Rate of misdiagnosis getting worse!

Benjamin I. Broder Benjamin.I.Broder at KP.ORG
Mon Oct 2 19:36:18 UTC 2017


I had to look it up: (from Wikipedia):

Scruggs first came to the public eye after successfully suing the asbestos<https://www.wikiwand.com/en/Asbestos> industry on behalf of ill shipyard workers. He later represented the state of Mississippi in the tobacco litigation of the 1990s.[1]<https://www.wikiwand.com/en/Richard_Scruggs#citenotelatindictment1>[2]<https://www.wikiwand.com/en/Richard_Scruggs#citenotenytindictment2> He also represented hundreds of homeowners in lawsuits against insurance companies following Hurricane Katrina,[2]<https://www.wikiwand.com/en/Richard_Scruggs#citenotenytindictment2> and a national class action of patients against HMOs in the early 2000s.[3]<https://www.wikiwand.com/en/Richard_Scruggs#citenoteWho27sAfraidOfDickieScruggs3>
Scruggs legal career was derailed by his indictment in a judicial bribery scheme in 2007. Scruggs pled guilty to conspiracy to bribe Circuit Judge Henry L. Lackey in 2008.[4]<https://www.wikiwand.com/en/Richard_Scruggs#citenoteapguilty4>[5]<https://www.wikiwand.com/en/Richard_Scruggs#citenoteUSvSCRUGGS5>He also entered a 2009 guilty plea for a scheme to influence Circuit Judge Bobby DeLaughter.[6]<https://www.wikiwand.com/en/Richard_Scruggs#citenoteplea6>

Scruggs was sentenced to 5 years in prison on June 27, 2008 by U.S. District Judge Neal Biggers<https://www.wikiwand.com/en/Neal_Biggers>; and on February 10, 2009, Judge Glen H. Davidson<https://www.wikiwand.com/en/Glen_H._Davidson> sentenced him to 7 years for the second scheme, to run concurrently.[7]<https://www.wikiwand.com/en/Richard_Scruggs#citenote7> He served six years in federal prison and was released in 2014.[8]<https://www.wikiwand.com/en/Richard_Scruggs#citenotebloggulflivecom8>

https://www.wikiwand.com/en/Richard_Scruggs

--------
Ben Broder, MD, PhD, CPPS
Regional Assistant Medical Director of Quality and Clinical Analysis (Regional Offices), Diplomate in Clinical Informatics, Hospitalist, KFH Baldwin Park
Kaiser Permanente / Southern California Permanente Medical Group, 393 E Walnut St 3rd Flr NW, Pasadena, CA 91188-8034
626-405-2501 (office) 8-335-2501 (tie-line), 626-728-0457 (pager), 626-720-9422 (mobile)
Kelly R Wynter (kelly.r.wynter at kp.org) (assistant) 626-405-6151
https://wiki.kp.org/wiki/display/hcit/HCIT
https://kpinsight.kp.org/kpinsight/


From: "peter.dayton at MARTINHEALTH.ORG" <peter.dayton at MARTINHEALTH.ORG>
Reply-To: Society to Improve Diagnosis in Medicine <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>, "peter.dayton at MARTINHEALTH.ORG" <peter.dayton at MARTINHEALTH.ORG>
Date: Monday, October 2, 2017 at 11:23 AM
To: "IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG" <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
Subject: Re: [IMPROVEDX] Rate of misdiagnosis getting worse!


Caution: This email came from outside Kaiser Permanente. Do not open attachments or click on links if you do not recognize the sender.

________________________________
Dr. Westover demonstrates one of the big problems with how liability is adjudicated in the US. True, very few cases get to trial and a majority of them are won by defense however one must look at the broad picture of our Tort System in general and medical liability in particular. I don’t see any significant improvement in our tort system because the stakes are so high for the tort bar. They have lots of money and political power both within the legal system, in government legislatures and congress. Settlements like Tom’s description are frequent because of the cost of litigation.

One of my hero’s once said “ The tort bar is the fourth unregulated branch of government”. He is right as you see the flurry of class action litigation over drugs, devices, and procedures. Lawyers often use the power of the threat of a lawsuit to pressure business and organization to comply with a certain positions or pay out to remove the threat of litigation. I wish there was a larger role for legal principle of abuse of process but that is like telling the fox in the chicken coup to lock the door so the chickens can’t get back in. I have been reviewing  medical neglect cases for 20 years. I find many docs clearly negligent and others the provider of a less than optimal outcome. Outcomes of the litigation are a mixed result of outcomes,  fact patterns, quality of experts, and competence of counsel.  You also see the tort bar fighting against more efficient methods of dispute resolution.  Look at the Wall Street journal Article today on what is before the Supreme Court this year. The attack on the Federal Arbitration Act is just another example of the trial bar attacking the right of contract in our society.  Arbitration, mediation and alternative specialized courts , like in patent law, could help patients be rightfully compensated. What bothers me is that the system forgets the little person who has a legitimate but “low value’ injury in the eyes of plaintiff counsel. There is no remedy for someone who has an injury worth $500 - $10000 . No matter the merits, the case is not worth pursuing. Anyone who does patient safety and quality work knows there are a lot of those. Many proactive risk management departments do approach the complaints and try to compensate injured parties but the system is blind to access to all but the most profound high profile actions.

While the plaintiff bar “ fights for injured” because the injured have no alternative way to adjudicate their grievance , I find myself “ fighting to prevent the injury in the first place” as a patient safety and quality officer.

The larger issue is the tort law in general. Read The Rule of Lawyers: How the New Litigation Elite Threatens America's Rule of Law by Walter Olson. It is a great primer on the abuse of the tort system even though the book was written in 2004 is as valid today as 13 years ago.

It is good that Dicky Scruggs sits in jail.


Peter M. Dayton MD
Medical Director of Patient Safety and Quality
Martin Health Systems
1815 Kanner Highway
Stuart FL 34994
peter.dayton at martinhealth.org<mailto:peter.dayton at martinhealth.org>
772-285-4020 cell
772-288-2999 fax
Our mission is to provide exceptional health care, hope and compassion to every person, every time.
1 Peter 3:15







From: Twest54973 [mailto:000000040134e744-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG]
Sent: Saturday, September 30, 2017 12:47 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] Rate of misdiagnosis getting worse!

Peggy

It’s disheartening that you even mention that lawsuits are a "solution" or remedy for the current state of affairs

Lawsuits rarely improve hospital care processes: instead,  they are helping bankrupt our healthcare system via the over usage if defensive medicine , forcing doctors to change their practice patterns , and actually can hurt future pts

As an high risk pregnancy obstetrician  practicing in a highly litigious state , I have been sued approx. 12 times in my 25 yr. career and have three active lawsuits against me right now ... (American families unfortunately have an unrealistic perception of the ability of modern obstetrics to prevent fetal injury and harm)

Litigation is one important reason why the cesarean rate in the USA is around 33%

And the repeat cesarean rate is around 90%

Which can and does result in harm to women

Simple example of inappropriate litigation : a parent carries a familial gene for a thrombophilia (gene that predispose to blood clots), the baby develops a stroke before birth resulting in harm, family sues because the baby wasn't delivered "before the stroke" ; hospital system settles the case to avoid prolonged and expensive litigation

Obviously true medical errors do occur but the tort system is filled with cases of harm that were not the result of medical error (at least in obstetrics)

We need to focus on revamping the tort system and developing a "no-fault injury compensation" system similar to the vaccine manufacturer system whereby hospitals are encouraged/mandated to report true errors (in order to fix the relevant etiologies)

And where the injured pts are duly compensated and included in the remediation process

Respectfully
Tom

Thomas Westover MD
Vice Chair NJ section
American College OBGYN
Chair: NJ Hospital Association Statewide Perinatal Safety Collaborative
Cooper Medical School
Camden NJ

Sent from my iPhone

On Sep 29, 2017, at 1:00 PM, Peggy Zuckerman <peggyzuckerman at GMAIL.COM<mailto:peggyzuckerman at GMAIL.COM>> wrote:
Jason, I would say that most patients are either too busy trying to deal with the consequences of the medical errors, or think that these errors are atypical--that they had the single bad doctor or single poor hospital.

Furthermore, as they come to understand that they have been harmed, there is no clear way to correct those errors or even bring some attention to a problem.  Often, the only option seems to bring a legal suit, and few patients have the heart or financial resources to do that.

Peggy

Peggy Zuckerman
www.peggyRCC.com<http://www.peggyRCC.com>

On Fri, Sep 29, 2017 at 8:05 AM, Jason Maude <jason.maude at isabelhealthcare.com<mailto:jason.maude at isabelhealthcare.com>> wrote:
The NPSF has just published an updated survey (attached with my highlights) of Americans’ experiences of medical error with pretty shocking results.

As a survey, we may think less of it but it essentially repeats and expands on questions from the first one done in 1997 and also one which our founding charity commissioned in 2005. The results are very consistent across all them. They also all used sample sizes of well over 2,000.

The shocking take away for me is that effectively the number of Americans who say they have experienced a misdiagnosis personally or of someone close to them is 24%, up from 17.5% in 2005. This is almost 1 in 4 of the adult population!

Either the figures are rubbish or how is it there are not riots on the streets?!

Regards
Jason

Jason Maude
Founder and CEO Isabel Healthcare
Tel: +44 1428 644886<tel:+44%201428%20644886>
Tel: +1 703 879 1890<tel:(703)%20879-1890>
www.isabelhealthcare.com<http://www.isabelhealthcare.com/>




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