The appeals court found that Wisconsin’s cap on noneconomic medical malpractice damages always reduces noneconomic damages only for the class of the most severely injured victims who have been awarded damages exceeding the cap. Yet, the cap always allows full damages to the less severely injured malpractice victims. The court therefore concluded that the cap denies equal protection to that class of malpractice victims whose noneconomic damages are determined by the factfinder to be in excess of the cap. The court therefore concluded the statutory cap is facially unconstitutional.
In Pennsylvania, a medical malpractice lawsuit must be filed in the county where the alleged malpractice occurred.
The Superior Court in Pennsylvania recently reversed a trial court decision in a medical malpractice case that transferred venue from Philadelphia County to Berks County, sending the case back to Philadelphia County.
The case involved a premature infant who was being treated in the neonatal intensive care unit in a Berks County hospital. The infant underwent a transthoracic echocardiogram in Berks County, which was interpreted by a pediatric cardiologist working in a hospital in Philadelphia County. The Philadelphia cardiologist wrote a report of her findings, including her diagnosis and treatment plan. The diagnosis of the Philadelphia doctor was pulmonary hypertension requiring immediate treatment or intervention, which was to be forwarded to plaintiff’s treating providers in Berks County.
Endo Pharmaceutical’s recent decision to halt sales of Opana ER (oxymorphone hydrochloride) quickly followed the U.S. Food and Drug Administration’s (FDA) request that it remove the abuse-linked opioid pain medication from the market. This is the first time the agency sought to remove a currently marketed opioid pain medication from sale due to the public health crisis of opioid abuse.
In 2015, more than 33,000 people died from opioid overdoses, according to the Centers for Disease Control. Almost half of the deaths involved a prescription medication.
A physician cannot perform a surgery or other medical procedure on a patient without first obtaining the patient’s informed consent. Informed consent means that the patient was advised of the risks, benefits, and alternatives to the procedure and, knowing these, made the decision to undergo the procedure. A physician can be legally liable where he or she fails to obtain a patient’s informed consent before performing a medical procedure.
In a recent medical malpractice action, the Pennsylvania Supreme Court held that a physician’s duty to provide information to a patient sufficient to obtain her informed consent is non-delegable. Thus, conversations between the patient and members of the physician’s staff will not suffice. The duty to obtain a patient’s informed consent for a major medical procedure belongs to the physician, who must inform the patient about the risks, benefits, likelihood of success, and alternatives.
Most people are aware that a dog owner can be sued if his dog bites you. But what if a dog runs up to you, jumps on you, and knocks you down, causing injury? That scenario highlights the difference between injuries from dog bites and injuries that occur from a dog attack or confrontation.
- Inflicted severe injury on a human being without provocation on public or private property.
- Killed or inflicted severe injury on a domestic animal, dog, or cat without provocation while off the owner’s property.
- Attacked a human being without provocation.
- Been used in the commission of a crime.
And the dog has either or both of the following:
- A history of attacking human beings and/or domestic animals, dogs, or cats without provocation.
- A propensity to attack human beings and/or domestic animals, dogs, or cats without provocation.
The Supreme Court of Florida held that the state’s statutory caps on personal injury noneconomic damages in medical negligence actions violate the Equal Protection Clause of the Florida Constitution. The statute, section 766.118, set noneconomic damages caps of $500,000 per claimant in personal injury or wrongful death actions arising from medical negligence. If the negligence resulted in a permanent vegetative state or death, noneconomic damages were capped at $1 million. In cases not involving death or permanent vegetative state, the patient injured by medical negligence could be awarded up to $1 million, if the trial court determined that a manifest injustice would occur unless increased noneconomic damages were awarded, based on the special circumstances of the case, and a finding that the noneconomic harm sustained by the injured patient was particularly severe.
In striking down the damages caps, the Florida Supreme Court affirmed the decision of the Fourth District Court of Appeals in North Broward Hospital District v. Kalitan. The Broward County lawsuit was filed after dental assistant Susan Kalitan underwent carpal-tunnel syndrome surgery and suffered a perforated esophagus during the anesthesia process. A jury awarded $4 million in non-economic damages. The amount of the award was reduced by approximately $2 million based on the damages caps in the statute.
The 4th District Court of Appeals ruled that the damage caps were unconstitutional, noting the Supreme Court’s 2014 decision in Estate of McCall v. United States, finding that the caps in section 766.118 are unconstitutional in wrongful-death malpractice cases. The McCall Court found that the statute “arbitrarily diminished noneconomic damage awards based on the number of survivors and lacked a rational relationship to addressing the medical malpractice crisis.”
Based on the plurality opinion in McCall finding that there is no evidence of a continuing medical malpractice insurance crisis justifying the arbitrary application of the statutory cap in wrongful death cases, the Court reached the same conclusion with regard to the application of caps in medical negligence cases. The Court found that the statutory caps in section 766.118 “unreasonably and arbitrarily limit recovery of those most grievously injured by medical negligence.”
The Court concluded that “because there is no evidence of a continuing medical malpractice insurance crisis justifying the arbitrary and invidious discrimination between medical malpractice victims, there is no rational relationship between the personal injury noneconomic damage caps in section 766.118 and alleviating this purported crisis.”
Therefore, the Court held that the caps on personal injury noneconomic damages provided in section 766.118 violate the Equal Protection Clause of the Florida Constitution.
The four-member majority included Chief Justice Jorge Labarga and Justices Barbara J. Pariente, R. Fred Lewis and Peggy A. Quince.
Justice Ricky Polston dissented, joined by Justices Charles T. Canady and C. Alan Lawson, arguing that “It is the Legislature’s task to decide whether a medical malpractice crisis exists, whether a medical malpractice crisis has abated, and whether the Florida statutes should be amended accordingly.’’
While some states continue to impose damages caps, Pennsylvania does not impose caps on damages in personal injury cases unless the case is brought against a Commonwealth agency. In fact, damages caps are otherwise unconstitutional under the Constitution of the Commonwealth of Pennsylvania.
Pennsylvania’s Medical Marijuana Act was enacted in May 2016 (the “Act”). Under the Act, patients with serious medical conditions, such as cancer, HIV/AIDS, Parkinson’s Disease, Multiple Sclerosis, and severe chronic or intractable pain, are authorized to use medical marijuana to treat their condition after obtaining a certification from a physician and an identification card issued by the Pennsylvania Department of Health. Medical marijuana may only be issued to an individual or an individual’s caregiver who has received the certification and identification card. Medical marijuana may not be smoked and may only be dispensed in certain enumerated forms.
Access to a nurse’s personnel file became a key issue in a recent PA medical malpractice wrongful death and survival action. In Snyder v. DeCesare, the Court of Common Pleas of Lackawanna County considered whether plaintiffs were entitled to disclosure of the personnel file of defendant Heather Shingler, RN. Plaintiffs alleged that their unborn child died in utero due to negligent fetal monitoring by the nurse, who was subsequently terminated from her employment with defendant Moses Taylor Hospital.
Plaintiffs sought a court order to compel production of the nurse’s personnel file, alleging a nexus between her termination of employment and her alleged negligent fetal monitoring. Defendants claimed there was no connection between the two events. Also, Nurse Shingler denied that her termination was related to the facts alleged in this case.
Industry stakeholders, contractors, and industry associations recently provided testimony at an OSHA public hearing regarding reinforcing steel and post-tensioning standards. As reported by The Ironworker, the rationale for pursuing new standards is:
- The current OSHA standard written in 1971 is antiquated and only contains three references specifically pertaining to reinforcing steel and two for post tensioning.
- Common hazards during reinforcing steel installation and post-tensioning operations are not addressed in current standards.
- Fatality and accident trends indicate a direct correlation between accident causation factors and lack of specific regulations.
- The usage of steel reinforced and post-tensioned poured-in-place concrete is expected to double.
- The negotiated rulemaking process will produce the best safety standard and regulations through the cooperative efforts of OSHA, stakeholders and experts in the reinforcing steel and post-tensioning industry.
Protecting members during reinforcing steel activities is part of the “2017 Zero Incident” campaign. The goal of the campaign is to pursue safety standards that will prevent workplace incidents. Key safety provisions of the proposed OSHA standards pertain to reinforcing steel and post-tensioning standards and prevention of structural collapse during the hoisting process of walls and columns. The proposed text of the standard is available here.
On March 10, 2017, the Accreditation Council for Graduate Medical Education (ACGME) announced that first-year doctors will be allowed to work 24-hour shifts in hospitals starting July 1, 2017. The cap that has limited shifts to 16 consecutive hours of patient care since 2011 will be lifted. The 80-hours-per-week cap remains in place.
Balancing the logistics of physician training with the safety and needs of patients has been the subject of controversy and debate for decades. According to a recent article in the New England Journal of Medicine, the debate centers on the concern that longer hours mean less sleep and sleep-deprived residents might make errors. However, that is countered by other concerns about shorter work hours resulting in more patient hand-offs that could affect patient care.