WhiteCoat

Healthcare Update — 03-19-2012

Also see the Satellite Edition of this week’s Update over at Medbloggers.org.

“Super losses” – malpractice verdicts totaling $50 million or more – are increasing. Verdicts from just seven cases in the past two years totaled more than $1 billion and the number of cases with verdicts of $5 million or more will quadruple between 2000 and 2014.

CDC win. Graphic anti-smoking ads cut rate of cigarette smoking. These ads ought to be all over YouTube and other video sites.

Clostridium difficile cases are at an all time high in this country. It causes horrible diarrhea, kills 14,000 patients each year, and costs more than $1 billion in extra health care costs. And the government’s CDC web site says that the number one way to reduce C. difficile infections is to “Prescribe and use antibiotics carefully. About 50% of all antibiotics given are not needed, unnecessarily raising the risk of C. difficile infections.”
Odd. The government’s “Hospital Compare” site says that anyone who is diagnosed with pneumonia must receive antibiotics within six hours of arrival in the emergency department or else the hospital is a “bad” hospital. This is despite the fact that more than 50% of pneumonias are viral and therefore antibiotics are unnecessary because they are useless in treating viral pneumonia.
So isn’t our government’s inane Hospital Compare site contributing to the uptick in Clostridium difficile infections that our same government wants us to eradicate?

Several very interesting statistics about medical malpractice payouts for 2011. Six states accounted for more than 50% of all malpractice payouts. One state accounted for about 20% of all money paid out in the entire US — and had more than 20 times the amount of money paid than in the lowest six states combined.

Some people sue because they don’t get the care they want. This guy sued because police forced him to go to the emergency department after a well-being check at his home. Talk about a shotgun suit – there are 34 defendants. Another example of why a loser pays system is needed in this country.

Another successful “we wish you’d never been born” lawsuit. Couple wins $2.9 million in wrongful birth case after child born with Down’s Syndrome. Nice. And I still think that parents who file such suits should be forced to put their “unwanted” children up for adoption. That way the children won’t be such a burden to their parents. Or at least an affirmative defense of “failure to mitigate damages” should be raised in pleadings.
What do cases like this teach medical providers? Never ever make predictions about a child that hasn’t been born.

New York woman settles malpractice suit for $17.9 million after going to emergency department, being diagnosed with kidney stone, being sent home, having “agonizing pain” the following day, calling 911 twice but being refused transport, then waiting until the following day before returning to the hospital. She developed sepsis, lapsed into a coma, and eventually required amputation of her hands and feet.

Pennsylvania jury awards $13 million to woman who vomited after surgery and occluded her airway, resulting in brain anoxia and a persistent vegetative state.

What did he drink? Man goes to the emergency department after drinking “dangerous chemical”, prompting closure and decontamination of the entire department. Man later dies.

Former prison inmate wins $312,000 after breaking ankle jumping out of cell bunk bed, then falling down stairs when walking on crutches.

“Triage out” policies are popping up all over the world. After noting an increase in patients who come to the emergency department with minor complaints or who want to have their appointments sooner, one of Malta’s hospitals is sending non-emergency patients to local clinics for care.

Bartow Regional Medical Center in Florida halts payments to obstetricians for on call duties. Now if patients have a gynecologic emergency like a complicated delivery, a ruptured ectopic pregnancy, or hemorrhage from their uterus, they’ll need to be transferred to another hospital. Instead of paying for obstetrical physicians $135,000 per year to be on call, Bartow spent more than $1 million on a daVinci surgical robotic system.

14 Responses to “Healthcare Update — 03-19-2012”

  1. Matt says:

    That stat about one state having more payouts than the 6 lowest states isn’t that surprising. There are 12 states which each have more people in them than the 10 least populated combined. More people equals more claims.

    http://en.wikipedia.org/wiki/List_of_U.S._states_and_territories_by_population

    And when the one state with more payouts is New York, that’s not surprising either, given that the bottom 6 states in payouts are likely small, rural states where you’re less likely to have significant economic damages. Pure economic damages of one middle aged well paid person in the financial sector in NYC is likely the amount of 10 people with the same injury who work at a Tyson Foods plant in Mississippi. Maybe 20 of them. Just due to income disparity.

  2. James says:

    True about income disparity. You’ll also notice, though, that there are some states like California that have much lower payouts than New York which would be more likely due to tort reform in that state compared to New York, IMO. Nice figures, though. 2-way line graph is pretty awesome. I, too, though – would like to see some stats that take into account payouts per capita for all of the states.

  3. Matt says:

    Your “super losses” post includes three cases involving nursing homes.

    What’s more, while there are 7 that are over $1 billion, 2/3 of that total was a single nursing home class action case based on inadequate staffing in violation of state statutes which resulted in a $670 million verdict on behalf of 32,000 class members. That works out to $20,000 per person.

    That’s not exactly “malpractice” in the sense of negligence cases against a physician. It is more of a claim against the healthcare industry. I guess if you want to consider yourselves part of the “industry” rather than independent professionals you can.

    You should check your press releases closer before regurgitating them. Physicians really shouldn’t tie their ship to nursing homes.

  4. throckmorton says:

    From the articles on malpractice, the summary seems to be: Stay away from anything that has to do with obstetrics or nursing homes and stay out of the State of New York.

    • Matt says:

      There are 15,000+ nursing homes in the country. You have three cases of them up there. One of them that has nothing to do with physician malpractice. The only message from that one is follow state law with regard to staffing guidelines.

      There are over 4,000,000 babies born each year in this country. Pretty sure you can’t reach the broad conclusion from those few cases.

      New York has one of the highest ratios of physicans per capita in the nation. Wonder why that is?

      • doc99 says:

        Inertia – NY Trains over 15% of the physicians in the country. Stats hide much as most docs are concentrated downstate – there are regions of NY state with acute shortages – seven counties without an OB. Shortages of Emergency Med specialists too – http://www.buffalonews.com/city/article312141.ece

        NY stats are misleading in that once you have a license, even if you leave the state, you are listed as licensed. Stats are like bikinis – what they reveal is suggestive but what they conceal is vital.

      • Matt says:

        Good points all. The NY info confirms what is true of all professions. We are concentrated where the money to pay us is. That’s the overwhelming key to access. To any services really.

  5. Anonymous says:

    “So isn’t our government’s inane Hospital Compare site contributing to the uptick in Clostridium difficile infections that our same government wants us to eradicate?”

    Yeah it’s simple: HHS is run by bureaucrats and the CDC is run by intelligent people. But because HHS gives better blowjobs to politicians I bet they get way more funding.

    • Anonymous says:

      Yep HHS gets 8x more funding than the CDC if you exclude Medicare and Medicaid from their budget.

      • Aaron says:

        The CDC is a part of the department of Health and Human Services. The budget for the CDC is part of the HHS budget, ergo the HHS budget will always be bigger.

  6. Beauzeaux says:

    “And the government’s CDC web site says that the number one way to reduce C. difficile infections is to “Prescribe and use antibiotics carefully. ”

    All my life (I’m creeping up on 70) I have avoided antibiotics unless absolutely necessary. I don’t use anti-bacterial soaps, cleaners, etc. And what do I get for my efforts? A chance to get c.difficile or some other super bug when/if I go to hospital. I’m beginning to understand that a “herd benefit” means nothing to individuals. They want what they want now and think MRSA is a fairy tale that will never affect them.

  7. SeaSpray says:

    How AWFUL the woman lost her hands and feet and also left with compromised vision in one eye!

    All the money in the world isn’t worth that!

    Why wouldn’t the EMS bring her back? Kidney stone pain is transport worthy if no other ride is available. ???

    Didn’t know a stone could harbor infection.

    • doc99 says:

      I favor early apology and Bronx Judge McKeon’s Early Settlement solution – cases such as this should be settled expeditiously. Agree w SeaSpray.

  8. MC says:

    The anti-smoking ads? I have already heard adolescents who think they are funny. There must be a better way than exploiting the misfortune of the cancer/COPD/trach people pictured.Remember Reefer Madness, Faces of Meth, the Disney Epcot fat child bully display? Does this stuff ever really help?

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