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Costs of medical malpractice insurance are soaring. Major insurers are refusing to write policies. And doctors are struggling to pay their premiums. Find out what's behind the insurance crisis.
Communicating with patients, keeping accurate records and actually taking time to examine patients are three of the top 10 ways to avoid a lawsuit. Find out more in this article by a doctor who's reviewed over 200 malpractice cases.
Malpractice suits have a devastating emotional impact on physicians. Learn about a unique service offered by the HealthTexas Provider Network to help doctors deal with the shock and sadness.
As clinical practice guidelines become more and more prevalent, they will define the requisite "standard of care" for medical treatment and impact medical malpractice litigation. They may even replace expert testimony.
The purpose of this study was to evaluate the anesthesia care provided during obstetric adverse events. Malpractice claims filed against nurse anesthetists for care involving obstetric anesthesia (n = 41) were extracted from the American Association of Nurse Anesthetists Foundation Closed Claim database. The events represented in the claims occurred from 1990 to 1996 and represented anesthetics provided by both anesthetists and anesthesiologists. Risk factors for adverse outcomes identified in this study included advanced maternal age, ethnicity, and obesity. Patients requiring emergency cesarean sections under general anesthesia were found to be at considerable risk for sentinel events. The most common adverse outcome in the obstetric closed claim database was neonatal death (n = 11 [27%]), followed by maternal death (n = 9 [22%]) and complications resulting from regional anesthesia (n = 8 [20%]). The leading cause of maternal death and brain damage was a failure to secure a patient airway. The mode of delivery in 95% (n = 19) of the 20 claims in which death was the outcome was surgical. In the claims representing maternal death, 89% (8) of the 9 claims represented surgical deliveries under general anesthesia. These maternal death cases were designated emergent in 56% (5) of the claims. The anesthetic care was deemed appropriate in 56% (23) of the claims. The median payment for appropriate care ($2,866.00) was less than for care determined to be inappropriate ($45,000.00).
The interests of the public and the medical profession are best served when scientifically sound and unbiased expert witness testimony is readily available to plaintiffs and defendants in medical negligence suits. As members of the physician community, as patient advocates, and as private citizens, pediatricians have ethical and professional obligations to assist in the administration of justice, particularly in matters concerning potential medical malpractice. The American Academy of Pediatrics believes that the adoption of the recommendations outlined in this statement will improve the quality of medical expert witness testimony in such proceedings and thereby increase the probability of achieving equitable outcomes. Strategies to enforce ethical guidelines should be monitored for efficacy before offering policy recommendations on disciplining physicians for providing biased, false, or unscientific medical expert witness testimony.
The courts are protective of the plaintiff's rights under law to seek redress in the court by placing the facts of their allegations before a judge or jury. Because the avenue to the court is through representation and advocacy, the courts equally are protective of the agent of that representation, the attorney. To date, no physician who has been sued for medical malpractice in Louisiana has brought a successful malicious prosecution claim against the plaintiff or his attorney.
An overview of the malpractice insurance market in the United States today: which insurers remain, what clients they're willing to cover, and what may lie ahead for the troubled industry.
Fewer patient injuries and a more favorable malpractice experience do not happen by accident. However, since we know that errors, mistakes, and patient injuries cannot be avoided with absolute certainty, it is the duty of all OB clinicians to be clearly aware of the common risks and to take appropriate steps to reduce their occurrence. The best OB practitioners and the best perinatal units are characterized by their efforts to improve individual and system performance by examining and learning from the past mistakes of others.
This article discusses ten clinically based behavioral approaches to minimizing the risk of a malpractice claim. Suggestions are stated in both a positive and negative way and ranked from least significant to most significant. Recommendations include the need to develop effective listening skills; learning to communicate with patients verbally and in writing; keeping patient expectations realistic; being thorough when examining and diagnosing; and knowing one's limitations. Also included is the need to inform patients concerning adverse events; keeping written records of what was said and done; discussing alternatives, risks, complications, and fees in advance; and developing a relationship with patients based on mutual respect and trust. Case examples are presented for each approach.
206 autopsy cases related to the death of non-malpractice medical tangle from 1972 to 1998 were studied retrospectively. 111 (53.88%) were died of natural diseases, 82 (38.81%) inevitable complications and 13 (6.31%) unpredictable medical accidents. For the cause of medical tangles, the diagnosis of 92 cases (44.66%) was questioned. The other disputes focused on the infusion/blood transfusion (31 cases, 15.05%), the injection (20 cases, 9.71%), drug misuse and delay in making diagnosis or giving treatment (18 cases, 8.74% respectively). 13 cases (13.11%) involved complains on medical staff's rudeness and hospital management.
A malpractice suit is an event that no orthopaedic surgeon wants to go through; however, reality says you will. The authors outlined a step by step approach to your needs during such a suit and offer possible helpful actions by recommending collecting and securing all of the written documentation, being able to familiarize yourself with the entire events without notes, constant appraisal and discussion of the events with your attorney, considerations for settling, and finally emotional events surrounding the trial. The initial shock and insult eventually will subside, your patients will not note the difference, but you never will forget the event.
Spiraling malpractice premiums are leaving physicians with few and difficult choices: stop performing risky procedures, leave their states, or "go bare"--that is, practice without insurance. See how hospitals are facing this serious problem nationwide.
Testing the hypothesis that physicians trained in problem based learning formats versus traditional lecture based formats develop equally strong physician-patient relationships, the rates of malpractice filings against graduates trained in each format at the John A. Burns' School of Medicine were compared. With the graduation of 10 more PBL classes, statistically significant differences between the two groups could be obtained.
This article reports the results of a survey of the attitudes of medical practitioners in the Sudbury and Manitoulin Health District of Northern Ontario with respect to their experience of litigation alleging medical malpractice. The survey is part of a research project, funded by the Foundation for Legal Research, Montreal, investigating the extent to which the very high incidence of medical litigation in the United States of America is likely to spread to Canada.
The Medical Review and Advisory Board has been established as a committee of the Commission on Professional Welfare of the California Medical Association to make studies and recommendations toward solution of the growing problems of professional liability insurance and malpractice actions in California. The members of the Board are: Joseph F. Sadusk, Jr., Oakland, Chairman; Wilbur Bailey, M.D., Los Angeles, vice-chairman; Howard W. Bosworth, M.D., Los Angeles; H. I. Burtness, M.D., Santa Barbara; Paul W. Frame, Jr., M.D., Sacramento; Verne G. Ghormley, M.D., Fresno; Carl M. Hadley, M.D., San Bernardino; Joseph J. O'Hara, M.D., San Diego; William F. Quinn, M.D., Los Angeles; Rees B. Rees, M.D., San Francisco; and Bernard Silber, M.D., Redwood City; Mr. Rollen Waterson, 564 Market Street, San Francisco 4, is executive secretary, and Mr. Howard Hassard is legal counsel.
Anesthesia-associated nerve injury is a common cause of patient morbidity and litigation. To identify factors associated with perioperative nerve injuries and rationalize preventive strategies, 44 cases from the American Association of Nurse Anesthetists (AANA) Foundation Closed Malpractice Claims Database pertaining to nerve injuries in which nurse anesthetists provided care were analyzed. Emerging patterns and themes related to the development of injury were identified. The database is a collection of medical liability claims filed against CRNAs insured by the St Paul Fire and Marine Insurance Company; 44 claims of anesthesia-related nerve injury were analyzed. The most common injury was to the brachial plexus (15 [34%]), followed by ulnar nerve injury (7 [16%]), radial nerve injury (5 [11%]), peroneal nerve injury (4 [9%]), paraplegia (4 [9%]), lumbosacral injury (3[7%]), and a variety of "other" injuries (8[18%]). These numbers and percentages total more than 44 (100%) as some patients incurred multiple injuries. Documentation on the anesthesia record of the use of intraoperative protective padding and patient position was lacking or inadequate in a majority of the claims. Effective strategies for the prevention of nerve injury during anesthesia are reviewed. Abnormal body habitus, several disease states, anesthesia technique, improper positioning, lack of adequate padding, and tourniquet use have been implicated as risk factors.
The issue of patients' rights is relatively unknown in our country but it is often recalled when an incident of death or disability is suspected as being caused by a physician's error. However patients' rights are being violated thousands of times every day in our country. More than these patients' rights' violations, the essential point is the lack of a mechanism to claim those rights and to complain about the practices which violate them. In our country, patients and their relatives are uninformed, powerless and unprotected against physicians and health organizations, and they typically accept whatever happens to them without complaint. Some of the reasons for this are, presumably, an underdeveloped consciousness of patients' rights, an absence of patient organizations, and insufficient ethical and legal regulations on patients' rights. These deficiencies were diminished somewhat by the "Regulation on Patients' Rights," which was prepared by the Ministry of Health in 1998. Another legal draft law referred to as "Responsibilities Due to Malpractice in Medical Services" has been prepared and is in the process of becoming law. This draft law and the general conditions of the country on this subject are evaluated in this article.