Status of Med-Mal in USA

2003 - 2012

Internists faced maximum litigations ObG paid highest damages Neurosurgeons paid the highest individual

claim

State of the Profession

In 2013:

Internists: 15% - Family physicians: 13% - ObGyn: 9% - Psychiatrists: 8%

1 in 14 doctors will face litigation in a year 60% of doctors over 55 years of age would have

had at least one litigation

The Litigation Black Hole

Proposed solutions

Cap on damages Limit attorney fees Allow periodic payment Public-patient compensation funds No-fault compensation for Obstetric cases ‘Sorry’ Law – Early disclosure offer

What the sued doctors say… Medscape study

93%: Saying "I'm sorry" would not have prevented their lawsuit

23%: The experience was "horrible, one of the worst experiences of their life"

16%: "disruptive and humiliating“ Only 3% said it was a "neutral" experience

29% said, "I no longer trust patients. I treat them differently”

Many doctors said they now practice ‘defensive medicine’ rather than face the risk for another lawsuit

"If it hurts between the nose and the toes, consider it a heart attack and stress-test everyone from 9 to 90!" said one respondent

Volume 198, Issue 3 , Pages e7-e8, Am J ObG, March 2008

Permanent brachial plexus injury following vaginal delivery without physician traction or

shoulder dystocia

Henry M. Lerner, MD Eva Salamon, MD

The fall out!

Since 2008, this article has been used by the defense at brachial plexus trials

Lawyer Ken Levine wrote to the Am J ObG and the ACOG, and demanded a retraction. Both refused

He is filing a lawsuit claiming that article is fraudulent and deceptive

He is searching for anyone who lost her brachial plexus case at trial in which the Lerner/Salamon article was referenced or discussed

• 12 year-old Darcy sued his mother’s Obstetrician & won the case• His mother had Induction of labor & Prolonged 2nd stage• Nurses misinterpreted her CTG as normal & did not inform the obstetrician in time•As CTG was abnormal, the obstetrician did CS• Darcy was born with cerebral palsy

Baby sues the Obstetrician

Marlise Munoz

Was declared Brain-dead following Pulmonary Embolism

Kept on Life support She was 14 weeks

pregnant at the time of her death

Her advanced directive, her husband and family called for removal from life support

Texas law prohibits removing life support from pregnant women

Mona Prasad, her doctor argued that the baby is likely to be infected by mother’s pneumonia

And that, as only 20% 0f cardiac output goes to fetus, there is also a 90% risk of cerebral palsy

But permission was refused

Breaking News!

8 weeks later, at 22 weeks of gestation, the hospital admitted in court that the fetus now was ‘distinctly deformed, abnormal & not viable’

The Judge ordered withdrawal of life support on 27th January 2014

Legal/Moral/Ethical dilemma?

Mrs B was admitted to the hospital for PROM & preterm labor at 25th week of pregnancy

As she was dissatisfied with her doctor and the hospital, asked to go elsewhere for care

Her doctor and attorneys for the hospital spoke to the judge as she was not fit to be transferred

The judge ordered her to stay in hospital She delivered a stillborn by C section

Medical Misadventures!

A Sperm Bank Nightmare

Thomas Ray Lippert, a medical technologist in an Infertility clinic replaced a customer's sperm for IUI with his own in 1991

The clinic shut down in 1998 and he died in 1999 21 years later, a girl discovered her genetic mismatch by

tracing her lineage and DNA of Lippert’s mother The University of Utah is offering free paternity testing

to anyone who used the Utah clinic from 1988 until the late-1990s

A different AID!

Cecil Jacobson, a fertility specialist used his own sperm to impregnate his patients without consent

He told them that they would have IVF-ET with the sperm of an anonymous donor

Jacobson was sentenced to five years in jail In the 1960s, he claimed to have successfully

impregnated a baboon with his sperm! In 1994, his story became a movie, called ‘The Baby

maker’!

Dr Nikita Levy, a Johns Hopkins gynecologist had secretly photographed and videotaped his patients

When lawsuits were filed against Levy and his employer, Levy was found dead, apparently by suicide

The case is still on against Johns Hopkins

Hepatograph?

Simon Bramhall has been suspended after branding his initials ‘SB’ into a transplant patient's liver

The letters were spotted by a colleague during a repeat surgery

It is feared the letters may have been imprinted onto hundreds of other transplant recipients.

Hysterograph!

• After performing a hysterectomy, Red Alinsod used cautery to brand his patient's name on her removed uterus • The doctor called the souvenir a “friendly gesture,” • But the woman termed it “despicable conduct” in a medical negligence lawsuit.

Post partum Vaginoplasty

James Burt performed vaginal reconstruction following delivery on several women over many years without their consent

He claimed that his surgery improved sexual satisfaction & increased their libido

Nick named, ‘Love surgeon’, he even wrote a book called “Surgery of Love”

His surgery led to sexual dysfunction / infection / vaginal reconstruction

Sued for 21 million, he surrendered his license & became bankrupt

Unexpected ways to get sued!

Mrs MDA arrived at hospital after a heart attack She was pronounced dead on arrival At the funeral, her body was found face down

inside the coffin with facial lacerations, contusions & a broken nose

Her family filed a suit saying that she was wrongly declared dead & frozen to death when she was still alive in the morgue

Mrs DD reported with stroke-like symptoms The duty doctor called Neurologist over phone He advised against administration of tPA But, Mrs DD suffered a stroke next day & sued

the hospital The hospital (not the neurologist) was held

vicariously responsible

Pramipexol was prescribed to Mr S to treat ‘Restless leg syndrome’

He became addicted to gambling, lost his home & became bankrupt

He sued the doctor for 3 million USD, because.. His doctor failed to warn him that addiction to

gambling is a side effect of Pramipexol

Mr MN applied for medical leave claiming depression The employer asked for a psychiatric opinion As per US law, the psychiatrist sent his opinion to the

employer by fax The employer did not receive the fax & terminated Mr MN

from service Mr MN sued his employer for 5 million USD The jury held the psychiatrist 82% & the employer 12% at

fault

Some crazy reasons to get sued!

Alexander Baez

Body builder Runner up at Mr Universe contest Wanted Pectoral implants He was given Breast implants instead!

Carol Weiher

Was aware of everything during her surgery But could not move or speak She sued and won her case Anesthetic awareness has been reported in over

42000 cases

Caught fire during surgery Died 6 days later of burns The culprit was the cautery

Janice McGill

You made me shoot myself!

Mr SS was on treatment for insomnia He fell asleep at home while cleaning his gun When his telephone rang, he woke up startled Instead of the phone, he held up the gun to his

mouth & pulled the trigger He miraculously survived & sued his doctor He lost his face but won his case!

“You threw away my nipples!”

Mrs KK underwent surgery for breast reduction She sued her surgeon one year later, because he

forgot to put her nipples on

Interrogation at the Court

Q. How did you notice the absence of your nipples? A. While taking a shower Q. When did you make this discovery? A. About a year after surgery Q. You took a shower one year after surgery? A. No sir, but I usually take a shower in the dark!

(She won her case!)

May Justice prevail!