Michigan Supreme Court throws out huge malpractice verdict

[Joe]

Go Michigan!

LANSING, Mich. - The Michigan Supreme Court on Friday tossed out a $21 million medical malpractice verdict against a Dearborn hospital, saying the jury had no basis for deciding that a doctor's error caused a baby to develop cerebral palsy and other neurological problems.

The court, in a 6-1 ruling, overturned the judgment and ordered a lower court judge to enter a verdict in favor of Oakwood Hospital in Dearborn and the doctors involved. Justice Marilyn Kelly dissented.

A Wayne County jury awarded the $21 million verdict in 1997, after Kimberly Craig sued, alleging her son, Antonio, then 13, was born with brain damage that left him a quadriplegic.

The jury agreed with Craig's argument that the hospital used too much of a labor-inducing hormone and failed to adequately monitor Antonio's fetal heart rate.

But the court faulted Wayne County Circuit Court Judge Carole Youngblood for not granting the hospital an evidentiary hearing to determine whether the testimony of an expert witness should be admitted.

"There was no evidence from which the jury could infer that plaintiff's present neurological disabilities were caused by a breach of the applicable standard of care," the court wrote.

The hospital and Dr. Elias Gennaoui argued the expert's theory of what causes cerebral palsy was novel and not accepted within the medical community.

Craig's attorney, Mark Silverman, said Friday he was "very disappointed" with the ruling. Silverman, also a doctor, declined to comment further, saying he hadn't spoken with Kimberly Craig.

Barbara Erard, who represents Oakwood Hospital, said the decision ensures that only reliable, well-founded expert testimony is put before juries.

The testimony of one of Craig's experts, she said, "was really speculation dressed up in the credentials of an expert."

Other defendants in the cases included Detroit's Henry Ford Hospital, which bought the administrative part of Associated Physicians. The clinic employed four obstetricians, including Gennaoui.

The court said the trial court was wrong to make Henry Ford liable because only the clinic's medical portion is potentially liable for medical malpractice.

The court's ruling came a day after it threw out a $21 million sexual harassment verdict against DaimlerChrysler, calling the award "excessive."

And that's after they junked a 21 million dollar sexual harassment award, too. We need this court in every state!

[Master of Ossus]

Ah, yes. It seems that the courts are finally realizing the flaws in John Edwards' old cases.

[Howedar]

John Edwards was not in any way affiliated with this case.

[Master of Ossus]

John Edwards was not in any way affiliated with this case.

His specialty was cerebral palsy cases. Apparently the courts have finally figured out that the doctors aren't responsible for such problems.

[Darth Wong]

Does this mean the doctor gets off scot-free for giving a pregnant mother an overdose of labour-inducing hormone?

[EmperorChrostas the Cruel]

Scott free of WHAT?
Giving to much of a drug to a patient by accident, resulting in NO measurable damages to anyone? Malpractice isn't a criminal matter. You sound like you want him locked up!
As far as scott free, WINNING a case like this is bad enough. In man hours of time , energy and trouble, this doctor has already been through the wringer.

And for WHAT? An honest error that most likely resulted in no harm? Standard medical theory says it wasn't the doctors fault the kid was a paraplegic. Standard medical theory says NOTHING bad happened to either party as a result of this accidental overdose.
That's all we have to go on, so where is the civil case?

Sometimes bad shit just happens, and every dead or flawed child isn't the direct result of a doctor's error. MORE harm results from the cover your ass, by the book, take no risks method forced by the lawsuits changing the medical system. More women actualy die as a result of the over use of C sections than babies are "saved".
All surgery is a risk, and more surgery means more deaths. Not to mention the money draining effect this has on the medical system. Or the shortage of OB Gyn specialists, further increasing the risk factor.

The desire to "punish," or get compensation for normal bad luck or human error actualy increases the misery factor, in aggregate.
Legal lotto.

[Master of Ossus]

Does this mean the doctor gets off scot-free for giving a pregnant mother an overdose of labour-inducing hormone?

Pretty much, since no damage was done. I've bumped people's cars before and not done any damage to them. Should I have been allowed to get off scot-free for doing that?

[Tsyroc]

The physician doesn't get off entirely scott-free. There are state organizations that keep track of complaints against physicians so if people are looking for a physician the information on complaints is available for them.

You can also bet that winning this case has not helped the physician's mal-practice premiums at all. There are a lot of states in the US where it just isn't worth it anymore for physicians in the higher risk areas to bother practicing anymore because they are paying a quarter million dollars or more in insurance premiums each year.

[Darth Wong]

Scott free of WHAT?

Criminal negligence. Serious professional incompetence. Stuff that matters to a lot of people.

Giving to much of a drug to a patient by accident, resulting in NO measurable damages to anyone?

Don't be an imbecile. To say that there was insufficient evidence to nail somebody in court is NOT proof that there was no damage. The lack of studies on hormonal overdoses among infants does not prove that there is no damage; it only proves that there is insufficient evidence to determine that there is damage, and that there is certainly insufficient evidence to declare that a particular syndrome such as CP was definitely caused by the mistake.

And for WHAT? An honest error that most likely resulted in no harm? Standard medical theory says it wasn't the doctors fault the kid was a paraplegic. Standard medical theory says NOTHING bad happened to either party as a result of this accidental overdose.

I would like to see those studies showing that hormonal overdoses during delivery of a baby can be definitively said to have zero effects whatsoever on the child.

[EmperorChrostas the Cruel]

Asking me to prove a negative, tisk tisk.
The burden of proof is on the accuser. Show harm!
Standard medical theory states no harm was done, or did you miss that part?

Professional incompetence isn't a matter for criminal law, and for it to be criminaly negligent, it must be far outside the normal standards and practices, or an error so egregious it presents an obvious danger. It wasn't.

[Alyrium Denryle]

Don't be an imbecile. To say that there was insufficient evidence to nail somebody in court is NOT proof that there was no damage. The lack of studies on hormonal overdoses among infants does not prove that there is no damage; it only proves that there is insufficient evidence to determine that there is damage, and that there is certainly insufficient evidence to declare that a particular syndrome such as CP was definitely caused by the mistake.

CP IIRC is a genetic condition it isnt caued by an overdose of hormones during birth.

[Darth Wong]

Asking me to prove a negative, tisk tisk.

Employing a blatant strawman, tsk tsk.

The burden of proof is on the accuser. Show harm!

Actually, the burden of proof is on YOU here, since you went beyond showing that the accuser failed to meet her burden of proof in this case (something I already acknowledged in case you suffer from severe reading difficulties, which seems to be the case), and YOU ASSERTED THAT ABSOLUTELY ZERO HARM WAS DONE by this breach of standard of care. Since there is considerable medical evidence to indicate that an overdose of hormones is NOT FUCKING HEALTHY FOR ANYONE, much less a newborn infant, and your statement goes far beyond anything that was established in the case or stated by witnesses, YOU bear the burden of proof for YOUR statements.

BTW, "no harm" is not the same as "a phenomenon does not exist", moron. Drug companies are required to prove that there are no dangerous side-effects associated with a drug ALL THE FUCKING TIME. This is not a "proving a negative" scenario.

Standard medical theory states no harm was done, or did you miss that part?

WRONG, moron. The article stated only that IT COULD NOT BE LINKED TO CEREBRAL PALSY. I await your evidence that cerebral palsy is the only conceivable form of harm that could be caused by a hormone overdose to a fucking infant.

Professional incompetence isn't a matter for criminal law, and for it to be criminaly negligent, it must be far outside the normal standards and practices, or an error so egregious it presents an obvious danger. It wasn't.

Irrelevant, you blustering twit. I never said he should be necessarily put in JAIL, and in fact, the original court case was a matter of CIVIL law in the FIRST PLACE. There is a difference between saying "it probably didn't cause his CP" and "it did NO HARM WHATSOEVER". All I said was that SOMETHING should be done about this.

In engineering, a professional can lose his license for professional malpractice even if his breach did not hurt anyone. Are you suggesting that medical practitioners should be held to a lower standard?

[Illuminatus Primus]

Does this mean the doctor gets off scot-free for giving a pregnant mother an overdose of labour-inducing hormone?

If the overdose of the labour-inducing hormone has no negative side-effects, there are no damages to reemburse for, and there should be no lawsuit.

Quite frankly cerebral palsy cases are a major malpractice fraud in this country and makes being a practicing Ob/Gyn almost financially unteniable due to ridiculous insurance on malpractice.

In Florida the risk is so bad that the legislature decided that all doctors must pay a fee to the government to be redistributed among cerebral palsy children's families, in spite of the cause or even the doctors in question. In other words, an oncologist will pay money to a family due to the fact they had a malformed baby on no fault of the doctor.

[Illuminatus Primus]

I should clarify, if no damages can be demonstrably shown as a direct effect of the hormone, he shouldn't be charged.

Whether that actually means the hormone cannot cause harmful effects, however minor, is not what I meant to argue.

And Mike is quite right. M.D.'s regularly have their license to practice revoked for professional negligence, even after winning malpractice courses.

[Darth Wong]

Does this mean the doctor gets off scot-free for giving a pregnant mother an overdose of labour-inducing hormone?

If the overdose of the labour-inducing hormone has no negative side-effects, there are no damages to reemburse for, and there should be no lawsuit.

For the third fucking time, I ALREADY ACKNOWLEDGED THAT. But it does not mean there should be no consequences. It is my opinion that the doctors' associations in North America have increasingly become insular and are more interested in protecting their members than the public, with whom they feel they are at war. While they should nominally discipline this guy, there have been numerous cases in which doctors have gotten away with shocking amounts of malpractice before being disciplined.

[Illuminatus Primus]

That does not mean there should be no consequences. It is my opinion that the doctors' associations in North America have increasingly become insular and are more interested in protecting their members than the public, with whom they feel they are at war.

I think I'll need something better than "Craig's feeling" that the hormone was an overdose. Did you know most cerebral palsy cases develop after fetal distress during labor? Perhaps this was detected and the doctor made a decision to try to deliver the baby more quickly. And furthermore, if science never determined a correlation between negative health effects on the baby (beyond the possibly lesser and thus more acceptable risk in light of possible stillbirth or cerebral palsy in a slower labor), than why should the Ob/Gyn take that into consideration? Because it might just possibly have undiscovered complications?

[Darth Wong]

I think I'll need something better than "Craig's feeling" that the hormone was an overdose.

Read the article again. The court concluded that based on the evidence presented, the hospital DID negligently administer a hormone overdose. The only question is how much harm it did, and the plaintiffs failed to show to the court's satisfaction that the negligence in question was responsible for the child's CP. For the umpteenth time, that does not mean the people responsible for the mishap should go laughing and dancing off to the fjords.

[Master of Ossus]

For the umpteenth time, that does not mean the people responsible for the mishap should go laughing and dancing off to the fjords.

I completely agree that the hospital should pay for its mistake (ie. face sanctions, etc.), but I totally disagree that a $20 million+ pay out is the way to do it. Huge payoffs like that are consistently damaging health care in the US, which is why we should have an oversight committee or some other regulatory body with the capability of sanctioning doctors and hospitals that don't do an adequate job without damaging the ability of legitimate health care professionals to do their work properly.

[Darth Wong]

For the umpteenth time, that does not mean the people responsible for the mishap should go laughing and dancing off to the fjords.

I completely agree that the hospital should pay for its mistake (ie. face sanctions, etc.), but I totally disagree that a $20 million+ pay out is the way to do it.

The "lottery lawsuit" is a distinctly American phenomenon, and I am not in any way supporting it. But something must be done, and I have begun to lose faith in the self-regulation of medical practitioners. I've seen too many cases of doctors who make a serious mistake and then, rather than being drummed out of the profession or suspended, they merely move to a new district, like a Catholic priest looking to leave the scene of the crime.

[Stormbringer]

I've seen too many cases of doctors who make a serious mistake and then, rather than being drummed out of the profession or suspended, they merely move to a new district, like a Catholic priest looking to leave the scene of the crime.

And this was, according to the medical evidence a harmless mistake. Exactly why is it that we should drop the hammer on that?

[Darth Wong]

I've seen too many cases of doctors who make a serious mistake and then, rather than being drummed out of the profession or suspended, they merely move to a new district, like a Catholic priest looking to leave the scene of the crime.

And this was, according to the medical evidence a harmless mistake.

Wrong; it was ruled that it was not responsible FOR THE CHILD'S CEREBRAL PALSY. It was never stated that it was completely harmless. How many fucking times do I have to repeat this?

Exactly why is it that we should drop the hammer on that?

For the same reason that an engineer found negligent can face professional discipline even if no one gets killed: high professional standards of conduct are essential to the public trust in the profession, and ultimately the public welfare when the profession in question is crucial to aforementioned welfare.

[Stormbringer]

Wrong; it was ruled that it was not responsible FOR THE CHILD'S CEREBRAL PALSY. It was never stated that it was completely harmless. How many fucking times do I have to repeat this?

Frankly, unless there's some evidence that it was harmful in any other way the point stands. It was apparently a harmless mistake.

For the same reason that an engineer found negligent can face professional discipline even if no one gets killed: high professional standards of conduct are essential to the public trust in the profession, and ultimately the public welfare when the profession in question is crucial to aforementioned welfare.

And an honest mistake that causes no harm requires drumming some one out why?

[Darth Wong]

Wrong; it was ruled that it was not responsible FOR THE CHILD'S CEREBRAL PALSY. It was never stated that it was completely harmless. How many fucking times do I have to repeat this?

Frankly, unless there's some evidence that it was harmful in any other way the point stands. It was apparently a harmless mistake.

So you reject all of the medical evidence that hormone overdoses or even long-term low-level exposure can be harmful?

For the same reason that an engineer found negligent can face professional discipline even if no one gets killed: high professional standards of conduct are essential to the public trust in the profession, and ultimately the public welfare when the profession in question is crucial to aforementioned welfare.

And an honest mistake that causes no harm requires drumming some one out why?

I already explained why. Please address my response rather than mindlessly repeating your question.

[BlkbrryTheGreat]

So you reject all of the medical evidence that hormone overdoses or even long-term low-level exposure can be harmful?

Hormones are nothing more then a specific pattern of protein, they work via a "lock" system found only on the designated receptor cells and only produce effects within those cells. With most hormones, an overdose won't have the damaging effects you're implying. The ones that do, such as the adrenal hormones (ephonphrin and neuraephonephrin), do so for very obvious reasons.

As for long term low level exposure to hormones being harmful.... You're a fucking idiot if you think that. Your body makes many hormones naturally and your cells are exposed to "low level" doses of them daily. Did it somehow escape your notice that you're exposed to testosterone on a daily basis?

[EmperorChrostas the Cruel]

As BlkbrryTheGreat states, only a select few hormones will hurt you with a short term overdose. These ones directly relate to short term metabolic changes, kicking you into "fight or flight" mode. (It should be noted that the amphetmine family are very similar chemicaly to adrenaline, but just different enough to be bypassed by the body's norman blood filtering. That is why speed lasts so much longer than fear or anger.) The emergency action hormones are very quickly filtered out of your blood, as they are for short term use only. There are specific mechanisms in the kidneys and liver to quickly metabolise these short term ones, while the others have mechanisms for reintroduction to the blood, (like with many minerals and vitamins) so you don't lose the precious things, by pissing them out as fast as you can make them.
I can tell you from personal experience, that when artificialy elevating your testoserone levels, (Taking anaboloic streoids) it takes close to two WEEKS before they start affecting you. You body naturaly excreets exsesive hormones rapidly, and it takes days to have the hormones enter the cells and change their behaviour.

Case and point, if you ate 5 complete monthly packs of birth controle pills, you would piss them out within 48 hours, long before they would whack up your metabolism. (No growing breast overnight, or lactating) That's why hormone treatments require once or TWICE daily dosages, over time. If you ate a 6 month supply of Dianabol, it would be sewer water withing two days. No heart attacks, no turning green and growing huge muscles.

It is very doubtful that the hormone in question, being a labour inducing one, would have any effect measurable on a non pregnant person.
Given the timeline involved, the infants body couldn't have absorbed enough into the cells, (rather than merely in the bloodstream) to effect ANY changes.
Not having either a uterus, or the birthing reflex, just what is a small spike in that hormone lasting less than 48 hours going to DO anyway? It won't be in the blood long enough to go into the cells.


As to Wong's "high professional standards of conduct," medicine can't be compared to engineering the way he wants it.
When a part fails, a bridge collapses, or gun explodes injuring or killing someone, there is a failure of design, manufacture, use, or material, or the part wouldn't fail, and no one would be dead. Even if no one is hurt, the flaw is still a preventable one through testing, and quality controle.

Medicine is different, in that you can do everthing right, and the patient will STILL die, or get worse through no fault of the doctor.
That is the key here. medicine works on bodies that we only parlty understand, and with key unknown varables that simply are not there when building a bridge or car.
EVERY patient is unique, in many ways both important, and irrelavant to treatment. The crapshoot is, until you try the treatment, you mostly don't know if there is something like being alergic to pennicilin, that you CAN'T anticipate. Until you have a bad reaction, you probably won't know you are alergic to something as common as peanuts.
The level of professional standards he wishes for is somewhere down the road, knowledge wise.