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A new study in the American Journal of Infection Control found that 15% of our nursing homes received poor marks for controlling infection.

Things are a little dirty. Okay. So what? The “so what?” answer makes you do a double take: infections kill 400,000 nursing home residents each year.

It is important to make clear that due diligence from the nursing home would not have changed the outcome for the vast majority of these people. Still. That is an incredible stat. The Internet provides so much great information but one of the great downsides is statistics are more meaningless than ever, even good statistics. If an unassailable study came out that said kids who have first names starting with the letter “S” scored 200 points higher on the SATs, people would start naming their kids Sarah and Steve for a few weeks and then everyone would forget about it.

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DEA agents tell a Maryland doctor he can no longer prescribe medication. As they are leaving he shouts:

Your mothers wanted you to become physicians and because you didn’t, they are mad at you. So you are mad at physicians and are arresting all physicians in the area.

Later, things get weird and the doctor’s wife puts him in a full Nelson.

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My understanding of Maryland law is that doctors do not have to consent to settle before the insurance company can make a settlement offer, absent specific policy language giving them that right. (I say “my understanding” because I really don’t know the source. It could be the “Law of Ron.” But I think that is right.)

Either way, I think the point is largely moot in Maryland. Med Mutual, who insures most Maryland doctors, seems to require the doctor’s assent to settling a malpractice case. It it not a bad policy – it is a doctors’ owned insurance company. Most doctors pushing Med Mutual to stick its chest out likely have enough coverage. No one is usually so bold with their own assets on the line.

A lot defendant’s malpractice lawyers use this as a faux means of not pursing settlement discussions before a pretrial. But I know we have tried at least one case because the doctor did not want to settle out of fear which we think was out of fear that Med Mutual would drop him.

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Plastic surgery malpractice cases are extremely difficult to win not because malpractice in plastic surgery is rare but because it is incredibly difficult to prove. We have never taken a plastic surgery malpractice case and probably never will.

So credit is due to a New Jersey plaintiffs’ medical malpractice lawyer who won a jury verdict in an eye surgery case. The case involves a blepharoplasty, eyelid surgery that basically makes your eyes look younger.

Defendant’s medical malpractice lawyer showed the generosity of spirit for which malpractice defense lawyers are known, when he pointed out in a statement after the verdict that the woman had plastic surgery on 10 previous occasions. What exactly is this lawyer’s point? You just lost a case – a zero offer case, by the way. After getting beat, do you really have to go after the plaintiff? What exactly is the point that is made here? She had 10 good procedures so what is one bad one? She should not be getting more plastic surgery? Than why did this doctor agree to do it? Oh, who cares? The important thing was to try to publicly embarrass the Plaintiff. Well, then, mission accomplished.

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I’m a big fan of the law of unintended consequences. Here’s one: better medical care because of a bad economy.

Why? I’m glad you asked. The economic downturn has helped the quality of nursing. During good times, every nurse (and their mother) was selling real estate on the side or involved in some other economic opportunity that provided economic growth. So nursing vacancies were high. In today’s economy, nurses are losing those opportunities and are retreating to the hospitals and nursing homes, which increased the number of full-time permanent nurses. This is cheaper for the hospitals and allows them to be choosier about the nurses they pick, immediately improving patient care.

Does a bad economy really decrease incidence of medical malpractice? I don’t know. I’ll leave that to the Freakanomics guys and their progeny. I just think this is interesting.

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Explore Baltimore County writes about a bill introduced by a doctor who is in the Maryland House of Delegates that says, in effect, that if a doctor says he or she is ‘sorry’ for a medical outcome, that apology would be inadmissible in a Maryland courtroom.

I just looked for the bill. I couldn’t find it. But how much do you want to bet me that that is not what “in effect” it says? Instead, if doctors explain exactly how the malpractice occurred and they deny it later, the fact that they have completely changed their story in front of perhaps multiple witnesses is excluded. How is that fair? The idea that the purpose of this bill is to allow doctors to say “Hey, I’m sorry for your loss” is just plain inaccurate.

There is no question in my mind that this bill is well-intentioned. It obviously sounds like a good idea. In fact, there is evidence that patients and their families benefit when doctors fess up and admit medical malpractice. So let’s just move on. Let’s go all George Bush and just go with our gut. Apology = good.

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Premises liability claims make up 8% of nursing home cases. So while these claims are “nursing home cases” in one sense, they are really premises liability cases in nursing homes. This may come with nursing home specific fact patterns, but they are still premises liability claims.

You can get an overview of premises liability claims on our website.

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Both lawyers and laypeople have misconceptions about the application of the wrongful death cases. Making matters more complicated, we now have different rules in medical malpractice cases than we do in accident or other tort liability death rules.

On our website, we are making a continuing effort to explain the nuances of wrongful death/survival actions in Maryland.  This page provides an overview of wrongful death survival actions in Maryland and contains a lot of links to other subcategories of interest. If you think there is something we should add to this, let us know.

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Maryland enacted a self referral law in 1993 to help decrease the costs of health insurance and medical care after concerns that Maryland doctors would order unnecessary testing if they had a financial stake in ordering the testing. I think this was a problem with few doctors, but as we saw with the St. Joe’s stent debacle; it does not take many doctors to create a real problem for patients. Accordingly, Maryland-Self Referral Law prohibits any self-referral or any arrangement which has the practical effect of a self referral.

Where there is radar, there is usually a radar detector. I don’t mean that necessarily in a sinister way, but doctors are looking to make a profit like anyone else. It does not necessarily mean they plan to order unnecessary tests, but if they see a chance to make byproduct business, many doctors want to take that opportunity.

In Potomac Valley Orthopaedic Associates, et al. v. Maryland State Board, doctors appealed a ruling by the Maryland State Board of Physicians forbidding orthopedic doctors from referring patients for an MRI to a facility that is owned or leased by the orthopedic group in which the doctor holds a financial interest.

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