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Medical Malpractice “Shock Loss Claims” are on the rise Print E-mail
Written by Matt Gracey   
Tuesday, 16 July 2019 16:30

Insurance underwriters use simple loss ratios (losses and expenses divided by premiums) as one of the tools with which to gauge a company's suitability for coverage. High loss ratios, in which the losses approach, equal, or exceed the premium, are not good. One factor that has a large effect on loss ratios are “shock loss” claims, catastrophic losses so large that they have a material effect on the underwriting results of an entire insurance company.

These shock losses wreak havoc on a carrier’s overall loss ratio. As one can imagine, it is only a matter of time until the carrier can no longer absorb these losses if they become the norm, and the damages must be addressed and recovered in order to maintain sustainability. Inevitably, this leads us into all-too-familiar territory for Florida’s medical professionals – a return to a hard market, with increased rates and strict underwriting requirements for medical malpractice insurance.

Let’s look at just a few of the larger malpractice judgments from 2018 close to home: 
  • Hillsborough County, 2018
Award Amount: $109,760,930

A patient was admitted for outpatient surgery to remove a benign ovarian cyst. During the procedure, the doctor sliced through a portion of the patient’s small intestine, closing the wound without addressing the damage. After the surgery, her blood pressure dropped to 67 over 48. A nurse guided her to a bathroom, where her incision opened and emitted large amounts of bloody fluid. She later went into respiratory failure, with signs of sepsis.

Days later, a second doctor reopened the patient’s surgical wound and found the intestine nearly sliced all the way through. Flesh-eating bacteria had already consumed parts of her intestines, stomach, and abdominal muscles. She endured several more operations as doctors cut away the decaying tissue. Medicine that the doctors administered to boost the patient’s blood pressure caused blood to flow away from her limbs, the suit stated, which caused complications leading to gangrene in her hands and feet, requiring amputations below both of her knees and both elbows.
  • Pinellas County, 2018
Award Amount:  $9,250,000

A patient was born prematurely at Mease Countryside Hospital on October, 2010, and was diagnosed with stage II retinopathy of prematurity (ROP), which, if not treated in a timely manner, can cause blindness. According to the plaintiffs, because the patient did not timely see an ophthalmologist upon being discharged from the hospital on December 29, 2010, she lost all of her vision. The plaintiffs were referred to an ophthalmologist, who was unavailable to see the patient and who had not screened neonates with ROP in over a decade. They alleged that the defendants were negligent by, among other things, failing to appreciate the severity of the disease process, failing to adequately inform the plaintiffs of the seriousness of the condition and its consequences, failing to adequately stress the importance of follow-up eye screening, failing to provide the plaintiffs with the name of an alternative ophthalmologist when told that the referred doctor was unavailable to see them, and failing to plan adequately for the patient’s discharge.
  • Pinellas County, 2018
Award Amount: $6,584,674

A mother with high-risk pregnancy was admitted for labor at 42 weeks. Fetal heart rate (FHR) monitoring initially showed normal accelerations and absence of decelerations. Several hours later, however, the monitoring strips began to deteriorate with diminished fetal heart rate, variable decelerations and absent accelerations. The nurse called the OB/GYN at home to report the situation and EFM tracings, but he told her to continue with labor and vaginal delivery, at which point the doctor went back to sleep. The jury in Pinellas County found the doctor was negligent in ignoring the EFM warnings resulting in the death of the baby.
  • Polk County, 2018
Award Amount: $4,914,513

A 61-year-old patient complaining of feeling severe lower leg pain was seen by a vascular surgeon. The patient alleged that the doctor delayed the patient’s treatment after his arrival at the hospital, leading to the loss of his leg a few days later. The doctor’s defense team argued that the patient lost his leg due to chronic artery disease, and not due to the blood clot and its treatment. After a six-day trial, the jury deliberated for about four hours before ruling in the patient’s favor.
  • Palm Beach County, 2018
Award Amount: $1,039,000

A patient suffered a heart attack resulting in heart bypass surgery. The doctor who performed the bypass surgery discovered the tip of a catheter and a ruptured balloon that were left inside the patient during a previous failed angioplasty, resulting in the lawsuit against the medical center and the cardiologist who performed the original failed procedure.

Other notable 2018 cases include:

Dade County - Freidin Brown, P.A. represented a plaintiff that was awarded a $4,020,000 settlement against a Miami hospital.

Dade County - The Law Offices of Orlando R. Ruiz and The Tinstman Law Firm secured a $3,713,898 settlement against a Miami chiropractor. 

These awards and settlements are not to be taken lightly; their implications are far reaching. We are already seeing rate increases across the board in Florida and other states. Many doctors are receiving their renewal policies to discover their rates have been increased 30% – 40%. 

These high-award cases are already making headlines in 2019 as well – including an $11.9 million verdict against a Broward County orthopaedic surgeon and a $24.5 million verdict for a mother’s death shortly after giving birth, also in Broward County.  

Many insurers have announced rate increases and more will follow. In the early 2000s as the med mal market was in a similar cycle, the number of insurers offering coverage to doctors in Florida for their malpractice risk went from over 50 to fewer than five in two years. Wisely choosing your insurer has now become very important, and finding an experienced, honest expert in the field to lend advice is essential.
Licensed as an insurance broker since 1981 in Florida, Matt Gracey is an expert in medical malpractice insurance coverages and leads the team at Danna-Gracey. Matt has created malpractice insurance purchasing groups or endorsed programs with the following organizations:

Network of Florida Otolaryngologists, Inc.
Florida Orthopaedic Society
Florida Gastroenterologic Society
Palm Beach County Medical Society
Obstetric and Gynecologic Society (FOGS)

Contact Matt 
phone: 800.966.2120

Last Updated on Tuesday, 16 July 2019 16:53
Private equity, physician-owned centers & more: Dr. Michael Rivers on ASC trends Print E-mail
Written by FHInews   
Tuesday, 16 July 2019 00:00

Rachel Popa interviews Michael Rivers, MD, Director of EMA Ophthalmology for EHR developer Modernizing Medicine, based in Boca Raton, for Becker's ASC on July 16, 2019. He weighed in on the key ASC trends this year.

Question: What trends should ASC leaders expect to see this year?

Dr. Michael Rivers: ASCs are drawing increasing market emphasis in specialty practices, specifically ophthalmology and gastroenterology, due to the profitability potential for doctors combined with the cost-effectiveness for patients...

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Last Updated on Monday, 26 August 2019 18:12
Designing Benefit Plans for Healthcare Organizations Print E-mail
Written by Patrick Pilch and Beth Garner   
Friday, 12 July 2019 17:38

Healthcare is one of the largest and fastest-growing portions of the U.S. economy. Against a backdrop of an extremely tight labor market, many hospitals, physician groups, skilled nursing facilities and other organizations across the healthcare continuum are having a difficult time filling jobs with the right people. While offering a competitive salary matters, it takes more than a paycheck to attract and retain workers in today's labor market. Record low unemployment rates are forcing employers in the healthcare sector to take a closer look at their benefit plans to remain ahead of competing healthcare organizations...

Confused about what to eat? Science can help Print E-mail
Written by FHI's Week in Review   
Monday, 08 July 2019 14:31

A July 5th strawberrypost in The Conversation clears up a lot of confusion, including among doctors, about proper nutrition. Author P.K. Newby, a nutrition scientist, points out that, despite seemingly conflicting advice from so-called experts, there is broad consensus in the scientific community supporting a plant-based diet.  According to the author:

While it may sound like a fad, a plant-based diet has been studied for decades. Awareness escalated as it addresses two urgent public health challenges: the chronic disease epidemic and the climate change crisis. It's a win-win for human health and the environment.

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Last Updated on Monday, 19 August 2019 17:34
Is My Doctor Any Good? Print E-mail
Written by MD Whistleblower   
Monday, 24 June 2019 00:00

When I meet patients in the office, our conversations do not focus exclusively on the medical issue at hand. Of course, if you come to see me with a stomach ache, at some point I will direct the dialogue toward your abdomen. Often, our conversations are far removed from livers and pancreases, and deal with more personal vignettes and anecdotes. Why does this happen? First, I enjoy it; and secondly, it helps me to understand the patient better as a human being. I won't give this up, despite the many forces - Electronic Medical Records in particular - that conspire to dehumanize the medical experience.
I am a trained typist and had several secretarial jobs in my younger days. The tool of the trade then was a contraption unknown to the generation whom are now soldered to their smart phones. It was called a typewriter. For those curious, you might actually be able to palpate one of these dust covered devices in your grandmother's attic. My favorite was the IBM Selectric, which had a sphere covered with raised letters and characters which rotated with each key stroke before striking the paper. Oh, the simple world devoid of Google, cut & paste, Instagram and Wikipedia.

Last Updated on Tuesday, 25 June 2019 12:16
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