50 Shades of Malpractice

Mark Crane

Disclosures

February 27, 2017

In This Article

A Whirlwind of Lawsuits; Should Peers Have Taken Action?

South Dakota

A controversial surgeon has inspired a whirlwind of lawsuits, ensnaring more than a dozen physicians who served on hospital committees that granted him privileges.

A jury in 2013 found that orthopedic surgeon Dr Allen Sossan was negligent in performing two unnecessary spinal fusion operations and rendered a $933,835 verdict for the family of the deceased 80-year-old patient.

That lawsuit was one of almost three dozen other suits brought in South Dakota courts by Dr Sossan's former patients or families of patients who died after undergoing surgery. The doctor also settled several other cases, according to a report in USA Today.

During 2015, more than a dozen doctors were named in federal lawsuits charging that they acted in bad faith by allowing Dr Sossan to perform surgery. The doctors were accused of "negligent credentialing" in extending him privileges to perform complex spine surgeries, despite knowing of his history of unnecessary procedures and unprofessional conduct. The plaintiffs alleged that the hospitals granted him privileges because spine surgeries are lucrative revenue streams.

Numerous complaints were made to the South Dakota and Nebraska medical licensing boards about Dr Sossan from other doctors and patients, but he was allowed to keep his privileges for some time afterward.

Tennessee

It's important to examine a cast for skin changes, rather than let it go for a significant period.

A 72-year-old woman with a history of peripheral vascular disease and smoking fell and fractured her ankle. Her orthopedist placed her in a walking cast and told her to return after a week.

The doctor decided to leave her in the cast and check her again in a month. On that visit, the cast was removed, and it was discovered that the patient had developed a heel ulcer, as well as dark eschar and sloughing of the skin on the dorsum of her foot.

Two weeks later, her skin condition was worse, and the patient was referred to a wound care specialist. The ulcers on her left ankle and heel were infected, and she had a large ulcer with an exposed tendon. After several weeks of wound therapy and debridement at a hospital, the patient elected to undergo a below-the-knee amputation.

Her lawsuit against the orthopedist and his clinic alleged that he failed to properly monitor her foot and should have removed her cast earlier because she showed signs of ecchymosis at the time the cast was placed. The defense argued that the patient may have been self-medicating with alcohol, and that removal of her cast would have made no difference in whether she would ultimately have experienced skin breakdown.

A jury in 2013 found the orthopedist and his clinic were negligent, but the patient was 25% at fault for her injuries. It awarded her $1.3 million, which was reduced to $981,000 for her apportionment of fault.

Texas

The case of a "dangerous" physician prompts the question: If these charges are true, should peers have taken action to keep him from operating?

A controversial former neurosurgeon in Plano whose Texas medical license was revoked for allegedly killing or maiming patients during spinal operations was arrested in April for assaulting several people and shoplifting about $900 worth of clothing and other items from a Dallas Wal-Mart, according to a report in the Dallas Morning News.

The Texas Medical Board previously found that Dr Christopher Duntsch, 44, now of Centennial, Colorado, violated the standard of care in six patients, had a pattern of failing to follow appropriate procedures before operations, and failed to recognize and respond to complications during and after surgery.

Numerous malpractice suits against him are still pending. He was accused of maiming several patients and causing the death of at least two patients between July 2012 and June 2013. In one lawsuit, a patient who was a friend of the surgeon alleged that they both used cocaine the day before the surgery. Duntsch has denied using drugs. Several of the lawsuits also allege that Baylor Regional Medical Center at Plano knew that Duntsch was a dangerous physician but didn't stop him from performing back surgery.

In a series of interviews with the newspaper, Duntsch said he was the victim of a Texas cabal of rival physicians and personal injury lawyers. "I am a well-trained surgeon. I'm a complex spine surgeon. My record is excellent. Ninety-nine percent of everything that has been said about me is completely false."

Utah

As increasingly more physicians work with nurse practitioners (NPs) and PAs, it's useful to know that in some states, supervising an NP doesn't mean that a doctor must review and sign off on every prescription she writes.

David Ragsdale shot and killed his wife in a church parking lot in 2008 while under the influence of medications prescribed by an NP. He pleaded guilty to felony aggravated murder and was sentenced to 20 years to life in prison.

A conservator for the couple's young children sued the NP, her consulting physician, and the clinic, claiming that the prescriptions for at least six antidepressants, steroids, and other drugs led to Ragsdale's deadly attack. A judge initially dismissed the suit but the Utah Supreme Court reinstated it, unanimously ruling in 2012 that healthcare providers have a duty to consider how treatment of patients might affect their families. The NP later reached a settlement with the children.

Family physician Hugo Rodier, who was the NP's consulting physician, asked to be dismissed from the suit.

In another unanimous decision, the state's high court ruled in January 2014 that the doctor had no duty to consult with the NP on each individual prescription she wrote. The Utah Nurse Practice Act gave the NP the authority to prescribe controlled substances and doesn't impose any obligation on the nurses to discuss with a doctor each prescription of a controlled substance.

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