New York City taxpayers are probably going to be liable not only for the physical injuries inflicted in Wednesday’s Staten Island Ferry crash — which include ten deaths and about 60 injuries resulting in hospitalization, some of them horrific — but also for damages potentially payable to all of the unhurt passengers, widely estimated to number 1,500. A “federal maritime doctrine allows all those who were in the face of danger and who suffered emotional distress to file for compensation, even if they were not physically injured”. Among likely claims, according to Columbia law dean David Leebron, are those from “passengers who claim to now have a fear of ferries that affects their ability to commute and earn a living”. (“City Could Face a Deluge of Suits Over Ferry Crash”, New York Times, Oct. 18; “Staten Island ferry pilot to be investigated”, AP/Globe and Mail, Oct. 16). For awards of $300,000-$6.5 million in the related area of suits by air-crash survivors with minor or no injuries, see Oct. 8, 1999, Oct. 19, 2000, and Aug. 24-26, 2001. (& welcome Samizdata.net readers)
Posts Tagged ‘hospitals’
First-rate bilge on secondhand smoke
Jacob Sullum eviscerates an embarrassingly bad op-ed that the New York Times chose to run yesterday (Rosemary Ellis, “The Secondhand Smoking Gun”, Oct. 15) on the issue of smoking in public places, based on the supposed “Helena miracle” — heart attacks in the Montana capital (population 26,000) are said to have dropped suddenly by 58 percent when smoking in public buildings was banned. The claim, he says, is based on a single unpublished study “involving tiny, highly volatile numbers”. Had the Times been interested in whether the asserted result would hold up as a matter of epidemiology, it could easily have checked out the experience of other jurisdictions which could offer much, much larger sample sizes than wee Helena: “why have we not heard about a dramatic drop in heart attacks [in New York City itself] since the city’s smoking ban took effect in April”? A few phone calls to Columbia-Presbyterian, St. Lukes-Roosevelt and the city’s other big hospitals should suffice to establish whether there had been any massive effect of this sort on New Yorkers’ proneness to cardiac arrest. (Reason Hit & Run, Oct. 16; Jacob Sullum, “Heartstopping Discovery”, Reason, Apr. 4). More: Cato’s Steven Milloy weighs in (“Secondhand smoke scam”, FoxNews.com, Oct. 17).
Oh, that medical privacy
Police have arrested 42-year-old Juvenal Caballero Guerrero, formerly a patient-care assistant at Houston’s Memorial Hermann Hospital, on charges of “selling about 12 pages of patient information for $500 to a representative of Industrial Safety Consultants, a company that advertises ‘investigations regarding accidents and injuries’ from its Houston offices. According to court documents, investigators were told the company has sold stolen patient records to personal-injury lawyers. … Prosecutors said the arrests won’t stop with Guerrero…’There are lots of other people involved,'” Harris County prosecutor Lester Blizzard told the Houston Chronicle, including employees of other health institutions. Lawyers might also face charges if they can be proved to have directly solicited business from accident victims. (“Former Houston hospital worker arrested”, AP/Fort Worth Star-Telegram, Aug. 28; “Hospital Employee Charged With Theft, Sale of Patient Information”, BNA Health Law Reporter, undated Sept.; Annie Blanco, “Hospital worker arrested for medical record theft”, News 24 Houston, Aug. 28)(via SickOfLawsuits.org)
Before he reached the Senate
The Boston Globe looks into Sen. John Edwards’s career before he came to Washington and finds “he was more than just a practitioner of medical malpractice law. He was one of its most prominent specialists, stretching the reach of the law for nearly two decades. But he also came to personify some of the alleged excesses that reformers have sought to curb.” Among them: emotionally manipulative trial arguments, selection of deep pocket defendants and suits on behalf of victims who had contributed to their own victimization, including a woman who committed suicide and whose survivors successfully sued the hospital with Edwards’ help. (Wendy Davis, “Edwards’s career tied to jury award debate”, Sept. 15).
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)
Australia: “$300,000 payout for psychotic killer”
Updating our report of Oct. 16-17: “A man acquitted of murder because he was psychotic has won a $300,000 payout after suing a hospital for negligently releasing him into the community.” (Louise Milligan, The Australian, Aug. 20). Supreme Court Justice Michael Adams “found Hunter Area Health Service and a psychiatric registrar had breached their duty of care by failing to detain [Kevin Presland] in Newcastle’s James Fletcher psychiatric hospital.” After Presland’s release he brutally murdered his prospective sister-in-law, Kelley-Anne Laws. Justice Adams “noted that while it was generally unacceptable for someone to recover damages where they had committed a crime, in this case ‘he was insane at the time of the killing and innocent of any crime'”. The murder victim’s mother “was devastated at yesterday’s judgement. ‘Don’t give it to him,’ said Christine Laws. ‘Put it back into the mental health system to help people … It was his choice to take marijuana, his choice to drink — nobody else’s. No one made him do it, yet the system sees fit to pay him. I can’t understand the law.'” (Leonie Lamont and Miguel Holland, “Judge awards woman’s insane killer $300,000”, Sydney Morning Herald, Aug. 20).
Employment Policy Foundation finds med-mal system lacking
“The Employment Policy Foundation?s (EPF) analysis of data comparing states with and without limitations on damage awards in malpractice cases found that capped damage awards could save $54.8 billion to $97.5 billion annually — 7.2 percent to 12.7 percent of the $764.8 billion spent on hospital and physician services each year. … In 2001, the gap between premiums collected and underwriting losses amounted to $4,033 per physician, assuming that all 744,000 full-time physicians in the U.S. were covered. … Plaintiffs eventually receive only 38 percent of the total dollars that flow through the malpractice litigation system.” (“Medical Malpractice Litigation Raises Health Care Cost, Reduces Access and Lowers Quality of Care”, EPF Issue Backgrounder, Jun. 19 (PDF); news release, Jun. 13).
Pa. malpractice insurers lost $18M last year
“Medical-malpractice insurance underwriters in Pennsylvania lost $18 million last year, according to a new analysis by the state Department of Insurance that appears to underscore industry claims that Pennsylvania’s tort system is driving insurers out of the state. … Medical-malpractice insurance underwriters in Pennsylvania paid out $345.4 million in claims last year, about 31 percent less than the $499 million that insurers received in premiums from doctors, the department said. But while insurers earned $46.4 million in investment income, they also paid $136.9 million in legal costs and $81.1 million for taxes and other operating expenses.” The actual loss figure attributable to 2002 may come in a good bit higher than $18 million when all accounts finally come to reckoning: “The insurers also put away $209.4 million in reserves for future claims.” (Marc Levy, “State analysis shows Pa. malpractice insurers lost $18M last year”, AP/Doylestown (Pa.) Intelligencer, Jul. 15).
More: reader James Ingram writes, “So what do these numbers show? Insurers collected $499 mm in premiums and paid $345 mm in claims and $137 mm in legal costs. If we assume that 1/3 of the amount paid in claims went to plaintiffs’ lawyers (actually a pretty conservative figure, many charge more) that amounts to another $115 mm going to legal costs. Add $137 mm and $115 mm and you have $252 mm of the $499 mm that doctors, hospitals and other providers paid in premiums (more than half) going to legal expense while a maximum of $230 mm (46%) went to claimants. Great system, if you are a lawyer!”
“Once a C-section, always a C-section” policy blamed on legal risks
Oregon: “Women who have delivered a baby by Caesarean section must deliver their next child the same way if they give birth at Merle West Medical Center. The hospital’s board of directors today announced a new policy that supports a decision by local obstetricians to not deliver a baby vaginally if the mother has had a previous Caesarean section, a surgical procedure that delivers the baby by making an incision in the abdomen and uterus. The decision is based more on legal implications related to the potentially high-risk procedure than on medical statistics, said Dr. Rick Zwartverwer, vice president for medical affairs at Merle West Medical Center.” (Marcia McGonigle, “Hospital alters C-section policy”, Klamath Falls (Ore.) Herald & News, Jul. 8)(see Feb. 5, 2001). Update Nov. 29, 2004: New York Times covers the story.
“Lawsuit faults hospital for overdose”
Amanda C. Hagan, 29, of Allentown, Pa., is suing Norristown State Hospital “for allowing a visitor to bring into the hospital the illegal drugs she used.” She also “is blaming the hospital and county for not noticing she was high and that her heroin or cocaine needle was broken and still stuck in her arm when she received an antidepressant. The overdose that followed should have been prevented, Hagan’s civil lawsuit states.” (Pamela Lehman, Allentown Morning Call, Jun. 25; “Ridiculous suit is a waste of time” (editorial), Jun. 27).