Overlawyered: Chronicling The High Cost Of Our Legal System

Posts Tagged ‘Pennsylvania’

“The county had no neurosurgeon, and the boy died”

Chester County, Pennsylvania:

The boy [a 17-year-old who had sustained head trauma in an auto accident] could not be treated at Brandywine Hospital in Coatesville because the trauma center had closed, so he was transferred to Crozier-Chester Medical Center in Delaware County….

‘The last neurosurgeon in Chester County was Sam Lyness, a world-class neurosurgeon,” [Robert] Surrick said, but Lyness left Pennsylvania when his malpractice premiums reached $383,000. With no neurosurgeons, Brandywine shut down its trauma center in 2002.

(Paul Carpenter, Allentown Morning Call, Nov. 28).

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$3.5M to unsuccessful suicide

Such suits are sufficiently common (e.g., Oct. 8, May 20, Jan. 31, 2003) that we can almost retire the category. Lawyers for Christopher Foster, a male prostitute who, while imprisoned, attempted to hang himself but only managed to self-inflict severe brain damage, argue that the mix-up in paperwork that resulted in his being put in a conventional cell instead of on suicide watch was a constitutional violation. While it’s perhaps too much to ask that suicides only blame themselves, most federal courts recognize that the standard for a constitutional violation is “deliberate indifference” rather than negligence. This case somehow got to trial and the City of Philadelphia is on the hook for $3.5 million (7% of the $50M Foster asked for) after a settlement. Foster won’t be conscious of the marginal difference in life-long nursing care (which one suspects is being shifted from one government expense account to another), but his lawyers, from the firm Kline & Specter (Jan. 24, 2003), will sure appreciate their seven-digit cut from taxpayers. (Joseph A. Slobodzian, “City abruptly settles suicide-prevention suit for $3.5 million”, Philadelphia Inquirer, Nov. 23; Jim Smith, “City to pay $3.5M in jail hanging case”, Philadelphia Daily News, Nov. 23).

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Blonds not protected class

Not sure exactly how this one escaped our notice last year: a Pennsylvania federal judge has ruled (or, really, observed) that whatever other advantages blonds may enjoy, they are not a protected class under Title VII federal employment discrimination law. Brigitte Shramban had sued Aetna claiming that her boss had made various tasteless and disparaging remarks which belittled her on account of her sex, race, national origin, religion and blondness. Aside from noting that the last-named flower could not properly be included in the Title VII bouquet, the judge dismissed the case as a whole because the improper remarks were not sufficiently severe, pervasive, or bothersome to a reasonable listener. (Shannon P. Duffy, “Offensive Behavior Not Necessarily Harassment”, The Legal Intelligencer, May 23, 2003). It seems doubtful that a case could be made out that discrimination against those with fair tresses operates as a “proxy” for bias against those of certain ethnic origins; thanks to modern technology, blonds (as the Census says of Hispanics) “may be of any race”.

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Sports medicine: a view from Pa.

Independent team doctors getting scarcer: “The rising cost of medical malpractice insurance, and the proliferation of sponsorship arrangements between teams and large medical groups, have changed the landscape for team physicians in recent years — particularly at the major pro level, but also reaching down to college and high school sports. As part of the sponsorship deals, health care groups provide the team physicians, who have come to realize they need the umbrella of a large health care system to provide malpractice insurance. The combination of the rising cost of malpractice insurance in states such as Pennsylvania that don’t have tort reform and the potential for large judgments going to high-paid athletes has increased the risk for team doctors and made it nearly impossible for independent doctors to work in the field. … Although malpractice lawsuits filed by athletes against team physicians aren’t common, there have been several multimillion-dollar judgments and settlements, and that’s enough to cause a lot of concern.” (Shelly Anderson, “Is there a doctor in the clubhouse?”, Pittsburgh Post-Gazette, Oct. 10). For more, see Apr. 7-8, 2003, Jun. 13, 2002 and Dec. 7, 2000.

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Pennsylvania malpractice roundup

The IssuesPA/Pew Poll has found that a remarkable 26 percent of Pennsylvanians polled “said rising malpractice insurance costs have forced their family to change doctors in the past year”, and that state residents polled also favored a constitutional cap on pain and suffering damages by a margin of 68 percent to 24 percent. (The state legislature has refused to allow such a measure to reach the ballot.)(doctor availability survey, Sept.; caps survey, Aug.). The Scranton Times Tribune, a newspaper heretofore known for skepticism about the extent of a malpractice crisis, now credits reports that the number of local doctors practicing in key specialties “has declined sharply in recent years” and that specialties with high legal risk are disproportionately affected (Jeff Sonderman, “Area losing its specialists”, Sept. 12). And in a Sept. 3 speech in Scranton, President Bush “cited the tale of Carbondale physician Neal Davis … Dr. Davis, a longtime family practitioner, stopped delivering patients’ children in January because he could no longer afford obstetrics insurance.” The result, said Bush, was that “then-expectant mother Mary Coar of Honesdale [was] out in the cold”; she wound up driving 50 miles each way to see different doctors. (Chris Burk, “Bush stresses liability reform by tale of Carbondale doctor”, Scranton Times Tribune, Sept. 4). More on Pa. malpractice: Jul. 16, May 20, Jan. 18, 2004; Sept. 12 and Jul. 23, 2003, etc.

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In-car sobriety test

Jason Reali of Pennsylvania has been convicted of drunk driving twice, and he was ordered by a court to install on his dashboard an ignition interlock, “a small machine that measures alcohol on the breath and won’t allow a car to start if the driver has been drinking.” Forty-five states use ignition interlocks; last year, such interlocks have stopped would-be drunken drivers from starting their cars over 33,000 times. Reali, however, is also a heavy smoker, and he claims that blowing into the interlock while driving caused him to pass out and crash. This is, according to his lawsuit, the fault of Pennsylvania and the interlock manufacturer, LifeSafer Interlock Inc. (Oliver Prichard, “Sobriety devices drawing criticism”, Philadelphia Inquirer, Sep. 12; AP, Sep. 12).

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Gun dealer settles for $850K

Perry J. Bruce purchased ten guns between 1994 and 1997 from Jon K. Sauers of Sauers Trading in South Williamsport, Pennsylvania, and dozens from other gun shops in the area. The guns were sold to Bruce legally–he had no record–but Bruce would then go on to illegally resell the guns on the street for a profit, eventually leading to his conviction for gun trafficking in 1998. On April 19, 1999, one of those guns was found by a child under a parked car; that child proceeded to shoot and kill 7-year-old Nafis Jefferson. So, given that someone illegally sold a gun to someone who eventually negligently left on the ground where it was found by someone who then negligently (or worse) killed someone, the mother, with the help of the Brady Center and co-counsel Mark LeWinter, sued… Sauers, who legally sold the gun, and Rossi, who manufactured the gun, and Taurus, which bought Rossi. (Taurus was sued because they failed to “recall and retrofit” the gun with safety devices–as if a Philadelphia thug who leaves his gun under a parked car was going to turn in his illegally possessed gun to be outfitted with a childproof lock.)

As the Philadelphia Inquirer reports,

Sauers testified in a deposition in the Jefferson case that he complied with state and federal law, properly filling out all forms in each sale to Bruce.

But he never asked Bruce why he was buying all the guns.

Asked why he never questioned Bruce, Sauers replied in the deposition: “I don’t know what my reason would be to ask him. I didn’t think it was any of my business.”

Sauers settled out of the suit for $850,000. I still haven’t seen an explanation in the Brady Center materials what Sauers was supposed to have done differently, though they emphasize that Bruce was unemployed and used his welfare card for identification. (Is the state of being poor is reason enough to preclude someone from buying a gun?) “There is a risk of liability that is now real for gun sellers all across the country,” the Brady Center’s Dennis Henigan said, and we couldn’t say it better ourselves. (L. Stuart Ditzen, “Dealer settles suit over gunplay”, Aug. 24; AP, Apr. 21; our gun coverage).

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Pennsylvania Reform Roadblocked

Doctors in Pennsylvania had high hopes for the possibility of caps on non-economic damages in their state. They had managed to get a bill for an amendment to the state constitution that would allow the caps, only to see it killed in committee by opponents of tort reform. Evidently, the legislators don’t want to take the issue to the people, who would have had to vote on the amendment. Will they be willing to answer to the consequences of their inaction? Young doctors already view Pennsylvania as a state to avoid :

In 2003, only 17% of residents who trained in Pennsylvania stayed there, according to the Pennsylvania Medical Society. The state had a net loss of 507 physicians from 2002 to 2003, and it dropped into the bottom 10 states for the number of young physicians in the state, PMS data show.

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Suffer the Poor

The practice of obstetrics is not easy. Doctors who deliver babies face long, late hours, life-threaatening complications that can spring up in a split second without warning, and the constant threat of litigation for events beyond their control. Now, the malpractice crisis is making it even harder, with doctors in crisis states like Pennsylvania finding themselves in a manpower crunch thanks to the exodus of obstetricians from the state. Not only are doctors leaving, but hospitals are shutting down their obstetrics departments:

According to the 2003 American College of Obstetricians and Gynecologists Survey on Medical Liability, 12.5 percent of OB/GYNs in Pennsylvania have stopped practicing OB and 57.5 percent have made some change in their practice because of issues with affordability or availability of liability coverage, including relocating, retiring, dropping OB, reducing number of deliveries, reducing amount of high-risk OB care, or reducing gynecological surgical procedures.

Those statistics, however, do not come close to revealing the extent of the current problem of obstetrician supply in the five-county Philadelphia region, which lost 25 percent of its staffed OB beds between 1993 and 2003, according to Delaware Valley Healthcare Council President Andrew Wigglesworth. Within the past 18 to 24 months, he says, the region lost 10 hospital OB departments, including those at MCP, Methodist, Nazareth, Warminster, Mercy Fitzgerald, Episcopal and Elkins Park; while OB services were also lost from hospital closures including City Line, Sacred Heart in Norristown and Community Hospital in Chester.

That means longer hours and a greater proportion of riskier cases for the hospitals and doctors who remain. Which means they’re more prone to errors. It also means that they can no longer spread themselves as thinly as they once did. Hospitals that once staffed inner city public health clinics are can no longer spare the staff to do so, leaving the poor without easily accessible prenatal care. Remember that the next time you hear John Edwards say that he has spent his career helping the down and out.

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Oft-sued Pennsylvania doctors

The litigation lobby has worked hard to advance the theme (accepted at face value in places like the New Republic) that a few bad apples in the medical profession account for most malpractice claims. On the other hand, some medical observers (see Apr. 10-13, 2003) have pointed out that if it’s true that five percent of doctors account for a majority of malpractice payouts, the most accurate description of that five percent would be not “incompetent M.D.s who should not be in practice” but rather “members of high-risk specialties in litigious localities”.

Reinforcing this latter view, a Pew Foundation project has surveyed 1,333 Pennsylvania specialists and drew responses from 824 physicians in high-risk fields including emergency medicine, general surgery, neurosurgery, orthopedic surgery, obstetrics/gynecology and radiology. “Eighty-six percent of specialists had been named in a malpractice suit at least once during their careers, and 47 percent had been sued in the three years prior to the survey.” Details today at Point Of Law, which also has new posts on Eliot Spitzer and on John Kerry’s Pennsylvania fund-raising.

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