deny compensation to people who’ve suffered due to a doctor’s negligence. Let’s not create more Texases as part of national health reform.

Originally posted at InjuryBoard by Mike Ferrara

Fatal Hospital Errors - New Jersey Reports 71 Percent Increase

Mike Ferrara — Sat, 20 Dec 2008 22:29:43 GMT

The New Jersey Department of Health and Senior Services has announced the results of its third annual Patient Safety Act report, which show that in 2007, a full 72 New Jersey hospital patients died as a result of preventable medical errors.

This figure represents a 30% from 2006 figures—a potentially disturbing finding, considering the deliberate effort New Jersey has been taking in recent years to reduce the number of medical errors (particularly “never events”—errors so egregious, they should absolutely never happen) in its hospitals.

Officials are saying that the increase may be due to more widespread reporting of error-related deaths, since the 2004 Patient Safety Act requires that New Jersey hospitals report every serious accident, as well as every serious surgical or medical error made by their staff. Since the 2004 Act, the number of total reported preventable errors has increased every year, peaking last year at 456.

Despite the mandate, data suggests that NJ hospitals are still vastly under-reporting their medical errors and accidents—which inevitably deters the implementation of effective preventative and corrective measures, ultimately leading to more errors and accordingly, to more of the medical malpractice lawsuits that those without the facts are citing as the greatest financial problem in the health care system.

Lawsuits are not the problem. They happen after the problem, because there’s a problem, to help fix the problem.

If you would like a free consultation by an experienced New Jersey attorney to tell you whether or not you have a meritorious medical malpractice case, contact New Jersey medical malpractice attorney Michael A. Ferrara, Jr. at mferrara@ferraralawfirm.com.

Originally posted at InjuryBoard by Mike Ferrara