July, 2015 – Medical Malpractice Bulletin

Perspective: Pursue? Defend? Settle? Drop?

The value of a “case viability analysis”

By Charles A. Pilcher MD FACEP
July, 2015

Every malpractice case demands thorough review to determine whether it should be pursued/dropped (plaintiff) or defended/settled (defense). In order to determine the best course of action, attorneys do a thorough analysis. In this “Perspective” the role of the medical expert is addressed. Fortunately for physicians and their defense team, most cases never see the light of day, often because of an objective review by a plaintiff expert. For a plaintiff and his/her attorney, a wrong decision will just complicate an already complex situation. Continue ->

Spinal epidural abscess: Why is the diagnosis still being missed?
Far too many patients continue to be left with neurological disability after inordinate delay in diagnosing their spinal epidural abscess. This article by Davis et al in the Journal of Emergency Medicine in 2004 – yes, that is 10 years ago – demonstrates that if physicians wait for the “classic triad” of fever, back pain and neurological deficits, they have waited too long. Other findings are almost always present much earlier. Because this is such a high-stakes diagnosis, suspicion needs to be equally high.

Utah ruling protects peer review
In the November issue was a report of court rulings in Kentucky and New Jersey that opened peer reviewed incident reports to legal scrutiny. The Kentucky case is being appealed. Similar to NJ, the Utah Supreme Court recently upheld the confidentiality of peer review proceedings designed to improve patient safety. To read the AMA’s opinion on this latest decision, click here.

Apologies for mistakes: The pros and cons for physicians
For a nice article by Debra Beaulieu-Volk summarizing for physicians the pros and cons of apologizing for a medical error, check out page 52 of the June 10, 2014, issue of Medical Economics.

A reader response to “Nice Doctors Don’t Get Sued”
[edited for brevity]:
I had a case many years ago where a prominent local pulmonologist asked a surgical colleague to evaluate a patient with hemoptysis and a presumed bronchial “lesion.” During a rigid bronchoscopy, the surgeon biopsied the “lesion” – which he quickly discovered was a bulge on the pulmonary artery and the patient bled to death on the table. The surgeon immediately sought out the patient’s wife, told her what happened, hugged her and told her how sorry he was. The pulmonologist was never seen or heard from again. When the lawsuit was filed, the only doctor named was the pulmonologist because the patient’s wife said that the surgeon “really cared about his patients – and no one’s perfect.”


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