In July, 2009, the family of Massachusetts teenager Yarushka Rivera went to their local Walgreens to pick up Topomax, an anti-seizure drug that had been keeping her epilepsy in check for years. Rivera had insurance coverage through MassHealth, the state’s Medicaid insurance program for low-income children, and never ran into obstacles obtaining this life-saving medication. But in July of 2009, she turned 19, and when, shortly after her birthday, her family ...

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What is evidence? How do we gather evidence of patient harm? More importantly, what is the evidence that counts? A research paper dating back to 2004 suggests that besides research evidence, clinical and patient experiences, as well as contextual information also constitute evidence. However, the only currency of science is data collected through systematic and rigorous research. But when it comes to the business of medical error,
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Several years ago, a colleague of mine did a procedure on my daughter. What was supposed to be routine has become a nightmare for her.  When he saw her post-op, he told her she was fine.  Because of this obfuscation, years went by before she really understood how damaged she was. By then, the statute of limitations had lapsed and she had no recourse. Still seeking closure on this disaster, my daughter ...

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The vast majority of births and deliveries are joyful ones. Families celebrate the wonder of the new addition to their families, and clinicians go home at the end of the day with a sense of pride, deriving meaning from their professional lives. This is one of the reasons that many of us chose obstetrics in the first place. But unfortunately, that is not always the case. As an obstetrician, I know firsthand ...

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Nothing troubles physicians more than an unforeseen outcome and a malpractice lawsuit. It cracks open self-doubts and assumptions about medicine and may be life-changing. It commonly fuels burnout, loss of confidence, PTSD and early retirement. And there are links to depression and physician suicide. There's another side to this story, though. Like all of life's great challenges, a patient's unexpected loss, and professional litigation present us with huge opportunities for growth. I am ...

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A single error oft inters the good that doctors do. The case of Dr. Hadiza Bawa-Garba, a trainee pediatrician in the NHS convicted for homicide for the death of a child from sepsis and hounded by the General Medical Council is every junior doctor’s primal fear. A boy in shock Friday, February 18th, 2011 was not a typically unusual day in a British hospital. Dr. Bawa-Garba had recently returned from a 13-month ...

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Dr. Pramela Ganji had just finished her lunch when she was told that the appellate court had reversed and vacated her conviction.  At first, she didn’t believe it.    After all, this whole experience had been surreal.  Dr. Ganji, a 68-year-old well-respected medical doctor and married mother of 3 children, had practiced medicine for 40 years without incident.  Her patients loved her, and she had dedicated her life to helping others. ...

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There are a lot of TV commercials for structured settlement companies these days. You know, the companies that say if you are cash-strapped but have a structured settlement they will be happy to buy your settlement and give you "cash now." Some of the commercials are quite clever and catchy featuring everything from operettas to boy bands. After seeing so many of these, one has to conclude that there has ...

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From the earliest days on the clinical wards, everyone probably worked with a senior physician who knew how to game the system. It might be doing a rigid sigmoidoscopy on admission for every patient who had a rectum — something not the standard of care forty years ago. Or maybe it was accepting a pharmaceutical company subsidized tax-deductible junket under the guise of CME at a place with sparkling white ...

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I was a chubby kid, but my parents still introduced me to lots of sports. Soccer, swimming, tennis, basketball; so many sports, when all I wanted to do was read and eat Doritos.  I wasn’t particularly good at any of them, but some of my teams were better than good. We were champs. My swim team won the Cape Cod Summer League, my soccer team won its division one year, ...

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Long ago, I represented a doctor who was … difficult. He was a phenomenal surgeon, world famous in his field, but he was not warm and fuzzy — not even close. Cold and hard were more his speed. We spent two weeks together, on trial in city hall. It takes about two years from the time a case is filed to the time the case goes to court. During that ...

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From the wrong diagnosis to the incorrect medication, medical mistakes kill as many as 250,000 people annually in the United States — and injure thousands more. This figure could be much higher, considering there’s never been an actual count of how many patients experience preventable harm. We only have an approximate figure, which may indeed be very far off from the truth, considering the inaccuracies in ...

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An orthopedic surgeon and a neurosurgeon walk into a room … Unfortunately, this is not the start of a joke. While we would prefer to be sharing best practices and treating patients in our exam rooms, the fact is we’re spending more time than we’d like in a courtroom. Because our medical liability system is broken, orthopedic surgeons, neurosurgeons, OB-GYNs and other specialty physicians continue to find themselves on the receiving ...

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I’m not here to tattle. No siree, Bob. I’ll save that for my kids. But what I am here to do is spell out a story in which I ended up down in the dumps. A medical mistake happened. To me. On me. I’ll never forget it. I can’t because I carry it with me forever. Here’s the short of the long: My obstetrician messed up. She took care of my pregnancy during one of the most ...

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When Donna Helen Crisp, a 59-year-old nursing professor, entered a North Carolina teaching hospital for a routine hysterectomy in 2007, she expected to come home the next day. Instead, Crisp spent weeks in a coma and underwent five surgeries to correct a near-fatal cascade of medical errors that left her with permanent injuries. Desperate for an explanation, Crisp, who is also a lawyer, said she repeatedly encountered a white wall of ...

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Anyone watching daytime or late-night cable TV has to notice that every third commercial is for a toxic tort. As my wife had breast cancer, one, in particular, caught my eye. In it, the claim was made that: "If you suffered from permanent hair loss due to chemotherapy, you might have a claim because less toxic treatment was available." This struck a chord with me because my wife was in ...

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In the mid-1970s, malpractice lawsuits and skyrocketing jury awards caused commercial insurance companies to raise physicians’ malpractice rates by as much as 400 percent. The practice of medicine was deemed to be “uninsurable.” Thousands of physicians faced cancellation of their policies. As a result, doctors came together to form their own companies to provide affordable and sustainable coverage. However, today’s physicians need more. We spoke with more than 800 doctors, practice ...

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A study of over 890,000 Medicare beneficiaries shows that states with malpractice environments unfavorable to physicians do not see improved postoperative outcomes for 11 different types of mostly elective major operations. States with higher general surgery malpractice insurance premiums had significantly more episodes of postoperative sepsis, pneumonia, acute renal failure, and gastrointestinal bleeding. Those with higher numbers of paid claims per 100 physicians had more postoperative myocardial infarctions, surgical site ...

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Two doctors I work with were recently asked to testify in court. I knew it was a case involving domestic violence and I knew I wanted to see what it was like to testify: One day I’d like to work with families in the foster care system, and that will likely mean having to testify in court. So I asked my clerkship director, and with her support, the clerkship coordinator ...

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Most of the lawsuits I deal with have more than one named defendant. For example, the plaintiff (typically a deceased patient’s next of kin) might sue a hospital, a nursing home, and the attending physician at each facility. Sometimes they go a bit further and may even include the administrator, the director of nursing, and individual HCPs, such as the wound care nurse or the registered dietitian nutritionist. When a lawsuit ...

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