Articles Tagged with physician

A man who was injured by a driver who suffered a seizure due to his brain tumor could not sue the driver’s neurologist for allegedly failing to warn him not to drive, or for otherwise failing to control his driving.

On December 21, 2001, the plaintiff suffered serious personal injury when he was struck by a car operated by the defendant driver. The driver had been diagnosed with a brain tumor in September 2000 after he had suffered a grand mal seizure. The tumor was malignant and inoperable.

The driver waited six months before he began driving again, as required by Massachusetts law. His treating neurologist, Frederick Hochberg, M.D. of Massachusetts General Hospital, allegedly did not attempt to prevent his patient from driving again and did not warn him not to drive. 

After he was hurt, the plaintiff sued the driver’s estate (the driver had passed away). He also brought a medical negligence claim against Dr. Hochberg. The plaintiff claimed that Dr. Hochberg owed a general duty to the public who might be injured due to the nature of the underlying medical condition that he was treating. The plaintiff argued that the duty rose from the special relationship between a physician and a patient. The plaintiff argued that general negligence principles created a duty in Dr. Hochberg to warn his patient of the dangers of driving while suffering from the brain tumor. The Supreme Judicial Court rejected both arguments.

The court found that this doctor-patient relationship was not a “special relationship” which would give rise to a duty to prevent harm to a third person. Absent such a special relationship, the court said, “there is no duty to control another person’s conduct to prevent that person from causing harm to a third party.”

In 2007, the court had found, in Coombes v. Florio, 450 Mass 182 (2007), that a physician may have a duty to warn his or her patient about the side effects of medication being prescribed. The court ruled that this duty extended to third parties who might be injured if the warning had not been given. But the court refused to extend that ruling to include medical conditions under treatment.

The Coombes case was seen by the court as a very narrow exception to the general rule that a physician owes no duty to third parties who might be injured by a patient. The court stated that the duty sought by the plaintiff would “impose on physicians an affirmative duty … to nonpatients to warn patient of the risks of driving due to any underlying medical condition. We conclude this is an unwarranted and ill-advised expansion of liability for several reasons.”

The main concern of the court was that the physician did not do anything to increase the likelihood of harm by the patient, compared to the physician who might be liable for prescribing medication and thus creating additional risk. The court also believed that further imposition of duty would intrude on the doctor-patient relationship and might increase collateral costs. 

This case represents the second time the court has stated that it will not be expanding the duty recognized in the Coombes case.  At least that narrow exception survived.

The case is Medina v. Hochberg, SJC-11178 (May 13, 2013).

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The state Attorney General is in the preliminary stage of a systematic review of the Massachusetts healthcare system and has already made some startling discoveries about healthcare costs. Martha Coakley’s office found significant cost variations among hospitals and physicians based on factors other than quality of care.  Although the investigation is still ongoing, Attorney General Coakley has expressed concern about affordable and accessible healthcare if the identified systematic failures are not addressed and has urged policymakers to implement cost containtment measures.

As part of the investigation, the Attorney General’s office reviewed documents from insurance companies and healthcare providers representing the bulk of the healthcare market in the state to examine healthcare costs and costs drivers. Specifically, the Attorney General examined insurance contract prices between insurance providers and hospitals between 2004 and 2008. The concern is that although Massachusetts has improved access to the healthcare market–97 percent of the population has healthcare coverage–this improvement could be compromised by cost increases.  Attorney General Coakley warned if left unchecked, price disparities in the market could create a  provider marketplace dominated by expensive “haves” as lower priced “have-nots” are forced to close down or consolidate with higher priced providers. 

The initial findings of the investigation showed that:

In a recent article in the medical journal Radiology, a study of several hundred radiologists reveals that mammographers may be reluctant to reveal medical mistakes, even if the mistakes relate to potential risk of breast cancer.

In the study the radiologists were given a hypothetical question. They were asked to assume that films were read out of order; that the calcifications in the films were actually increasing and not decreasing, and that they discovered the mistake after initially reading and reporting the results to their patients. Calcifications may be associated with the growth of breast tumors.

Only 14% of the physicians said they would definitely disclose the error. Twenty-six percent said they would probably report the error. The rest would either disclosed the error only if asked by the patient, or not at all.

In the hypothetical conversations with the patients after the mistake was revealed, only 15% of the doctors polled would admit that they made a mistake during the reading of the films.

Failure to diagnose breast cancer due to mammography errors is a common cause of medical malpractice claims, and almost half of the doctors in the study had been party to a suit alleging negligence.

The authors concluded that even though there is a trend towards more physician openness regarding mistakes, disclosure is “the exception, not the rule.”

Information

Radiology: Radiologists reluctant to disclose mammo errors to patients. www.healthimaging.com. October 30, 2009.

 

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Everyone knows about the hazards associated with falling asleep at the wheel of a car. Workers are told not to operate heavy equipment if tired or impaired. We all have first hand experience with the effects of sleep deprivation on clarity of thought and reaction time. Would you knowingly put your life in the hands of someone who is at the end of a 30-hour shift? Would you feel confident in the judgments of a young doctor in training who has just put in an 80 hour work week? Well, if you have received treatment at a major teaching hospital in Massachusetts or anywhere in the country, you probably have already done this.

You have probably already seen this reality depicted on popular television shows like Grey’s Anatomy or ER showing the impossibly long shifts and adrenaline-pumping situations medical residents must face each week. Of course the show’s writers throw in a lot of extra drama, but real medical residents do typically work 80-hour weeks that include 30-hour shifts–sometimes with little or no sleep.

Medical residency programs are designed to be rigorous, to prepare doctors for difficult situations and to expose them to as many medical procedures as possible over their 3-7 years in residency. There are teaching hospitals throughout Massachusetts, including Boston, Worcester, Springfield, Cambridge, Waltham, and Framingham.

For years the medical malpractice insurance companies have been complaining about the medical malpractice “crisis”

in Massachusetts. High insurance rates, they complain, are driving physicians out of the state, making specialists hard to find.

But now there is good news: The insurance crisis does not exist! In fact, when adjusted for inflation, medical malpractice insurance rates are, on average, dropping in Massachusetts, according to a recent report from Suffolk University. The study examined rates for a thirty year period, and compared rates from 1990 to rates in 2005.

When your doctor makes a mistake, it is only fair to expect to get a truthful explanation about what happened. After all, there is the Patient Bill of Rights under state

and federal law. There are professional ethics. And then there is plain old human decency. All of them tell us that our physicians and other medical

practitioners should quickly tell you about any mistakes they made, especially if your medical treatment is affected.

If you believe you have suffered personal injury due to medical error, it is essential that you promptly obtain your medical records. Under Massachusetts law, you have the right to get a copy of your hospital and physician records.  The procedures is not complex, though sometimes there can be delays.

For details on how and why you should get you records after you may have suffered an injury due to medical malpractice, please read our detailed article on our medical malpractice web page.

What Should You Do If You Have A Medical Malpractice Case?