Insurance companies make a ton of money by delaying everything. They delay paying the bill you submit, hiding behind the “we need more information” umbrella. They delay responding to legitimate requests to settle meritorious malpractice cases.

In one case it took a surgeon’s insurance company months to respond to a demand when the doctor had clearly operated on the wrong body part. Amazingly, after months of “evaluating” the case, they said “no payment.” (That doctor is now facing a medical board inquiry.)

In another case the hospital and surgeons left a sponge a patient after surgery. We wrote a fair demand package and provided all of the records. We gave them 30 days to respond.

Didn’t even get the courtesy of a response, for over three months.

Their response? “We need more time–please don’t sue us.”

All of these delays allow the insurance companies to bank millions in investment income while injured party, the one who ends up suing, winds up being called a “liar, cheat and fraud” because he had the temerity to file suit.

Here is a very interesting transcript of a recent court hearing involving a hospital in Virginia. We have previously blogged about this case and have received a letter as well asking us to remove the blog post.

Lest there be no mistake about what actually happened, including the fact that the hospital’s attorney has actually filed a bar complaint about the attorney blogger he is litigating against, we have obtained the transcript of the hearing.

The judge said “no” to the hospital’s attempt to have the attorney remove the blog post. Read this interesting transcript about an attorney’s right to truthfully blog about a case and arrive at your own decision.

What happens when a record made by a hospital is claimed to be privileged? Is it important to justice that all facts about an incident see the light of day in order that justice be completed?

Here is a very interesting transcript that is wealth worth the read and will give you an “insider’s look” at a real medical malpractice case.

All credit to Newport News attorney Avery Waterman for continuing the fight to bring to light all relevant facts in a medical malpractice case in order that juries, judges and the public can see and arrive at their own decision.

Here is the medical malpractice transcript regarding incident reports and whether they should remain secret or not.

A lawsuit filed in the Circuit Court for the City of Fredericksburg alleges that an orthopedic surgeon who was to operate to remove a cyst on the back of a woman’s shoulder, forgot where the cyst was located and operated on the front of the shoulder, allegedly causing unnecessary scarring and disfigurement.

The lawsuit alleges that the surgeon failed to take appropriate steps to mark the surgical site and then failed to awaken the patient and stop the surgery once he realized that he couldn’t remember where he was supposed to operate.

Remarkably, the surgeon’s medical malpractice insurance company took the position that the surgeon did no wrong and denied the patient’s attempt to settle the case.

More information about the Fredericksburg surgeon who has been sued is here.

Newport News attorney Avery Waterman has described a shocking attempt by Sentara Obici Hospital to hide critical information in a wrongful death lawsuit.

Avery represents the family of a woman who “mysteriously” bled to death in July 2008. In the medical malpractice lawsuit Waterman sought the “incident report” that contained facts surrounding the patient’s death.

Hospitals fight tooth and nail to hide relevant facts about patient deaths and injuries behind “incident reports.” They often claim that the “incident reports” are “confidential investigations” and that even if they prove malpractice that somehow “justice is served” by hiding the true facts from the public, the court and from its own patients (and families).

Waterman went into court and asked the court to compel the production of the incident report. According to Waterman’s blog, the hospital’s attorney initially told the court that this particular report was a “blood bank protocol document that was irrelevant to the medical malpractice.”

Eventually, the hospital’s attorney, Ted G. Yoakam, Esq. of Virginia Beach, Virginia, voluntarily turned over the incident report.

Guess what? Its wasn’t “irrelevant to the medical malpractice.” It told the facts of how this poor lady died.

So here’s the deal: not only did this lady’s family grieve when she died, but they have undoubtedly suffered enormously not knowing why she died until now. Now they are probably suffering again, knowing not only how she died but that the very hospital to whom they entrusted their loved one to care for tried to hide the very facts of her death.

But wait…..there’s even more to this story of hospital conduct.

After Waterman wrote on his blog about this now public document that the hospital voluntarily (eventually) turned over to Waterman the hospital’s attorney filed a motion against Waterman, seeking to have him reprimanded and thrown off the case. You can read Waterman’s blog about Sentara’s Attempt to Continue to “Hide the Ball” in this medical malpractice case.

The judge, in rejecting the “emergency petition” filed by Sentara Hospital said that Waterman could publish whatever he wanted.

Here’s the bottom line: Medical malpractice happens. We know it happens with alarming frequency. While many defendant’s eventually own up to their mistakes with integrity, others play the “hide the facts and deny everything game.”

You never hear about that from the tort reformers and it takes a lot of work by attorneys like Avery Waterman to seek the truth and bring it to the public.

Virginia Lawyers Weekly released their Virginia’s Largest Verdicts list for 2009 recently. Medical malpractice cases were represented at spots number 4, 5, 9, 11, 13,15, and 20.

The “amount” numbers for the medical malpractice are somewhat skewed, however, due to Virginia’s current medical malpractice cap.

The cap statute reads:

“In any verdict returned against a health care provider in an action for malpractice where the act or acts of malpractice occurred on or after August 1, 1999, which is tried by a jury or in any judgment entered against a health care provider in such an action which is tried without a jury, the total amount recoverable for any injury to, or death of, a patient shall not exceed $1.5 million. The maximum recovery limit of $1.5 million shall increase on July 1, 2000, and each July 1 thereafter by $50,000 per year; however, the annual increase on July 1, 2007, and the annual increase on July 1, 2008, shall be $75,000 per year. Each annual increase shall apply to the act or acts of malpractice occurring on or after the effective date of the increase. The July 1, 2008, increase shall be the final annual increase.” Va. Code 8.01-581.15.

This means that any med mal verdict over $2 million is certain to be reduced, the question is by how much. For example, the $7 million medical malpractice verdict listed at #5, Butler v. Trivedi, was reduced to $1.8 million meaning that the incident took place between July 1, 2005 and July 1, 2006. Each of the top 5 medical malpractice cases were similarly reduced by the statute, effectively nullifying the jury’s valuation of the claim.

Many critics of the Virginia medical malpractice cap criticize the arbitrary nature of such statutes. One such critic, Fairfax attorney Ben Glass, says “It’s unfortunate that the people of Virginia have their right to a jury limited by these caps. In every other type of personal injury case in Virginia there is no limit to recovery and the award is based on a valuation of the case by a jury of ordinary citizens.” Glass continued, “These juries that come to these verdicts are not out to get doctors or anything, they’re simply doing their job of evaluating a case. A job that the legislators in Richmond feel they can do better, even without ever sitting in on the case.”

Glass’ comments are echoed by many Virginia attorneys who are opposed to so-called “tort reform” but they will have to wait at least a year for any changes to the cap as the Virginia Trial Lawyers Association and healthcare associations in Virginia have agreed to table the issue until 2011.

A patient suffering from acute chest pain, diaphoresis (heavy sweating associated with physical distress), and pain radiating to the left arm with numbess. He was taken by ambulance to the hospital where he later suffered a myocardial infarction (heart attack). Despite the fact that catheterization was called for by the EMT the patient did not undergo the procedure until 13 hours after admittance to the hospital. In that time he suffered the heart attack.

The experts enlisted by the plaintiff’s attorney were prepared to testify that heart catheterization should have occurred within an hour and a half and that 13 hours between admittance to the procedure was well outside the standard of care. As a result of the heart attack the patient’s heart was permanently damaged and now will only pump blood at less-than-half the rate of a normal heart.

The case, brought by the plaintiff and his attorney, R. Lee Livingston of Charlottesville, recently settled for $690,000.

We hear all the time the complaint that lawyers are “destroying” the economy or chasing doctors out of town or increasing the cost of medicine. I see very few blog posts, news articles or critiques of the common practice of the insurance industry in frivolously denying claims on the hope that the plaintiff or her attorney will find the case too expensive to pursue and, hopefully, they will go away.

We are investigating a claim right now involving a Fredericksburg, Virginia orthopedist who:

1. decided to do an operation to remove a small lipoma on the back of our client’s shoulder;
2. once the surgery started he couldn’t figure out whether he was supposed to be operating on the front or the back;
3. he thought about canceling the surgery because he couldn’t figure it out and, since the patient was already anesthetized, he couldn’t ask her;
4. he decided against canceling the surgery and, instead relied on his “memory” of what the MRI said (he was wrong and the report telling him he was wrong was right in the file);
5. He then went and got the MRI, but misread it;
6. He went ahead and operated on the wrong side of the shoulder and when he couldn’t find the lipoma he get digging deeper and deeper;
7. He finished the operation and never did what he was supposed to do.

The patient ended up with one unnecessary surgery, lots of bruising, unnecessary scarring and needing additional care in the form of physical therapy;

(By the way, all of the above comes from the doctor’s own notes, not anything we are “guessing” about.)

The next day, during an office visit, he apologized to the patient, admitted he was wrong and offered to do the right surgery when he got back from vacation (which he was leaving for the next week.) –she’s no fool, though…what he did was very, very dangerous and she opted to have the lipoma removed later by a general surgeon (why was an orthopedic surgeon removing a lipoma anyway?)

This young lady did everything right. She made a very reasonable proposal to the doctor’s insurance company.

How–you say–could they possibly deny this claim.

They did. In a terse letter that explained nothing, the doctor’s insurance, company, (one that prides itself on taking every single case all the way through trial) said “we didn’t do anything wrong.”

The next time you see anyone writing anything about tort reform and plaintiff’s lawyers and “opportunistic patients” please drive them to this blog and get them to comment. I’d love to hear what they have to say about this.

By the way, we’ll release the name of this doctor once we file the case. We’ll also be filing a complaint with the Virginia Board of Medicine.. Again, by this doctor’s own words, he engaged in a very, very dangerous activity by starting a surgery he knew he should have canceled.

It is tragic when a patient goes to the hospital for one problem then sustains an injury from an accident that happens while in the hospital. Falls in hospitals are more common than you can imagine. Here is a case from the Supreme Court of Virginia where a patient fell and the hospital was forced to disclose its internal procedures and manuals that should have been used to prevent falls.

As amazing as it sounds, doctors sometimes forget to do a part of an operation. You can imagine how this happens, especially if they’ve got surgeries backed up, one after another, at the local hospital.

Is that malpractice? Can you recover damages. Here is an interesting case decided by the Supreme Court of Virginia that allowed a cases against a doctor to proceed when the doctor had forgotten to do a part of a surgery and the claimant had to have another surgery.

This is slightly different from wrong-sided surgery, which also happens.