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DOCUMENTS


The Tentacle


January 30, 2004

Malpractice Makes Perfect

Norman M. Covert

As I was climbing back up to the keyboard in search of a suitable discussion topic for The Tentacle, the subject of “Tort Reform” was right there in front of me: it’s those big and little puncture marks on my arms, hands and legs which have almost healed. They are the remnants of modern medical care, which gives me the hope of living a bit longer.

The President of These United States discussed tort reform recently and the topic seems timely and relevant.

(He is the same President George W. Bush whom the trash-mouthed, jealous Democrats hate with such a passion that they have lost track of what America has stood for these past 227 or so years. I haven’t heard such vitriol since the Watergate hearings. What losers!)

Our President commented that lawyers are receiving their 40 percent fees; patients often owe more than the awards; medical insurance companies are having to pay outrageous jury awards; doctors are beginning to look for less expensive locales in which to practice; or searching for careers in other than medical specialties.

We read the first local installments in the doctors vs. lawyer’s brouhaha from a Frederick Memorial Hospital bed during Christmas Week. The front page of the Frederick News-Post reported the professional midwives, who were associated with Dr. Gerrit Schipper’s OB/GYN practice, had lost their home, effective at the end of December.

This came as a big blow to large group of Frederick’s population of child-bearing women. These outstanding midwives delivered two of my granddaughters and treated their mothers with skill and compassion. Now the question is where, when and how will they be able to resume their caring work?

The reason the midwives lost their home was simply that the medical office could no longer pay the huge insurance premiums, which had increased dramatically for 2004. The insurers said the large number of medical malpractice suits filed had simply pushed the cost of doing business out of sight and doctors would have to make up the difference.

Thus the gauntlet was thrown down by Maryland doctors, who say with great conviction that they can barely afford to stay in practice because of insurance premiums. The respected urologist Dr. Robert Crouch admitted on Blaine Young’s Saturday morning radio show (WFMD-AM) that he pays almost $100,000 in annual premiums. Dr. Crouch coincidentally had been acquitted of wrongdoing by a court in recent days.

I wasn’t in my den or the old Blue Ridge News reading more of the back and forth from doctors and lawyers, whose competing letters and op-ed pieces pointed fingers of blame. I read the news, avoiding the tubes attached to me, as I lay on gurneys in the hallways of Frederick Memorial Hospital. My discomfort with the news matched my frustration that FMH had no available beds that day, and neither for a short time did Washington Hospital Center, which had graciously fitted me into the cardiac catheterization, schedule.

Finally back home, I read about the doctors scheduling a rally to urge the General Assembly to enact tort reform, limiting payouts to victims of medical malpractice.

The day following the Annapolis rally, I was perchance in the examining room with my cardiologist, whose best previous efforts to diagnosis my problems nearly one year ago had missed three cardiac blockages. He explained how I was one of those patients for whom the routine testing failed (again) to reveal that one of my bypasses had died, apparently within weeks of the surgery in March.

We could now explain why I wasn’t getting better on the exercise apparatus at “FMH at the ‘Y.’” Apparently through the intervention of God (don’t tell me He doesn’t exist), exercise, diet and proper medicines I didn’t keel over for nine months.

The cardiologist remarked at FMH that he had learned from the previous experience with me when the tests swore I had the heart of a young athlete. He ordered an ultra sensitive test that revealed a miniscule elevation in cardiac enzymes. That was enough to justify sending me back to Washington Hospital Center (WHC), where the flagellating, failed arterial bypass was discovered, the coronary artery cleaned and a metal “stent” inserted to help keep the blood flowing freely.

It’s amazing how much better I feel, excepting the beating I took from needles and other foreign objects, which coursed through my arteries and heart with such abandon. Technology is great, but the procedure has about a 10-15 percent chance of failure within three to six months. The doctor warned that I must remember exactly how the pain coursed across my chest, neck and arms, because the emergency docs at FMH initially diagnosed me with atypical chest pain. Atypical, that’s me.

So once again I’ve learned just how medicine is sometimes a game of chance. Again I depended on the knowledge and the skill of Dr. Anantha Rao to manipulate the catheter from an opening in the femoral artery, insert the contrast dye, analyze the entire heart, specifically the coronary arteries and the three bypasses, determine the problem, discuss it with a surgical associate and with a groggy me, then take action to fix it.

Any number of problems could have occurred, including my allergy to the contrast dye. A dose of benedryl before and after the procedure solved that problem. It was critical that I not bend my leg for at least four hours after the procedures to ensure the seal didn’t rupture in the femoral artery. The level of care at WHC was wonderful. A patient in the next cubicle was difficult to awaken and a crisis team did lots of hands-on to ensure his well being and bring him to consciousness.

Surgical teams do make mistakes and patients pay the price, but I cannot believe that a surgeon would be intentionally careless. I remember seeing my surgeon in pre-op last March and seriously asking “How is your energy level, are you feeling strong and alert?”

“I’m pumped and ready,” he said with all sincerity. He had my life in his hands and I trusted God and the surgeon.

My primary thinking is that medical victims deserve a reasonable award for expenses incurred, pain and suffering and something in the way of a punitive payoff to punish the guilty medical practitioner. However, even I can see that some of the awards from well-meaning juries are way out of line. I agree with the President that lawyers seem to be the only winners.

I suppose I could find a lawyer who is willing to represent me if I felt my surgeon was not competent and perhaps failed to properly secure the mammary artery that failed as a bypass. The other two bypasses appear to be working great, fully engorged with blood, so I guess two-out-of-three isn’t bad.

Maybe I have a case against the hospital for forgetting they were supposed to discharge me before noon, but realized their error just in time for my wife to bring me home via 270 in Friday rush hour traffic at 5 p.m.

But, the nurse practitioner said, “You have been such nice people….“ I’m a sucker for that any time.



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