A recent malpractice case nets $20 million. The “percent blame” seems amazingly specific to me:
Shanin Specter, an attorney for Lee and his parents, said the jury concluded the hospital was 60 percent responsible for what happened to the child, and that Dr. Ara Moomjian, the head of the neonatology unit, was 35 percent responsible . . . He said the jury concluded that Koller’s medical practice was four percent responsible, and that the child’s pediatrician was one percent responsible.
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ROP can be a medicolegal minefield for everyone involved. Cases have been brought against pediatric ophthalmologists who were regularly following at-risk infants but whose patients were transferred a substantial distance away to another medical center nearer the patient’s family. Similar care was not readily available at the receiving facility. The ophthalmologist did not authorize transfer, yet was found responsible, even though he was unable to follow the patient and render care himself. The jury’s finding was outrageous.
It is no surprise that getting a pediatric ophthalmologist or retina specialist to cover a NICU can be difficult; it is a substantial liability. Worse, the prognosis for ROP even when treated with laser at threshhold is often not very good (but better than not treated, of course) , and there is usually significant longstanding visual risk.
The facts aren’t cited. We can only guess whether the parents understood instructions for urgent followup after discharge. Whether they were given instructions but forgot or disregarded them, or whether they didn’t understand the consequences of delay or whether they were just never told isn’t said.
I think awards like this will be damaging to hospital staffs and will result in higher malpractice premiums for doctors who provide this kind of care, which will result in reduced access, as much of this kind of care–despite being in hospital and very time-consuming–is paid by Medicaid and of course often not at all.
If I were doing this kind of consultation, I would send certified and receipted letters of instruction to each parent prior to hospital discharge basically teling them that if they didn’t follow up as instructed the consequences could be irreversible blindness for their child. I would never rely on a hospital staff member, NICU nurse or attending neonatologist to convey that message. The problem comes when the child is discharged against your advice or without your knowledge. The problem is that even with demonstration of clear warning, or of derelict or irresponsible parents, the plight of a blind child is often too much to ask a jury to weigh dispassionately. They see a claim as a substitute for disability payment and don’t regard how an outsized award is unfair to the defendant or how those awards will affect access to care in their communities.
As a physician performing this service I can tell you that the fear of this scenario is why many specialists have given up providing hospital screenings of premature infants. I am sure that the verdict in this case will cause many others to cease providing this important care.
Hospitals will be unable to find physicians to see these kids. The results of cases like this hurt more children then they help. There is the potential that more children will go blind from lack of available screenings.
Those that need screenings can be transfered to facilities providing this care. This has its own set of problems. Very sick children who need to be screened will suffer other life threatening complications during the transfer.
Ultimately the kids who these types of suits are trying to “protect” will be the ones that suffer.
“Ultimately the kids who these types of suits are trying to “protect” will be the ones that suffer.”
Lawsuits? Protect patients ? HAHAHAHAHAHA!! You willing to sell what you’re smoking?
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