Home / Healthcare Updates / Healthcare Update — 09-12-2014

Healthcare Update — 09-12-2014

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40 year old father/husband went to emergency department two days after feeling nauseous when he ate breakfast. Reportedly had cardiac symptoms, including chest pain. Was in the emergency department 4-5 hours, during which time no cardiac enzymes were ever ordered, and then released. Two days later, clutches his chest and dies from heart attack. Jury awards family $4 million.

Good news: Chinese researchers discover new way to kill cancer cells by injecting the metal gallium into the arteries supplying the tumors.
Bad news: In rabbit studies, the metal somehow finds its way into the heart and lungs and forms deposits there.

$62 million medical malpractice award to patient who goes to Winthrop University Hospital for endoscopic removal of an ectopic pregnancy, developed complications from an unnoticed bowel perforation, then developed sepsis that eventually required amputation of both legs. In addition, the high doses of antibiotics she was receiving caused her to lose her hearing.
When a front page story about the patient ran in the newspapers during trial, the hospital’s attorneys requested a mistrial, stating that the plaintiff “should be thankful the doctors were able to save her life.” Not really a good argument to use.
In the end, the plaintiff and her attorney were happy that “justice was served” and someone in the comment section to the article suggests that everyone “remember this case the next time you find yourself asking why a Tylenol in the ER costs you 30 bucks.”

Ohio jury awards patient and husband $1.2 million when patient had persistent pain after undergoing partial hysterectomy and physician didn’t order CT scan to diagnose perforated bowel until the patient was “critically ill.” By the time the complication had been diagnosed, she had developed respiratory distress syndrome and now requires a walker to help her walk.

Remember how the government is making elderly patients pay for more care when they’re admitted as “observation” versus fully admitted? Then they came up with the “two midnight” rule, where providers had to predict whether a patient would need to stay in the hospital for two midnights – and then sign an attestation to that effect. The government won’t give “prior authorizations” for admissions, so providers are left to guess whether the government will retrospectively consider an admission appropriate, and anything deemed as “unnecessary” care is considered fraudulent when the government is billed for it. End result? Community Hospital Systems pays $98 million to settle false claims allegations.
“The United States alleged that from 2005 through 2010, CHS engaged in a deliberate corporate-driven scheme to increase inpatient admissions of Medicare, Medicaid and the Department of Defense’s (DOD) TRICARE program beneficiaries over the age of 65 who originally presented to the emergency departments at 119 CHS hospitals. The government further alleged that the inpatient admission of these beneficiaries was not medically necessary, and that the care needed by, and provided to, these beneficiaries should have been provided in a less costly outpatient or observation setting.”
Several emergency physicians and emergency nurses were “whistleblowers” in the case.
When a hospital wants to admit you as an “observation” status, keep criminal investigations and settlements like this in mind.
One US Attorney was quoted as saying “We will not allow this type of misconduct to compromise the integrity of our health care system.” Widespread fraud in the VA causing death and disability to our veterans? Who cares? Fraud and waste in creating the healthcare.gov site? No problem. Fail to have a crystal ball to determine how long a patient will need to be admitted? Hey! THAT’s not allowed!

Kanye West experiences “excruciating” migraine after playing basketball before a show in Australia and rushes to the emergency department for treatment. One of my son’s friends thinks he was just losing at his basketball game.

Some plaintiff attorneys pretend that “defensive medicine” doesn’t exist and is some creation of [insert the group you want to demonize here – insurance companies/hospitals/attorneys/physicians] to fleece the patients. What about “defensive lawyering”?
“In defensive lawyering, a list is developed of every document having even marginal relevance, every witness who might know something about a subject and every interrogatory that can be propounded. Lawyers practicing defensively live in mortal fear of the smoking gun buried in the pile of documents or the mystery witness who appears out of nowhere to sink our client’s case.”

Both sides preparing for battle as they take positions on California’s Proposition 46 ballot vote to quadruple limits on noneconomic damages in medical malpractice cases and to require drug and alcohol testing of physicians. This article by a local city council member notes that in voter guide information, attorneys are trying to downplay the increase in damages and the benefit it would have to the malpractice attorneys. The article also notes that many parts of the state already have physician shortages and that passing the proposition would likely worsen those shortages.
“Paving the way for more malpractice lawsuits is not a way to improve health care coverage nor will it help slow the rapidly growing cost of health insurance premiums. But it will certainly be good for the lawyers behind Prop. 46. Unfortunately, getting this message to the voters will surely be more difficult due to some deceptive official voter guide information.”
We can’t sue our way to better health care.

Dog waits outside emergency department as elderly owner undergoing surgical procedure. A lot of people commenting on these pictures express disgust that a dog would be allowed inside of a hospital. On one hand, I suppose there would be a risk of contamination from the animal, but I’m not sure that risk has ever been proven. On the other hand, it would light up my day to see my dogs there with my family if I was in a hospital recuperating from surgery.

Instapundit posts a link regarding how health care costs are taking a bigger bite out of Americans’ budgets, asking “How’s that Hopey-Changey stuff workin’ out for ya?” The commenters to the articles are full of insight. One of my favorites is from a commenter named Carl who initially noted that a large percentage of health care costs are in response to government regulations and liability protection and then stated “the parasites [referring to the government] all think the host should get much more efficient at using what little blood is left to it — so there’s more for them!


  1. Re: the pooch waiting outside the ED:

    It’s all fun and games, until one staff member or patient is allergic or suffers an asthma trigger, or Spot turns out to be a parasite-ridden vector bus scattering fleas hither and yon; or simply bites someone, because dog. JCAHO (or whatever they are now), not to mention the hospital’s Risk Management Dept., loves all that, right? Then there’s the problem of providing the ability to feed, water, and clean up after the dogs – as the ASPCA and local animal control would expect – without compromising health codes and common sense.

    So nobody will mind when their hospital bill goes up another 10-20% to build the $2M Puppy Paradise Hotel next to PACU, and the hospital has to hire a legion of dog walkers, kennel attendants, and more sanitation and infection control staff to scoop poop and mop up “accidents”. Especially if they had the wit God gave a jackass not to bring their five hounds to the ED in the first place and try to claim they were all “Service Animals” under the ADA guidelines, but get to pay for those who do, right? Right??

    And hey, Prez. Obama told me “If you like your dog, you can keep your dog”. So let’s make the government pay for it. Unlike the doggie, that plan will never bite me in the @$$.

    Unless the dog is a Service Animal, which in a healthcare setting is defined as a dog which can talk in English and advocate on the patient’s behalf, the proper place for Spot is home, in his dog house. Bring a picture of a dog, if it’s that big a deal.

    It’s a hospital, not the Beverly Hills Hotel. Bringing pets to the hospital is near the top of the list on the Patients Bill Of Wrongs. It should be grounds for either flogging by staff, or ejection to the curb at the speed of pique, solely at the discretion of the treating physician.

    But how about a Chutzpah Award for that attorney who argued that the patient should be happy the doctors saved her life after almost killing her! Next, amnesty for killers who change their mind at the last second, and thugs who only beat you almost to death. (cf.: Why Patients Sue, and Why Juries Hand Out $62M awards in the Journal Of Stupid Attorneys’ monthly column called “Legal Jackassery We Like”). At least he didn’t stand up in open court (AFAIK) and tell the double amputee plaintiff that she didn’t have a leg to stand on. Tip your waitresses, try the veal, I’m here all season.

    If punitive damages included the opportunity to forego $1M in awarded damages for each 5 minutes of plaintiff (or designated hitter in American League cities) beating the crap out of defendant’s counsel with a MLB-regulation ash baseball bat for such conduct, justice, malpractice premiums, and the local ABA roster would all be well served, if not the caliber of legal argument, and the local ED would appreciate the chance to return the favor by treating such sterling examples of the legal profession for a richly-deserved set of lumps. Win-win.

    True Hammurabic justice would be sawing off defendants’ legs and nearly killing them, but ethics rules would probably make finding medical staff to do that hard to find, so it would either be contracted out to Qatar, or non-licensed staff would be used, and that just strikes me as just a tad too far to go just to make a point. And designating the offending physicians as the victim’s wheelchair pushers and personal attendants for life would be vastly better, but unfortunately runs smack into the prohibition against indentured servitude. Dang. This law stuff is tricky.

  2. Also the ADA and the Constitution.
    The benefits of a classical education.
    I’m sure with a little more effort and polish, I could probably have worked in a Looney Tunes reference as well, but my time was limited.

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