Home / Healthcare Updates / Healthcare Update — 04-23-2013

Healthcare Update — 04-23-2013

Also see more Healthcare Updates on my other blog at EP Monthly.com

New York family wins $130 million in medical malpractice lawsuit stemming from obstetrical negligence case where patient was born with cerebral palsy.
The back story to the verdict is even more wild. The plaintiffs rejected an $8 million settlement offer, then lost the case at trial. An appellate court reversed the verdict and the case was tried a second time, resulting in a hung jury. The third trial resulted in the $130 million verdict.

Georgia hospital gives up fight to erect a freestanding emergency department. State denies request because the area “already has plenty of emergency services and that the proposals failed to demonstrate the need for new services”.
Ever wonder why the state only controls hospital construction? Why doesn’t the state say that areas already have plenty of strip malls or Burger Kings or banks and deny building permits to those businesses?

Hospital in Nevada accused of “patient dumping” by giving psychiatric patients one-way bus tickets to California. The article doesn’t say whether the patients are prematurely discharged from the Nevada hospital before being sent to California, but if not, California officials are certainly stretching the definition of “patient dumping”.

Ohio man found intoxicated and cursing in Kettering Medical Center ED. Taken outside by police and wants bus ride back to VA.
Good thing this wasn’t California or the police would have been accused of patient dumping for bringing him there.

Couldn’t resist clicking on the link after reading the headline. Seven Things Teenagers Can Do To Stay Out of the Emergency Room. Ultimately the advice, such as avoiding guns, avoiding drugs, and regularly exercising, is common sense … but then again, if some teenagers used common sense they wouldn’t end up in the emergency department, so the advice is worth repeating.

Patients gone wild. Perhaps more appropriately patient families gone wild. Stabbing victim brought to ED in Albany, GA, then victim’s family attacks stabber. A doctor and several nurses were pushed in the melee by a friend of the victim, apparently for “taking their time” when the perpetrator, one Quantavious Thomas, wasn’t sure whether or not his friend was still alive.

“Ever hurt anyone?” It’s like a story line from that canceled Fox TV series Mob Doctor. Cleveland Clinic emergency nurse tries to hire an emergency room patient to kill someone over a property dispute. Now the nurse will be wearing striped scrub suit in the Greybar Motel.

Does a charge of $2500 for a five mile ambulance ride and $1900 for a “60 second” emergency department visit demonstrate a need for universal health care?
I don’t think so. Changing the payor won’t necessarily decrease the charges.
Another thing I found interesting with the article was the number of commenters who weren’t as concerned with the charges as they were with making sure that someone else was paying for them.
Eventually that “someone else” trickles back to all of us.

Expanding liability for medical malpractice. A cancer patient was moved to a long-term care hospital where the patient was made a DNR without the patient or his wife agreeing to DNR status, then was started on “comfort care” measures and allegedly died from an overdose of pain killers. An autopsy listed the patient’s death as an overdose and listed the manner as an “accident.” If plantiffs can show that the hospital’s actions were “willful, reckless, or a felony,” then New Jersey’s medical malpractice caps on non-economic damages don’t apply.
I’m torn on this case. On one hand, do we want the Liverpool Pathway to be instituted in this country? On their face, the allegations made by the plaintiff sound egregious. On the other hand, is the pendulum going to swing too far in the other direction and cause patients with cancer pain to be undermedicated so that the hospitals and doctors aren’t the next ones on the evening news when a patient dies from an alleged overdose?

More unintended consequences from the UnAffordable Care Act. Can poor scores or failure to abide by the reimbursement-driven guidelines be used to bolster a claim that a doctor committed malpractice? Georgia is already contemplating that issue and has introduced legislation to prevent such claims.

One comment

  1. I see the point that dumping definition being somewhat overbroad. Maybe we could just enact a federal statute against institutional douchebaggery instead.
    Because when patients arrive at my hospital courtesy of a free rail token and a printed map to our front door, both provided by nearby EDs, I don’t feel dumped on at all. I’m sure my state having 10% of the country’s population, but 1/3rd of its welfare recipients is just a coincidence too. It’s not like they migrate here or anything.

    So besides sending our frequent flyer psych patients from SoCal to Nevada in response (which clearly wouldn’t be dumping if we discharge them here first too, right?), what city are YOU in? I only ask because my ED’s case management department just got a bunch of free Amtrak monthly passes, and maybe when somebody else’s ox is being gored, the light of truth will be easier for us to discern amidst the fog.

    Or at least, we can finally get the Homeless Exchange Program off the ground, and we can all see some new faces at all our EDs once in awhile. Maybe even start a Grand Tour circuit: springtime in the Rockies, summer in California, New England in the fall, and Florida in the winter. As long as we put Sheriff Joe Arpaio in charge of Health & Human Services.

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