50 Shades of Malpractice

Mark Crane

Disclosures

February 27, 2017

In This Article

Varying Interpretations of the Facts

Kentucky

High complication rates from a single physician are worth paying attention to.

A morbidly obese 39-year-old music teacher died 1 month after she had laparoscopic gastric bypass surgery at Lake Cumberland Regional Hospital, which heavily marketed its bariatric surgery program.

The mother of two had a rocky recovery after the operation, performed by Dr John Husted. She showed signs of infection resulting from a gastric leak. Dr Husted performed a second exploratory surgery and discharged her. The patient died days later. An autopsy found her pelvis filled with pus, and intestines that were "full of adhesions and virtually falling apart," according to a report in the Commonwealth Journal.

The patient's family sued Dr Husted and the hospital, alleging that the hospital had allowed an "unsafe bariatric program to operate" despite an abnormally high incidence of complications. The hospital stopped its program after analyzing data showing that about 30% of patients reported postoperative complications after surgery by Dr Husted, the suit charged. Several other malpractice suits are pending against the surgeon and hospital.

Dr Husted declared bankruptcy during the course of the litigation and has moved away from Kentucky. The defendants countered that the patient didn't follow instructions to return to the hospital if she experienced pain and other symptoms and that she had refused CT before her discharge.

In 2014, a jury awarded the patient's family $10.6 million, finding that the hospital should pay 60% of the award and Dr Husted 40%.

Louisiana

It's wise to keep in mind that jurors and physicians interpret facts very differently, leading to different conclusions.

A state medical malpractice screening panel cleared two pediatricians of negligence in the death of an 8-year-old girl. A New Orleans jury disagreed and awarded the child's mother $8 million in early 2014. However, the trial judge reduced the judgment to $500,000, the maximum allowed under Louisiana law.

Chela Butler went to the pediatricians' office in 2009 with a fever and sore throat of 2 days. One doctor diagnosed sinusitis and discharged her with prescriptions for an antibiotic, an inhaler, and a decongestant, according to a report in the New Orleans Times-Picayune. Eleven days later, the child was dead owing to respiratory failure caused by H1N1 influenza, an autopsy showed.

The child was considered at high risk for complications from the flu; she was born 7 weeks premature and had a history of asthma, bronchial pulmonary dysplasia, and pulmonary hypertension stemming from her early development and should have been treated with antiviral medications as advised by the Centers for Disease Control and Prevention, the lawsuit charged.

As the child's condition worsened, she was admitted to a hospital and administered oseltamivir phosphate (Tamiflu®), but it was too late, the suit charged. She developed pneumonia and was put on a ventilator before dying 3 days later.

The state screening panel, comprising three physicians, found that the doctors acted reasonably and that it would not have been useful to order an influenza test or prescribe oseltamivir phosphate at the time. The panel said that the case was a sympathetic one, and the verdict appeared to have been influenced by compassion for the family.

Maine

In one of the largest malpractice verdicts ever recorded in Maine, a jury in 2011 awarded a family $6.7 million against Eastern Maine Medical Center and Dr Lawrence Nelson, a Bangor surgeon.

Thomas Braley Sr, then a 44-year-old who worked as glazier, was injured in 2005 in an all-terrain vehicle rollover accident. He suffered several broken ribs and other injuries. At the hospital, CT scans ordered by an emergency department physician indicated internal bleeding, according to a report in the Bangor Daily News.

The physician didn't order follow-up radiography to monitor the internal bleeding, the complaint said. Over the next 2 days, one of Braley's lungs collapsed. The lack of oxygen precipitated a massive heart attack, from which he died, said the family's attorney. The death might have been avoided with the placement of a chest tube for drainage of accumulating fluid, he said.

The surgeon's attorney said that Mr Braley died of an unexpected and unpredictable rupture of an intercostal artery and that "no test, lab, or evaluation could have predicted or prevented what happened." He added that the jury ignored the finding of a prelitigation screening panel, required under Maine law in all medical malpractice cases, that actions alleged by the patient's family did not cause his death.

The award was substantially reduced by a judge because of Maine's caps on awards for pain and suffering.

Maryland

A definite effort to defraud the healthcare system, while putting patients at risk, took place over several years—but at least it came to a halt.

In 2010, St Joseph Medical Center sent notices to hundreds of patients, warning that they might have had unnecessary heart stent procedures. As you might expect, scores of malpractice suits soon followed.

An internal hospital review done amid a federal investigation found that many of cardiologist Dr Mark Midei's patients had only minor clogging and didn't need stents.

A $37 million settlement between the hospital's former owner and Dr Midei's patients was approved in 2014 by a Baltimore judge. As many as 273 patients will get payments of at least $134,000 before lawyers' and other fees, ending class-action suits in Maryland and federal courts, according to a report in the Baltimore Sun.

Dr Midei lost his medical license after the Maryland Board of Physicians found that he falsified records to justify the expensive procedures. He has denied any wrongdoing. He told the newspaper that many of his patients would have died without the stent procedures.

As of August 2015, several suits were still pending against Dr Midei, who is employed at a healthcare consulting business.

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