Supreme Court To Reconsider Lawsuits Against The Military

[frostfire]

Originally Posted by craigepo

Question: Is there any sort of review of medical care in the military at present, specifically concerning a hypothetical report of substandard care?

http://www.jointcommission.org/
WAMC had to go through this a few months ago.

Had discussion about this with the ACLS director some time ago. Fear of lawsuit and losing license cause some to not go when Code Blue is called.
This is why I prefer to work downrange. There's so many moving variables (swiss cheese model) that are simply lawsuits waiting to happen.

I'm not going to second guess what happened, but in SF, CA nurses are allowed to put advanced airway? Was the nurse the only available personnel?Is a failed attempt worse than no attempt? The fear of doing something wrong may lead to doing nothing. Then what, lawsuit for pt abandonment. It's a lose-lose situation

In OBGYN, parents can sue any perceived mishaps during delivery until the child turns 18. I concur, once the law is changed, the flood of lawsuits might as well put military to bankcruptcy

[wook]

I think we need to be careful when we use the term "standard of care". Standard of care is a legal term not a medical one. It is decided by a particular jury about care a particular patient received at a particular time. I'm sure the lawyers can explain this more in depth, but our various specialty organizations recognize that "Guidelines" are created for a more standardized and evidence based approach to patient care. These same organizations also recognize that it is not posssible to develop a "cookbook" approach to every situation and patient.

Thanks.


Wook

[scooter]

Originally Posted by craigepo

"Standard of care" is a relative term. A paramedic in a ditch is not held to the same standard of care as a physician at the Mayo Clinic.

This serviceman died from an appendectomy. Let me say that again: this serviceman died from an appendectomy. No brain surgery, no bullet wounds. This is a procedure that is usually done with a freaking scope. He was not in a warzone MASH hospital---he was stateside. Moreover, he didn't die from surgery complications. He died because the people in charge of his care failed to maintain his airway, which caused braindeath. Is there anybody here who didn't learn the necessity of maintaining an airway? "ABC's"? Hell, this is taught during EIB training. And nurses and physicians in a stateside Air Force hospital can't get this done?

There is a bill that has been brought before Congress with the following provisions: The measure would allow lawsuits on behalf of military personnel who are killed or injured by medical malpractice. It contains an exception for combat-related injuries and requires that any paid claim be reduced by the amount of any other government compensation resulting from the injury.

I am attaching a link to the article, so that you might read some of the comments from former service members who have had some horrendous care.
http://hamptonroads.com/2009/05/serv...st-malpractice

If the Supreme Court would allow these suits to be brought, the would have to be filed under the Federal Tort Claims Act. These tort claims are different than state law claims. A few of the differences are: 1) the plaintiff has no right to a jury trial, so damages are determined by a judge; 2) the plaintiff's attorney's fees are maxed-out at 25%; 3) the statute of limitations is very short.

Like many of you, I am quite hesitant to open the litigation floodgates on this issue. However, if servicemen are dying because nurses and physicians in stateside military hospitals are so inept that they can't maintain an airway, something needs to be done.

I'm not denying that there have been specific instances of horrible medical care in military treatment facilities, and I understand the desire to hold doctors and nurses accountable for their actions, but I still disagree with this.

Military doctors have leeway right now to provide care that is not considered propper in civilian circles, or has not been approved by the FDA. Pulmanary bypass machines for blast lung patients going from Balad to Germany for example. Or the use of Factor VII for hemmorhage control, which has been effective but isn't FDA approved. Fentanyl lollipops for combat pain control are designed for cancer patients; the military uses them off-label and without FDA approval. The FDA has actually tried to stop that particular practice at one point.

Hell even the heavy use of early touriquet use advocated in the Haagman-Butler paper was heavily criticized in civilian circles, before the data from the Iraq war backed up their ideas.

Subjecting the military to Federal Tourt Law would put a giant chill in every doctors spine who has great ideas that arent FDA approved, but work. Any one of those ideas would be cannon fodder to any competent trial lawyer, regardless of whether they First Did No Harm or not.

[Richard]

Originally Posted by frostfire

I'm not going to second guess what happened, but in SF, CA nurses are allowed to put advanced airway? Was the nurse the only available personnel?

Coulda been a Nurse Anesthetist.

Richard

[alright4u]

I ask as some of us have been appointed as investigating officers for tragic deaths.

I vividly recall being the investigating officer after a rapelling death in late 69-early 70. I was a CPT in A CO 6th SFGA just trying to do my job and get the facts plus prevent any future such deaths. A fine SFC fell some 75 feet from the chopper with nothing but a loose rope. He fell to his death. I had the FM out and asked all the NCO's if the rig was right? Hell, the safety officer for C or D Company was a 2LT. I could not really say any man screwed up as the rope just came loose from the doughnut ring. Obviously someone screwed up, but; SF training is not 100% safe, never has been, and; I do not think ever will be. The man had a 27 year old wife. He was a 28-29 year old SFC. I did my job, sent the report to the Group CO, then I heard nothing.

That was like the investigations we did when a USSF RT man was KIA and the INDIG scattered to the wind only to be found the next day later on. I can only state I am no man's judge.

[The Reaper]

Lawyers will make money.

Politicians will get some money from the lawyers to make their jobs easier/more lucrative.

Some military doctors might make more money, but there will be fewer and they will be harder to get.

A few patients/families will make money.

More military lawyers will have to be hired to handle these cases.

There will be less money for soldier medical care as a result.

Taxpayers will lose out, guaranteed.

TR

[PRB]

Originally Posted by The Reaper

Lawyers will make money.

Politicians will get some money from the lawyers to make their jobs easier/more lucrative.

Some military doctors might make more money, but there will be fewer and they will be harder to get.

A few patients/families will make money.

More military lawyers will have to be hired to handle these cases.

There will be less money for soldier medical care as a result.

Taxpayers will lose out, guaranteed.

TR

Agree, the 2/3rd order of effects on this would be catastrophic for Military medicine

[alright4u]

Once the door is opened, claims will creep into other areas of military life then just medical. At present the VA allows 100% ratings for men who were given substandard medical treatment and were further disabled under the Federal Tort Claims Act.

An extremely well educated man was left with a serious staph infection by the VA after lumbar spine surgery. He is required to use oxygen the rest of his life. All he could get was 100%. He does not complain. He already had a PH or two.