> an autopsy that could have indicated whether there had been medical malpractice associated with her death was “rendered impossible”, according to the lawsuit
This is just horrible but I’m not surprised since I have read so many stories of malpractice recently, from the skull flap thing to the Texas hospital triple booking surgeons to other stuff
A lot of hospital care is done by residents with surgeons overseeing and stepping in for the most difficult parts.
Our healthcare system would literally collapse without residents doing the heavy lifting. It won’t change until we stop artificially limiting the supply of doctors or give mid level practitioners more power.
Yep professional medical organizations and universities are causing this artificial supply limit to benefit those who are already practicing and part of this ecosystem.
Without claiming the two systems have the same limiting factors, the UK health system is also struggling, and there the staff shortage is the government's limits on (1) how many spots universities have, (2) immigration.
This is despite health in general, and the HNS in particular, being a major source of interest for the electorate.
Alternatively (or also) pay scales and emigration. There are doctors leaving for Australia (which advertised golden handshakes & Australian lifestyle in the UK to UK doctors) and nurses for better pay/conditions in private care facilities; it's not (just) a supply of trained people at source issue.
Salaries are also much more compressed than in North America - UK junior doctors generally earn more than NA residents, but then not that much more (maybe 4-5x from lowest to highest, not >10x to reach hundreds of thousands) as consultants (attendings). Locum pay & additional private work can make up for some of that, but probably not all, and I assume similar could be done in NA if you wanted to earn more (or open their own practice, pharma sponsorship, etc.)
It's probably true in general (relatively compressed salary ranges) actually, not just in medicine.
What the Canadian government does isn't as important as the (now previous) UK government telling foreign doctors to keep away while also not offering enough local people the opportunity to train to make up the difference between supply and demand.
The UK government has no power to keep people in (though my own departure shows they could do a better job of not making people want to leave in the first place), but it does have power over the other two.
In Texas, three hospitals (Baylor St. Luke’s Medical Center (BSLMC), Baylor College of Medicine (BCM) and Surgical Associates of Texas P.A. (SAT)) agreed to pay $15m as part of a settlement with the DOJ. These doctors/surgeons were booked for multiple simultaneous procedures that they could not have possibly conducted, even though they recorded things to make it look like they conducted all the surgeries. In reality many procedures were performed by unqualified residents and other caretakers and not who the patient was told would be performing the procedure.
> To make it seem as if the teaching physicians were present during the "entire" operation, they would lie on medical records, the court filings say. The medical staff also would not tell patients that the surgeon planned on leaving the room to perform another operation, the documents continued.
This only came out because of a whistleblower, and because the DOJ pursued it. It is nearly impossible for a patient to know if they are wronged or harmed this way because they are put under for these procedures, and because friends/family are typically not allowed to observe or record anything (likely to prevent accountability). And then there’s the cost of lawsuits, the stress, and limitations under law (like tort reform in Texas) - it’s just lucky that this was pursued by a government agency (DOJ).
> Under the False Claims Act, the private whistleblower who reported the allegations will receive over $3 million from the settlement, the Justice Department said.
We need more incentives like this, but we also need greater penalties and jail time for the practitioners and literally everyone who knew. They should be investigating who was in the room, what was recorded in logs, and who accessed records, and go after all of them. Right now, this settlement achieves nothing. Some articles claimed that these hospitals made more than $150 million off these procedures for which they are settling the lawsuit for just $15 million.
Texas also has "tort reform", limiting you to a maximum of $250k in damages. Good luck suing a big hospital for malpractice, you gotta pay the lawyer too out of that $250k.
The cap applies to actual damages, specifically non-economic actual damages such as pain and suffering, mental anguish, and loss of companionship. It does not apply to economic actual damages such as lost wages and medical costs.
Before tort reform punitive damages were already capped in Texas at a value twice the amount of economic damages plus the amount of non-economic damages, so tort reform does also have a effect of sometimes reducing punitive damages.
On average, a medical malpractice case might require anywhere from 500 to 1,000 hours of legal work, with more complex cases potentially requiring over 2,000 hours.
Average lawyer cost in 2022 was $313/hr.
So we're basically looking at, generously, 750 hrs x $300, or $225k to the lawyer.
And that's just one side - the hospital presumably pays near the same.
... Huh.
Once again, I am stunned at the American legal system being so obviously and cartoonishly evil.
Texas is probably limiting malpractice suit damages because they are a significant contributor to our insane healthcare costs. The math above where a hospital is out a minimum of $200k for any suit that isn't thrown out is not restricted to Texas; this is a national issue with some Texas duck tape slapped on.
They are more likely limiting malpractice suit damages because hospitals and clinics donate to political campaigns, but people hurt by medical malpractice don't.
The end result is that doctors are essentially lawsuit-proof (as the minimum cost of a suit exceeds the maximum possible recovery) in Texas, and you have no recourse if yours was at fault.
That’s a good argument for it that I didn’t think of. But I can’t help but think this was likely just some business friendly thing that was lobbied for under the misleading label of “reform”
It's amazing how many stories like this come out of the U.S. Normally, one can say "you get what you pay for" but what American hospitals charge for this level of quality is so expensive compared to other countries.
Basically they had to cut into someone’s skull as part of a surgery. They did not label and catalog skull parts properly. Because they lost the skull part they had to use a synthetic skull flap, and they charged the patient for it. The synthetic flap caused an infection. The patient was on the hook for something like $150K for all of this (the synthetic part, the procedure of placing it, the infection) which was due to the hospital’s own criminal negligence. An investigated showed that the hospital was not properly labeling and cataloging parts for many patients and basically had a mess of random skull parts that would not make their way back to all those patients, so it is a systemic issue and not just an unfortunate one off mistake. All of this is alleged and there is a lawsuit pending, but it seems to me like the part about a systemic issue of mishandled parts is confirmed.
I'm just imagining some refrigerator in the nurse's breakroom with a big fiesta bowl of what looks like odd tortilla chips with a Post-In note labeled "skull bits do not eat".
This is truly horrifying and also illustrates a massive incentive problem. The hospital probably made money through its negligence (until the inevitable lawsuit)
This crosses into criminal liability.