Saturday, October 13, 2007

Cities bringing a gun to the knife fight when they're sued for medical malpractice

Sorry for the dearth of writings! I've been in California all week.

An interesting and ironic story in the New York Times today "Rules to Collect Care Costs Are Coming Under Attack."

In summary, in a number of instances where complications involved with indigent medical care resulted in large medical malpractice judgements against municipalities, the cities have subsequently turned around and presented bills for their care to be subtracted from the judgement. I LOVE IT!

The case discussed in the article involved a psychiatric patient who's estate sued a city after he gauged his own eyes out in a treatment center (because obviously it must be the cites fault according to trial lawyer logic).

“This is a matter of fiscal responsibility,” said George Valentine, the Washington district’s deputy attorney general for civil litigation, explaining that city taxpayers deserved to be protected from expenses that could be shouldered by patients. Payment from Ms. Motley would have been due only if a jury found in her favor and the city would not have collected more than what was awarded, Mr. Valentine said."

Trial lawyers have complained that such attempts to re-compensate cities for free care gives too much leverage to the city when they're trying to negotiate settlements from them (and removes much of a potential windfall from their share of the settlement). This is just one more example of just how crazy our med-mal system has become.



Rob

5 comments:

Anonymous said...

According to the article, the patient had "been a patient -- for 34 years -- at a city-run psychiatric hospital here after being declared insane by a court", when he clawed his eyes out because his restraints were left off him for a little while.

Ok, I do see a negligence: ordered restraints being left off, leaving the patient able to harm himself, which he did. BUT, I don't fully understand the lawsuit:

- How is his guardian (the one suing) related to him? Is she family, or a court-appointed guardian? Is she an attorney?

- Is she responsible for paying any portion of his medical bills and/or housing (at the county psych ward)?

Those questions would make a big difference for me, but the article didn't cover any of those issues.

If she is family, and is responsible for paying for part of this patient's care, and the unfortunate incident that caused his injury caused the bills to be higher, then I wouldn't have a problem with her suing.

But on the other hand, if she's not related, but a court-appointed guardian (maybe even an attorney), and does NOT have to pay for his housing/medical care, then by her suing, it seems like she's a money-grubbing scammer.

If she's family that's paying for part of the medical care, then it's scummy on the part of the local government to try to recoup malpractice fees. But if she's a court-appointed guardian that's not financially responsible for his medical bills/housing, then good for the local government for trying to recoup taxpayer money from a scammer.

I hope the lawmakers take those considerations into account if they make new laws to 'protect' malpractice payments. Looking at it one way would protect the 'innocent', but looking at it the other way would protect the 'guilty'.

S

Dr. Rob Oliver said...

You make lot's of good thoughts about this. For me, I thought the interesting thing was to point out that med-mal or liability suits are not designed to be some kind of financial windfall for a plaintiff. It is perfectly reasonable to ask for parts of "unpaid bills" (uncompensated indigent care in this instance) to be paid when patients come into circumstances where they can be it an inheritance, the lottery, a new job, or in this case a large tort settlement.

joanne said...

i don't see asian on ur visitor map

Anonymous said...

Ah, from your perspective, it doesn't matter if the guardian was family, or a court-appointed guardian (possibly an attorney), because the state's already been footing the bill, and will continue to foot the bill. So any med-mal tort awards would offset past, present, and future care costs.

Dr. Rob Oliver said...

In this instance, the plaintiff was an indigent and uninsured psychiatric patient who's care was 100% subsidized by the state. Like I said, it certainly is reasonable to recover that cost when someone's circumstances change such that they can repay that cost (at least in part)