Posts Tagged ‘hospitals’

ADA week: Dark v. Curry County

One reads a lot about how a conservative judiciary has supposedly pulled the teeth of the Americans with Disabilities Act. Particularly noteworthy is a series of decisions in which the Supreme Court, faced with employment claims in which safety might be at risk (from commercial pilots with poor vision, for example), ruled against the employee’s claim and widened the effective range of employer discretion.

No doubt there is some truth to the idea that the high court’s employment decisions have curbed the ADA’s expansionary momentum. But then there are the cases like that of Dark v. Curry County, decided by the Ninth Circuit this summer. Robert Dark, an epileptic from youth, operated heavy construction equipment for the road department of an Oregon county. One morning he experienced an “aura”, a sensation which often presages a coming seizure, but did not inform anyone at the job about it when he reported for work. Later that day, he did in fact experience a seizure. An accident was avoided because a co-worker managed to seize control of the machine Dark was operating before it could do any damage.

The county terminated Dark, with emphatic language about how his medical condition prevented him from safely accomplishing his duties. A lower court agreed with the county, but a three-judge Ninth Circuit panel reinstated his suit. Its key points: the county did not adequately give consideration to reassigning Dark to light-duty positions, in particular those that it might have anticipated would “become available within a reasonable period” following his removal from the machinery job, even though the jobs were not in fact open at the time. And although the county placed considerable weight during the dispute on Dark’s misconduct in not informing his supervisors or co-workers about his indications of a possible impending seizure, it did not cite that reason at the time in dismissing Dark, instead (and more diplomatically) reciting the safety concerns of a prospective nature.

The case (available at FindLaw here in PDF format) sparked considerable discussion on the web, including Phillip J. Griego (to whom the above discussion is indebted), HRHero/M. Lee Smith, and Proskauer Rose. Robert Loblaw at Appellate Decisions writes (Jul. 6):

The ADA often places employers in a difficult position, since they have knowledge of the dangers of employing a particular individual but cannot always take steps to address those dangers. Indeed, this case is similar to last year’s Pacific Bell case, which involved a home repair technician who had spent time in a mental hospital after being found not guilty of attempted murder by reason of insanity (my coverage here). As in that case, Curry County would probably be found liable in tort if Dark injured somebody while on the job, due to its knowledge of his condition. Indeed, Curry County is even more likely to be on the hook if Dark has another seizure that results in injury, since he already had one near-miss on the job. But as far as the ADA is concerned, Curry County’s potential tort liability is simply not relevant.

And before assuming that this is just one of those wacky Ninth Circuit cases, note (as does Ross Runkel) that the author of the opinion is the highly regarded conservative jurist Diarmuid O’Scannlain. Maybe it just is an extreme law, with no judicial activism needed to get extreme results out of it.

Updates

Recent developments on past stories:

* Remember Shannon Peterson, the Denver condo owner who got sued by a neighbor who complained that she was taking baths too early? (Feb. 27). The case is still dragging on the better part of a year later, a judge having refused so far to throw it out. David Giacalone has the details (Nov. 30).

* Glamourpuss lawsuit-chaser Erin Brockovich, fresh from the humiliating dismissal (Nov. 18) of suits she fronted against California hospitals alleging Medicare overbilling, has been rebuffed in another high-profile case. This time a judge has dismissed twelve lawsuits brought by her law firm of Masry & Vititoe alleging that exposure to oil rigs at Beverly Hills High School caused cancer among students there (Martha Groves and Jessica Garrison, “School oil-rig lawsuits dismissed”, Los Angeles Times, Nov. 23) (via Nordberg who got it from Legal Reader). For more on the case, see Jul. 15 and Nov. 19, 2003, and Mar. 16, 2004. The New Republic has marked the occasion by reprinting its revealing 2003 article on the affair by Eric Umansky. P.S. More from Umansky, who has his own blog, here.

* Reader E.B. writes in to say:

Remember the group of parents (Oct. 23) who threatened litigation over their daughters’ playing time on the girl’s basketball team? The ones who demanded a six-person panel to oversee the selection of the players?

None of the parents’ daughters made the team. And they’re not happy about it. See C.W. Nevius, “Castro Valley hoops coach can’t win”, San Francisco Chronicle, Nov. 30.

* A court has dismissed the action (Aug. 10, 2005; Feb. 9, Feb. 20, Mar. 6, Jun. 28, 2006) by fair housing activists against Craigslist over user ads that expressed improper preferences or mentioned forbidden categories in soliciting tenants, apartment-sharers and so forth. (Anne Broache, “Craigslist wins housing ad dispute”, CNet, Nov. 17). However, blawger David Fish says the court’s reasoning was highly unfavorable to many other Internet companies generally, and may expose them to future liabilities (Nov. 15). Craigslist now has an elaborate page warning users that it is unlawful for them to post preferences, etc. in most situations not involving shared living space. Update: David Fish’s name corrected, apologies for earlier error.

* 3 pm update to the updates from Ted: “An Illinois intermediate appellate court overturned the $27 million verdict in Mikolajczyk v. Ford (which we reported on last year), ordering the lower court to replace the arbitrary jury verdict with a lower arbitrary number. Why the jury’s damage award is considered the product of passion and prejudice, but the same jury’s liability award is kosher, remains unclear. (Steve Patterson, “Court says $27 million crash award too much”, Chicago Sun-Times, Nov. 23).”

Update: “Brockovich’s Medicare-billing lawsuits tossed”

Glamor proved no substitute for legal merit as U.S. District Judge Thomas Whelan in San Diego dismissed two lawsuits by the highly publicized Brockovich against major hospital chains, alleging that the chains should refund to Medicare sums spent on treating injuries caused by earlier hospital negligence (see Jun. 22). The suits “made no specific claims of patient injury” but instead proffered studies estimating the nationwide incidence of negligent patient injury in hospitals. The judge termed the claims “speculative allegations” intended to allow Brockovich and the lawyers for whom she was fronting to “begin a fishing expedition”. “The judge also noted that Brockovich, 46, was not eligible to receive Medicare benefits, was never treated at any of the Scripps or Sharp hospitals, and was never injured by hospital staff misconduct.” (Keith Darcé, San Diego Union-Tribune, Nov. 16). For more on Brockovich’s activities generally, follow links from Nov. 3, 2005.

Two more hot coffee lawsuit data points

Add the Stony Brook University Hospital cafeteria to the list of servers unsuccessfully sued over burns caused by hot coffee. If you recall, the theory of the McDonald’s coffee case (and repeated by such trial lawyer defenders as congressional candidate Bruce Braley) was that McDonald’s, and only McDonald’s, served coffee so hot as to burn. For some reason, the reporter for the New York Law Journal tries to leave the reader with the impression that the original Stella Liebeck case was justifiable (though that opinion is irrelevant to the article itself) which shows how successful trial lawyer propaganda has been within the legal community and press. (John Caher, “N.Y. Judge Cool to Injury Claims Over Spilled Coffee”, New York Law Journal, Nov. 2). We earlier listed other hot coffee lawsuit defendants.

Speaking of which, you may recall the Russian McDonald’s coffee case litigation that we covered a year ago, with identical allegations from a woman who spilled coffee on herself; the press is reporting that the plaintiff has dropped her case. As in the Stella Liebeck case, the Russian McDonald’s had a warning on the coffee cup that the contents were hot. (“Moscow McDonald’s coffee-spill case closed”, RIA Novosti, 1 Nov.).

Dr. Lawrence M. Poliner v. Presbyterian Hospital update

The ludicrous $366 million award on a conspiracy theory (Aug. 30, 2004; Sep. 2, 2004) was, as we predicted reduced by remittitur to a still ludicrous $22.5 million. (Plaintiff’s attorney’s press release, Sep. 21). Kevin M.D.’s commenters note that the trial bar simultaneously complains that doctors don’t do enough to police themselves and then hold doctors liable for policing other doctors.

Note that the doctors whom the verdict was issued against weren’t even the ones on the peer review committee that suspended Dr. Poliner’s privileges for a few months; they were just the ones who started the peer-review process.

Florida reform in trouble?: Jeff Kottkamp

Florida has staggered towards reform in the last few years under Governor Jeb Bush, bush GOP candidate Charlie Crist’s running mate, Jeff Kottkamp, is a trial lawyer, reform opponent, and plaintiff in a ludicrous suit blaming a hospital construction contractor for medical complications he had following heart surgery. (John Kennedy, “GOP candidate breaks rank on tort reform”, Sun-Sentinel, Oct. 5) (via Childs). Earlier coverage: Sep. 18 and links therein.

Elsewhere in Florida, the Florida Supreme Court has essentially undone a 2004 reform voters passed in a referendum (Nov. 3, Mar. 1: it will allow attorneys to avoid the effect of a constitutional amendment capping medical malpractice attorneys’ fees, so long as their clients sign a waiver saying they’re willing to pay more. (Aaron Deslatte, “Court lets lawyers bypass lawsuit cap”, Tallahassee Democrat, Sep. 29). I actually applaud this step to the free market, but just wish doctors had the same rights to get their patients to sign waivers. Apparently courts and consumer advocates are willing to trust only lawyers with the freedom of contract or speech.

Jackpot justice: $217M for misdiagnosed stroke in Florida

[Bumping October 5 9AM post to reflect new details.]

$100.1 million in punitive damages, and the “compensatory” award is almost certainly mostly non-economic damages, though the press coverage does not distinguish. (Thomas W. Krause, “Jury Puts Punitive Award At $100 Million”, Tampa Tribune, Oct. 3). TortsProf blog, Peter Lattman, Kevin MD, and Greedy Trial Lawyer comment. So no one accuses us of unfairness, we’ll repeat the GTL summary of the case:

ProAssurance’s subsidiary, ProNational Insurance Co., was the malpractice insurer for a doctor’s group running a Tampa area hospital emergency room where patient Allan Navarro’s stroke was misdiagnosed by an unlicensed physician’s assistant as a headache and sinus infection.

[Plaintiffs’ attorney Steve] Yerrid told the Tampa newspaper he tried to get the insurance company to settle for the maximum allowed under the policy – $1 million for the doctor and $1 million for the physicians’ group. Instead, he said, the insurance company wanted to settle for $300, offering $100 for Navarro, $100 for his wife and $100 for his 10-year-old son.

Update: Daily Business Review has a more detailed summary than the mainstream press:

On Aug. 9, 2000, Navarro, who was a professional basketball player in his native Philippines, entered University Community Hospital-Carrollwood with a headache, nausea, dizziness, confusion and double vision. He described a personal medical history of hypertension, diabetes and elevated cholesterol plus a family history of strokes to the triage nurse. A different nurse than the triage nurse also noted he was unsteady on his feet.

When Navarro spoke with Herranz in the examination room, he mentioned the sudden onset of a headache earlier that day and that he had felt a “pop” in his head.

According to the 2005 second amended complaint, Herranz did not complete an adequate medical history of Narvarro, nor did he do a complete or adequate neurological exam.

Navarro spent about 5 1/2 hours at UCH-Carrollwood, during which time he had two CT scans of his brain and was diagnosed with “sinusitis/headache” by Austin, prescribed Vicodin for the pain and an antibiotic by the doctor and sent home. He was not told to watch for any stroke symptoms.

The suit alleged that Navarro presented classic stroke symptoms that Austin should have noticed. It further said that CT scans are not adequate diagnostic tools for ruling out the type of stroke Navarro had.

Early the next morning, Navarro woke with a severe headache, slurred speech, nausea, confusion and trouble walking. He was readmitted to the UCH-Carrollwood Emergency Room at 6:05 a.m. Upon his return, he was labeled “urgent,” but doctors still had not diagnosed a stroke. It wasn’t until he was transferred to Carrollwood’s sister hospital, UCH-Fletcher, that afternoon that surgery was finally performed. By then, the stroke had already left him paralyzed with mental disabilities. During surgery, he slipped into a four-month coma. He is now confined to a wheelchair.

(Rebecca Riddick, “Judge Halts Defendants’ Bid to Avoid $116M Med-Mal Verdict”, Oct. 6).

Multiple issues here:

Read On…

Medical tourism

Bumrungrad International Hospital in Bangkok, Thailand, treated 58,000 American patients in 2005, and looks to treat 20 percent more this year. Why?

At Bumrungrad Hospital, [spokesman Ruben] Toral said, the lower cost of living is a major factor in the savings, but so are differences in how the medical system operates.

Doctors in Thailand pay about $5,000 a year for malpractice insurance, compared with more than $100,000 for some specialties in the United States.

Thai courts will adjudicate malpractice claims, but the largest award ever issued was about $100,000 and the law there doesn’t permit damages for pain and suffering.

(Mark Roth, “Surgery abroad an option for those with minimal health coverage,” Pittsburgh Post-Gazette, Sep. 10). Apparently the Thais haven’t heard the propaganda from the American trial bar that caps on non-economic damages don’t lower malpractice insurance premiums or medical expenses. And apparently, thousands of Americans prefer cheaper healthcare to the opportunity to recover pain-and-suffering damages: unfortunately, plaintiffs’ organizations fight very hard to ensure that American consumers don’t actually get that choice. (Via, of all places, Bizarro-Overlawyered, where one can almost see the smoke coming out of the ears of the posting blogger because of the “Does-Not-Compute” cognitive dissonance.)

Read On…

“Death after two-hour ER wait ruled homicide”

In Waukegan, Ill., 49-year-old Beatrice Vance died of a heart attack after waiting two hours in a hospital waiting room. A coroner’s jury has declared her death a homicide. (Lake County News-Sun, AP, Chicago Tribune). Medical blogs are discussing: GruntDoc, MedPundit, KevinMD. Plus a discussion at Prof. Bainbridge’s. (cross-posted from Point of Law).

From the comments: a chill on safety discussions

While the comments action has been lively elsewhere on this site, I noticed a comment that Jim Collins made on Ted’s post “Damned if you do, damned if you don’t files: Putnam Hospital” which I thought deserved its own freestanding entry:

The medical profession isn’t the only place where this happens. I used to be an aircraft mechanic for one of the major airlines, several years ago. Twice a month, after finishing our shift, we would go to a breakfast meeting. This meeting was attended by all of the mechanics from all of the airlines at that airport who worked the same shift. Several people from the airport and the FAA also attended. The purpose of this meeting was to share information on maintenance and airport safety issues. The FAA rep always took notes, compiled them from all of the shifts and a couple days later a copy was in your mailbox. I know of several problems and possible accidents that were prevented because of the information shared at these meetings. These meetings were suddenly stopped after company management found out that trial lawyers could obtain the minutes of them, from the FAA, through the Freedom of Information Act and use them against the airline in court.