WhiteCoat

Healthcare Update — 03-28-2011

Johnny Stickyfingers. Patient in Chicago suburbs arrested after breaking into a code cart and attempting to steal an I.V. catheter syringe, tourniquet band, roll of clear medical tape, several electronic monitoring pads, assorted bandages, and 25 thermometer probe covers. What was he going to do with these things?

Montana is the latest state to consider increasing the level of negligence for EMTALA mandated care to “clear and convincing” rather than ordinary negligence. Montana’s trial lawyers object to the bill, stating that it will make it much harder to pay for their multimillion dollar ranches “provide unmerited protection for those folks who really aren’t doing their job.”

What’s wrong with Obamacare? Authors of the book “ObamaCare Is Wrong for America” say that, among other things, it will “cause a staggering increase in the national deficit, will limit the creation of new jobs by discouraging companies from hiring, and will cripple innovation and research.”

Indiana family awarded $13 million after physician fails to diagnose lung cancer in family member. Doctor still faces more than 350 malpractice suits against him.

New Jersey family awarded $8.5 million in settlement for child born with permanent brain damage allegedly due to delays in performing a Caesarian section.

Law firm plans to file class action suit against West Virginia hospital for overradiating patients during CT scans.

Chicago area man gets charged with felony and possible five years in prison for threatening to kill judge because the judge’s scolding “made him cry.” Of course, when patients threaten to kill hospital employees, the hospital employees get in trouble for not “empathizing enough” with the patients and the patients get flowers sent to their homes because their low satisfaction scores forced them to threaten the employees. Sounds to me like all those sissy judges need to toughen up a little.

What stresses out surgeons? Phone calls? Fresh air? Patients? All of the above? According to the conclusions of a study in the Archives of Surgery, “surgery was associated with stress on surgeons ….” Longer surgeries and increased patient blood loss made the stress even worse.

The next wave of superbugs hits California. Carbapenem resistant Klebsiella pneumonia. The infection is resistant to most antibiotics and about 40% of infected patients die. But hey – keep popping those Zithromax and Levaquin prescriptions for your coughs and nasal congestion. CRKP is already resistant to those. The only thing that will cure it is colistin which, in one study, caused renal failure in 27% of patients who took it.

Violence against women increases by 10% on days in which an underdog beats the home team in NFL football. The logical response: Have JCAHO ban the NFL as a patient safety violation. Look at all those “never events” we could prevent.

If you build it, will they come? Cayman Islands looking to increase medical tourism by decreasing prices, limiting medical malpractice awards, changing doctor registration laws and changing organ donation laws.

41 Responses to “Healthcare Update — 03-28-2011”

  1. midwest woman says:

    re the theft of random things from a crash cart….hints of Magyver (sp?)…what’s he doing with that? :)

    • Anonymous says:

      Good one. I was thinking maybe he wanted to re-enact the movie Crank where he needs adrenaline.

      …come to think of it I wonder what injected adrenaline is like to a normal person. Go out to the parking lot and lift some cars :D

    • nurseygurl says:

      Fix the **&&& copy machine for the ED staff

  2. Miss Chevious says:

    Wow. I just finished reading an article called “I Married a Con Man” in the latest issue of Marie Claire magazine, and it was written by Dr. Mark Weinberger’s ex-wife (he’s the $13 million nose job guy you mention in your article). Fascinating article! I recommend it highly. She had NO CLUE he was a con man.

  3. Matt says:

    I think it’s funny when WC, a member of the world’s highest paid profession, tries to make it look like others are greedy. Doctors and the insurers just don’t want to pay for the damages caused by their failure to meet the standard of care because they care about “the people” right? It has nothing to do with insurer profits and physicians hoping to pay less in premiums, does it?

    Such saints.

    • VA Hopeful says:

      Actually, I’d say both of those suits had the correct outcome. One could make a case about the amount of damages, but both of those docs were in the wrong is seems.

      One thing I am curious about… was the doctor who missed that lung cancer an ENT/plastic surgeon? I wouldn’t expect them to catch lung cancer.

      • Matt says:

        You think $8.5M is stiff for a lifetime of permanent brain damage?

        I think the physician who missed the lung cancer has bigger issues than his specialty. Hope he’s not in your insurance pool. Does he still have his license?

        This was an interesting comment from the plaintiff’s attorney in the lung cancer case:

        “An Indiana medical review board had previously decided that the actions of Weinberger and Clinkenbeard failed to comply with ethical standards.

        “Clinkenbeard was in the suit, frankly, because the medical malpractice review panel said he should be in the suit. At all times our focus was Mark Weinberger, and candidly, [Clinkenbeard] was kind of a distraction,” said Allen.”

        Hopefully, the lawyers who put their time and money in that case won’t make any money so WC can’t mock them for how they spend it since they clearly don’t deserve it. It’s important that doctors keep their money so they can use it to try and disappear in Europe on family vacations.

      • VA Hopeful says:

        Yeah, that particular physician seems to have had some issues. Just pointing out that missing cancer isn’t always worthy of a lawsuit, depends on who missed what symptoms.

        OK, let’s assume that costs of medical care and basic living (food, shelter, clothing, and so on) for said brain damaged person is $2 million. The issue for me is, and has always been, the pain and suffering part. How do you decide who gets $1 million for that and who gets $4 million for that?

      • Matt says:

        I’m not disagreeing with you on the missed cancer issue. You’re absolutely right, and I’d bet the vast majority of those don’t result in a lawsuit.

        Where did you come up with only $2M? Of course, we’re speculating here since we don’t know the life expectancy or the extent of the physical damages, but $2M seems low if he’s predicted to live very long. Plus you have the lost income if one of the parents has to stay home.

        As to pain and suffering, that’s unique to each case. In that situation, we rely on a cross section of the community to make the call based on the evidence they’ve heard. How would you do it?

      • VA Hopeful says:

        The $2 million was a number partially pulled at random and partially not. A person with that kind of disability is going to qualify for state aid (medicare usually) which will cover hospitalizations and most doctor visits/drugs. In addition, there’s a good chance that it will cover some amount of home health nursing care and any medical equipment needed.

        Let’s also say that $2 million is invested with an average broker and a 8% return. That’s $160,000 annually, with a lower tax rate than most. On top of that, many states will pay the patient’s primary caretaker if the patient requires their help so much so that having a job would be impossible.

        My state does all of this, and I’m in one of the most conservative tight-with-a-buck states in the country.

      • Matt says:

        Actually, it appears $6.5M of it was for economic expenses, which I don’t believe was further broken down. They will only qualify for Medicaid and various other forms of aid depending on their income, often times. I for one don’t see why the taxpayer should have to pick up the tab if someone specific is responsible. If I run over a kid on the highway today in your state, why is it your responsibility as a taxpayer rather than mine?

        “Let’s also say that $2 million is invested with an average broker and a 8% return.”

        Point me to the average broker netting an 8% return. Right now, I believe the average return is less than 5%. Particularly at the retail, net of fees and costs. And, almost immediately a chunk of that money is going to be paid back to a health insurer due to subrogation.

    • Hueydoc says:

      Hmmm. Texas Monthly used to have an annual article about the “100 richest Texans”. Despite having DeBakey and Denton Cooley in our state, there were never any doctors in the top 100- yet there were always 30-40 lawyers.

      • Matt says:

        And yet, on average physicians make 50% more than attorneys. Still the world’s highest paid professions.

        But if we’re just going for the few wealthiest, no lawyer is as rich as Dr. Frist.

        I’d like to see that list you’re talking about. Of the 32 Texans on the Forbes list, only one is a practicing lawyer – and he made his fortune on a business dispute case.

      • Hueydoc says:

        The silicon breast implant lawyers made a fortune- despite never having a single shred of proof that the implants caused any problems. And the Tobbacco lawsuit money made at least one a Billionaire.
        Physicians make more than attorneys ? I’d tell that to my lawyer neighbors- but they’re at their house in Hawaii at the moment. It’s a change from their Colorado ski lodge at least. And the wife retired from law at age 35 after receiving her cut of a multimillion dollar payoff..er.. settlement.
        Admit it- that’s why you are a lawyer- hoping for that one big payoff !

      • Matt says:

        Did they make a fortune? How much?

        You seem mad at a whole group because a few bad ones make money. Should I indict you because of the physician with 350 malpractice suits? He undoubtedly has made money.

        Yes, physicians make more than attorneys. US physicians make more than any other profession in the world on average, with US lawyers a distant second. These are Dept. of Labor statistics, feel free to verify. Apparently you think some lawyers make more than you, and you’re mad about it. I can’t help that.

        And actually, I became a lawyer because I wanted to be able to live about anywhere in the country and provide a decent living for my family. I like the work, but my firm will never have a mass tort payoff like you’re so jealous of. We don’t have the resources necessary to fund the litigation.

    • doc99 says:

      Class warfare argument? Come on, Matt. That’s truly weak.

      • Matt says:

        If you’ll notice, I didn’t make it. It was WC who made it:

        ” Montana’s trial lawyers object to the bill, stating that it will make it much harder to pay for their multimillion dollar ranches ”

        I merely noted the fact that it seems silly for physicians to keep using the “rich lawyers” line, when physicians make so much more.

        I presume, though, since you seem offended by the money argument, that you reject much of the physician marketing about “rich trial lawyers” and find it unseemly. I look forward to your denunciations of such in the future.

  4. girlvet says:

    Re: stealing out of the crash cart. Same thing happened in our ER.

    • Hueydoc says:

      And ours- she stole a bunch of Epinephrine vials and hid them in her vagina- we could hear her “clinking” as she walked out of the room.

  5. SkullCandy says:

    My internist has had to put locks on some of his cupboards and move the sharps totally out of the exam rooms. He does not work in the hood. Beside the usual needles and syringes shrinkage:

    He has had ripped off

    1.Otoscope, but left charger base

    2. KY Jelly (gross)

    3.Small sharps bucket

    4.Vaginal spectum (now WTF)

    5. Digital themometer (left charge)

    Stupid me. Never thought to help myself to the things in the exam room.

    • tracy says:

      i have always been amazed at the things that are literally left out in the open at my Internest’s examination rooms. The Physicans there must really trust their patients!

    • DefendUSA says:

      Me either. And being of medical mind, all I would do is ask. WTH does a lay person *do* with a vaginal spec anyhoo? Ho-ly cow!!!

  6. DensityDuck says:

    “New Jersey family awarded $8.5 million in settlement for child born with permanent brain damage allegedly due to delays in performing a Caesarian section.”

    And then everyone complains that we have such a high rate of C-sections these days.

    • Matt says:

      Was the ruling incorrect? If you don’t know, then what’s your point?

    • Matt says:

      I’m sorry, was the settlement incorrect? You believe an insurer pays out that kind of money because they think they have a winner? If so, I’d like to know the company that does.

      • DensityDuck says:

        Legal fees: $3 million
        Percentage chance of win: 85%
        Cost of failure: $35 million

        Dollar value of risk: $8.25 million (15% of 35, plus 3)

        Dollar value of settlement: $8.5 million

        So, for a mere $250,000 they have eliminated the risk of being on the hook for $38 million ($3 million legal fees plus $35 million judgement).

        I’d call that a good trade.

  7. Matt says:

    So you agree it was a good case? If you think there’s an 85% chance of winning, you must. And how do you know how much coverage they had – you think it was $35M, really? Legal fees of $3 million? That’s actually quite funny if you think an insurer would pay $3M in legal fees on that case.

    If it was in fact a good case, and the physician and hospital employee were negligent, then it probably was a smart financial decision for the insurer. They’re not in the habit of paying on dogs. And a good one for us taxpayers, as well.

    Not sure how it makes the case that it’s the reason for so many C-sections. I would think it would make the case for acting differently in that situation, however it went down (without the records and testimony it’s hard to say what happened).

    • DensityDuck says:

      As usual, Matt’s attitude is that either he’s right or we don’t have enough information.

      “They’re not in the habit of paying on dogs.”

      I just proposed a scenario where it made sense to take a settlement on a case with an 85% chance of winning.

      • Matt says:

        I agree, that does make sense. I’m not sure how it supports your original point that it leads to a lot of C-sections that when there’s negligence someone has to pay.

      • Matt says:

        I also disagreed with some of your figures ($3M in legal fees), but the premise that it makes sense to pay on the 85% is true, if you think your damages are possibly higher than your limits. Otherwise you leave yourself open to a bad faith claim if you’re an insurer.

  8. Hueydoc says:

    Matt- I seriously wonder why you are on here. This is a medical blog, not a legal one. You are very adversarial on here. Why would a doctor go onto a legal blog and be a pain to everyone ?

    In my professional opinion (seriously), you have some issues. Like a problem child, you think bad attention is better than no attention and you don’t realize how it backfires.
    Get some counseling. Seriously. You need it.

    • Matt says:

      I’m sorry you find it odd that an attorney discusses legal issues when the legal issues are discussed in any setting. Perhaps you prefer more of an echo chamber.

      I’m not really interested in your attention. In fact, if you’ll notice – you originally replied to me. Evidently you have a hard time with disagreement, and don’t care for being asked to back up your grandiose claims or being shown how wrong they are. I don’t think you need counseling as a result, that’s how most people are. Realizing your opinions are not the same as facts is a tough thing, and I wish you luck with it.

  9. Avenger says:

    Matt – lawyers should make less than physicians – it is much easier to become an attorney than a physician. The legal profession is full of people who were “C” students as undergraduates and then entered law school for three years more school, then took and passed the bar exam. No apprenticeship required and, frankly,no brains or ethics either. To become a physician requires much better undergraduate academic credentials, a more rigorous post-graduate course of study and then an extended apprenticeship.

    The fact that any attorney, entertainer or professional athlete makes more than a physician tells you all you need to know about just how warped our society’s values are

    • Matt says:

      I think everyone should make whatever the market allows them to make. The beat criminal lawyer defending an innocent man for his life may well have a value greater than the worst podiatrist. And, to a large extent physicians have removed themselves from the free market. But to say as a blanket statement that any physician is worth more than all those others and if not society’s values are warped is foolish.

    • Matt says:

      How much do you think society should pay the physician with over 350 malpractice claims who tried to disappear in Europe? Hopefully he gets a premium for his ethics, academic credentials, and completion of such a rigorous field of study. He deserves it.

      • Avenger says:

        There are the occasional bad eggs among the medical profession just as there are the occasional good eggs in the legal profession.

        As an aside, just try to pursue a malpracice claim against an attorney in most states. In many states attorneys are not required to carry malpractice insurance and in many states, complaints against attorneys are kept secret, even those resulting in disciplinary action!

      • Matt says:

        In many states doctors aren’t required to carry malpractice insurance. Your point?

        In many states the bars actually dedicate a portion of the dues to a fund to compensate victims of legal malpractice. Do state medical societies do that, since they’re chock full of ethical people?

        In what state are disciplinary actions against attorneys kept secret? Because they’re in my bar magazine every month, from reprimands to expulsions, and you can find them online in most, if not all, states.

        Just because you believe things doesn’t make them true.

  10. Hueydoc says:

    Yet a coworker years ago quit the ER and went to Law school. Three years later she was out practicing malpractice defense.
    Her exact words were ” I now work 8 to 5, no holidays, no weekends, no nights, I make 3 times as much as I ever made in the ER and no one with HIV or Hep C is vomiting or bleeding on me”.
    I should have been so smart.
    Actually, I looked into law school after that but balked at signing my soul away in my own blood.

    • Matt says:

      I like anecdotal stories, especially funny ones like that. They’re so meaningful. If your friend told you that, it’s because it’s April Fools day. Or she didn’t get out of residency.

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