Microblog 2008-10-13

  • Don’t kvetch about Krugman Nobel, it’s for his work in economics not his politics [Cowen, MargRev] #
  • “Law Grad Cited for Frivolous Suits is Source of Obama Muslim Rumors” [ABA Journal] #
  • Garrison Keillor reads a poem on product warnings [Point of Law] #
  • Last will and testament, handwritten on a shopping list [Giacalone] #
  • Fast, fast relief from troublesome teens, just drop ’em in Nebraska [Houston Chronicle] #
  • Michael Arrington: “suing someone to get them to return your calls is not exactly a sign of brilliance” [TechCrunch via Blawg Review #181 at Mediation Channel] #

Critical lab value? Gotta page the doc

We’ve often touched on the subject of lab testing and defensive medicine, but as Happy Hospitalist points out [Oct. 11], ordering needless testing is by no means the only way the various parties endeavor to avoid liability. Another is the superfluous communication of not-really-urgent abnormal test results, sometimes on a doctor’s pager at 4 a.m.:

Unfortunately, patient safety is rarely an issue. It’s a giant game of shifting liability. The lab documents they notified the nurse–>lab off the hook if something bad happens. The nurse notifies the doctor —> nurse off the hook if something bad happens. Doctor is left with a critical value called 10 or 20 times a day, interrupting the entire flow of patient evaluations and discharges. Every time, I must stop what I’m doing and answer a page for a critical lab value, I lose valuable face time with patients. And it all adds up over the course of a day. I wouldn’t have a problem with the system, except that critical thinking has been removed from the equation. The nurse is not allowed to make judgments as to whether a phone call is warranted or not.

As a default protocol of calling all critical lab values, the liability is shifted up the educational food chain, landing ultimately on the physician’s lap. Often times a nurse is not allowed to not call a critical lab value. The problem is, what the hospital has defined as critical, does not apply to the vast majority of critical lab values reported. What’s considered critical by hospital standards, is a normal or chronic value for [that particular] patient.

Whole thing here.

Microblog 2008-10-12

Microblog 2008-10-11

  • Would single-payer fix malpractice woes? Not likely given trial bar political clout [KevinMD] #
  • Prosecuting candidates for crowd-inciting campaign speeches? Now there’s a truly bad idea [Point of Law] #
  • Her busy docket: “For people like Oprah, lawsuits are a part of life” [Roeper, Chicago Sun-Times] #
  • Nebraska hospital sues patient for refusing to leave [Happy Hospitalist; related earlier] #
  • Community covenant craziness: “Dad’s in prison because we can’t afford to sod the lawn” [St. Petersburg Times] #

Update: B.C. tribunal dismisses Mark Steyn case

The provincial government of British Columbia will not punish the magazine Maclean’s for running an article exposing Islam to asperity (coverage at Steyn’s site). Jay Currie, via Steyn at NRO “Corner”:

…the way I read this decision is that it imposes a two part test a) are your words offensive and hurtful? b) are you a major media organization with deep pockets represented by serious lawyers. If “a” and not “b” you are a hate monger; if “a” and “b” you are engaged in political debate.

Commenter “Binks” at FreeMarkSteyn:

The ordinary Joe or Jane Canuck is no safer today than last year when this all started. The Human Rights Commissions have probably learned only two things: the internet bites back when bloggers get rolling on an issue; and don’t chew on famous and well-connected targets.

Update: wrestlers’ class action against WWE

When guestblogging at this site not long ago, Daniel Schwartz of the Connecticut Employment Law Blog contributed a highly popular post about the class-action lawsuit filed by three professional wrestlers (“Raven”, “Chris Kanyon”, and “‘Above Average’ Mike Sanders”), a lawsuit based on the theory that the three had been improperly categorized as independent contractors while in reality standing in the position of employees to Connecticut-based World Wrestling Entertainment, Inc. Now he’s posted a couple of substantial updates at his blog (Oct. 4, Oct. 8) introducing the litigants, attorneys and judge, describing how the suit can be expected to unfold, and explaining why its outcome might turn out to be important for those other than wrestlers and their fans.

Signaling the client during cross-examination? Me?

Lawyer Robert Bundy, representing a key witness at the Ted Stevens trial, is said to be all “torn up” about the judge’s accusation that he was transmitting secret nods and movements to convey to his client what testimony was desirable. Eric Turkewitz says that in his experience coaching during testimony takes three forms: “speaking objections”, nods and head movements (which may be unconscious), and deliberate signaling. (Oct. 7; AP/Google).