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Md. lawmakers revisit malpractice laws

March 10, 2005|by TAMELA BAKER

tammyb@herald-mail.com

ANNAPOLIS - If legislators thought they had settled Maryland's medical malpractice crisis in January, the flock of physicians testifying before a Senate committee Wednesday left little doubt that they had not.

Testifying in favor of a bill to further reform Maryland's medical malpractice liability laws, most said they were grateful that the General Assembly approved the Maryland Patients' Access to Quality Health Care Act of 2004 - but only as a first step in dealing with the crisis.

That piece of legislation, vetoed by Gov. Robert Ehrlich after a special session of the legislature in December but overridden in January, created a stop-loss fund to protect physicians from having to pay significantly more for their malpractice liability insurance this year than last year. The fund will be funded by a new 2 percent premium tax on health management organizations.

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That measure didn't go nearly far enough, said Carol Ritter, an obstetrician/gynecologist from Towson, who told the Senate Judicial Proceedings Committee she delivered her last baby in December 2003 and refused to practice obstetrics after that date because her malpractice insurance was about to rise to 80 percent of her revenues.

The last malpractice bill may have stabilized insurance rates, Ritter said, "but they were stabilized at a rate that was already too high."

"I can tell you it wasn't enough because I'm still not practicing OB," she said.

She said the state is seeing few residents willing to specialize in high-risk medicine, and the few insurance companies willing to offer malpractice coverage were threatening to leave the state.

Michelle Gourdini, deputy secretary of public health for the Department of Health and Mental Hygiene, told the committee that the number of doctors restricting their practices "has led to growing access problems, particularly in rural areas."

In all, 37 witnesses registered to testify for the bill; nine registered to testify against it. Four of those represented the Maryland Trial Lawyers Association, but five told personal stories.

Catherine Reuter-Lake, of Boonsboro, told the committee that her mother, also named Catherine Reuter, was hospitalized in Washington, D.C., for a heart problem. After surgery, she had breathing complications and was being prepared for a tracheotomy, but was severely burned on the right side of her face and back when vapors from an alcohol-based solution ignited.

After a number of treatments, infection and complications, she was transferred to Western Maryland Hospital Center in Hagerstown, Reuter-Lake said. Problems with her white blood count prompted personnel there to send her to Washington County Hospital, where she died in December just days before she was to be discharged. Reuter-Lake said her mother's death was being investigated.

Reuter-Lake's husband, Mitchell Lake, is an emergency medical technician and firefighter for Fairfax County, Va. He told the committee that his mother-in-law's injuries at the Washington hospital were the result of "a fire in an operating room caused by a ... surgical team." The problem with the new malpractice bill, he said, is that "there's nothing to enforce the standard of care."

He said he believed Maryland's malpractice crisis was caused by "a continuing deviation from the standard of care" and a lack of discipline for bad doctors.

Their experience prompted Mitchell to hatch plans for an organization to promote responsible medicine, he said.

"It is never about patient safety that's where these doctors made their mistake" in promoting malpractice law reforms.

Hagerstown surgeon Karl Riggle, president of Save Our Doctors Protect Our Patients Inc., said patient safety initiatives are being developed at Washington County Hospital, and were included in the malpractice bill the General Assembly approved in January.

It provides that factual findings by the Board of Physicians must be by a "preponderance of the evidence" rather than the previous requirement of "clear and convincing evidence" - which makes it easier to prove malpractice.

It also provides for funding for hospital safety initiatives and imposes a fine of up to $5,000 on hospitals or related institutions for failing to report a disciplinary action against a doctor.

Riggle submitted written testimony documenting the number of Washington County physicians who had left - or were contemplating leaving - or who were restricting their practices because of the malpractice crisis.

While the state has dealt with what he called "a short-term economic issue" with the previous legislation, "we have not changed the perception doctors have of targets on their backs."

The new bill would tighten requirements for expert witnesses, set new caps on awards in malpractice cases and allow for structured payments of awards.

Riggle said it's probably not perfect, but that he sees it as a vehicle to get at least some of the reforms he believes are needed.

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