Environmentalists have filed a lawsuit to block construction. [Santa Barbara Daily Sound via Popehat]
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Chronicling the high cost of our legal system
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Environmentalists have filed a lawsuit to block construction. [Santa Barbara Daily Sound via Popehat]
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Manhattan Institute Senior Fellow John Avlon, in Forbes:
New York City spends more money on lawsuits than the next five largest American cities — Los Angeles, Chicago, Houston, Phoenix and Philadelphia — combined. The city’s $568 million outlay in fiscal year 2008 was more than double what it spent 15 years ago and 20 times what it paid in 1977.
And the odd and extreme cases continue:
A Brooklyn insurance investigator won $2.3 million this year after he tumbled onto the subway tracks with a 0.18 blood-alcohol level and lost his right leg. (”They’re not allowed to hit you just because you’re drunk and on the track,” his lawyer explained.) A corrections officer received $7.25 million after unsuccessfully attempting suicide, on the grounds that the city should not have permitted her to have a gun. (”Ms. Jones could just have easily turned her city-authorized firearm on anyone,” her lawyer said.)
The piece is adapted from a contribution to a City Journal symposium, “New York’s Tomorrow”, and there’s also an associated podcast (cross-posted from Point of Law). More: Eric Turkewitz talks back from a plaintiff’s point of view (”when you account for inflation, there really hasn’t been much change at all” [compared with 15 years ago)] (& welcome Above the Law, WSJ Law Blog readers)
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San Francisco Chronicle columnist Debra Saunders discusses the large settlement paid by Santa Clara County to the family of Andrew Martinez, who suffered from schizophrenia and became famous as Berkeley’s “Naked Guy” before taking his own life in jail. She quotes me on the terrorizing effect of suing public managers individually and on the way outside direction of public agencies by litigators often (as consent decrees, court orders and legal avoidance layer one atop another) can add up to “management by no one at all.” [Debra Saunders, "A naked million", San Francisco Chronicle, May 24].
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That’s what the federal government, if not common sense, says. But what if the fall is from the roof?
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We’ve already aired much dissent from the medical profession about whether or not top-notch hospital care can in fact prevent all instances of patient falls, decubitus pressure ulcers (bedsores), hypoglycemia, deep vein thrombosis, delirium, suicide attempts, c. difficile infection, or iatrogenic pneumothorax. Nonetheless, Medicare has adopted its proposal to deny hospitals reimbursement for the cost of treating such events and complications, with likely consequences both for hospital behavior (refusal to admit some patients at high risk of never events), for private insurer behavior and for the climate of medical malpractice litigation. (Kevin Sack, “Medicare Won’t Pay for Medical Errors”, New York Times, Sept. 30). White Coat Rants, who has blogged extensively on the issue in past months, has some predictions (Oct. 1) of things we can now expect to see more of: more patient transfers between hospitals (since Medicare will not punish the second hospital for the first’s “never event”; underdiagnosis of certain conditions and overdiagnosis of others; and, more remotely but no less alarmingly, pressure on some families to serve as ultimate bearers of risk for supposed never events affecting the frailest and most elderly:
Say hello to the Advance Beneficiary Notices. Medicare won’t cover preventative care, so you are going to have to pay for it out of your pocket. If you’re prone to falls or bedsores, you’ll have to pay for a personal nurse to wait on you hand and foot so you don’t develop these never events. If you don’t pay for a personal nurse 24 hours around the clock to keep a never event from happening, you’re personally responsible for paying the costs of treatment if the “never events” occur. You had the opportunity to prevent the events but you were just too cheap to pay for it. I think that ABNs are less likely to catch on, but eventually I think they will become commonplace.
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One assumes that in the U.S., the First Amendment would restrain the government from regulating this variety of online content. Not so in Britain, where parliamentarians frankly avow their intent to shut down websites that morbidly encourage notions of self-destruction. “I would recommend that publishers who moderate all comments on their forums or chat rooms should silence discussions that encourage suicide, and sites that rely on others to complain about material before they review it should take down such discussions if complaints are received,” said technology lawyer Struan Robertson. What would have happened to Goethe’s Sorrows of Young Werther? (Out-Law News, Sept. 18, via @lawtweets).
“The family of a 26-year-old man who died two years ago after an off-duty firefighter tried to rescue him from the edge of a roof will receive a financial settlement from The City, after claiming the firefighter was at fault.” Fire Lt. Victor Wyrsch tried to grab the suicidal Nick Torrico from the roof, but Torrico tore himself loose and fell to his death, and now the city’s taxpayers will pay Torrico’s family based on their contention that Wyrsch should have held back. (Beth Winegarner, “San Francisco pays up for failed rescue”, San Francisco Examiner, Aug. 26).
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In Longview, east Texas, the Patterson Nissan dealership held a contest awarding prizes to the participants who could hold their hands on a car the longest. One contestant dropped out, ran to a nearby store where he broke a gun out of its case, and shot himself. The dealership has now settled the lawsuit by Richard Thomas Vega II’s widow claiming that the stress and sleep deprivation of the event amounted to “brainwashing” and that the sponsors failed to make allowances for temporary loss of sanity. (AP/FoxNews.com, Aug. 17).
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On November 14, 1999, high-school dropout Rolando Domingo Montez, celebrating his 19th birthday, was arrested for public intoxication and trespass after the owner of the boat on which he and his friends were sitting complained. Police placed him in Cell No. 1 of the Port Isabel City Jail. The next morning, Montez was permitted to make some collect calls from his jail cell to seek bail money from his mother, Pearl Iris Garza. Mom, complaining that Montez was in jail again, refused. But she generously came to pick up Montez on the 16th when he was released on his own recognizance. Unfortunately, while Garza was waiting in the lobby, and while police were responding to a call for assistance regarding a suspicious vehicle, Montez hung himself with the 19-inch phone cord from the phone he had used to make the calls.
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41-year-old South Texas personal injury solo practitioner Hermes Villarreal was admitted to a McAllen hospital on April 16, 2005, reporting that his heart was racing. The hospital put him on a 24-hour EKG. Villarreal reported being under stress, but refused a psychiatric consultation or the recommended medication. At 5 a.m. on April 19, 2005, the day of his scheduled discharge, “Villarreal summoned the nurse on duty and requested a razor, saying that he wanted to take a shower and shave his chest, because the EKG monitor leads attached to his chest were bothering him.” The nurse complied with his wishes, and Villarreal locked himself in the bathroom and committed suicide with the razor.
This was, said Villareal’s family, the hospital’s fault; since it’s South Texas, a Hildalgo County jury, after a three-week trial, awarded $9 million in March (which looks to be reduced at least to $1.64 million under Texas law capping damages). Ironically, the opening line of the Texas Lawyer story says “It was a suicide no one saw coming,” but doesn’t question the resulting jury verdict.
Somehow, the trial lawyer, Raymond L. Thomas, a close friend of Villarreal’s, interjected himself into the closing argument, telling an emotional story of a Rolex Villarreal had given him as a gift that left the jury in tears; the press coverage doesn’t acknowledge the blatant violation of ethical rules (see also Texas Rule 3.04(c)(3)), much less indicate whether he got away with it because of the failure of the defense to object or a judge’s failure to oversee her courtroom. (Jenny B. Davis, “Attorney, Interrupted: Seeking Meaning, Recovery for a Legal Life Lost,” May 5 via ABA Journal).
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…or the universal adoption of round-the-clock patient guards or restraint devices, it’s hard to go along with the notion that hospital falls should be so-called “never events”. (Happy Hospitalist, Jan. 15, Feb. 20). Nor is the concept much more useful when it comes to patient suicide attempts or hypoglycemia, among other misadventures (White Coat Rants, Feb. 5)(via KevinMD). Related: letters section, 2004 (pressure wounds/bedsores).
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I’d like to thank Walter Olson for inviting me to contribute to one of my favorite blogs, Overlawyered. As an attorney and psychologist, I’ve worked in a number of different hospitals across the country. Health care institutions are unique places to work for in many respects because the decisions made there can directly lead to serious or even fatal outcomes. Of course this is obvious, as should be the fact that despite the best intentions of everyone involved in a patient’s care, bad outcomes occur.
Alison Cowan has this article in last Friday’s New York Times highlighting a recent case involving the suicide of Ruth Farrell. By all accounts Farrell had been quite depressed for a very long time. As is the case with some people who struggle with chronic depression, Ms. Ferrell was admitted to the hospital for care and observation related to her depression and suicidal ideation. Sadly, Ms. Farell hanged herself with her own pants between the standard 15 minute “checks” performed by staff on psychiatric wards. In turn, her estate sued her doctors and the hospital claiming improper care.
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