Maryland Injury and Disability Law : Washington DC Metro Injury & Disability Lawyer & Attorney : Greenberg & Bederman : Accidents, Falls, Medical Malpractice : Maryland, DC, Virginia

What follows is a list of what makes a patient in Maryland properly informed.

The information should be in writing: Every aspect of your procedure should be written down, and all of it should be properly communicated to you by your doctor. If you simply get handed some documents with no explanation and are told to read it and sign, then you haven’t been properly informed. There is no way that someone with no medical training can be expected to fully understand everything that will be done during a surgery. The doctor or surgeon should give you a thorough verbal briefing of everything that will happen in conjunction with any documents that you are given to sign.

You should be told exactly what the procedure will involve: How long will this procedure last? Who will be performing the surgery? Will the anesthetic be local or general? How long is the recovery time? Will the recovery be painful, and if so, how painful? What exactly will the surgeons be doing during the surgery? Where are they going to cut? How big will the scar be? All of these questions should be answered as clearly as possible. If your surgeon flashes you a winning smile and little information, find yourself another one.

You should be told how a successful surgery would benefit you: There shouldn’t be anything vague about an operation, nor should there be anything that you don’t understand completely. That includes the results. Will you be back to normal after the operation, or even better? What can you expect as an outcome if things go well, or if things go poorly? Otherwise, what is the point of going through all of this?

You should be told what the chances are of the procedure being successful: No surgery is a guaranteed success. A successful surgery depends on the skill of the physician, the condition of the patient, what sort of procedure is taking place, and any number of unquantifiable things. The people responsible for your care took all of this into account before deciding that you were a candidate for surgery. But what might seem like favorable odds to them might not seem that way to you. Nor should these odds be understated or exaggerated. Remember, a surgery is a voluntary procedure. No one can force you to undergo an operation.

You should be told what other non-surgical options, if any, are available: In many cases, cutting you open is one of the options, and not the only option. If a patient has any other opportunities for treatment, it is the duty of the medical staff to tell them what they are.

You should be told how minimal or substantial the risks are: This is extremely important. Of course there are risks to any sort of surgery, but some are riskier than others. For instance, if you are getting an ingrown toenail handled, there risks are indeed minimal. But if you are having an arterial splint put in, then obviously the risks are much greater. What your doctor owes you is an honest assessment of any risks or dangers that are involved in your treatment, no matter how minimal they might be.

All of this information should be explained to you verbally and put in writing, and you must agree to be operated on before you undergo any surgical procedure. If there are elements that you don’t understand, ask that they explain again.

Another important thing for you to remember is that if you agree to a procedure, you are agreeing to that and nothing else. A surgeon cannot do anything except what you have agreed upon. Unless he sees something that will immediately place your life in danger, he or she has no right to poke around in there. There are many reasons for this. The first is that surgeries are a costly business, and your insurance company is looking for any reason to pay as little as possible. If the surgeon does something beyond what was agreed upon by you and the insurance company, the costs will be passed on to you. The second reason is that such practices are dangerous. A surgeon might be completely prepared for your operation, but it can be assumed that he or she didn’t prepare for anything else. A mistake is a likely occurrence during any operation, and if your surgeon is straying into an area that he or she is not completely familiar with, the odds of a drastic and harmful mistake become more and more likely.

Greenberg and Bederman is rated AV by Martindale Hubbell for Ethical conduct and professional excellence. Greenberg & Bederman is a member of the Million Dollar Advocates Forum, which is limited to trial lawyers who have demonstrated exceptional skill, experience and excellence in advocacy by achieving a trial verdict, award or settlement in the amount of One Million Dollars or more.  One of our main practice areas is helping those who have been injured due to medical malpractice in the Washington DC Metropolitan area. If you or a loved one in Maryland, the District of Columbia or Northern Virginia has been injured due to a medical malpractice surgical error, or a wrong or late medical diagnosis, contact Greenberg and Bederman for afree legal consultation today.

If you want to learn more about medical malpractice issues, please visit our medical malpractice page. If you want to learn more about our medical malpractice lawyer, John Sellinger, please read about him or watch his medical malpractice video.

If you feel that you are suffering from not having been properly informed about your surgery, or if you feel that your surgeon went beyond what you agreed to, contact Greenberg and Bederman for a free legal consultation today.

Even though the potential for abuse in a nursing home is an important concern, all nursing homes are not plagued by abuse. Additionally, many companies and people are taking a progressive approach to the construction of nursing homes, and developing new ideas to make the facilities more livable for patients. Many doctors are beginning to recognize that the current approach to the care of elderly and disabled individuals is not working as well as it should, and that it is time to explore other options. One of the major tenets of this rethinking of elderly care is to put a bigger focus on the social and relational aspects of the lives of senior citizens. Such progressive thinking is beginning to have an influence in Maryland. Life-Bridge Health is considering plans for a nursing home in Northwest Baltimore. The Levindale Hebrew Geriatric Center and Hospital may be expanded, and with this expansion, there will also be more of a focus on the patients in the nursing home. The current idea for the expansion is to promote social relationships among the residents to give a more ‘homey’ feel. The expansion will have three floors, with two ‘households’ per floor. A ‘household’ is a cluster of about 14 patient rooms (each complete with bedroom and bathroom) which circle around a living room, den, and kitchen area. The idea is to foster relationship between the residents in each ‘household’ with the goal of the nursing home turning into a more livable place. Yet another goal behind the implementation of a more social nursing home design is to help foster healthy relationships with the staff. For example, out of the nursing homes that have implemented more socially focused plans, 60% have found a decrease in behavioral incidents, there has been a 57% decrease in Stage I and Stage II pressure sores, 25% decrease in bedfast residents, and 48% decrease in absentee staff.

It is also important that you recognize the potential signs of abuse when you see them. If you notice any of the following symptoms, your loved one may be a victim of abuse or neglect; dehydration, bedsores, sudden changes in finances or abrupt changes to a will. Remember that you can take action to stop the mistreatment your loved one is experiencing. In Maryland, plaintiffs in nursing home mistreatment cases have over a 50% chance of recovering, and the median verdict of approximately $200,000. The average recovery amount in Washington, D.C. is over $700,000.

If you think that you or a family member has been a victim of nursing home abuse please contact Greenberg & Bederman for a legal consultation.
 

TO learn more about Maryland Nursing Home Abuse, please visit at website at md nursing home abuse.  To learn more abour our medical malpractice attorney, John Sellinger, please go to about our firm, and click on John Sellinger's Bio.

Noneconomic damage caps. Non economic damages compensate for injuries and losses not easily quantified by a dollar amount, such as loss of enjoyment of life, loss of consortium, or severe physical impairment. This compensation is for the family of the victims who have died or been severely injured. There has been a lot of publicity in connection with huge awards running into the tens of millions of dollars.  Noneconomic damage caps limit the amount for a victim who wasn't damaged economically. In contrast, if the same person's capacity to earn money were damaged as a result of noneconomic damages, there would be no limits on that figure.

Punitive damages caps. These awards are designed to punish outrageous behavior such as companies or individuals who knowingly injure others. Reform opponents argue that by capping punitive damages, there is less cost to companies who put out defective products. Those in favor of tort reform deny that companies would benefit in any way by manufacturing and marketing defective products.

Contingency-fee limits. In many tort cases lawyers do not charge their clients an up-front fee, but  receive a percentage of any monetary award the client receives. Limits on contingency fees would curb the large amounts some lawyers and law firms make on such cases, tort reform advocates say. On the other hand, anti-tort reform groups believe that many poor consumers who were wronged wouldn't have access to effective legal representation if such fees were capped because lawyers couldn't afford to spend the time and money necessary to win such cases.

Other tort reform issues include:

·         Limits on prejudgment interest that would either abolish or greatly restrict the amount of interest on a consumer's award between the time the suit is filed and when a judgment is rendered.

·         Restrictions on a company's liability to compensate victims when several companies are found at fault. In this case, if one or more of the at-fault companies goes bankrupt, consumers who were wronged could receive substantially less than awarded by a judge or jury. While under the current system, consumers may recover the amount of full award from a single defendant regardless of whether the other defendants are solvent.  

·         Rules that would allow juries and judges to reduce the amount of compensation by the amount of any insurance or disability coverage the victim will get.

A factor often overlooked by the proponents of tort reform is not what judicial awards cost the big companies, but what injury and accidents cost the economy and society in terms of lost productivity and the impact on family members who have to take care of the disabled. Some opposed to tort reform claim that accident costs dwarf the costs in the tort system.

Most states have instituted some type of tort reform during the past 10 years. Virginia has done a lot over the last 25 years to enact liability reform. The state has a cap on liability, which has gone from $750,000 to $1 million to $1.6 million. The cap covers economic and non-economic grievances. Furthermore, those caps cover all providers involved in an alleged incident of malpractice, so if the hospital, doctor and nurse are each sued, the caps apply to all parties taken together, not individually. Maryland initiated tort reform in 1986, limiting the amount of non-economic damages patient may receive in medical malpractice cases. The current cap of $1.4 million increases with inflation. These reform efforts has had mixed success, but proponents are working at the federal level to pass laws dealing with class action lawsuits, medical malpractice and asbestos-related claims, among others.

Although The United States is a country with more tort lawsuits than most other countries, in most countries that have lower tort lawsuits, there is a more extensive social safety net. Our country has a free market approach to health care, disabilities and other social issues which also become economic problems. Our tort system is designed with our economic system considered in order to compensate for the lack of social services. In many countries with tort reform, there are more stringent regulation and provisions for health care, disability, and wage replacement, leaving its citizens with basic necessities if injured. In America, many injured people are facing destitution if they are badly hurt.  

First, most claims are not frivolous. Hospitals self-report injuries that occur due to doctor malpractice. There is an extreme difference between the number of cases reported by hospitals and the number of claims actually filed (an estimated 1,000,000 injuries per year versus 85,000 lawsuits). This statistical gap leads to two conclusions. Most injured patients do not pursue a claim against the responsible doctor(s). Also, the system filters claims – preventing the frivolous from coming to court.

No doubt the greatest signal barrier to reducing the number of frivolous claims is the plaintiffs’ lawyer. Because plaintiffs’ lawyers frequently work under a contingency fee arrangement, there is a strong economic incentive to pursue only those claims that have a high likelihood of recovery and a high potential recovery value. Professor Herbert Kritzer of the University of Wisconsin surveyed plaintiffs’ attorneys in Wisconsin regarding acceptance rates of medical malpractice cases. Professor Kritzer found that 80% of all medical malpractice cases were declined at the initial contact with attorneys. Another study looked at how particular attorneys handled such inquiries. The lawyers’ office received calls from 730 people over 10 randomly selected days. Only 1 in 30 calls resulted in litigation – lawyers rejected 97% of potential plaintiffs. Greenberg & Bederman has accepted only 5% of medical malpractice inquiries in 2007. Additionally, cases that are initially accepted by lawyers are dropped because they turn out to be weak. In short, lawyers must screen potential cases because:

• the contingency fee economic model requires that lawyers select only those cases that have a high likelihood of succeeding.
• the costs of pursuing a claim are extremely high – court costs, discovery costs, expert fees, etc.

• medical malpractice claims take longer to resolve than other types of civil cases.

• provider-defendants win at least 73% of all cases taken to trial

These facts create an incentive system for lawyers to only select the most meritorious claims.

Second, there has not been an increase in the amount of medical malpractice pay-outs. As stated before, when insurance premiums spike the go-to explanation is an increase in claim pay-outs. A Texas study from 1988 to 2002 found that no sudden changes in the number or amount of pay-outs occurred during the period of dramatic premium spikes in late 1999. A Florida study from 1990 to 2003 found that pay-outs per 100 doctors dropped from 3.98 in 1990 to 3.33 in 2003. These studies (and others) have lead researchers to claim that "factors outside the medical malpractice system were responsible for the premium spikes." One can only speculate then as to what those outside factors might be. Personally, I favor two explanations:

1. insurance companies are corporate entities and thus seek to maximize profits. Increasing premiums will effectuate this goal. The negative publicity this generates can be safely passed on as the work of legal boogeymen

2. insurance companies need to compensate for poor corporate investment strategies (sub-prime markets, dot-coms, Enron, etc.)

Either way, doctors should not look to plaintiffs’ lawyers as the cause of premium increases. Instead, the AMA should require insurance providers to explain the need for premium increases based on actual statistics rather than rhetoric. And, voters should ask politicians to find real problems on which to base campaigns.

Citations:

Prof. Herb Kritzer's article is Risks, Reputations, and Rewards: Contingency Fee Legal Practice in the United States (Stanford University Press, 2004).

Suggested Reading:

David A. Hyman and Charles Silver, Medical Malpractice Litigation and Tort Reform: It's the Incentives, Stupid, 59 Vand. L. Rev. 1085 (May 2006).

Jason Fernandez

To learn more about medical malpractice issues, please see medical malpractice.  To learn more about our medical malpractice lawyer, John Sellinger, please click on medical malpractice lawyer maryland, and read his firm bio.