Legal fears stifle hospital review of bad outcomes

New in the Annals of Internal Medicine: “Fear of litigation either stifles hospital efforts to improve patient safety or drives them underground, according to the latest article in a journal series …” In the case under study, a critically ill patient suffered permanent brain damage while under hospital care; the authors, both with the Harvard School of Public Health, consider it “unreasonable” to blame the attending doctor but a suit was filed nonetheless. In the incident’s aftermath, the hospital did not take vigorous measures to involve its staff in any debate about whether procedures needed to be changed — a logical enough course of action given that “generally, hospitals must confine discussions about adverse events to small committees of insiders” if they are to avoid losing their privilege against turning over the results of peer review investigations to hostile lawyers. In the case at hand, “it seems that it would have been beneficial for the hospital and staff to have openly evaluated issues of seamless cross-coverage, protocols for emergent intubation on the floor, and timely transfer to the ICU. Unfortunately, it appears that nothing of this sort occurred.” (“Fear of Litigation Stifles Hospitals’ Efforts To Improve Patient Safety”, press release, California HealthCare Foundation, Aug. 19; Troyen A. Brennan and Michelle M. Mello, “Patient Safety and Medical Malpractice: A Case Study”, Annals of Internal Medicine, Aug. 13; CHCF case study series)

Appeals court nixes $10m for drunken pier roll-off

Those mean old appeals judges: now they’ve gone and reversed a Texas jury’s $10.5 million award against the city of Galveston and the lessee of its Flagship Pier on behalf of the survivors of a couple whose car, rolling backwards, broke through railings and plunged into the water one night in 1996. The court ruled that the defendants, by failing to erect a stronger guardrail, had not injured the couple willingly, wantonly or through gross negligence as specified under state law dealing with recreation facilities. “Medical evidence presented at the trial showed that [Kenneth Wayne] Garza, who had been convicted on numerous occasions for drunken driving, and [passenger Dorey] Fabian were legally drunk, but the jury found Garza only 10 percent accountable for the accident.” (Carter Thompson, “Flagship accident verdict reversed”, Galveston County Daily News, Aug. 26).

Vancouver radio tonight

Our editor is scheduled to appear this evening at 8 p.m. Pacific time on Vancouver’s CKNW, am 980, with host David Berner. The main topic on the agenda — is Canada going the litigious way of the U.S.? — plays off a feature article that ran yesterday in the Vancouver Sun, Ottawa Citizen and other CanWest newspapers but doesn’t seem to be online yet.

Our editor interviewed

Last week this site’s editor visited the Sooner State to speak to the Oklahoma Council of Public Affairs, in conjunction with which visit commentator/radio host Brandon Dutcher recorded this informal Q & A which touches on the tobacco and fast food litigation, the prophetic role of former Okla. Sen. Fred Harris, and more (“No Joke: Lawsuit Abuse Hurts Us All”, interview with Walter Olson, OCPA Perspective, August)

Why doesn’t Arnold…?

…tell us what he thinks about California’s bounty-hunting s. 17200 law? Timothy Sandefur wonders (Aug. 27)(see Jul. 28, Aug. 4, Jul. 22). And the Manhattan Institute (with which our editor is affiliated) has just published the proceedings of an Oct. 24, 2002 conference on state unfair competition statutes, of which California’s s. 17200 is perhaps the most extreme. Among the conferees: prominent attorneys Sheila Birnbaum and Elizabeth Cabraser, Duke law prof Francis McGovern, and Federation of Defense and Corporate Counsel president Robert V. Dewey, Jr. Our editor moderated a panel (“Unfair Competition and Consumer Fraud Statutes: Recipe for Consumer Fraud Prevention or Fraud on the Consumer?“)(PDF)

Torricelli’s environmental patronage

Ethics-challenged former New Jersey Sen. Robert Torricelli is back in business: “A federal judge who was appointed to the bench after being recommended by Mr. Torricelli has assigned him as special master of an environmental cleanup site in Jersey City, a position that allows him to control millions of dollars in contracts and collect an estimated $500,000 a year in administrative fees.” (David Kocieniewski, “Hardly in Disgrace, Torricelli Emerges as a Trenton Power”, New York Times, Aug. 26). Julian Sanchez at Reason “Hit & Run” comments.