Medical Malpractice Bulletin for July, 2009

Perspective: What did Obama tell the AMA about malpractice reform?

On Monday, June 15, President Obama spoke to physicians assembled in Chicago for the annual AMA convention. His subject: health care reform. I listened to most of the speech on the radio and have read the reviews. What I heard and what I read seem divergent.

Bottom line: Care will hopefully improve, access will be better and costs will decline. That is the “holy grail” of healthcare reform. But I don’t foresee malpractice attorneys, plaintiff or defense, having to look for work under the Obama administration. More ->

AMA News: Physician duty to third party limited
William Freund, a patient of psychiatrist Dr. Laurence Greenberg, went to the home of his friend, Brandon Smith, and shot and killed Brandon’s father and sister, then killed himself. Brandon’s mother, Denise Smith, sued Dr. Greenberg claiming the doctor had a duty to treat Freund so as not to cause harm to himself or others. The California Court of Appeals recently overruled a decision in favor of the plaintiff. However, Dr. Greenberg’s reprieve will now be reviewed by the California Supreme Court. Should that court overturn the appellate decision, it would have a chilling impact on all physicians, not just psychiatrists. For example, could doctors now be sued by partners of their AIDS patients who contract the disease? Or by victims of alcoholics who drive drunk and injure others? Stay tuned.

Strokes/TIA’s continue to make medical news
Failure to diagnose or treat stroke in a timely fashion is currently the number one problem in terms of cases on which I’ve been asked to consult in the past 2 years. See the sidebar for several articles previously published in Malpractice Bulletin on this topic. Now, the June 2 issue of Neurology reports that about half of major strokes occur within 24 hours of a TIA. Patients who experienced a TIA had a 5.1% chance of a major stroke within the next 24 hours. Up to 52% of those experiencing a major stroke did so in 24 hours or less. The authors emphasize the value and importance of the ABCD2 score when evaluating the TIA patient.

Does Tylenol kill? FDA group recommends stronger warnings on acetaminophen
An FDA report recommends stronger warnings and dose limits on drugs containing the painkiller acetaminophen due to an increased risk of liver damage. Between 1990 and 1998, acetaminophen was linked to 458 deaths and 26,000 hospitalizations annually. This appears to include all injuries from all medications in which acetaminophen was one of the ingested drugs. The FDA working group that issued the report recommended lowering the allowable daily dose from 4000 mg per day to 3250 mg per day. Key question: Given the widespread use of this medication, what percentage of users experience ill effects. Another FDA group will meet June 29-30 to discuss implementation of the group’s recommendations.

Stroke following chiropractic manipulation
Those readers with current or past cases involving stroke following chiropractic manipulation may wish to read the opinion of one plaintiff attorney who believes that the problem is vastly under-reported.

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