Articles Posted in Medical Malpractice

Military hospitals will continue to be plagued by medical malpractice and systemic medical errors in the most routine procedures as long as nothing is being done to address the weakness of the patient safety system in the military environment. According to a recent examination by the New York Times, from 2011 to 2013, medical workers in military hospitals reported 239 unexpected deaths, but only 100 inquiries were forwarded to the Pentagon’s patient-safety center, where analysts recommend how to improve care. Cases involving permanent harm often remained unexamined as well.

The problem is particularly concerning in maternity care and surgery. Babies born at military hospitals are twice as likely to be injured during delivery as newborn nationwide and their mothers have a higher risk of suffering hemorrhage after childbirth. The rate of surgical complications such as infections or improperly done procedures is above the expected rate in half of the 16 biggest military hospitals.

In an excellent article in the New York Times, Sharone LaFraniere and Andrew W. Lehren describe how medical errors have affected or destroyed the life of military families and analyse the reasons behind this disaster.

To reduce costs of medical malpractice in the Bronx, NYC, Judge Douglas McKeon helped launch in 2002 a pilot program to address lawsuits against municipal hospitals. The program uses judges who are specially trained to negotiate early settlements in medical malpractice cases and decreases the costs associated with trials and appeals.

This program will now be expanded to New York State and Judge Douglas McKeon will supervise the expansion. The program supported by New york City Health and Hospital Corp. will allow plaintiffs and defendant hospitals to go to a judge to mediate disputes in a controlled environment.

In 2010 the Obama Administration said the program contains medical costs and liabilities. If adopted nationwide it could potentially save the country a billion dollars per year.

When a doctor is sanctioned for medical malpractice in New York there is a high probability that he will be able to continue to practice. There is also a good chance that his patients will never know about their doctor’s punishment. A recent NYPIRG report entitled “Questionable Doctors” shows that the New York State Department of Heath’s Office of Professional Medical Conduct (OPMC) is not doing enough to protect patients. The report also proposes recommendations for improvement.

The report found that:

• 77% of the doctors that have been sanctioned for medical malpractice in New York State can continue to practice
• it is highly unlikely that New York patients know if their physician has been sanctioned because the information is too hard to find
• close to 60% of New York State actions against doctors were based on sanctions taken by other states, the federal government, or the courts, and not as the result of an OPMC investigation
• over the past 10 years New York’s population grew by 2% while New York’s number of doctors grew by 36%
• The Health Department hasn’t updated its report on OPMC’s physician discipline activities since 2010

What are the most common medical malpractice claims filed against internists? Which ones have the most chance to be paid? Which ones are the most expensive? A study published yesterday in JAMA Internal Medicine and led by Sandeep S. Mangalmurti, MD, JD, from the Bassett Heart Care Institute in Cooperstown, NY uses data from the Physician Insurers Association of America to analyze 250,000 lawsuits against internists that have been closed between 1985 and 2009 to answer these questions and others.

Diagnostic errors represent 26% of all closed lawsuits against internists, 36% of all paid claims and 43% of the total amount paid for medical malpractice by internists. Among the 8,925 closed claims only 34% of them were paid. The study also highlights that most frequent diagnostic errors claims are error in diagnosing lung cancer, myocardial infarction, colon cancer and breast cancer.

The second most common type of claims filed against internists are medical malpractice claims not related to a medical error but to a breach of care such as a failure to obtain consent or failure of medical equipment or other. 95% of these claims are rejected therefore even though they account for 25% of all closed claims they only represent 5% of paid lawsuits and 5% of the total amount paid toward internists medical malpractice claims.

Engaging patients and their families can prevent medical errors and reduce harm to patients. In their latest report “Safety Is Personal: Partnering with Patients and Families for the Safest Care” the National Patient Safety Foundation’s Lucian Leape Institute is advocating for the inclusion of patients and families in clinical activities, health care design and delivery as well as policy development.

The report points out that the actual health system makes it difficult for patients and families to partner with care providers in order to improve patient safety. Lack of access to health records, intimidation or fear of retribution promoted by a generally paternalistic professional culture as well as a lack of easy to understand tools and checklists are among the many barriers that prevent a positive collaboration between the medical staff and the patient’s family.

The report calls for targeted education and training for health care clinicians and staff to give them skills to better engage patients in decisions and management of health problems and to redesign processes and systems to facilitate patient and family partnerships.