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Healthcare Update Satellite — 12-04-2013

What are the busiest hospital emergency departments? An American Hospital Association survey from 2011 published earlier this year is surprising (link to .pdf file). The 25 busiest hospitals in the US see more than 5 million patients per year. Florida Hospital in Orlando is the busiest in the US and sees 407,000 patients per year – an average of 1,100 per day.

Georgia Supreme Court rules that emergency physician’s to diagnose a pulmonary embolism in 15 year old football player who had arthroscopic knee surgery a week prior to ED visit can constitute gross negligence. The patient had pleuritic chest pain, a normal CXR, a normal EKG, normal pulse oximeter, and normal vital signs. He was discharged with a diagnosis of pleurisy. Two weeks later, the patient had chest pain and difficulty breathing. He was transported to another hospital and later died from a pulmonary embolism.
Georgia enacted laws to protect doctors who provide mandatory emergency care by requiring that any malpractice claims must prove by clear and convincing evidence that the physician engaged in “gross negligence” which is defined as failing to “exercise even a slight degree of care” or “lack of the diligence that even careless men are accustomed to exercise.”
The Appellate Court held that the emergency physician had provided some degree of care and therefore the plaintiffs could not meet the statutory burden of proving gross negligence. However, two “nationally recognized specialists” testified that the patient’s symptoms and history “constituted a classic presentation of pulmonary embolism” and that failing to order a chest CT scan and an ultrasound of the patient’s leg therefore must have constituted gross negligence.
Whacked out opinions like this are the problem with any attempts at tort reform. Courts and experts twist definitions to suit their own means, thereby rendering legislative actions moot.
If someone can get me the names of the experts and/or their opinions in this case, I would like to publish the expert’s names and discuss their opinions.

Teenage emergency department visits related to “ecstasy” or “MDMA” have more than doubled between 2005 and 2011. One emergency physician quoted in the article notes that the pills may be mixed with other substances and that taking the pills is “Russian Roulette at its best.”

Reporter on Obamacare describes how personally being in “coverage gap” affects her. According to a Kaiser Family Foundation graphic in the article, patients who earn between $11,490 and $45,960 are eligible for a marketplace subsidy. Patients who earn less than $5400 per year are covered by Medicaid. Patients who earn between $5,400 and $11,490 have no coverage. So what incentive does the law create for patients in the coverage gap who need medical care?

California hospital sued for wrongful termination after secretary fired when she reported sexual harassment against ED Director who allegedly spanked women’s bottoms and stuck his tongue in someone’s ear.

Interesting case. New Jersey statutes require that physicians have malpractice insurance with limits of at least $1 million or that they obtain a “letter of credit” for $500,000 if no such policy exists.
In a malpractice case involving reportedly botched surgery, the surgeon allegedly didn’t meet those requirements and didn’t tell the patients that he had no malpractice insurance. The patient sued and won a judgment for $930,000, but their claims against the surgeon for failing to disclose that he didn’t have malpractice insurance were dismissed.
Now the NJ Supreme Court has taken the case and is going to decide whether failing to disclose lack of malpractice insurance can constitute fraud in New Jersey.

Another successful lawsuit regarding da Vinci robots. This gynecologist was found liable for $110,000 after a da Vinci device reportedly malfunctioned and a plastic sheath was left in the patient’s abdomen after surgery. The foreign bodies were not found in the patient’s abdomen until a CT was performed more than three years after the patient’s surgery.

Patients gone wild. Family member of patient in Philadelphia emergency department punches nurse in the face after alleging that family member was not receiving proper medical care.

Taking patients gone wild to a whole new level. Minnesota obstetrician hunted down and murdered in his home by disgruntled patient who blamed physician for medical issue with which patient was born. The shooter, Ted Hoffstrom, was a 30-year-old attorney.

43 year old Army Veteran wins $8.3 million against St. Louis VA Medical Center in federal court after site from routine cardiac catheterization becomes infected, then “further negligence” caused severe brain injury, then patient’s leg became gangrenous and required amputation.

Interesting statistics about medical malpractice cases in Tennessee. In fiscal year 2013, there were 385 medical malpractice cases filed in Tennessee which was only 0.18% of all trial court filings (one in 555 cases). Despite this, Tennessee trial judges spent nearly 4% of their time on medical malpractice cases — 70% more than first degree murder cases which was the second most time-intensive type of court case.

University of Massachusetts settles malpractice suit for $4.25 million when child born with brain damage after obstetrician mishandled the mother’s labor and did not immediately agree to a mother’s demand for a Caesarian section. Of course, if the doctor had agreed to the mother’s demand for a C-section and there was a bad outcome, the doctor would have been sued for that, too.

2 Responses to “Healthcare Update Satellite — 12-04-2013”

  1. Mark says:

    Regarding the murdered Minnesota obstetrician.

    Article is terrible.
    The article writes [his death came as a “complete shock.”]
    WTF? his murder came as a surprise? no kidding!

  2. Steven Zeitzew says:

    FYI: I found the following on the web at https://efast.gaappeals.us/download?filingId=df4a99a4-99fb-4b5d-982f-4b0b88f916c7 :
    Dr. Peter Rosen and Dr. Steven Gabaeff served as medical experts in this case. Dr. Rosen had been a licensed physician since 1962, and he was the author and editor of numerous textbooks on the subject of emergency medicine, including a text
    and reference book entitled, “Emergency Medicine: Concepts and Clinical Practice.”
    Dr. Rosen had maintained teaching faculty privileges at Harvard University Medical
    School’s teaching hospital; had maintained hospital staff privileges at several
    hospitals where he served as an emergency physician; had diagnosed the condition
    of pulmonary embolism hundreds, if not thousands, of times during his career as an emergency physician; and had taught medical students, interns, and residents how to properly consider, rule out, and diagnose the presence of a pulmonary embolism. Dr. Gabaeff had been an emergency physician for 35 years, and he had considered, ruled out, and diagnosed the condition of pulmonary embolism hundreds of times. Dr. Gabaeff had also been a faculty physician at the University of California Medical
    School in San Diego, and had taught medical students, interns, and residents on how
    to properly consider, rule out, and diagnose the pulmonary embolism condition.
    Based upon these qualifications, the trial court denied Dr. Omondi’s motion to exclude the medical expert’s testimony, and ruled that the medical experts were qualified to give expert opinion testimony in this case pursuant to OCGA § 24-9-67.1(c).2

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