Fear of civil litigation can result in silliness, but also tragedy. The Tri-City Herald reports today that a federal court ruling in Louisiana has lowered from $7.5 million to $1.4 million the amount that the insurer of Kadlec Medical Center in Richland must pay to the family of Washington woman left in a permanent vegetative state after malpractice by a drug-impaired anesthesiologist. His former partners and employer in Louisiana reportedly knew of his Demerol habit but nonethless issued glowing recommendations prior to his hiring in Washington. The doctor is now ordered to pay $2.7 million; his Louisiana partners and the hospital that discharged him for drug abuse another $4.1 million total. Kadlec, which hired him based on misinformation, is left with a $1.4 million share of the penalties, as the Herald details in the above-linked article. All this follows an earlier pre-trial settlement against Kadlec and its insurer reached in Benton County court in March 2004. An appeal of this latest decision is possible, and perhaps likely.

Read on........

(Patient Kim) Jones was left in a persistent vegetative state after a November 2002 tubal ligation surgery at Kadlec at which Dr. Robert Lee Berry was the anesthesiologist. Berry, according to court documents, failed to monitor Jones properly, allowing her blood pressure to drop dangerously low. He also removed her breathing tube while she still was paralyzed from the sedatives. Only minutes earlier, Jones had given birth to her third child.

Berry previously had been employed at a hospital and a medical office partnership in Louisiana, where he was fired for drug abuse. Court records and testimony in the lawsuit revealed that Berry had been diverting the narcotic Demerol from patients for his own use while in Louisiana, and that his drug habit continued after he was hired at Kadlec. Trial testimony said he was drug impaired while attending to Jones. Kadlec officials, who hired Berry on the recommendations of his former employers, said they did not know of his drug problem or that he had been fired in Louisiana because of it.

According to a statement from Kadlec's insurer, hospital officials in Louisiana whitewashed the real reason for Berry's discharge at the time. "Primum non nocere," or "first, do no harm," as Hippocrates wrote in "Epidemics" (not in the Hippocratic Oath as commonly thought). This whole sad story represents a twist on the usual medical malpractice debate, which is centered around often egregious or unwarranted lawsuits by patients. I am concerned about abuse of the civil courts by the often-rapacious plaintiff's bar; and about rising medical insurance costs to practitioners. But an award cap of $350,000 on non-economic damages, such as that unsuccessfully advocated in Washington's Initiative 330 last year, would not have served justice in this instance.