Newsletter XXXI August 2002
Contents
Clark County Health District Disease Statistics
Trial Verdicts Reveal ...
By Weldon Havins, MD,
Esq., CCMS CEO/Special Counsel
Last month's issue included "closed claims" information regarding the amounts of resolved medical malpractice disputes reported to the Insurance Commissioner (and to the Nevada Board of Medical Examiners and to the National Practitioner Database). This issue focuses on medical malpractice trials in Clark County (Eighth Judicial District) from 1996 through 2001. The accompanying chart includes the month and year of the verdict (or dismissal), the names of the plaintiff and defendant, the names of the plaintiff's attorney (or plaintiff attorneys' firm) and defense's attorney (or defense attorneys' firm), the Medical Dental Screening Panel (MDSP) Finding, and the jury verdict. For verdicts in favor of the plaintiff, the jury award is divided into economic damages (past and future wage losses, and past and future medical expenses) and non-economic damages (pain and suffering, inconvenience, humiliation, etc., both past and future). Some jury verdict forms did not distinguish between economic and non-economic damages. Awards in those cases can be found in the "not specified economic and non-economic" column. All this is public information which may be obtained by anyone sojourning to the County Clerks' Office at the Clark County District.
When the MDSP finding is "there was a probability of medical malpractice by the respondent and the claimant was injured thereby", i.e., a probable malpractice finding, the plaintiff can request a mandatory settlement conference with a judge other than the trial judge. This "settlement" judge convenes a hearing to consider the value of the case. Shortly thereafter, this judge notifies both parties of the value he or she places on the case. Where that information is available, it is included in the "settlement conference Judge evaluation." Under NRS 41A, the plaintiff then may make a demand to the defendant for that (or a lower) amount, if the plaintiff determines that the judge's valuation is sufficient. The defendant may then pay that amount (and the case is over) or refuse the plaintiff's offer. Where the amount of the plaintiff's offer is known, it is included under the column headed "Plaintiff demand". Where the defense counters with an offer, or later in the process makes an offer of settlement to the plaintiff, that amount, when known, may be found under the column entitled, "Defense offer." Where the insurer is known, the name of the insurer is included.
In cases where the economic damages are distinguished from non-economic damages, non-economic damages (pain and suffering) were almost twice as large, in the aggregate, than economic damages. Of the approximately 1000 cases filed in District Court during this period, only 55 resulted in a verdict for the plaintiff or defendant; two were settled during trial, two were dismissed, and one resulted in a mistrial. Thus, a case alleging medical malpractice filed during this period had an approximately 5% chance of actually proceeding to a jury trial. As illustrated in last month's issue, Division of Insurance information for 1999 indicated that 94% of claims filed in District Court resulted in an indemnity (insurance) payment to the plaintiff. The average amount for closed claims can likewise be seen in a graph in last months County Line. For those of you who may have recklessly, carelessly, or negligently discarded or misplaced last month's fabulously fascinating and informative County Line, you may find that issue, as well as recent previous issues, online in the CCMS website: www.clarkcountymedical.com.
Of eleven (11) solo defendants (no co-defendants) with a "No Probable Malpractice" finding, two (2) trials resulted in verdicts for the plaintiff and two settled during trial. Nine of the eleven resulted in a defense verdict.
Of fifteen (15) solo defendants with an MDSP finding of "Probable Malpractice," six (6) trials resulted in a verdict for the defense. Eight (8) of the fifteen resulted in a verdict for the plaintiff. Those verdicts ranged from $55,000 to $2,000,000. One verdict of $1,237,220 occurred against a trauma center orthopedic surgeon, in a trauma center case, involving an inebriated, uninsured motorcyclist. The orthopedic surgeon did not have malpractice insurance because his insurance broker had embezzled his (and others) medmal insurance premium. This orthopedic surgeon makes incremental monthly payments on the jury award. An insured ophthalmologist (1 million/ 3 million policy) was hit with a $2,000,000 jury award. With prejudgment interest, he reports that he is paying off $1,600,000.
Of sixteen (16) solo defendants with MDSP Findings of "Unable to Decide," thirteen (13) received defense verdicts. Three (3) trials resulted in plaintiff verdicts. One of those jury verdicts found $20,000 in future medical damages and $1,500,000 in pain and suffering.
In four (4) lawsuits with multiple defendants, wherein at least one carried a "Probable Malpractice" MDSP finding, all four (4) resulted in a plaintiff verdict. These jury verdicts ranged from a low of $1,200,000 to a high of $6,000,000.
Of five (5) trials involving multiple defendants, wherein none of the defendants carried a "Probable Malpractice" MDSP finding, three (3) resulted in plaintiff verdicts, one a defense verdict, and one a mistrial. Here, verdicts for the plaintiff ranged from $130,000 to $5,412,031.
How have various attorneys of record for the defendants fared? For those attorneys of record defending health care providers in medical malpractice trials (with more than one trial), the data is presented in the chart below.
How have plaintiff attorneys fared? Data on plaintiff attorneys of record with more than one trial between 1996 through 2001 are detailed in the chart below.
No plaintiff sued more than once, although one plaintiff trial ended in a mistrial. When re-tried, a defense verdict resulted.
A few physicians have suffered the hell of more than one medical malpractice trial. Dr. Kaplan endured two: both defense verdicts. Dr. Kramer experienced one trial with a defense verdict, one with a plaintiff verdict. Dr. Egtedar endured two trials: one with a defense verdict, one with a plaintiff verdict. Those who contend that UMC trauma center never was associated with an adverse lawsuit against a physician should speak with Dr. Egtedar. Those who contend plaintiff attorneys never take the personal assets of physicians in medical malpractice cases should speak with Dr. Egtedar and Dr. Buzard and Dr. Fleischer, among others. All these doctors are Board Certified and have reputations as competent, caring physicians.
Their experience could just as easily be ours. "There, but for the grace of God, go I" has acquired amplified meaning in recent months.
President’s Message
By Warren Evins, M.D., PhD, 2002-2003 CCMS President
The Clark County Medical Society (CCMS) has about 1041 members. Almost 150 physicians have been identified by name as indicating their intention to stop practicing medicine in Nevada; 63 have already left or are ceasing practice in a few weeks. Other physicians, who had planned to continue to work (before the current Malpractice crisis), have retired, made plans to move and practice elsewhere, or are making plans. Many others are still hoping to receive some encouraging news that real and significant progress is being made.
We are expecting Governor Guinn to call a special session of the Nevada legislature at the end of July to address the malpractice liability crisis. The outcome is still uncertain as 1. The legislators have reached no consensus on solutions, and 2. The Nevada Trial Lawyers Association (NTLA) continues to oppose the Nevada Medical Liability Physicians Task Force's proposal for Nevada tort reform patterned after California's Medical Injury Compensation Reform Act (MICRA) which has worked successfully in California for 27 years.
As President of CCMS, I represent CCMS on the Task Force. Dr. Raj Chanderraj, Past President, also continues to work actively with the Task Force. But our real ace is CCMS Executive Director, Weldon (Don) Havins, MD, JD. Don is an enormous asset, with his legal and medical training. He has spent hundreds of hours doing legal research, advising the Task Force and medical society members, lobbyists and advisors, and preparing graphs, charts, and position papers. Don, I, and others have met with many legislators to explain the issues.
Our first crisis was unavailability of insurance. Gov. Guinn and Nevada Division of Insurance Commissioner Molasky-Arman established the Nevada Essential Insurance Association (NEIA), as a temporary fix. NEIA is now writing malpractice insurance that does not require the insured doctor to buy tail coverage from the prior insurer. There may be a Nevada mutual medical insurance company to take over from the NEIA, but will it be financially viable?
Our second crisis is patient access to doctors, because doctors cannot continue to practice in Nevada under such an unfriendly legal climate.
Even if the Special Session is successful, it will be unable to address all of the needed issues. However, the next legislature can modify or repeal anything enacted in the Special Session.
We need to elect legislators who understand and will solve the current crises. We need to elect persons who will champion and enact the critical reforms and endure political heat from trial lawyers. We need to elect friends in the Legislature who share our deep concerns about our community. The Task Force and the CCMS Alliance (physicians' spouses) are very active in educating, informing and organizing public support.
Join the Alliance's grassroots campaign-"Lose my doctor, lose my vote!" Get free patient handouts, petitions, and information (call CCMS office).
However, the Task Force and Alliance cannot make the political donations required to elect friendly legislators.
SEND MONEY. MED-PAC, the Clark County Medical PAC (Political Action Committee) needs funds to support candidates from Clark county (annual membership dues are $200, but we will accept any amount-send to the CCMS office). The NSMA's PAC (NEMPAC) needs donations to support statewide candidates. The Task Force and Alliance need contributions. Also, give money, give support, host fundraisers, allow signs, walk neighborhoods, etc. for candidates who will make a difference. (Monetary contributions legally need to be personal and not corporate expenditures.) Please do it NOW, before it is too late.
Send your contributions to: MEDPAC, 2590 East Russell Road, Las Vegas, NV 89120
CCMS Alliance
For a copy of the CCMS Alliance membership application, please visit their web site at www.ccmsa-lv.org
Please join us for our Welcome Back Luncheon
September 17, 2002 at the Foundation Room in Mandalay Bay.
For details contact CCMSA President Karen Schroeder at 898-2595/401-4345.
New Members
Congratulations and Welcome to the Clark County Medical Society New Members for July 2002
· Yvonne Barry, MD, Family Practice, 2031 N. Buffalo, Las Vegas, NV 89134
· Said Daneshmand, MD, Reproductive Endocrinology, 8851 W. Sahara Ave. #100, Las Vegas, NV 89117
· Eric A. Gerson, MD, Radiology, 3560 E. Flamingo Rd., Las Vegas, NV 89121
· Deborah Kuhls, MD, Trauma Surgery, 2040 W. Charleston Blvd. #302, Las Vegas, NV 89102
· David Kuo, DO, Vascular Radiology, 2950 S. Maryland Pkwy., Las Vegas, NV 89109
Membership Applicants
If you have any pertinent information about the following membership candidates, please contact:
Clark County Medical Society, 2590 E. Russell Rd., Las Vegas, NV 89120
· Terry L Bagley, MD, Physical Med. & Rehab
· Philip R Vaughn, MD, Neonatology/Pediatrics
CME Calendar
Cardiovascular Consultants 691-9154
Clark County Medical Society 739-9989
Southwest Medical
Associates 242-7347
Some courses also approved for nursing CEUs.
8/8 - “Stroke Therapy in the New Millennium in terms of Treatment,” 7:30 a.m., 1 hour
Sunrise Hospital 731-8210
UMC 383-2604
Valley Hospital 388-4847
8/13 - “The Role of the Medical Student and Medical Resident at Valley Hospital - What Can They Do?,” noon
8/27 - “Elements of the TORT of Malpractice,” noon
9/10 - “HIV: Care and Treatment of the Hospitalized Patient,” noon
9/24 - “Heparin Induced Thrombocytopenia,” noon
*Special Note: CCMS members can receive free CME courses on the internet with World Medical Leaders.
To have your CME courses listed on our calendar, please contact Deborah Barton at 739-9989 prior to the deadline of the 12th of each month.
Clark County Health District Disease Statistics
JUNE 2002
DISEASE CASES REPORTED YEAR TO DATE
6/ 2001 6/2002 2001 2002
VACCINE PREVENTABLE DISEASES
DIPTHERIA 0 0 0 0
HAEMOPHILUS INFLUENZA 1 0 2 4
(invasive)
HEPATITIS A 2 0 34 9
HEPATITIS B 4 2 16 21
INFLUENZA 0 0 28 59
MEASLES 0 0 0 0
MUMPS 0 1 1 2
PERTUSSIS 0 9 3 10
POLIOMYELITIS 0 0 0 0
RUBELLA 0 0 0 0
TETANUS 0 0 0 0
SEXUALLY TRANSMITTED DISEASES
AIDS 13 24 77 126
CHLAMYDIA 379 303 1948 2250
GONORRHEA 170 151 850 852
HIV 24 11 64 88
SYPHILIS 0 0 1 5
(Primary & Secondary)
SYPHILIS (Early Latent) 0 0 5 4
ENTERICS
AMEBIASIS 0 2 0 10
BOTULISM-INTESTINAL 0 0 0 0
CAMPYLOBACTERIOSIS 22 11 82 54
CHOLERA 0 0 0 0
CRYPTOSPORIDIOSIS 0 0 2 2
E. COLI O157:H7 0 2 2 6
GIARDIASIS 11 9 53 44
ROTAVIRUS 37 27 318 323
SALMONELLOSIS 7 23 61 92
SHIGELLOSIS 8 2 23 5
TYPHOID FEVER 0 0 0 0
YERSINIOSIS 0 0 0 0
ANTHRAX 0 0 0 0
BOTULISM INTOXIFICATION 0 0 0 0
BRUCELLOSIS 0 0 0 0
COCCIDIOIDOMYCOSIS 1 1 12 15
ENCEPHALITIS 0 0 0 1
HANTAVIRUS 0 0 0 0
HEMOLYTIC UREMIC
SYNDROME (HUS) 0 0 0 0
HEPATITIS C 0 1 0 2
HEPATITIS D 0 0 0 1
LEGIONELLOSIS 0 1 2 1
LEPROSY (HANSEN'S DISEASE) 1 0 1 0
LEPTOSPIROSIS 0 0 0 0
LISTERIOSIS 0 0 4 0
LYME DISEASE 1 0 1 0
MALARIA 0 0 1 3
MENINGITIS,
ASEPTIC/VIRAL 5 9 21 35
MENINGITIS, BACTERIAL 2 1 11 13
MENINGOCOCCAL DISEASE 0 0 4 11
PLAGUE 0 0 0 0
RABIES (HUMAN) 0 0 0 0
RELAPSING FEVER 0 0 0 0
RSV (RESPIRATORY 39 59 1244 1720
SYNCYTIAL VIRUS)
ROCKY MOUNTAIN SPOTTED 0 0 0 1
FEVER
TOXIC SHOCK SYNDROME 0 1 0 1
TUBERCULOSIS 4 6 30 28
TULAREMIA 0 0 0 0
*Numbers include confirmed and probable cases
Classifieds
· IMMEDIATE OPPORTUNITY FOR General Pediatrician. Shared call, Mon-Fri, No HMO’s. Competitive Compensation Package, Malpractice, Health Insurance, Etc. If interested please call Joe Kaufman @ 219-7779.
· INDIVIDUAL OFFICES FOR RENT Individual offices available for rent or sublease on the fifth floor of a Class “A” office building, near UMC and downtown courts. Contact Carol at (702) 385-3801.
· 50% OFF MEDICAL, SURGI-CENTER Endoscopes, Ultrasound and Hospital Equipment. Appraisals By Certified Consultants for Mergers, Buy/Sell Acquisitions, Donations, Insurance Claims, Divorce and Estate Planning. Medical Equipment Resale, Inc. 800-962-4419, 248-380-7951, Fax: 248-380-7954
· PRIME MEDICAL OFFICE SPACE Available 1st floor space in Tower 1 of Sunrise Hospital Complex. Approximately 4500 sq. ft. If interested please call Joe Kaufman @ 219-7779.
· FIFTH FLOOR OFFICE SUITES Attractive fifth floor office suites in Class “A” building, located at 1701 W. Charleston, near UMC. Suite 500 includes 8 large and 3 small offices, 6 secretarial bays, a large conference room, a kitchen and a marble entry/reception area. Suite 550 includes 4 large and 1 small offices, a secretarial bay, a kitchen and a conference room. $1.80/sf per month on full services lease. Ample covered parking available for monthly fee. Panoramic view of city, mountains and the Las Vegas Strip. Minutes from state and federal courts, city and county government buildings. Call Carol (702) 385-3801.
· OFFICE SPACE AVAILABLE Medical/Non-Medical - 1160 SF near Desert Springs Hospital. Phone system, some furniture included. Rent negotiable - includes all utilities and janitorial. Short or long term - Full or Part Time considered - Motivated. Call 734-2292 Lisa or Amanda.
· FOR LEASE - MEDICAL OFFICE Del Webb Medical Plaza in Green Valley. Approx. 2335 sq. ft., turn key with four exam rooms, one procedure room, and nice decor. Call Connie at 702-951-0770.
· GREAT OPPORTUNITY Seeking Specialty Doctor to work at Silverado Medical Center in Green Valley/Henderson. Close to St. Rose Sienna. Part or full time, weekends available. Two rooms. Call Steve or Jason for details 492-0425.
· PHYSICIAN WANTED TO SHARE OFFICE. Nice Las Vegas Eastside office with X-ray on site. Utmost discretion used for all replies. Reply to fax # 732-0830.
· TO PLACE YOUR AD HERE Call Deborah Barton at CCMS, 739-9989, for rates and details. CCMS Members receive free classified ads (up to 40 words) - an $85 value!