I would like to take this opportunity to write to your law firm and thank you for coming through for me when I lost hope in my previous attorney.
We will gladly be a reference for you, and we certainly will recommend you as the attorney to have in Louisville. You have a gift in the way you are able to communicate with your clients and within the legal system.
My father would have been so proud to know that his case was driven home with such passion and genius. Thank you for giving that jury every tool they needed to hold those people accountable for the torture they inflicted on my Dad.
Well I say, "not so fast my friends." The wrongful death lawsuit may be virtually worthless. Here's why.
The primary component of damages that the Jackson Estate would be allowed to claim in a wrongful death suit is the loss of future earning. This would include concert ticket sales, royalties from albums, and commercial endorsements, any appearance fees, etc. In fact, Jackson was scheduled to start a 50 show tour later this year.
So, it should be simple to calculate the loss to the Estate, right? You simply hire an expert economist, an expert promotor, an expert music producer and manager and you have them estimate how much MJ would have earned over his projected lifetime. That would then be the loss to the Estate and it would then have the right to recover that amount amount from the negligent parties (assuming there are any).
That is would typically happens in wrongful death cases, albeit it on a much smaller scale; however, here, that formula may not work for one simple reason....
Celebrities often make more after their death than when they are alive. Or, to put it another way, Jackson's Estate may INCREASE in value as a result of his death.
Charles M. Schulz (Peanuts + Snoopy = $33 million)
Heath Ledger ($20 million)
Albert Einstein ($18 million in 2007, think Baby Einstein videos!!!)
Aaron Spelling ($15 million)
Dr. Seuss (Theodor Geisel)($12 million)
John Lennon ($9 million)
Andy Warhol ($9 million)
Marilyn Monroe ($6.5 million)
Steve McQueen ($6 million)
Paul Newman ($5 million)
James Dean ($5 million)
Marvin Gaye ($3.5 million)
This will likely be the case with Jackson's Estate as well. The "King of Pop" will likely equal or surpass the "KIng of Rock N Roll" in the post-death celebrity earnings category. Let's face it, when you think Hollywood you think James Dean and Marilyn Monroe, but when you think music, you think of Elvis and Michael.
In fact, according to the Wall Street Journal, it may have already started. According to an article about Apple's projected earning in the WSJ, "Michael Jackson’s death did move some recordings. According to The Journal’s Ethan Smith, U.S. retailers sold 415,000 albums by Michael Jackson in the four days following his June 25 death, according to Nielsen’s SoundScan. That’s compared with fewer than 10,000 copies that were sold in the previous full week. Over half of those sales were digital downloads made on services such as iTunes and Amazon.com’s AmazonMP3." Apparently, Jacksons fans appreciate his music more now that he's gone. Interesting.
And that, my morbid readers, is why the Jackson wrongful death lawsuit may not be frivolous, but it may be worthless.
I hate mandatory arbitration agreements, especially in healthcare cases. Nursing homes force residents, or their family members, to sign these agreements before admission to the facility. They then injur the resident and hide behind the arbitration agreement to shield them from have a jury pass judgment on their care in an open courtroom that is subject to public scrutiny. Many of these companies, and the legislators whose pockets they line with campaign contributions, point to all sort of supposed "benefits" to arbitration. These benefits are mostly myths:
THE ARBITRATION FAIRNESS ACT MYTHS AND FACTS
The Arbitration Fairness Act (AFA) would continue to allow voluntary arbitration while preserving the right to trial by jury. The bill would prohibit a corporation from forcing a consumer into a rigged mandatory arbitration system where the corporation hand-picked the arbitrator and all of the rules of the process before a dispute even occurred.
Myth: The AFA prohibits arbitration. Fact: The AFA encourages voluntary arbitration; it only prohibits corporations from forcing mandatory clauses on consumers without them having a chance to negotiate the terms and often without them knowing about it. Example: When admitting his father into a nursing home, Charles Miller Jr. signed a lengthy contract that, unbeknownst to him at the time, contained a binding mandatory arbitration clause. His father was not seen by a physician until three weeks after his admission, during which time he lost 19 pounds and suffered from dehydration and pneumonia, all of which led to his death. Charles Miller Jr. filed a claim against the nursing home corporation, but a court held that because he had signed this contract, he would be forced into arbitration for his claims against the nursing home, under the terms the nursing home corporation chose to put into the contract. Because Charles Miller Jr. had unknowingly signed a contract that contained a mandatory arbitration clause before any dispute had arisen, he was bound by its terms, no matter how unjust.
Myth: Most consumers favor binding mandatory arbitration. Fact: Consumers favor voluntary arbitration and being given the choice to arbitrate. Would an employee with a claim against Halliburton want Halliburton deciding how her claim should be handled? Would a homeowner with a claim against his home contractor want the contractor deciding how his claim should be handled?
The Chamber of Commerce's recent study, which purported to show that voters did not support HR 3010, asked voters: "If you could choose the method by which any serious dispute would be settled between you and the company, which would you choose?" (Emphasis added.) But what they didn't tell these voters is that binding mandatory arbitration takes away a consumer's choice. Under the current system, consumers are not allowed to choose which option is best for them. They are not allowed to choose to file a claim in court nor are they allowed to choose who the arbitrator will be, or even what state they will have to arbitrate the claim in. Instead, they are forced into an arbitration system that is set up to favor the corporation and trample on the rights of the consumer. When consumers are given the choice to arbitrate after a dispute has arisen, they gain bargaining power and are better able to enter into an arbitration system that is fair.
Myth: Arbitrators are neutral, unbiased decision-makers. Fact: Binding arbitration favors corporations because only corporations are repeat users of arbitration companies. If an arbitration company wants to be used in a company's mass consumer or employment contracts, the arbitration company has a huge financial incentive to appear favorable to those businesses in arbitration proceedings. Why would a company choose an arbitrator that rules against them?
Myth: Arbitration is cheap and more accessible to consumers. Fact: Arbitration is so expensive that most consumers will not be able to pursue their claim against a corporation because they can't afford the costs of the arbitrator.
Under mandatory arbitration clauses, consumers must pay steep filing fees just to initiate a case-seldom less than $750 – and pay their share of the arbitrator's hourly charges, which are routinely $400 or more per hour. All these fees must be deposited in advance and almost always amount to thousands of dollars. In addition, arbitration clauses often allow the corporation to choose the location, regardless of how inconvenient or costly travel will be for the consumer.
Myth: Arbitrators are like judges; they have to follow the law and publicly state the reasons they made their decision. Fact: Arbitrators are not bound by any laws. They do not have to follow the law and they don't have make public or even provide to the consumer any explanation for ruling the way that they did.
Most arbitration clauses require that proceedings be kept confidential, even if the case raises important public policy issues. As a result, only the corporation can track past decisions and know which arbitrators have ruled for them. In addition, arbitrators do not set or follow judicial precedent, something our judicial system requires to ensure consistency and fairness in legal proceedings.
According to this recent article in the New York Times, plaintiff who reject settlement offers and roll the dice at trial are statistically likely to get less money than if they had taken the settlement. According to the article, “The lesson for plaintiffs is, in the vast majority of cases, they are perceiving the defendant’s offer to be half a loaf when in fact it is an entire loaf or more,” said Randall L. Kiser, a co-author of the study and principal analyst at DecisionSet, a consulting firm that advises clients on litigation decisions. The study was based on over 2000 trials and it concluded that about 60% of the time the plaintiff (the person bringing the suit) got a worse deal that the settlement offer they rejected .The study, which is to be published in the September issue of the Journal of Empirical Legal Studies, found that plaintiffs typically received about $43,000 less at trial. And, while defendants typically do better at trial, when they don't the results are far more pronounced. When a defendant gambles wrong and goes to trial, statistically they end up paying about $1.1 million dollars more. I found this article to be particularly interesting based on my own (completely non-scientific) observations. Most medical malpractice insurance policies give the doctor the absolute consent to settle a malpractice suit. That's not to say the insurance company has to settle the case if the doctor gives consent, but the insurance company usually cannot settle the case until the doctor gives his/her consent. What this means, is that the healthcare provider is much more willing to take the risk of going to trial if the likely verdict is less than his/her policy limits. Most medical doctors carry about $1 million dollars in coverage. If the verdict is likely to be $1 million or less, the doctor has no reason to settle the case because there is not much of a chance the doctor will have to pay any money out of his/her own pocket. On the other hand, if the exposure to the doctor is significantly more than the $1 million in coverage, the doctor is much more likely to give consent in order to avoid his personal assets being at risk. Hans p.s. Thanks to John Day in Nashville for bringing this article to my attention.
If you are one of those politicians or pundits constantly railing about the need for tort reform to protect doctors and hospitals, there is no need to wait for the government to pass tort reform. Here is a form that will allow you to accomplish the same thing for you and your family RIGHT NOW.
That's right, by signing this simple form, you can waive your and your family's rights to pursue a claim for malpractice against your healthcare provider in court and limit your recovery, regardless of how serious your injuries are.
So, if you are truly for tort reform, go ahead and sign it. I dare you.
A couple of years ago two Louisville medical malpractice lawyers sued Jewish Hospital alleging it was unsanitary and led to people getting MRSA. A recent study now shows that hospital acquired infections are costing people big money.
Kentucky malpractice attorneys are fortunate not to have to deal with laws similar to those in Ohio that now give doctors immunity from malpractice if they have a medical student in the room with them.
Sunday's Lexington Herald Leader contained an editorial commenting on a New York Times article dealing with the increasing costs of health care. Here it is:
Tort reform doesn't cut health costs
Sen. Mitch McConnell's No. 1 idea for fixing what ails our health care system is to limit the rights of those maimed by medical malpractice.
But states that have enacted curbs on what McConnell calls "junk lawsuits" have yet to see the cost savings promised by McConnell and other proponents of tort reform.
On the contrary, Texas capped malpractice damages in 2003 only to experience a steep rise in health insurance premiums and medical costs.
Medicare spending rose 24 percent in the three years after punitive damages were capped at $250,000, according to the Dartmouth Institute for Health Policy.
One of the most expensive health-care markets in the country is the Texas city of McAllen. Only Miami, which has much higher labor and living costs, spends more per person on Medicare.
Boston surgeon Atul Gawande visited McAllen and wrote an account for The New Yorker, "The Conundrum: What a Texas town can teach us about health care" that's required reading for anyone trying to understand this admittedly baffling topic.
One night at dinner with six local doctors he asked why the average cost per Medicare enrollee had soared from $4,891, about the national average in 1992, to almost twice the national average of $15,000 per enrollee in 2006.
For perspective, the per capita income in McAllen is only $12,000.
Several of the physicians said doctors practiced defensive medicine to protect themselves from the city's especially aggressive lawyers; they ordered extra tests and procedures which drive up costs.
But what about the strict limits on malpractice damages. Haven't lawsuits gone down?
"Practically to zero," one of the docs said.
What's finally revealed is that doctors in McAllen are heavily invested in medical technology and imaging and surgery centers. They order lots of tests and procedures because they directly profit from them. They think of what they do as a business.
The critical choice facing this country is whether health care will continue to go the way of McAllen or whether it can be guided toward a Mayo Clinic model in which doctors work together to deliver the best care with the fewest tests and procedures.
We should all hope the Mayo model wins because the outcomes for patients are far better. Also, at the current rate, health care costs will soon eat up so much of the federal budget that this country will no longer be able to afford to defend itself.
The Texas experience with malpractice is not unique. Researchers at the University of Alabama at Birmingham surveyed 27 states that have limits on non-economic damages and discovered no savings for health care consumers.
McConnell is offering a few other of what he calls "common sense" ideas. He favors some insurance reforms, such as covering pre-existing conditions, and incentives for living a healthful lifestyle.
He also says individuals buying insurance should be entitled to the same tax deductions as companies buying insurance for their employees.
McConnell acknowledges that health care reform is necessary, but his prescription is mostly a placebo.
A Louisville doctor practicing in the south-end has given up his license after several patients accuse him of fondling, inappropriate sexual comments and, in one case, sex in an exam room.
And, if you need evidence there's a white coat code of silence, you need only know that the hospitals and clinics he worked at knew of the allegations since 2001--but did not report it to the medical licensure board until 2008. They might have some problems if some of these patients decide to sue.
Dr. Michael Hess' graphic disciplinary report, can be read here:
Kentucky doctors are not leaving the state because of medical malpractice suits (net loss of 19 doctors between 2000 and 2002). And medical malpractice premiums are not a large part of physician's overhead (less that 4% of revenue goes to insurance--physician salaries are 63% of overhead).
But those who want to limit injured patient's rights have never let the facts stand in their way. The phrase "sometimes wrong, but never in doubt comes to mind."
If your really want to know the truth about medical malpractice in Kentucky, read this report authored by an independent non-profit organization founded by Ralph Nader, Public Justice. Here is the report: www.citizen.org/documents/KY_MedMal_Report.pdf
I am so tired of uninformed people telling me that we need tort reform in Kentucky to keep good doctors in the state. Too many people wrongly believe that juries are shoveling money at injured patients like the government bailing out the auto makers.
Well the TRUTH of the matter is quite the opposite. In fact, the absolute worst kind of case to take before a jury is a medical malpractice case. Juries don't like to think doctors make serious mistakes that injure or kill. Couple that with the fact that most people sitting on juries have been drinking the insurance company Kool-Aid for so long that they actually believe the hype about medical malpractice suits being out of control and jeapordizing health care. So, when most people get on a medical malpractice jury, they are already predisposed to side with the doctor.
Think I'm making this up? Well, here are the actual statistics in kentucky on medical malpractice cases from the Kentucky Trial Court Review 2008.
In 2008, fifty-six medical malpractice cases were tried. The patient prevailed 11 times. That means the healthcare provider won 45 times. You don't need to be a statistics major to do the math. If you were a patient in a med mal lawsuit in Kentucky in 2008, you had about a 19.6% you would win at trial. Heck, you'd be better of taking the $100,000 - $200,000 it takes to get a medical malpractice case to trial over to the boat and play blackjack. At least in blackjack the House only has an 8% advantage over the player. Or better yet, bet it all on black in roulette, you have a 47% chance of winning.
Some of you may be asking, "Is gambling really a proper analogy for going to trial in a medical malpractice case?" Sure it is, in the few cases that the plaintiffs won, the juries awarded a total of $26,785,227 (this is in the entire state of Kentucky) divide that number by the number of trials, (56) and the average verdict was $478,307. So, if I told you I was going to give you $100,000 in cash (the amount of money it would take to get a medical malpractice case to trial) and gave you the option of going to trial were you have a 19.6% chance of winning an average of $478,000, or taking it to Caesar's and betting it all on black were you have a 47% chance of winning, where would the smart money play?
Please don't tell me our system of justice is a "lawsuit lottery." There is no place for that kind ignorance when dealing with catastrophically injured patients. Limiting the amount of money severely injured patients can recover does nothing to "fix" the system. The system is broken alright, its just broken in favor of the healthcare providers. And that's the REAL TRUTH.
Fortunately this isn't a story about a Kentucky lawmaker (but it very well could be considering who our senate leader is and the fact he has made tort reform one of his primary objectives). An senior Arizona state senator is introducing a bill to make a emergency room patient prove medical negligence by a "clear and convincing" standard. While this may not seem significant, it is. In Arizona, like Kentucky, requires a patient prove a doctor committed malpractice. The standard is "more likely than not." Even with this standard, physicians win negligence suits 80-90% of the time. The "clear and convincing" standard is significantly higher. The standard is usually reserved for situations that go beyond mere negligence, were the plaintiff must prove the at fault party did something more than simply "make a mistake." If a jury were to have to find negligence by a "clear and convincing" standard, I hate to see how many victims of medical malpractice would go without justice. I dare say a lot. hans p.s. want to know the difference between malpractice and negligence, check out our FAQ section
A Texas appellate court has ordered a new trial in a Vioxx case that originally rendered a $7.75 million judgment in favor of the plaintiffs. The three-judge panel of the Texas 4th Court of Appeals, earlier this year, overturned the initial verdict after finding that there was insufficient evidence Vioxx was to blame for the death of Leonel Garza. The new trial could be held as early as next summer, an attorney for the plaintiffs said.
Medicare has threatened to stop federal funding to Baptist Hospital East following a patient's suicide last month. State inspectors concluded that Baptist Hospital "failed to assure this patient's safety." The patient has only been identified as a Jeffersontown (a suburb of Louisville) man whose son had passed away and going through a divorce. The citation stems from the hospital's knowledge that the patient had expressed a desire to drink himself to death and was depressed over his circumstances. Even though two chaplains talked with the patient and concluded he was in a "critical and severe situation, the hosptial failed to place him in a psychiatric unit or under suicide watch. The state determined that the hospital's failure to include steps in its written care plan to address his psychiatric concerns was a violation of its duty to its patients and such conditions "pose an immediate and serious threat" to patients.
Baptist will probably not lose any funding; however, this may not be the end of the issue for Baptist.
These violations could lead to civil liability if the family chooses to file a lawsuit. Hospitals owe a duty to their patients to proivde appropriate treatment, including protecting a suicidal patient from him or herself. If a hospital violates its own policies and procedures- or fails to act like a reasonable hospital would in the same situation- and an injury or death results, the hospital is responsible for the harm. Because the patient was only 56 years old, he was probably still working. This means the man's estate can recover the reasonable value of what he would have earned over his lifetime (known as wrongful death) as well as a claim for pain and suffering (known as personal injury). It is unclear from the article whether the man had any children under 18, but if he did then they would have a claim for the loss of love and affection of their father. A child's consortium claim is measured from the date of injury through the 18th birthday. The child's claim can be brought any time before his or her 19th birthday. The wife also has a claim for loss of love and affection; however, it would likely be of very limited value for two reasons. First, because they were already going through a divorce, it would be difficult to argue that there was any loss of love and affection. Second, a spousal loss of consortium claim in Kentucky is limited to the time of injury until the time of death. Here, that period of time would be only seconds or minutes. Kentucky courts have held that a spousal consortium claim could not be brough in a case where the time between injury and death was only an hour. Unless and until the law in Kentucky recognizes a spouse's right to claim a loss for the loss of love and affection after the death, we are severly limited in the claims we can make. That being said, this exact issue is going to be addressed by the Kentucky Supreme Court in 2009.
According to a recent article in the New York Times, studies have now linked physician behavior and attitudes to poor patient outcome. For example, "A survey of health care workers at 102 nonprofit hospitals from 2004 to 2007 found that 67 percent of respondents said they thought there was a link between disruptive behavior and medical mistakes, and 18 percent said they knew of a mistake that occurred because of an obnoxious doctor. (The author was Dr. Alan Rosenstein, medical director for the West Coast region of VHA Inc., an alliance of nonprofit hospitals.) Another survey by the Institute for Safe Medication Practices, a nonprofit organization, found that 40 percent of hospital staff members reported having been so intimidated by a doctor that they did not share their concerns about orders for medication that appeared to be incorrect. As a result, 7 percent said they contributed to a medication error."
The article begins by recounting how a nurse knew her patient, a child with a shunt in his brain to drain fluid, was in trouble. She paged the on-call doctor who told her not to worry. She paged a second time and he told her that she wasn't a doctor and didn't know what to look for. The doctor ignored her third page. The nurse then called the child's treating physician at home who ordered the child rushed to emergency surgery.
These situations are not unfamiliar to attorneys that handle medical negligence cases. One particular area of concern is in obstetrical care. Generally, a labor and deliver nurse will be with the expecting mother. The labor and deliver nurse montiors the mother and child's vital signs. The most important vital signs are shown on the fetal monitoring strip. Sometimes the fetus can begin having problems in the uterus. One example is when the cord gets wrapped around the baby's neck. As a result, labor and deliver nurses must monitor the fetal strips for bradycardia and tachycardia.
When the labor and deliver nurse recognizes a problem with the baby, she must alert the obstetrician to the problem. Sometimes, the OB ignores the nurse, thinking the nurse is overreacting. This arrogance can lead to tragic consequences including death or injury (brain damage or cerebral palsy) to the child or mother.
We hope this study will empower nurse and other healthcare providers to be strong advocates for their patients and encourage doctors act as part of a the medical team and not mini-dictators. The stakes are too high not to.
More and more, healthcare providers are attempting to take away a patient's right to seek compensation if the doctor makes a mistake that causes the patient injury. Most of us regular people have to take responsibility for our actions. If you cause a wreck, someone is likely to make a claim against your insurance. But for some reason, doctor's (read "really their insurance companies") don't want to be responsible for their mistakes when the injure or kill someone becuase of malpractice and they are forcing their patients to sign documents agreeing to waive their right to file a lawsuit in the future or they won't provide medical treatment. Don't do it!! Here is a very interesting article on it from a Florida newspaper. Hans
"When I helped spearhead the tort reform movement in Nevada, I didn't foresee the unintended consequences of innocent, truly injured individuals not receiving their rightful awards due to jurors' misguided emotions. Had I been aware of that possibility, what would I have done?"
Not words you would expect to hear from a doctor, but they are. Arnold Wax, M.D., a Nevada oncologist recently wrote an article that appeared in the online publication The Medical Economist. In it, he recounts how he began treating a woman with a skin lesion in 2002. The lesion was removed and sent to a pathologist for review. The pathologist diagnosed a non-cancerous condition. In 2004 the lesion returned. It was again removed and send to a pathologist, only this time it was read as being cancerous. Dr. Wax was shocked. The pathologist that read the slide in 2002 admitted he misread the slide. Dr. Wax was asked to be an expert witness (doctor's very rarely ever agree to be an expert for their patient). in the lawsuit for a woman he describes as a delightful widowed grandmother taking care of her grandchildren. Here is what he said: "
The trial lasted six days. I was on the witness stand for two hours for direct and cross examination. I described the statistical decrease in Mary's five-year survival, as well as all treatment variations between the different stages of melanoma. I also stated that I thought the pathologist's admission of his mistake was "honorable." As I'd expected, the jury found the original pathologist negligent. But, to my surprise, Mary wasn't awarded any damages. One of her attorneys later told me that the jury wanted to pin an award on the pathologist's professional corporation, but it hadn't been named in the suit. The jurors reasoned that the pathologist had not acted maliciously, and that if he were found liable for a monetary award, he might leave the state. They were likely influenced by political ads that ran during the state's tort reform ballot campaign, describing physicians who were leaving Nevada because of its malpractice crisis.The trial judge was incensed by the verdict, because the jury didn't follow the legal standard that should have been applied in the case. I was later informed that the defense attorneys planned to go after Mary for court costs, something that the judge vowed he'd never let happen." Dr. Wax concludes his article with the realization that he did not fully consider the impact the caps on damages he had fought for would have on patients who suffered legitimate injuries. This is exactly what plaintiff's attorneys have been saying for years.... Hans
A while back I wrote in one of our newsletters about "The Power of the Apology" in the medical setting. Many healthcare facilites have adopted policies that focus on being honest with patients when medical mistakes have been made. While most facilities still practice behind the "white wall of silence" and bury most of their mistakes, some innovate and courageous hospitals have decided to break with business as usual and acknowledge their mistakes. Many of them are finding honesty is resulting in fewer lawsuits. Here is an article from the Lexington Herald leader on the subject.
Linda Cranfill, left, quality director, Ginny Hamm, attorney, and Dr. Steve Kraman, former chief of staff, all helped to develop the original VA policy of admitting medical errors. Photo by David Perry | Staff
It was an afternoon in 1987. The two grown children of a Kentucky woman who had died a few weeks earlier at Lexington's VA Medical Center arrived to hear details of their mother's death.
The children, who thought their mother had died of natural causes, had been asked to bring a lawyer.
When they sat down, Dr. Steve Kraman, then chief of staff at the VA hospital, made a startling admission: their mother had died because of a medication error made by a hospital staffer.
That meeting was the first major test of a pledge that Kraman and officials at the Lexington VA had adopted about a year earlier: the hospital would disclose all medical errors Ð even if it meant the threat of a malpractice lawsuit.
Today, that seemingly simple concept has become a model for many hospitals, medical insurers and health facilities around the country, as well as in some foreign countries. Major university medical centers -- including Johns Hopkins, Stanford and the University of Michigan -- have adopted all or parts of the program that started here. It also is standard policy at VA medical centers across the country.
The American Medical Association and the Joint Commission, the agency that accredits hospitals, both encourage disclosure of medical mistakes, following the general outline of the Lexington VA policy. And stories about the policy that started in the Bluegrass have recently appeared in the New York Times and other major newspapers.
The idea of a hospital "doing the right thing" by voluntarily admitting devastating medical errors might sound like insanity in today's litigious medical landscape. But hospitals that have tried the idea say it actually saves money by heading off expensive malpractice lawsuits and fostering rapid settlements of claims, often at amounts far less than would have been paid in protracted court battles.
For example, the University of Michigan Health System's chief risk officer recently told the New York Times that existing claims and lawsuits in the system dropped from 262 in August 2001 to only 83 in August 2007 after the university adopted a policy of full disclosure.
But things looked much less clear cut when Lexington VA officials made their first major disclosure that day in 1987.
Kraman recalls that the woman's children at first were shocked, then tearful, when they heard the story of how their mother had died. But if they had not made the admission, he said, the two almost certainly would never have known how their mother's death actually occurred.
"It was a situation where, in the tumult of taking care of a lot of patients, something was overlooked by somebody who otherwise was quite competent, and no one caught it," he said. "Once we had the evidence in front of us ... we knew we couldn't just sit on it. Our responsibility to the family outweighed the potential financial concern for the hospital."
'That felt good'
Ginny Hamm, who attended the meeting as regional counsel for the VA, said the family members were so grateful to get the truth that they and their attorney rapidly agreed to a settlement that cost much less than a lengthy lawsuit would have.
"The family members naturally were tearful and we had some moments of our own," she said. "But we told ourselves, 'That felt good; that felt right; this is the way we're going to do it from now on.'"
Linda Cranfill, quality director at the VA, says the disclosure policy actually grew out of a very down-to-earth goal -- saving money.
The Lexington VA had been hit with some large malpractice judgments in the early 1980s, totalling almost $2 million. Prompted by that, officials for the first time had launched a risk management program. The admission of the woman's death was the program's first big test, Cranfill said.
"We had started looking for a better way of doing things," she said. "Initially, the focus really was on protecting the institution. But it quickly moved to the next level of putting the patient and the patient's family at the top of the equation."
The Lexington VA made no public announcement of the new policy. Word really didn't start to spread until December 1999, when Kraman and Hamm wrote a report on the program for the medical publication Annals of Internal Medicine. Its title was "Risk Management: Extreme Honesty May Be the Best Policy."
The article got lots of attention -- partly because it came out right after a stunning federal report showing that medical errors were causing up to 98,000 deaths annually.
'Sorry Works!'
Suddenly, lots of doctors, hospital managers and news reporters wanted to know more about what the Lexington VA hospital was doing. Kraman recalled that news crews from around the country came calling, as did numerous hospital representatives, some from as far away as Australia. Hamm was invited to speak before medical groups, hospital associations and insurance companies in 39 states over the next two years.
Kraman said that while some doctors, and lawyers representing doctors, initially were taken aback at the idea of admitting errors, it began to catch on and facilities started adopting the VA program, or similar policies.
The Lexington VA never gave its program a name. But an Illinois publicist, Doug Wojcieszak, launched a program called "Sorry Works!" in 2004 that incorporated some of the main features of the VA program and advocated that doctors and hospitals fully disclose and apologize for medical errors.
Kraman, who now practices at the University of Kentucky, says some medical officials resist the idea of admitting errors. He noted that it's unclear just how many hospitals and medical groups have adopted disclosure policies because those that do often don't announce the fact.
"Some just don't want to talk about medical errors happening in their hospitals, no matter how they're handling it," he said.
Nevertheless, Kraman thinks medical disclosure will continue to be adopted by many hospitals and medical organizations.
"To me, the proof of the pudding is, would you do this even if you knew you could absolutely get away without admitting anything," he said. "If you could lock the information in a cabinet and walk away, would you still disclose it, even if you knew if might cost you half a million dollars?
"That's the question that really goes to the morality of a company or organization."
USA Today has published the results of Medicare's 5 year long study to determine the best places to get nursing home care. They have used any easy to understand 5-star system similar to that used to rank hotels and restaurants. You can read the article and look up a particular nursing home by following this link: USAToday Article and Results The article concludes that non-profit nursing homes and nursing homes associated with hospitals consistently rank higher. This begs the question that frustrates lawyers that handle nursing home negligence cases. Why doesn't the government demand transparency of corporations owning and operating nursing homes? Instead, they are allowed to participate in a "Corporate Shell Game" where multiples layers of corporations and LLCs are set up to hide assets from the individuals who are injured.
In a separate post, I'll discuss what I believe state and federal governments should be doing to protect our nursing home residents. hans