Category Archives: Pennsylvania

June 2018 Newsletter

Liability reform empowers physicians to avoid defensive medicine While evidence strongly suggests that the potential for liability lawsuits results in treatments and tests that may not be otherwise necessary, new data shows that medical liability reform may be empowering physicians to go on the offensive together with their patients. A newly published analysis compared diagnosis and treatment patterns in patients suspected of having coronary artery disease between states where liability reforms have been adopted and states without non-economic damage limits in place. The study included 36,647 physicians in nine states with reasonable limits adopted between 2003 and 2005, and 39,154 in states that had not taken any action to utilize limits on non-economic damages to rein in lawsuits. Physicians in states with reasonable liability limits were less prone to rely on angiography as a first diagnostic test and more likely to order noninvasive stress testing, the report found. In addition, fewer patients were referred for angiography following initial stress testing. These physicians also performed fewer percutaneous coronary intervention (PCI) procedures after ischemic evaluation, with indications that these patients were offered medical therapy as an alternative. “Our study suggests that physicians who face lower malpractice risk may be less concerned with…

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Pennsylvania physicians could face more medical negligence cases

Pennsylvania doctors could be held liable for harm even in cases where the patient suffered a known complication if the state’s Supreme Court doesn’t overturn a lower court ruling. In a case before the Pennsylvania Supreme Court, Mitchell v. Shikora, justices will determine whether trial judges can suppress expert witness testimony on the known complications of a medical procedure. If the state’s high court allows trial judges to bar that testimony, the state’s legal landscape would change and become even less favorable to physicians who already face unlimited noneconomic damages and other legal hurdles, the Litigation Center of the American Medical Association and State Medical Societies, the Pennsylvania Medical Society and other state physician organizations said in an amicus brief filed with the Pennsylvania Supreme Court. “The upshot will be that any patient can sue a surgeon or physician for any complication or unavoidable risk and a patient will be able to recover against a physician in the absence of negligence where the complication that occurred could not have been avoided even with the utmost care,” the brief states. The case stems from a laparoscopic hysterectomy where the patient’s bowel was perforated. The patient, Lanette Mitchell, sued obstetrician-gynecologist Evan Shikora, DO, for medical…

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May 2018 Newsletter

Maryland trial court attempts to redefine liability standards Under consideration by Maryland’s highest court is a case that attempts to redefine professional standards of care – and negate the testimony of expert witnesses. The basis of the case stems from a medical liability trial in which instructions provided to the jury deviated from well-established law on measuring standard of care as what a ‘reasonably competent’ physician would be expected to do, per expert witness testimony. Instead, the jury was instructed to consider only what a ‘reasonable layperson’ would do – potentially warping how physician negligence is defined. The Litigation Center of American Medical Association and State Medical Societies joined the Maryland State Medical Society (MedChi) and the Medical Mutual Liability Society of Maryland in filing an amicus brief that not only cited the likely increase in meritless lawsuits and implications for standards of other professionals in court, but also noted that experts must be relied on because medical procedures are not common knowledge. “Letting juries nullify professional standards would upend the basic premise that professional malpractice claims involve specialized knowledge and duties that laypeople cannot assess based on their common knowledge,” the brief states. A lower appeals court agreed that…

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Judge Stops State Plan to Take $200M Out of Malpractice Fund

HARRISBURG, Pa. (AP) — A federal judge on Thursday blew a $200 million hole in Pennsylvania‘s state budget by throwing out a law that appropriated the surplus from a state-created medical malpractice insurer of last resort. U.S. District Judge Christopher Conner sided with the Pennsylvania Professional Liability Joint Underwriting Association and declared the 2017 law violated the U.S. Constitution. Conner said the fund is private property that may not be seized by the government without fair compensation. The fund, he wrote, “has a perceptible benefit: it assures availability of medical professional liability coverage throughout the commonwealth at no public cost. By the same token, it also has a consequence: the General Assembly cannot claim carte blanche access to the association’s assets.” The law that authorized the transfer was the annual amendments to the Fiscal Code , a critical part of the $32 billion budget. The wider implications of the Fiscal Code’s fate were not immediately clear. House Republican spokesman Steve Miskin said they are reviewing their options, “especially in light of what appears to be an absolutely overly broad order — that goes way beyond the legal of the case.” The fund consists of money from policyholder premiums and investment income…

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March 2018 Newsletter

Bad examples: New York, Pennsylvania lead national liability rates Without reform to keep medical lawsuit abuse in check, examples of the inefficiencies of our nation’s liability system are emerging in several states in the form of increasingly large payouts. According to a recent survey by Diederich Health Care, a medical liability insurance and consulting company, New York topped the list for the largest liability payouts in 2017 with a total of nearly $618 million, with Pennsylvania second at $342 million and Illinois not far behind with $301 million. What do these states have in common? None have reasonable limits on non-economic damages in place, with liability climates that have worsened in recent years due to lawmakers who are more likely to push for changes that benefit personal injury attorneys rather than patients. In New York, 30,000 members of the Medical Society of the State of New York opposed extending the state’s statute of limitations on liability claims because it would increase their already high liability costs and drive more doctors out of the state. Unfortunately, the law passed, lengthening the statute of limitations from 15 to 30 months, beginning not when the error occurred, but the date at which the…

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Legal reform advocates point to medical malpractice figures in New York, Pennsylvania

ALBANY, N.Y. (Legal Newsline) – Experts who have watched medical malpractice lawsuits skyrocket in states like New York, Rhode Island and New Jersey say lawmakers have made it too easy and attractive to sue and reform must happen. “New Yorkers once again pay more for medical liability than anywhere in America,” Tom Stebbins, executive director of Lawsuit Reform Alliance of New York told Legal Newsline. “Sadly, Albany recently made matters worse by approving legislation that expands liability and makes it easier to file lawsuits.” The “2018 Medical Malpractice Payout Analysis” released March 1 by Diederich Health Care, a medical liability insurance and consulting company based in Carbondale, Illinois, includes figures comparing medical malpractice rates among states. Among Northeast states, New York topped the list for the most malpractice cases with a total approximate $617,973,000 in payouts with Pennsylvania second at $342,093,300, and New Jersey third with $267,913,250. The lowest in the Northeast were the District of Columbia with $11,498,500, Delaware with $8,253,250 and Vermont at the bottom with $1,536,500. Among Midwestern states, Illinois was far in the lead with $300,790,050 in payouts with Michigan second at $77,072,200. The lowest Midwestern states were Wisconsin at $13,527,100, North Dakota with $3,505,000 and…

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December 2017 Newsletter

Year-end report sheds light on “Judicial Hellholes” The American Tort Reform Association (ATRA) end-of-year “Judicial Hellholes” report offers a public glimpse at the most unfriendly jurisdictions for those defending themselves against civil litigation, including medical liability lawsuits. At the top of the list this year was Florida, where once-strong medical liability reforms have been continuously rolled back at the expense of patients seeking affordable and accessible care. “This year, thanks to a state high court majority’s barely contained contempt for the policy-making authority of the legislative and executive branches of government, and a notoriously aggressive and sometimes lawless plaintiffs’ bar, Florida earns the ignominious #1 ranking among eight Judicial Hellholes…” said American Tort Reform Association president Tiger Joyce. Also high on the list was St. Louis, where “antiquated rules have made it a favorite of personal-injury lawyers shopping for big-money verdicts” resulting in $300 million in awards since 2015. However, recent changes in state government, including a governor in support of changes to the liability system, do hold promise for much-needed reform in the coming year. To read more about ATRA’s “Judicial Hellholes” executive summary and report on the where physicians and defendants fare the worst when it comes to…

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Top cases show physicians had a forceful ally in the courts

One thing physicians from Florida to Hawaii had in common in 2017 was that the Litigation Center of the American Medical Association and State Medical Societies had their backs. The Litigation Center was involved in legal battles that helped prevent an insurance mega-merger, protected physicians’ right to free speech, and fought back on multiple fronts against attempts to sidestep or peel back established state liability reforms. But it was a case involving the staff at a hospital in rural California that may have attracted the most attention. Case signaled threat to end medical staff independence in California. In Tulare Regional Medical Center Medical Staff v. Tulare Local Healthcare District et al, the Litigation Center provided significant legal and financial support after the hospital’s board of directors voted to terminate the medical staff organization, remove elected medical staff officers, install a slate of appointed officers and approve new medical staff bylaws and rules without staff input. “This case serves as an existential threat to independent hospital medical staffs,” said Long Do, California Medical Association (CMA) legal counsel and director of litigation. Just before closing arguments were scheduled in October, Tulare filed for Chapter 9 bankruptcy. As part the process, the hospital…

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High Court’s Contempt for Lawmakers’ Authority, Lawsuit Rackets Place Florida atop Latest ‘Judicial Hellholes’ List

WASHINGTON, D.C., December 5, 2017 – The American Tort Reform Foundation issued its 2017-2018 Judicial Hellholes® report today, naming courts in Florida, California, Missouri, New York, Pennsylvania, New Jersey, Illinois and Louisiana among the nation’s “most unfair” in their handling of civil litigation. “With both this annual report and a year-round website, our Judicial Hellholes program since 2002 has been documenting troubling developments in jurisdictions where civil court judges systematically apply laws and court procedures in an unfair and unbalanced manner, generally to the disadvantage of defendants,” began American Tort Reform Association president Tiger Joyce. “This year, thanks to a state high court majority’s barely contained contempt for the policy-making authority of the legislative and executive branches of government, and a notoriously aggressive and sometimes lawless plaintiffs’ bar, Florida earns the ignominious #1 ranking among eight Judicial Hellholes, even as authorities have begun to crack down on some of the lawsuit industry’s most obviously fraudulent rackets. “Ranked #2 is perennial hellhole California, where lawmakers, prosecutors and plaintiff-friendly judges inexorably expand civil liability at the expense of businesses, jobseekers and those desperately in need of affordable housing,” Joyce explained. “The good news is the U.S. Supreme Court in June reversed a…

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Liability suit seeks change to informed consent

A case before the Supreme Court of Pennsylvania could have major implications on how physicians obtain informed consent prior to a surgery. At stake in Shinal v. Toms, is whether a patient’s informed consent to surgery can be predicated on information provided in part by a physician’s assistant, as opposed to just the physician. Both the Medical Care Availability and Reduction of Error Act (MCARE) and common law have made it the physician’s duty to see that the proper information is conveyed, but the question is whether delegating tasks to qualified professionals is also within the bounds of the law and common medical practice. How the case unfolded In 2004, Megan Shinal underwent surgery to remove a tumor, but it regrew and by 2008 she was experiencing severe headaches and was referred to Steven A. Toms, MD, for a second surgery. This type of surgery—the removal of a craniopharyngioma, a very serious and recurrent rumor located deep in the base of the brain—is one of the most complex surgeries in all of neurosurgery. For this reason, there were numerous important surgical decisions to be made, some by the surgeon and some collaboratively with the patient. The major decisions were which…

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