News Archives

Oregon Court Ruling Opens Avenues for Defensive Medicine, Lawsuit Abuse

The Oregon Supreme Court on Thursday revived a patient’s medical malpractice suit accusing a hospital and doctors of depriving him of a chance of a full recovery from a stroke, saying such “loss of chance” theories are fair game in medical negligence cases. The state’s highest court unanimously overturned the dismissal of a suit alleging Drs. Linda L. Desitter and Michael R. Harris and Providence Hood River Memorial Hospital failed to properly follow up on patient Joseph Smith’s complaints of stroke symptoms which robbed him of a one-third chance at a full recovery in cases like his, had he received timely and proper treatment. The justices said in the context of Oregon common-law medical malpractice claims, loss of chance of a better medical outcome is itself a type of injury, rejecting the defendants’ arguments that such a ruling would be an improper relaxation of standards regarding causation, or that a health care provider’s alleged negligence caused a patient’s injury. “When the lost chance is the injury in a medical malpractice action, the plaintiff still bears the burden to prove that, more likely than not, the defendant’s negligence caused the plaintiff to lose the chance of a favorable medical outcome,” the…

Liability Reform Brings Help to the Hawkeye State

Friday morning, Governor Branstad signed SF 465 — the IMS-crafted tort reform legislation. This legislation marks the culmination of decades of work by countless physicians throughout our state. “Today’s historic achievement is a victory for every physician, resident, and medical student in the state of Iowa. This success would not have been possible without the tireless work of so many individuals to give the house of medicine a strong voice in the legislative process. I am delighted to begin my tenure as President of the Iowa Medical Society with enactment of these sweeping reforms.” said newly-installed IMS President Joyce Vista-Wayne, MD, DFAPA. SF 465, which will take effect July 1, 2017, enacts the following reforms: A $250,000 Cap on Noneconomic Damages, With Some Exceptions Strengthened Expert Witness Standards A Certificate of Merit in all Medical Liability Suits Expanded Candor Protections A Brief History of These Reforms in Iowa Cap on Noneconomic Damages In 1975, California became the first state in the nation to enact a $250,000 cap on noneconomic damages. Shortly thereafter, IMS made its first attempt at enacting a similar cap here in Iowa. After nearly three decades of work, IMS championed the passage of a $250,000 cap on…

Pre-existing Condition: New York’s Broken Liability System

The ‘Worst State for Doctors’ Has a Dangerous Pre-existing Condition Another year, and another report naming New York the “Worst State for Doctors.” Time and time again, our state ranks dead last as a place for physicians to practice. The primary reason for the Empire State’s strained relationship with the medical profession is the staggering cost of medical liability insurance. New York has the highest per capita medical liability payouts in the country. These payouts are 35 times higher, per capita, than they are in the lowest state. Nearly 20 percent of all the medical liability payouts in the U.S. are paid in New York, more than all of the medical liability payouts for the entire Midwest. These costs drive doctors out of our state and weaken New Yorkers’ access to care. Since 2003, 16 hospitals in New York City have closed. To keep their doors open, some of the state’s remaining hospitals have opted to “go naked,” and not carry any medical liability insurance at all. While it is tempting to blame the insurers for this cost crisis, many medical liability insurers are operating at a loss. The real culprit for New York’s runaway medical insurance costs is New…

Panel Discussion Yields Insights into Future of Liability Reform

Taking part in a legal panel on the future of medical liability reform, HCLA chair Mike Stinson joined with legal experts and those supporting the interests of consumers to give insight on how efforts to change the currently broken system will evolve. Hosted by George Mason University’s Antonin Scalia Law School and the school’s Law & Economics Center, the panel represented varying legal, industry, and patient interests. Speaking on behalf of PIAA and their government relations efforts, Stinson talked about the benefit of liability reforms to deserving patients and federal health care spending. “The proposals [under consideration] have been scored as providing significant federal savings if enacted by Congress,” Stinson commented. “Our interest is that we get a more uniform system of medical justice across the United States.” Pushing back on assertions by other panel members that federal liability reform is unnecessary or unconstitutional, Stinson stated that “the system needs to be corrected – it’s incredibly inefficient. When two-thirds of all claims are dropped, withdrawn, or dismissed because they lack merit, but still cost tens of thousands of dollars each to defend against, you’ve got a system that’s not working correctly.” To watch the medical liability reform panel discussion in…

Pushing Back on Medical Liability Misconceptions – NYT Letter to the Editor

To the Editor Re G.O.P. Bill Would Make Medical Malpractice Suits Harder to Win (April 15): In 40 years of practicing medicine, I’ve witnessed a change in physician culture. Physicians no longer rely on clinical judgement based on training, experience and the best available evidence. The fear of lawsuits drives providers to adapt behaviors that lead to increased health-care costs. More than 90% of physicians engage in defensive medicine by practicing assurance behavior; ordering tests, particularly imaging tests, performing diagnostic procedures and referring patients for consultation. These behaviors have become standard of care. Patients also become educated through the internet and media to this new standard and change their expectations of their care perpetuating this expensive cycle. The current” patchwork quilt” medical liability system neither effectively compensates persons injured from medical negligence nor encourages the addressing system errors to improve patient safety. The Protecting Access to Care Act pending in Congress would address these inefficiencies. Most importantly, passing these sensible reforms represents a critical first step in restoring the appropriate practice of medicine where physicians make decisions based only on the patients well being. Stuart L. Weinstein, MD Iowa City, Iowa

A Doctor’s Place is in the Exam Room

An orthopaedic surgeon and a neurosurgeon walk into a room… Unfortunately, this is not the start of a joke. While we would prefer to be sharing best practices and treating patients in our exam rooms, the fact is we’re spending more time than we’d like in a courtroom. Because our medical liability system is broken, orthopaedic surgeons, neurosurgeons, OB-GYNs and other specialty physicians continue to find themselves on the receiving end of meritless lawsuits. As a pediatric orthopaedic surgeon practicing for more than 40 years in Iowa City, I’ve seen countless colleagues forced to defend their treatment decisions and reputations — leaving less time for patients — only for the lawsuits to be dropped, dismissed or withdrawn for lack of merit. Our medical liability system costs too much, takes too long, undermines the doctor-patient relationship and does not serve the needs of patients or physicians. Too often, the cost of defensive medicine — the tests and procedures above and beyond what is medically necessary to limit exposure to litigation — is tacked on to health care bills, leading to steep increases in costs year after year. When applied to 2015 health care spending, defensive medicine adds anywhere from $160 billion…

Medical Liability – Prospect for Federal Reform

Medical malpractice reform appears to be back on the federal policy agenda. The appointment of Tom Price, a long-time proponent of tort reform, as secretary of health and human services, in conjunction with Republican control of both houses of Congress, has created fertile conditions for several Republican proposals that have languished for years without the requisite support. Although it has been debated many times, a major federal foray into medical liability, a state-based area of law, would be unprecedented. The prospect raises several questions: Which reforms are on the table? Would they be effective? And is the time right? Although Price has not announced any specific proposals since his nomination, “lawsuit abuse” has long been an important issue to him. During his confirmation hearings, he described medical liability as “a really difficult challenge” and noted that there were “some exciting opportunities out there.” While serving in the House of Representatives, Price (R-GA) sponsored several bills aimed at limiting health care providers’ liability, most recently H.R. 2300 in 2015. Key elements of these bills are represented in H.R. 277, introduced by other House Republicans on January 4, 2017; H.R. 1215, introduced on February 24, 2017, by Representative Steve King (R-IA); and…

Iowa Senate Advances Bill To Discourage Med Mal Suits

The Iowa Senate on Monday approved a tort reform bill that would cap noneconomic damages in medical malpractice cases at $250,000 and require injured patients to obtain a “certificate of merit” from a medical expert before filing suit. S.F. 465 passed the Iowa Legislature’s upper house in a 28-21 vote that was split along party lines, with 28 Republicans voting to approve the proposed legislation and 20 Democrats and one independent senator voting no. If approved, the bill would impose a $250,000 cap on noneconomic damages such as pain and suffering, similar to a federal bill recently floated by Republicans in Congress. In addition, the bill would require medical malpractice plaintiffs to file a certificate of merit — essentially an expert opinion vouching for the validity of the claims — which is designed to weed out and discourage frivolous lawsuits. The bill would also make certain statements made by doctors to patients regarding adverse medical incidents inadmissible in court, and would tighten the requirements as to who can qualify as an expert medical witness. During floor debate on Monday, a Republican proponent of the bill, state Sen. Charles Schneider of West Des Moines, said that the proposed legislation would help…

Bill to change medical professional liabilities law passes state Senate

A bill that would change current state medical professional liabilities law has passed the state Senate. Senate Bill 338 would requires lawsuits against long-term care providers to be brought in the county in which the facility is located. Senate Judiciary Chairman Charles Trump, R-Morgan, is the sponsor of the bill. It has been sent to the House of Delegates Judiciary Committee. “Currently, most of the cases are brought in Kanawha County because corporate headquarters are in Charleston or because a company has a facility in Kanawha County,” said Patrick Kelly, CEO of the West Virginia Health Care Association. “If the bill passes, the people who know the facility best, local citizens, will hear the cases. “What’s happening now is that some of the facilities have a corporate office in Charleston, so if you have a case in the Northern or Eastern Panhandle, those folks have to leave their facility to come to Kanawha County. You can’t take an administrator or nurses out of the building for a long period of time.” The bill also would define occurrence as “any and all injuries to a patient arising from health care rendered by a healthcare facility or a healthcare provider and includes…