A Look into the VA Waiting List Debacle

The Veterans Health Administration is responsible for the healthcare of 8.76 million veterans and their families every year, representing “America’s largest health care system.” The VA’s crucial role in the life and wellbeing of some of our most honored citizens makes the recent waiting list scandal exponentially more appalling to medical malpractice attorneys as well as the public at large.

The Cover-Up

The VA crisis emerged in April, when a retired clinic director came forward with allegations that the Phoenix VA had falsified their electronic waiting list. Their “secret waiting list” concealed the number of veterans waiting for care, as well as their exorbitant wait times.

Since word of the cover-up has come out, investigators have identified at least 18 veterans that died while waiting for medical care. It is currently unclear whether these individuals’ deaths directly resulted from the delay in care. However, autopsy reports, death certificates, and medical records should provide more conclusive evidence.

The Solution


As the investigation continues, the VA has responded by opening up several mobile medical units throughout Phoenix to give more veterans access to the care they need. In addition, the Senate Veterans Affairs committee is working on a bill that would help veterans by expanding their network of healthcare facilities and providers, eliminating ineffective executives and administrators while increasing facilities and hiring across the country.

Hopefully, these measures will begin to turn around a seriously flawed system whose mismanagement and dishonesty have harmed countless American heroes. However, as more information emerges, we will likely learn that many more veterans have died or suffered needlessly due to the practices of VA facilities across the country.

Medical Malpractice


Each state creates its own medical malpractice laws, but the National Institutes of Health defines medical malpractice as “any act or omission by a physician during treatment of a patient that deviates from accepted norms of practice in the medical community and causes injury to the patient.” The VA, like any other medical provider, has an obligation to provide its patients with timely and effective healthcare and to abide by the law while doing so.

When healthcare organizations break their trust with those who depend on them for their care, they must be held accountable. Washington D.C. medical malpractice attorneys Regan Zambri & Long work with individuals who have suffered harm at the hands of their medical providers. For a free consultation to explore your legal options, contact us at (202)463-3030.

 

 

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Virginia Medical Malpractice Suits Against VA Clinics Settle for Over $1 Million

The Center for Investigative Reporting just released a report announcing that the families of four deceased military service members will collect around $1.4 million in settlement money. Caregivers treated the veterans at the Coatesville Veterans Affair Medical Clinic in Virginia.

  • One VA medical malpractice case (which settled for $100,000) concerned accusations that caregivers did not monitor a veteran who later died.
  • Another case, which closed back in February 2008 for nearly $500,000, concerned the VA's failure to manage a psychiatric patient.
  • A third case closed in August 2011: A misdiagnosed VA patient died.
  • A fourth case closed in December 2011 for $500,000: a caregiver failed to monitor a sick veteran.

Amazingly, those four cases constitute just a drop in the bucket. VA facilities around the country currently face over 1,000 wrongful death actions; the government has already settled various matters for over $200 million.

Why is this happening, and what are lawmakers doing about it?

Patrick Mayhem, a Democratic Congressman, lashed out recently against President Obama for allowing the situation at VA facilities to get so bad. Mayhem said “the President spoke of accountability at his press conference today but is showing none… The horrors that have been exposed at the VA facilities across the country are shameful, and addressing them requires less talk and more decisive action.” Among other things, Mayhem had wanted Obama to fire VA Secretary Eric Shinseki.

Obama did meet with Shinseki at the Oval Office, and he exchanged harsh words. The President said: "I told the Secretary I will not stand for [what is happening with the VA facilities] – not as Commander-in-chief but also not as an American.”

Nationwide outrage has been building, following repeated allegations of patients dying at VAs due to misdiagnoses or bad treatment. Patients and their families also complain about costly, nonsensical delays.

There has been a massive influx of soldiers back from campaigns in Iraq and Afghanistan over the past several years. These people often need more than just temporary assistance with medical problems. They also need long term psychiatric help as well as therapy for chronic issues caused by head injuries, PTSD and war-related depression.

Patient rights advocates want to see positive action to fix the VA facilities to make them more functional and make the system fairer. Obama reassured voters last week: “we are going to fix whatever is wrong, and so long as I have the privilege of serving as Commander In-Chief, I am going to keep on fighting to deliver the care and benefits and opportunities that you and your families deserve, now and for decades to come.”

Hopefully, that will be the case.

If someone you love was hurt, misdiagnosed, or otherwise poorly treated at a VA facility or any other medical center, call Regan Zambri & Long today for a free consultation at (202) 463-3030.
 

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Impassioned Forbes Magazine Piece Shows That Malpractice Lawsuits "Aren't Just About Money"

How widespread is medical malpractice? What are the real costs for patients, for the medical system, for doctors and for insurers? And what can be done to fix the system's fundamental structural problems? A compelling recent piece in Forbes Magazine, “Malpractice Lawsuits Aren’t Just About the Money,” dissects the scope and breath of the problem; it’s truly breathtaking.

The piece begins with the tale of a woman named “Karen,” a Board Certified physician whose mother had been rushed to the hospital, because she had been on the wrong medication. Terrified and enraged, Karen called her mother’s doctor, who proclaimed that he was “on vacation” and could not be bothered to come in and see the sick patient.

Even though Karen was “Board Certified in three specialties,” she felt helpless to navigate the system. Should she file a lawsuit? Perhaps she could complain to the Joint Commission on Safe Accreditation – a watchdog organization that promotes safety and quality care at hospitals. Good idea in theory. Unfortunately, only a third of the 3,000+ hospitals accredited by the Joint Commission have the distinction of being “top performers.” What's more: 2,400 hospitals throughout the country do not even have this accreditation.

The Scope of the Malpractice Debacle

Nearly 100,000 people die and 300,000 people suffer injuries every year at U.S. hospitals due to avoidable errors, per the National Institute of Medicine. This is simply an unacceptable situation.

And reformers are frustrated.

In 2004, reformers created the Institute for Health Care Improvement, which urged hospitals to sign on to evidence-based strategies to protect people from the dangers of malpractice, using objective metrics, and to implement positive changes. 1,000+ hospitals signed on, but these hospitals were notoriously slow to implement key recommendations and often behaved in recalcitrant fashion.

Hospitals have not been the only institutions resistant to change.

The American College of Obstetricians and Gynaecology (ACOG) famously failed to implement powerful changes that helped New York Presbyterian Hospital drop its rate of “sentinel events” (those causing death or serious injury) from 1 out of a 1000 to zero, over a span of just a few years.

Why did ACOG refuse to make these changes? According to the Forbes article, ACOG rejected the reforms “on the grounds they [might] infringe on individual doctor or hospital prerogatives.”

In other words, ACOG made a choice that it's more important to preserve doctor/hospital autonomy than it is to prevent sentinel events in patients.

That's a cynical calculus, if there ever was one.

By contrast, consider what the American Society of Anesthesiologists did back in the early 80s, in the wake of a series of awful patient incidents. That organization did a thorough work over of its processes and, within a decade, dropped the rate of death from anesthesia from 1 in 6,000 to 1 in 200,000.

If you or somebody you love needs legal assistance with a potential case, contact the Washington D.C. malpractice attorneys at Regan Zambri & Long today at (202) 463-3030 for a free consultation.
 

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Don't Buy into These Four Myths about Tort Reform

Medical malpractice attorneys are refuting the notion that claims are out of control. Many lawmakers, insurance companies, and medical practitioners, however, are championing tort reform, which seeks to place limitations on litigation or damages awarded in civil claims. These non-legislative proceedings have long been a way for individuals who have suffered harm to gain compensation from those responsible.

Tort reform proponents, however, believe (or would like the rest of us to believe) that medical malpractice claims pose undue hardships to doctors, insurance companies, the legal system, and the economy. Their messages often capitalize on several misconceptions about tort litigation, including:

•    Medical liability expenses hurt the economy. According to the Harvard School of Public Health, the United States spent $55.6 billion, or 2.4 percent, of 2008’s healthcare spending on “medical liability costs.”

•    High claims payouts lead to financial burdens on medical malpractice insurance companies. Regardless of whether a state imposes caps on claims payouts, insurance companies continue to rake in enormous earnings. For example, between 2003 and 2010, insurance companies in Florida reported 4300 percent profits, a staggering amount that should leave no question as to their profitability.

•    We need damages caps in medical malpractice cases to keep insurance costs down. According to a ruling by the Florida Supreme Court, no apparent correlation between medical malpractice settlement caps and insurance rates exists. The American Association for Justice further cites several sources that attribute high insurance rates to stock speculation and “mismanagement” of insurance company resources.

•    Healthcare providers will abandon states without medical malpractice caps for states that do. This myth is based on the faulty premise (see #3) that caps lower insurance rates. According to the American Association for Justice, the overall number of practicing physicians in every state has been steadily increasing.

Examining these falsehoods propagated by tort reform enthusiasts seems to reveal either a lack of understanding in the financial realities of medical malpractice claims, or a determination to increase profits for insurance companies at the expense of vulnerable patients.

The medical malpractice attorneys at Regan, Zambri & Long have been working with clients for many years to obtain fair and equitable compensation for those who have suffered harm. If you or someone you know has suffered from medical malpractice, contact us today to set up a free consultation.
 

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Could 12 Million People Be Really Misdiagnosed Every Single Year?

A very alarming new study puts DC medical malpractice cases -- and indeed, the entire issue of malpractice -- in a disturbing new light.

Researchers at Houston Veterans Affairs Medical Center, publishing in BMJ’s Quality and Safety Journal, suggest that one out of 20 Americans every year gets misdiagnosed by a physician. That means that doctors misdiagnose 12 million Americans every year.

Fortunately, most of these misdiagnoses likely do not result in serious injury or death. But that is still a staggering number, and if it’s even remotely accurate, it should set off alarm bells throughout the medical care system and instigate process improvements ASAP.

The researchers concluded that up to 50 percent of the errors in diagnoses could lead to major harm (not that they necessarily DO, fortunately). They wrote that their analysis “should provide a foundation for policyholders, healthcare organization, and researchers to strengthen efforts to measure and reduce diagnostic efforts.”

Traditionally, it has been challenging to identify misdiagnosis statistics outside of hospital and clinical settings. In this study, researchers examined hundreds of patient medical records as well as records of clinical doctor visits, and they then made estimates based on these data and extrapolated their conclusions to the population at large.

Obviously, this study has its limitations. For instance, perhaps the sample that they analyzed was just unlucky; and they endured many more misdiagnoses than typically happen to the patient population. Or perhaps the methodology was somehow flawed or the statistics used to measure and compare patient groups were not accurate or appropriate.

Most Costly Errors?

The researchers noted that “delayed cancer diagnoses is believed to be one of the most harmful and costly types of diagnostic care in the outpatient setting,” especially since early treatment can save lives for patients who develop some cancers and progressive, chronic diseases.

Whether the study accurately gauged the “true” number of misdiagnoses or not, many patients (and families of patients) don’t understand their rights or possible means of recourse after a misdiagnosis-related injury or illness.

The team here at Regan, Zambri & Long can help you understand your legal options. Our Washington D.C. medical malpractice attorneys are standing by to provide a free and confidential case evaluation at (202) 463-3030. Call or email us now for sound insight.
 

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The Data Are in: National Practitioner Data Bank (NPDB) Publishes Info on Medical Malpractice Payouts

Every year, the National Practitioner Data Bank (NPDB) creates a compilation of data about medical malpractice payouts in the United States. These data can be helpful, because they can help identify trends in medmal, state-to-state, and effectively “take the temperature” of how the country feels about the industry and about tort reform. Surprisingly, the report found that 93% of all payouts in 2013 came from settlements -- only 4% of the money came from verdicts. The survey also illustrated that trial can be quite a risky proposition, from a plaintiff's point of view. Doctors win substantially more cases than they lose in court. Perhaps doctors who feel confident in their positions don't mind going to trial to defend them, while doctors who feel less sure choose to settle.

The NPDB data only focus on medical malpractice cases against practitioners, not hospitals. Some analysts have expressed quibbles with aspects of the NPDB methodology, but these issues are too fine grained and technical to cover here. The data can certainly enlighten us about the key trends, however.

State by State Medical Malpractice Payouts for 2013

In terms of per capita payouts, New York State led the charge -- nearly $40 of per capita. Washington D.C.'s per capita was higher that average at $19.31 per capita. Maryland, meanwhile, had a basically identical rate of $19.27. Virginia fared slightly better at $10.26. North Dakota was on the low end -- just $2.96 per capita was paid out.

For the first in time in over a decade, the total number of payouts went up, as did the amount of payouts. Analysts suggest that this trend may reflect a national push back against the “tort reform” movement. The data do show significant variation from state to state, indicating a volatile industry in transition.

Three years ago, 308 medical malpractice practice cases were settled or decided in court in Maryland for total of $91 million. Meanwhile, in Virginia, 199 cases either settled or got decided in court for $77 million. Even though Virginia settled few cases, the total average payout amount was much higher in VA.

The distribution of medmal payouts roughly follows the Pareto Principle (also known as the “80-20 Rule”), in that just a handful of cases led to the majority of payouts.

Author Michael Krauss analyzed the NPDB data on the Forbes blog and asked penetrating questions about what these numbers might mean: “How much underreporting to the NPDB… goes on? Why is New York so seemingly different from every other state? Do statutes inadvertently skew results?”

When analyzing any data – even carefully controlled surveys that have been vetted and professionally assessed – you need to be careful to avoid jumping to conclusions.

The reality is that survey data like these need to be understood in context and supported by other studies and evidences. If you need a medical malpractice lawyer in Virginia, D.C. or Maryland, please contact Regan, Zambri & Long today for a free consultation at (202) 463-3030.

 

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California Advocates Push to Raise Golden State Medical Malpractice Cap -- Would Be First Increase Since 1975

Under California law, damages in medical malpractice cases are capped at just $250,000.

If that figure sounds anachronistic… well, that's because it is: literally!

The $250,000 cap has been in place for nearly four decades – it became law way back in 1975, when then-Governor Jerry Brown signed the Medical Injury Compensation Reform Act (MICRA). Forty years later, that same cap remains in place. (Curiously, Governor Brown is, once again, Governor of the Golden State).

But that old cap may not last much longer.

Passionate California consumer advocates and attorneys have demanded reform to make the system more fair and modern. Thousands of signatories hope to qualify the "Troy and Alana Pack Patient Safety Act" to go on California’s November ballot later this year. The Act takes its name from a tragic accident: in 2003, two children (Troy and Alana Park) died in a horrific car crash, after their mother felt asleep because her doctors overprescribed her pain killers.

Bob Pack, the father of the two children, wrote the bill. He said the Act would accomplish several things:

•    It would force doctors to undergo random drug testing;
•    It would curb drug abuse related to “doctor shopping” by leveraging the state’s current prescription drug data base;
•    It would increase the cap for pain and suffering in medmal cases, which is still stuck at the 1975 level of $250,000.

Pack told reporters that: “inside these boxes [the ballots for the vote] are the voices of many victims and many Californians who want to see this change." Unsurprisingly, hospitals, doctors, and community clinics have resisted moving the cap. They fear that doing so might spark a wave of lawsuits and increase patient costs. The California Medical Association’s President, Dr. Richard Thorp, did not mince words: “this initiative is bad for patients, bad for taxpayers, and bad for California’s entire system of healthcare delivery.”

Sacramento Democrat, Darrell Steinberg, hopes to ward off a ballot initiative by seeking a legislative solution to get the MICRA cap bumped up to $500,000. This rate, as he noted, would "still be far below the rate of inflation, since MICRA became law 39 years ago."

Steinberg hopes to avoid a political bloodbath: “initiative battles [are] costly and uncertain and will damage the reputation of two fine professions… The issue cries out for a legislative solution, and what I'm offering is a conservative increase that's fair to injured patients as well as the medical and legal communities.”

Steinberg maintains that his compromise number ($500,000) is reasonable and that it would fairly compensate injured patients without significantly increasing medical costs.

But a group called Consumer Watchdog is not so sure. That group's director, Jamie Court, said “legislators have had years to make this change… if there is no popular legislation for patient safety, then the people will make the change.”

The situation in California illustrates the complexity of the medmal cap debate and its divisive tenor. Fortunately, if you or someone you love got hurt due to a doctor or hospital’s negligence or carelessness, you don’t have to fight your legal battle on your own. Call a D.C. medical malpractice attorney here at Regan Zambri & Long today at (202) 463-3030 for a free consultation.
 

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Over 200 Patients Die Daily From Hospital-Associated Infections, Report Shows

Posted by: Salvatore J. Zambri, founding member and partner

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Results from the recently-published Centers for Disease Control and Prevention (CDC) 2011 hospital survey indicate that, despite progress in recent years, the deadly health-care problem of infection continues. According to survey results reported in The New England Journal of Medicine, an estimated 648,000 patients suffered from 721,000 healthcare-associated infections and 75,000 died from them. In his press release, CDC Director Tom Frieden said, "Today and every day, more than 200 Americans with healthcare-associated infections will die during their hospital stay."  The most common infections include:

  • pneumonia  -22%
  • surgical site infections - 22%
  • gastrointestinal infections - 17%
  • urinary tract infections - 13%
  • blood stream infections - 10%

Many antibiotic-resistant bacteria are prevalent in hospitals, including Clostridium difficile (C. diff) and methicillin-resistant staphyloccus aureus (MRSA). As a result, new approaches to controlling bacteria in hospitals have become necessary. Overuse of antibiotics is now discouraged with the hope that some will become more effective again. The proposed federal budget for 2015 includes additional funding for battling antibiotic resistance.

In his statement about the survey results, Mr. Frieden said, "We go to the hospital hoping to become better, and mostly we do, but not always." I hope that hospitals take more aggressive measures to protect their patients from hospital-borne infections. Lives depend on it.

Continue Reading Posted In Medical Malpractice , Patient Safety , Public Health
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Medical Malpractice Caps Limits Overturned in Florida

Posted by: Salvatore J. Zambri, founding member and partner

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For years, supporters of so-called tort reform claimed that the costs of medical care would decrease drastically if recoveries in medical malpractice lawsuits were limited. These anti-civil-justice advocates suggest that capping damages in cases would cause doctors to order less tests, reduce their medical malpractice premiums, and make frivolous lawsuits disappear. A number of states bought that theory and enacted laws designed to control medical malpractice lawsuits. Recent rulings and statistics show that "tort-reform" harms Americans. 

As recently reported in the Miami Herald, according to the National Conference of State Legislatures, thirty-five states cap the amount of money that can be awarded in medical malpractice lawsuits. Supporters of medical malpractice caps limits proclaimed that the excessive number of frivolous lawsuits were creating a "malpractice crisis" that drove insurance rates sky-high and forced doctors to leave the state. As a result, caps were enacted.

Florida's Supreme Court recently ruled that those laws were unconstitutional and violated the equal protection guarantee under the state's constitution. Prior to this ruling, Florida limited the amount of recovery for most patient deaths due to medical negligence to $1 million and non-economic damages to $500,000. The ruling did not address the caps limits where the patient didn't die. The court questioned whether the alleged crisis that led to the caps limit ever existed. The court concluded that not only was there no crisis, but that the creation of lawsuit caps enriched insurance companies at the expense of doctors and patients. According to the ruling, during the time that the law was in effect, insurance companies continued to charge excessive premiums to doctors. Any savings that may have resulted from the caps was never passed on to doctors or consumers.

"The most recent records and reports of the Florida Office of Insurance Regulation, and the annual reports of medical malpractice insurers, confirm that not only has the number of insurers providing medical malpractice coverage increased...the profits would probably shock most concerned.

Indeed, between the years of 2003 and 2010, four insurance companies that offered medical malpractice insurance reported an increase in their net income of more than 4300 percent."

The court wrote, "The cap on non-economic damages serves no purpose other than to arbitrarily punish the most grievously injured or their surviving family members." According to the executive director of the Florida Justice Association, "Caps on damages are fundamentally unfair to the victims of medical negligence."

Florida is not the only state where caps on medical malpractice damages hurt Americans. In 2003, Texas passed a malpractice law that capped damages at $250,000.  By 2009, reports indicated that Texas had the highest healthcare costs in the country and Medicare payments rose faster than anywhere else in the country.

As more states realize that artificial caps on medical malpractice claims are unfair to patients and their families who suffer from catastrophic injuries and damages from medical negligence, caps will be eliminated and the evaluation of damages will be returned to juries, as the Constitution of the United States requires.

Do you have any questions about this post?

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3 Counterintuitive Truths about Medical Malpractice Lawsuits


Whether you suffered an injury during a recent hospital stay, or your spouse endured an unnecessary surgery or a prescription drug overdose, you're angry. But you're also cautious. You're somewhat dubious about medical malpractice lawsuits -- you may have concerns about both their ethicality and their utility. To that end, let's explore 3 counterintuitive truths about med mal cases, so that you can make a more informed decision about your next steps.

Truth #1: The vast majority of medical malpractice suits have merit.


Many people sadly buy into the stereotype that medmal cases are often “frivolous” claims brought by greedy or poor claimants -- and that they punish innocent doctors.

Statistics just don’t back up this stereotype.

For instance, the Harvard School of Public Health recently conducted an exhaustive analysis of 1,400 medical negligence claims and found that 97% of them had merit. In fact 80% of the cases studied involved major injury or death. The Harvard researchers said “portraits of a malpractice system that is stricken with frivolous litigation are overblown.”

Likewise, the suits do a good job of zeroing in on the truly dangerous doctors. An analysis conducted from 1991 to 2005 found that fewer than 6% of doctors caused nearly 58% of all malpractice claims payments. Another study of 51 hospitals throughout New York found that the poor patients who lacked insurance were far less likely to sue than other patients.

Truth #2: The actual number of malpractice events likely dwarfs the number of medical malpractice lawsuits.

The Institution of Medicine estimates that 98,000 people, annually, die due to preventable medical errors. Hundreds or thousands of other patients suffer serious, nonfatal, preventable injuries. The number of medical malpractice cases filed is miniscule by comparison, constituting just 3% of all civil tort cases brought annually. In other words, most victims of malpractice do nothing, legally speaking.

Truth #3: Getting fair settlements in medmal cases is quite hard, and “outrageous” jury verdicts are few and far between.


The tort reform lobby convinced many Americans that so-called “runaway juries” enjoy awarding outrageously high settlement amounts. But here's the reality. Per the National Association Insurance Commissioners, payouts for medical negligence claims dropped by 50% between 2003 and 2008. Furthermore, fewer than 0.5% of cases led to verdicts or settlements that exceeded $1 million. The median award for a permanent injury – and remember, this is the total compensation package for someone permanently disabled for life due to someone else's negligence or carelessness – was just $315,000 in 2005.

These counterintuitive truths just scratch the surface. The reality is many myths make life needlessly challenging for injury victims and their families. Fortunately, the team at Regan Zambri & Long can provide thorough, strategic assistance. Call us now at (202) 463-3030 for a free evaluation of your D.C. medical malpractice case.




 

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