The medical liability crisis of 2003: Must we squander the chance to put patients first?

Health Affairs

Volumn 22, Issue 4, 2003, Pages 37-40

  Hatlie, Martin J ^a,b,c   Sheridan, Susan E ^b,c  

^a Partnership for Patient Safety   (United States)

^b Consumers Advancing Patient Safety ^*  (United States)

^c Parents of Infants and Children with Kernicterus ^*  (United States)

Author keywords

[No Author keywords available]

Indexed keywords

HEALTH CARE POLICY; HUMAN; INTERPERSONAL COMMUNICATION; LEGAL ASPECT; LEGAL LIABILITY; LICENSING; MALPRACTICE; MEDICAL ERROR; NOTE; ORGANIZATION AND MANAGEMENT; RISK ASSESSMENT; SAFETY; SOCIAL JUSTICE; UNITED STATES;

DISCLOSURE; HEALTH CARE REFORM; HUMANS; LIABILITY, LEGAL; LICENSURE, MEDICAL; MALPRACTICE; MEDICAL ERRORS; RISK ASSESSMENT; SAFETY MANAGEMENT; SOCIAL JUSTICE; UNITED STATES;

EID: 0042662832     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.22.4.37     Document Type: Review

References (19)

1. The Institute of Medicine shocked the American public in late 1999 with a report that found medical error to be the fourth- to eighth-largest cause of preventable death in the United States. See L.T. Kohn, J.M. Corrigan, and M.S. Donaldson, eds., To Err Is Human: Building a Safer Health System (Washington: National Academies Press, 1999). In fact, dialogue on tort reform has regressed since that time. No-fault compensation programs, organizational liability schemes, specialized administrative courts, and other alternatives were much more part of the tort reform discussion in the 1990s fostered by the Clinton health care planning effort or Speaker of the House Newt Gingrich's Contract with America. Today, these proposals have barely surfaced, even though each of them arguably is more aligned with the patient-centered, systems-based approaches to reducing harm advanced by the IOM than a fault-based tort system is.
2. K. Weick, "Organizational Culture as a Source of High Reliability," California Management Review (Winter 2 1997): 112-127.
3. C. Perrow, Normal Accidents (Princeton, N.J.: Princeton University Press, 1999);
4. and J. Reason, Human Error (Cambridge: Cambridge University Press, 1990).
5. Institute of Medicine, Crossing the Quality Chasm: A New Health System for the Twenty-first Century (Washington: National Academies Press, 2001).
6. Medical malpractice claimants are often advised by their own attorneys to keep quiet about their cases, to better position themselves for easier, faster, or higher-dollar-value settlements.
7. L. Belkin, "How Can We Save the Next Victim?" New York Times Magazine, 15 June 1997, 28-70;
8. and "A Case Study: How Does the Healthcare System Respond to an Injury Caused by Error?" Symposium on Examining Errors in Healthcare: Developing a Prevention, Education, and Research Agenda, Annenberg Center for Health Sciences, Rancho Mirage, California, 13-15 October 1996.
9. NBC News, "A Deadly Mistake: What Was to Blame for a Young Boy's Death during Surgery?" 1 January 2002, www.msnbc.com/news/657566.asp (21 March 2003).
10. Cal Sheridan is the son of Susan Sheridan, a co-author of this Perspective.
11. Neonatal jaundice, if identified, is easily treated by exposure to light, which breaks down bilirubin, the neurotoxin that causes jaundice.
12. L.H. Johnson, V.K. Bhutani, and A.K. Brown, "A Systems-Based Approach to Management of Neonatal Jaundice and Prevention of Kernicterus," Journal of Pediatrics (April 2002): 396-403. Systemic reasons include the increase in early discharges from hospitals after birth, failure to educate parents about the dangers of jaundice, a relaxation of concern about neonatal blood typing and screening before discharge, and a health workforce that was not alert to the risk of kernicterus.
13. Susan E. Sheridan, consumer, Testimony to the National Summit on Medical Errors and Patient Safety Research, Washington, D.C., 11 September 2000, www.quic.gov/summit/wsheridan.htm (21 March 2003).
14. "Fundamental Change: Can We Get There from Here?" Executive Summary (Pittsburgh: Pittsburgh Regional Healthcare Initiative, September 2002), 1-2.
15. R. Romano, "Fatal Error Becomes Catalyst for Reform," Boston Globe, 15 March 1999.
16. See JosieKing.org, "The Josie King Pediatric Patient Safety Program," 2003, www.josieking.org/program.html (15 April 2003).
17. Joint Commission on Accreditation of Healthcare Organizations, Standard RI.1.2.2 ("Patients and, when appropriate, their families are informed about the outcomes of care, including unanticipated outcomes"); and American Medical Association, "Council on Ethical and Judicial Affairs, Current Opinions," E-8.12, Patient Information ("Concern regarding legal liability which might result following truthful disclosure should not affect the physician's honesty with a patient"), 1994.
18. A handful of states have enacted or imposed by common law a rule that apologies are not to be construed as admissions of guilt. Pennsylvania is the only state to couple this shield with the requirement to disclose and to include this patient safety title in a bill designed to accomplish tort reform. See Medical Care Availability and Reduction of Error (MCARE) Act, 40 Pa. Stat. 1303.308 (2002).
19. Massachusetts Department of Public Health, Division of Health Professions Licensure, www.state.ma.us/dph/boards/index.htm (15 April 2003).