Lost Compensation

Sponge in Abdomen Case Dismissed

The Winona (MN) Daily News reported Sunday that a medical malpractice case was dismissed by Columbia County Circuit Court Judge Daniel George, ruling that the statute of limitations had expired and the case filed one day too late.

In brief:  surgeons left sponge in abdomen (07/23/03).  Surgeons discovered error, conducted 2nd surgery to remove sponge (08/08/03).  Patient died 3 days later (08/11/03).  Plaintiff files suit (08/09/06).

State law states a 3 year statute of limitation on medical malpractice suits.  Judge ruled that 3 year period began on the date of the 2nd surgery, not on the date of death, and that, therefore, the suit was filed one day after the SOL had expired.

As a citizen, I have but one question:  was justice served?

I suppose I have another question:  why was the suit filed at the proverbial 11th hour?  In other words, I would think that this issue should never have arisen.

Medical Malpractice Tort Reform in Texas -- good or bad?

Over at epluribus media, there is an interesting article on the impact of Texas tort reform on the number of practicing physicians in Texas.  Quick background: tort reform was passed in Texas in 2003 in an attempt to limit the burden of rising medical malpractice insurance premiums on physicians. The medical lobby’s logic follows that passing tort reform would make Texas more “doctor friendly” and thereby improve quality of, and access to, patient care.

But has it? The article cites statistics on the number of physicians, new license applications, and number of patient lawsuits (taken from the University of Texas System).  The number of physicians is up, but the growth rate of same is down: this does not bolster the original argument for tort reform – that physicians are going to come to Texas in droves, improving access to and quality of care.

Conversely, the number of lawsuits is down. For sake of debate, are the lawsuits down because otherwise injured patients cannot find an attorney interested in taking up the fight, given the cap on damages? Or, do the injured say “I’m injured, but the pain of the struggle is not worth what I can recover?” If either of these is true, then we have done nothing more than transferred wealth from the backs of the bruised to the wallets of: (a) the doctors, if premiums have decreased, (b) the insurance companies, if profits have increased as a result of tort reform (I am too busy to check on this), or (c) both.  Not terribly palatable, from a public policy perspective.

Moreover, the lack of penalty (e.g., increased premiums on poor doctors) no longer serves as a closed loop means of feedback which would otherwise encourage docs to clean up or ship out.  Quality of care in this case deteriorates.

The questions which I will continue to ponder:

(1) Should government legislate malpractice damages caps (ie. the front-end)?

(2) Or should they legislate insurance premiums (ie. the back-end)?

(3) Or stay out of it all together, and let free markets reign?

(4) How do we know when govt. interdiction in the medical malpractice insurance markets is working or not? And if we eventually come down to “not”, what will it take for the govt to step aside and the market find steady state?

I see arguments for both sides. Free market theorists argue that the most lawsuits will concentrate on the poor doctors, who accordingly are driven from the market or improve their quality of care. Physicians and Insurers say that tort reform makes for a more favorable environment to deliver care, and therefore will improve access to care, such as in rural areas (as mentioned in the article). Both sides argue that patients win.

I for one sincerely hope this issue continues to draw scrutiny. The light of day will drive accountability, and let us all know if mistakes were made, and if so, how/when to adjust course.  I suspect the solutions are as complicated as the problem itself.