Rising premiums in Pa. threaten access to health care;Lawyers say stop making mistake

[NRSKarenRN, BSN, RN]

Rising premiums in Pa. threaten access to health care, doctors and hospitals say. So stop making mistakes, lawyers respond.

http://inq.philly.com/content/inquirer/2001/07/01/business/MEDERR01.htm

Kathleen Ann Kensey died after getting a transfusion of the wrong type of blood.

By Josh Goldstein

INQUIRER STAFF WRITER

While doctors and hospital executives are campaigning hard in Harrisburg for legal relief from high malpractice verdicts, the lawyers who represent injured patients have an equally strong response: Stop making mistakes.

If doctors and hospitals reduced the number of preventable medical errors, the lawyers say, there would be fewer lawsuits and consequently lower malpractice premiums.

"Any reform has to take into account . . . not only the court system, but also the role played by hospitals and doctors in making mistakes that cause tragedies," said Frank M. McClellan, a Philadelphia plaintiff lawyer.

McClellan represents the family of a West Philadelphia woman who died last year because of a medical mistake. The hospital acknowledges that she received an incompatible blood transfusion.

Last August, Kathleen Ann Kensey was diagnosed with ovarian cancer and scheduled for surgery the next week.

At the Hospital of the University of Pennsylvania, Kensey received a transfusion to get her blood count up before her surgery. Everything was going well until a nurse gave Kensey a second bag of blood.

The blood in the second bag was Type A-positive and had another patient's name on it. Kensey's blood was Type O.

During the next six hours, Kensey developed a fever, became nauseated, and suffered a heart attack. Resuscitation failed. She died in front of family members because of the incompatible transfusion.

Now her family is suing the hospital as well as the doctors and nurses who treated her.

"Kathy did not have to die that horrible death," said her older sister, Doris Kensey-Chandler. "She couldn't get air, her body just broke down, and they worked on her and worked on her, but they didn't [figure out] what was going on."

The hospital does not dispute that Kensey received an incompatible transfusion.

"When we became aware of the incident, we contacted the family to explain what had happened and express our profound sorrow," hospital spokeswoman Rebecca Harman said. "This was a tragic and rare event, which also affected all members of the hospital's family, especially those directly involved in Ms. Kensey's care."

The Kensey suit is one of more than 1,000 medical malpractice cases that are expected to be filed in Philadelphia this year.

The number of malpractice cases filed in the city rose 13 percent between 1996 and 2000, according to court data. Insurer payouts to cover this liability - including out-of-court-settlements - rose even faster.

The state agency that provides the second tier of malpractice coverage for doctors and hospitals - the CAT Fund - saw its payout in Philadelphia cases go up by 37 percent over the same five years.

Last year in Philadelphia Common Pleas Court, there were 30 jury verdicts awarding $1 million or more in malpractice cases, according to court records.

Doctors and hospital executives blame the number of suits and the size of awards for the dramatic increase in their malpractice premiums.

Yet the current increases in premiums of 30 percent to 100 percent in the Philadelphia area are far out of proportion with the rise in the number of cases in the city and the size of the payouts.

From 1999 to 2000, 3 percent more suits were filed in the city, according to court records, and 11 percent more money was paid to plaintiffs by the CAT Fund - the Pennsylvania Medical Professional Liability Catastrophe Loss Fund.

Between 44,000 and 98,000 Americans die each year from medical errors, according to the Institute of Medicine. Hundreds of thousands more are injured.

Doctors and hospital administrators acknowledge that mistakes must be addressed, but they argue that those errors are not why malpractice premiums are rising.

"The trial lawyers are trying to divert the true nature of the crisis off onto medical errors," said Roger Mecum, director of the Pennsylvania Medical Society, which represents the state's doctors. "Even though we have one of the worst malpractice [cost] crises in the country, there isn't any evidence that Pennsylvania has a greater problem with medical errors."

He said that it was the number of suits and the amount of money paid on those claims, particularly in Philadelphia, that was driving up the premiums.

Ultimately, patients' access to care could be harmed, doctors and hospital administrators say, unless the malpractice costs are brought under control.

Their solution is tort reform - legislation they are pushing in Harrisburg to cap damages for pain and suffering, establish standards to judge the qualifications of expert witnesses, and impose sanctions to reduce frivolous suits.

"We need tort reform," said Andrew Wigglesworth, president of the Delaware Valley Healthcare Council, a trade group for local hospitals and health systems. "The reforms . . . are those to ensure that people receive fair and appropriate compensation when they are injured balanced with society's ability to pay."

Timothy A. Shollenberger, president of the Pennsylvania Trial Lawyers Association, called tort reform unfair because it would make it more difficult for injured patients or their survivors to collect appropriate damages.

And the lawyers argue that doctors and hospitals do such a poor job of disciplining themselves that the threat of a suit is often the only leverage available to force providers to fix problems and prevent errors.

"The bottom line in this whole debate should be public safety, not cost," said Thomas Kline, a prominent Philadelphia lawyer. "Public safety is being protected by a tort system which holds medical providers equally accountable for negligence as everyone else in our community."

Health-care providers say they are looking for ways to reduce injuries and create an environment in which mistakes will be prevented or will be caught before they cause harm.

Starting today, hospitals are required to tell patients when they have been harmed during their treatment, or risk losing their accreditation. The new standard by the Joint Commission on Accreditation of Healthcare Organizations, which monitors safety and quality at 5,000 hospitals nationwide, is intended to foster open discussion of mistakes and help reduce the problem without increasing the number of lawsuits.

And there is some evidence that hospitals that have been candid with patients about mistakes are less likely to be sued.

Locally, the Delaware Valley Healthcare Council has launched a $1.6 million project to reduce medication errors at the region's 73 hospitals.

While the legal and medical establishments try to sway Harrisburg legislators, cases such as Kathy Kensey's show that malpractice is not just about the cost of insurance premiums, the number of lawsuits, and the size of jury awards.

Kensey was the third of seven children. She was single, and her sisters describe her as the glue for her family. She remembered birthdays, anniversaries and other special occasions. She planned the parties and made sure there was cake.

In addition to working full time, Kensey was the primary caretaker for her 69-year-old mother, Vera, who was partially paralyzed after hitting her head in a fall.

"Her shoes are very hard to fill," Kensey-Chandler said, "even by six other people."

When Kensey went to the hospital after her cancer diagnosis, she was scared about the surgery. Two sisters were with her, sitting by her bedside, as the wrong blood dripped into her veins.

"She didn't get a chance," said her sister Sharon Jackson. "And it just makes me mad because so many people were trying to figure out what was wrong, but no one checked the blood."

[Barbara Rose]

Now, isn't that scary? The hospital made the mistake (nurses I am sure or "techs"?) yet they don't want to be held accountable for those errors? What then would happen? Imagine all the errors out there that would happen!!! Better practice, better staffing, and better know how will eliminate the cost factors. Of course, they will have to spend money to fix the problem either way and that is really the bottom line. Karen, find anything in my neck of thewoods? I have not been able to hunt good stories lately. If you have seen some, let me know. Thanks for the work!!

[NRSKarenRN, BSN, RN]

Doctors blast frivolous lawsuits, big awards

Health care costs may be real loser THE SUN HERALD

http://web.sunherald.com/content/biloxi/2001/06/29/local_news/0629_medical_suits.htm

PASCAGOULA - Two Coast doctors say they are concerned about the growing number of frivolous lawsuits filed in Mississippi and

By TRACY DASH

how it has affected the way they practice medicine.

Dr. Steve Demotropoulos, an emergency room physician at Singing River Hospital, said he practices "defensive medicine," taking extra precautions when treating his patients, so he can avoid being named in a malpractice suit.

"We're not trying to run away from responsibility," he said. "But frivolous suits, that eats up the money."

Demotropoulos and Dr. Jack Hoover, a Pascagoula gynecologist, spoke on behalf of the Coast medical community Thursday at a press conference coordinated by the Mississippi State Medical Association.

Liz Carroll, a spokeswoman for the medical association, said the doctors wanted to make the community aware that frivolous lawsuits and large punitive damage awards are causing the cost of health care to skyrocket.

Punitive damages are money a defendant must pay as punishment for wrongdoing.

The doctors speak from experience. Both have been sued by patients who claim they didn't receive proper care. The suits against Demotropoulos were dismissed, but Hoover settled his suit for a "small" amount.

Demotropoulos and Hoover hope the state Legislature in the 2002 session adopts new civil liability laws, which are known as tort reform. They say reform is needed to cap the amount of money a jury can award in punitive damages and prevent attorneys from filing suits in counties that historically award a lot of money to plaintiffs.

Hoover, who has delivered more than 5,000 babies in his 30 years as an obstetrician and gynecologist, said the lawsuit problem is partly to blame for some doctors retiring early or avoiding high-risk procedures.

"Fear of suit was a factor in giving up obstetrics," said 68-year-old Hoover. "Age was another."

Hoover said malpractice insurance rates vary, depending on the field of medicine. For instance, Hoover said he now pays about $15,000 a year for malpractice insurance. But it was $35,000 a year when he practiced both gynecology and obstetrics three years ago.

Doctors pay more for obstetrics insurance because there is a higher risk of problems occurring and the time allowed for patients to file suit is longer than with other fields of medicine, Hoover said.

He said insurance carriers recently announced that malpractice insurance is about to increase. His premium will rise by 10 percent, but other doctors will see an increase of 75 percent, he said.

"To some degree," he said, "we have to pass it on to the patient."

Tracy Dash can be reached at 896-2340 or at [email protected]