Med Mal News

Hospital Apologizes for Radiation Mistake

Cedars-Sinai, the Los Angeles-based hospital giant, has issued official apologies to the 260 patients who were exposed to excess radiation when they underwent CT scans at the hospital. The offending scanner at Cedars Sinai had been incorrectly recalibrated early in 2009 but the problem did not come to light until the summer, after a patient who had undergone a CT scan complained of hair loss. The apologies were made in letters sent in November to those affected, signed by Cedars Sinai's chief medical officer. The notices also informed affected patients that 20% of them might have suffered damage to their eyes, which could make them prone to developing cataracts. The hospital has offered to pay the medical costs of those who can show that health problems are related to their overexposure to radiation, which was reportedly eight times the normal level received during CT scans.

Another Circuit Says Contractors Have Employment Anti-Discrimination Rights

In a Nov. 19, 2009 decision, the U.S. Court of Appeals for the Ninth Circuit joined the Tenth Circuit in holding that independent contractors may sue their employers for discrimination. The decision reversed a lower court ruling that a doctor whose contract with a hospital was terminated because he had sickle cell anemia could not sue under the Rehabilitation Act because the hospital's relationship to him was not that of employer to employee. The appellate court reversed in Fleming v. Yuma Regional Medical Center, finding that there was no need to “extend” the Rehabilitation Act, as its language was “broad enough to cover employees and independent contractors alike.” Two other circuit courts of appeal ' the Sixth and Eighth Circuits ' have found that independent contractors are not covered, as those courts consider the Rehabilitation Act to have incorporated the Americans with Disabilities Act's restricted coverage of direct employer-employee relationships.

In Fleming, the plaintiff claimed that he entered into an agreement with Yuma Regional Medical Center to work as an anesthesiologist. However, when the hospital learned through a background check that he had sickle cell anemia it asked him to sign a contract addendum stating that he would not need any special accommodations due to his medical condition. According to the plaintiff, his refusal to sign led to his dismissal. Not so, says attorney Sandra Creta of the Creta Law Firm in Phoenix, AZ, who represents the medical center. Her client's story is that the hospital asked the plaintiff to sign the addendum in order to make sure he understood the requirements of the job and was certain he would be able to do it. Given the nature of sickle cell anemia, said Creta, “he could have acute attacks, and he's administering poisonous [injections]. Yuma had an obligation to ask questions out of concern for patients.”

Researchers Say Electronic Records Are Not Improving Patient Care

A study published in the Nov. 24, 2009 online edition of The American Journal of Medicine indicates that the implementation of electronic patient record systems ' recently touted by legislators and President Obama as one of the best new ways to improve patient safety ' may not significantly change the quality of care patients receive. The results of the research, which involved review of the 2003-2007 records of approximately 4,000 hospitals, showed that while the costs of implementing electronic medical record systems was high (and remained high even after full implementation), patient outcomes at those hospitals that employed electronic record-keeping systems were about the same as for those that did not. The only exception was for heart attack patients, who did slightly better if treated at hospitals with more advanced electronic record-keeping systems. The researchers surmise that the problem may be in the focus of many current electronic records systems, which concern themselves more with helping hospitals with their administrative needs than with improving the delivery of patient care.

New York Limits Rights of Subrogation When Settlements Occur

On Nov. 13, 2009, New York's governor signed into law Governor's Program Bill #95, which includes a provision that will limit the ability of health insurers and other benefits providers to obtain reimbursement for their expenditures through the malpractice, personal injury or wrongful death actions brought by or on behalf of their insureds. The need for the law became evident after New York's highest court, the Court of Appeals, declared in Fasso v. Doerr, 12 NY3d 80 (2009), that an insurer had the right to ask for reimbursement from its insured after she settled with the tortfeasor. In Fasso, that meant that the insurer could seek to recover the $780,000 it paid for the plaintiff's medical care from the $900,000 she received in her medical malpractice settlement. The new provision, General Obligations Law ' 5-335(a), reads, in part: “Except where there is a statutory right of reimbursement, no party entering into such a settlement shall be subject to a subrogation claim or claim for reimbursement by a benefit provider and a benefit provider shall have no lien or right of subrogation or reimbursement against any such settling party, with respect to those losses or expenses that have been or are obligated to be paid or reimbursed by said benefit provider.”

Hospital Apologizes for Radiation Mistake

Cedars-Sinai, the Los Angeles-based hospital giant, has issued official apologies to the 260 patients who were exposed to excess radiation when they underwent CT scans at the hospital. The offending scanner at Cedars Sinai had been incorrectly recalibrated early in 2009 but the problem did not come to light until the summer, after a patient who had undergone a CT scan complained of hair loss. The apologies were made in letters sent in November to those affected, signed by Cedars Sinai's chief medical officer. The notices also informed affected patients that 20% of them might have suffered damage to their eyes, which could make them prone to developing cataracts. The hospital has offered to pay the medical costs of those who can show that health problems are related to their overexposure to radiation, which was reportedly eight times the normal level received during CT scans.

Another Circuit Says Contractors Have Employment Anti-Discrimination Rights

In a Nov. 19, 2009 decision, the U.S. Court of Appeals for the Ninth Circuit joined the Tenth Circuit in holding that independent contractors may sue their employers for discrimination. The decision reversed a lower court ruling that a doctor whose contract with a hospital was terminated because he had sickle cell anemia could not sue under the Rehabilitation Act because the hospital's relationship to him was not that of employer to employee. The appellate court reversed in Fleming v. Yuma Regional Medical Center, finding that there was no need to “extend” the Rehabilitation Act, as its language was “broad enough to cover employees and independent contractors alike.” Two other circuit courts of appeal ' the Sixth and Eighth Circuits ' have found that independent contractors are not covered, as those courts consider the Rehabilitation Act to have incorporated the Americans with Disabilities Act's restricted coverage of direct employer-employee relationships.

In Fleming, the plaintiff claimed that he entered into an agreement with Yuma Regional Medical Center to work as an anesthesiologist. However, when the hospital learned through a background check that he had sickle cell anemia it asked him to sign a contract addendum stating that he would not need any special accommodations due to his medical condition. According to the plaintiff, his refusal to sign led to his dismissal. Not so, says attorney Sandra Creta of the Creta Law Firm in Phoenix, AZ, who represents the medical center. Her client's story is that the hospital asked the plaintiff to sign the addendum in order to make sure he understood the requirements of the job and was certain he would be able to do it. Given the nature of sickle cell anemia, said Creta, “he could have acute attacks, and he's administering poisonous [injections]. Yuma had an obligation to ask questions out of concern for patients.”

Researchers Say Electronic Records Are Not Improving Patient Care

A study published in the Nov. 24, 2009 online edition of The American Journal of Medicine indicates that the implementation of electronic patient record systems ' recently touted by legislators and President Obama as one of the best new ways to improve patient safety ' may not significantly change the quality of care patients receive. The results of the research, which involved review of the 2003-2007 records of approximately 4,000 hospitals, showed that while the costs of implementing electronic medical record systems was high (and remained high even after full implementation), patient outcomes at those hospitals that employed electronic record-keeping systems were about the same as for those that did not. The only exception was for heart attack patients, who did slightly better if treated at hospitals with more advanced electronic record-keeping systems. The researchers surmise that the problem may be in the focus of many current electronic records systems, which concern themselves more with helping hospitals with their administrative needs than with improving the delivery of patient care.

New York Limits Rights of Subrogation When Settlements Occur

On Nov. 13, 2009, New York's governor signed into law Governor's Program Bill #95, which includes a provision that will limit the ability of health insurers and other benefits providers to obtain reimbursement for their expenditures through the malpractice, personal injury or wrongful death actions brought by or on behalf of their insureds. The need for the law became evident after New York's highest court, the Court of Appeals, declared in Fasso v. Doerr , 12 NY3d 80 (2009), that an insurer had the right to ask for reimbursement from its insured after she settled with the tortfeasor. In Fasso, that meant that the insurer could seek to recover the $780,000 it paid for the plaintiff's medical care from the $900,000 she received in her medical malpractice settlement. The new provision, General Obligations Law ' 5-335(a), reads, in part: “Except where there is a statutory right of reimbursement, no party entering into such a settlement shall be subject to a subrogation claim or claim for reimbursement by a benefit provider and a benefit provider shall have no lien or right of subrogation or reimbursement against any such settling party, with respect to those losses or expenses that have been or are obligated to be paid or reimbursed by said benefit provider.”