Archives: November 2011

Medical liability concerns drive hospital admission decisions

Medical liability is a key reason physicians admit more emergency department patients and discharge them less, say two studies in the October Annals of Emergency Medicine. In one study, a survey of 849 emergency physicians and patients in two inner-city emergency departments found that 11% of physicians reported "medico-legal" concerns as a primary driver for admitting patients with potential acute coronary syndrome (www.annemergmed.com/article/S0196-0644%2811%2900824-9/fulltext). In another study, researchers compared admission rates for congestive heart failure patients in 27 emergency departments in New Jersey and New York between 1996 and 2010. The percentage of such patients discharged from EDs dropped from 24% to 9%. Concerns about medical liability probably were the reason behind the decreased discharges, study authors said (www.annemergmed.com/article/S0196-0644%2811%2900907-3/fulltext). The findings show that doctors consider factors other than patients’ health when making admission choices, said co-author of the coronary study David Newman, MD, an emergency physician and director of clinical research in the Dept. of Emergency Medicine at Mount Sinai School of Medicine in New York. "Most physicians know we consistently overestimate risk in our discussions with patients. The question is, why? Most physicians would say medico-legal fears are a big reason why," he said. Medical liability worries are not the…

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Indiana doctors face challenge to medical liability cap

Indiana physicians continue to battle a legal challenge over the state's medical liability damages cap. Indiana Court of Appeals judges on Oct. 25 allowed a lawsuit against the cap to move forward, denying a request by Community Hospitals of Indiana to throw out the case based on procedural grounds. The case stems from the death of patient Debra Plank, 47. In 2001, she sought treatment at Community Hospital in Indianapolis after experiencing abdominal pain. She was prescribed pain medication and sent home, said John Muller, the family's attorney. Doctors eventually diagnosed her with a small bowel obstruction, according to court documents. As a result of the missed diagnosis, Plank contracted sepsis and died, court documents show. Timothy Plank, her husband, sued the hospital and his wife's doctors. All but one physician were dismissed from the case. Jurors found the doctor was not negligent, but ruled the hospital was responsible. Timothy Plank was awarded $8.5 million in damages, which was reduced to $1.25 million — the limit for total damages in medical liability cases. He challenged the reduction, but the trial court said it did not have the authority to rule on the cap's constitutionality after the state Supreme Court in…

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Judge devises model for resolving medical malpractice cases more quickly

Medical malpractice lawsuits can be complicated, expensive and emotionally wrenching for patients, doctors and hospital officials alike. Now a program pioneered by a Bronx judge that speeds up the resolution of these cases is expanding into other parts of New York. Policy experts say the program, funded in part by a $3 million grant from the federal Agency for Healthcare Research and Quality, could provide a national model for handling medical liability cases. “We’re excited about it,” says James B. Battles, who oversees this grant for AHRQ. “It uses the existing court system and didn’t require any special legislation. That has some real advantages.” So far, some 200 cases have begun the process, though not all have completed it. Providers, patients and policymakers generally agree that the current medical liability system doesn’t serve anyone very well. A number of remedies have been tried, including caps on damage awards and programs that encourage providers to admit errors early and offer compensation to patients. The designated jurist At its core, the New York program, called judge-directed negotiation, is simple: When a medical malpractice lawsuit is filed, a judge with expertise in medical matters becomes the point person for that case. He or…

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LIABILITY CAPS SPECIAL REPORT

Since Texas enacted comprehensive medical liability reform in 2003, including a constitutional amendment ratifying limitations on non-economic damages in medical liability lawsuits against health care providers, Texas has seen significant improvements in access to critical health care services across the state. Opponents of these reforms, most recently Public Citizen, claim that liability reforms have not produced the promised results. This claim is simply false and rests on a deliberate misrepresentation of the purpose of the 2003 legislation. This report seeks to set the record straight on the success of the Texas medical liability reforms in achieving the Legislature’s intent. I. Prior to the 2003 reforms, the excessive cost of medical liability insurance and the high risk of medical liability claims against physicians and providers created a severe crisis in the availability of critical health care services across the state. The best evidence for the effectiveness of medical liability reform is to compare the legislative objectives of Texas medical liability reform to the documented results since its enactment in 2003. In 2002, Governor Rick Perry articulated these objectives: "Every Texan deserves access to medical care. Today, in many parts of the state, access to quality care is increasingly threatened by a…

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November 2011 Newsletter

Protect Patients Now Volume 6, Issue 11 November 2011 Newsletter E-Newsletter Special points of interest: Promises Made, Promises Kept: Liability Reform Delivers Increased Access to Care in Texas New Medical Liability Program May Lead to More Rapid Resolution of Claims Thirty Years Later, Indiana Liability Reforms Under Fire Physicians Say Liability Concerns Increase Hospital Stays Promises Made, Promises Kept: Liability Reform Delivers Increased Access to Care in Texas When medical liability reform was proposed in Texas in 2002, promises were made to patients that the system would be reformed to provide greater access to quality medical care for all. In 2002, Governor Rick Perry stated that he was committed to ending the medical liability crisis, by “reigning in abusive lawsuits, improving patient protections and reforming insurance regulations—to ensure patients have access to the best care possible.” Key points from a special report by the Texas Civil Justice League, “Liability Caps Deliver Increased Access to Health Care,” show just how well those promises were kept. In 2001 Texas issued new licenses to just over 2,000 physicians, the lowest number in the prior ten years. By contrast, in 2008 Texas licensed more than 3,600—the highest number in its history—and since passage of the…

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