Screwed both ways: Two doctors have to pay for the side effects of chronic systemic steroid treatment for an asthmatic

“Two area doctors must pay $1.9 million to an asthmatic patient whose bones were so badly damaged by being overmedicated with steroids that he needed both hips replaced by age 41, a Lackawanna County jury ruled Wednesday.”

Chronic systemic steroids are not routinely used for most cases of asthma – inhaled steroids are typically used. The fact that a pulmonologist was overseeing the care involving systemic steroids suggests that this case was particularly severe, and that all other routine options were exhausted. Unfortunately, the physicians were sued for this.

Consider the alternative – not maximizing steroids and having the patient die of status asthmaticus. A no-win situation for everybody involved.

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  • Anonymous

    I’m not sure how this works: Does the fact that the MD got his license revoked for drug use enter into whether or not he committed malpractice?

  • Anonymous

    Just from looking up the case in the Net, I think it got mentioned in the trial. But I wasn’t there. And the license got suspended not revoked….looked at the NY state board site. Don’t know the details with this individual, but I would imagine that involved suspension (no license until you get treated, if you come back clean/sober and consent to monitoring you can come back), versus revocation (the state takes your license and you don’t get it back).

  • Anonymous

    It’s funny that Dr. Kevin assumes from this entirely vague story that the doctors involved were saving their patient from a deadly asthma attack and got sued for their trouble. I interpret this story entirely differently.

    Two doctors were prescribing, on top of each other, medication that rots bone. One was a drug user, if not an abuser. This doctor’s judgement may have been impaired. Regardless, this patient’s care was not coordinated and this patient ended up disabled. How on earth is this not negligence?

    Dr. Kevin believes that to err is human, and the injured patient should just accept that fact and not be compensated. But he is wrong.

    Look at motor vehicle accidents. Those are just that, accidents. We all make mistakes. But sometimes your mistake hurts someone. Those people should not have to bear the costs of your mistake. That is why we have insurance. And tort courts. My car insurance costs too much. I’m sure your malpratice insurance costs too much. But it protects you from your potential mistake.

    You took on the noble profession of medicine. You should always try to never fail your patients. But some physicians don’t do that. Those physicians need to be complained and sued out of existence. Some good physicians make mistakes. Good physicians who make a mistake need to thank their insurance carriers. Kevin M.D. needs to stop whining about it.

  • Anonymous

    And now in Florida, you can sue the pharmacist who dispensed the medicine:

    http://www.boston.com/business/articles/2005/06/03/court_pharmacists_can_be_liable_for_drugs/

  • Anonymous

    How do you know the care was not “coordinated”?

    Actually, I was trying to find out details of the case, I could find nothing, one way or another.

    These days, if someone is prescribing steroids for asthma, it’s a pretty bad case, and nothing else is working.

    If the pulmonologist has the person on steroids to start with, and the person shows up at the GP’s office with acute worsening, and gets a short course of increased steroids for the acute attack, and a referral back to the lung specialist, is that “uncoordinated”?

  • jb

    Anon 1255-
    You have hit upon something that bugs a lot of docs in your mention of car crashes. That is, any injury that occurs in a medical context seems to be way more “tortful” than a similar injury in other situations. If you look at various state liability insurance requirements
    http://www.autoinsuranceindepth.com/state-minimums.html
    you will note that the max is $100K, and most states are a fraction of that. That indicates to me that society believes that $100K is a reasonable amount to expect to recover for an injury. I agree that it’s quite low, and I have bought, at significant expense, disability insurance to reimburse me if I am injured, on a no fault basis. I can’t buy “pain and suffering insurance” or “loss of consortium insurance” as no company offers such products, but those are the big money items that docs routinely get sued for. Docs don’t resent being asked to compensate for economic loss if we have truly screwed up. We do resent being seen as low-hanging fruit by the trial bar. We are sued for amounts that are multiples of the amount that a similar injury would bring in any other context, such as a car crash or industrial accident (see your workers comp regulations). C-JD will be in soon to remind me of the odds against winning a medmal suit and the tremendous costs of bringing such a suit. Save it. The trial bar is foremost in oppposition to no-fault insurance or special health courts (analagous to tax courts) because the medical industry is one of their cash cows, and they very much like it the way it is.

  • Anonymous

    JB,
    You are living in a fantasy-world. The enormous pain and suffering awards are rare and rarely survive appeal. Do the empirical research; it’s a handful.

    Your irrational anger at lawyers does point to the real motivation behind doctors’ oppositon to med mal. It’s all ego. You don’t like other people in society questioning your judgment and authority.

    You people are pathetic.

  • Curious JD

    “you will note that the max is $100K, and most states are a fraction of that. That indicates to me that society believes that $100K is a reasonable amount to expect to recover for an injury.”

    The link you provided only has minimum limits. How you extrapolate that into $100K being a societal belief is not clear.

    “but those are the big money items that docs routinely get sued for.”

    Wrong. Everyone who causes physical injury to another through negligence or intentionally, gets sued for pretty much the same things: economic damages and non-economics, and in some cases, punitives. In med mal, the biggest part of an award in most cases is medical expenses, both past and future.

    “We are sued for amounts that are multiples of the amount that a similar injury would bring in any other context, such as a car crash or industrial accident (see your workers comp regulations).”

    That’s just wrong. Most cases don’t even name an amount in the original complaint, unless it is to say that it’s in excess of federal jurisdictional limits ($75K). Your comparison to workers comp, as you well know, is faulty because workers comp is no-fault generally. No insurers are advocating a no fault system for med mal, are they? Your awards are higher because the economic damages are typically higher on average than, say, car wrecks.

    “The trial bar is foremost in oppposition to no-fault insurance or special health courts (analagous to tax courts) because the medical industry is one of their cash cows, and they very much like it the way it is.”

    Are any insurers advocating no fault in the med-mal context? Or even health courts? If not, why do you think that is?

    Do you do any critical thinking about the statements you make?

  • david

    I am a practicing Neurologist having the unfortunate experience of being sued since I started practicing 14 years ago.
    This case is indeed very unfortunate.
    My angle to this case has to do with the attorney defending the doctors.
    It appear, at least in NY that the Top Attorney the one who make the law review in their law school tends be go on to become the plaintiff attorney for malpractice cases as this field tends to be more lucrative
    The Defending Attorney are payed by hour and even though they theoretically represents the doctors they work for the Malpractice insurance company. They are also not often of the higher caliber either. Their interest is to get the case going (keep the Layer meter going if you know what I mean) they will speak to you on the telephone and prepare you for the deposition but for them all of this is just a charade to make an income.
    In my situation knowing these fact I requested that my malpractice insurance hire a “Board Certified Attorney In Health Care Law”. Yes board certification for lawyers exist but many of these layers do not take it they feel that their Bar exam (which does not require recertification is good enough).
    When I requested such an attorney the malpractice insurance threaten to drop my defence if I did not cooperate. So you are “screwed” from the Getgo.

    The bottom line if you can afford it always retain a good law firm to look at the shoulders of your Malpractice Insurer payed attorneys. It is worth the extra dollars.

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