Blog bringing news about cerebral palsy related litigation

If you live in New York State and are planning to have a baby, there are certain counties you should stay away from: Essex, Greene, Seneca, Tioga, Washington, Yates, Schoharie, and Hamilton. According to the Center for Health Workforce Studies, these 8 counties don’t have obstetricians. Another of the Center’s alarming findings: 18 counties in N.Y. State have fewer than 5 ob-gyns. If this continues, women may soon start asking: who will deliver their babies? And lest you think this is strictly a problem that affects the “Empire State”, over 1,500 counties in the U.S. don’t have a single obstetrician.
Fact: While it has never been a safer time to have a baby, it has never been more dangerous to be an obstetrician. During the last four decades, medical innovations like ultrasound and fetal heart rate monitoring devices have revolutionized the field of obstetrics, and other advances have virtually eliminated potentially devastating fetal medical disorders. This has resulted in a dramatic drop in debilitating diseases that had once been the predictable result of complicated pregnancies. These technological advances have reversed the potential threat to the health of new born children which might have occurred given the fact that an increasing number of women are having children at an age which is much older than their mothers and grandmothers.
The down side is the negative statistics for professionals in the field of Obstetrics care. Fact: The American College of Obstetricians and Gynecologists recently released a study which determined that approximately 90% of the obstetricians have been sued at least once in their careers. A decade ago the statistic was 75%. No l;ess disheartening to those beginning their professional careers, nearly 40% of obstetrical residents are forced to defend at least one claim filed against them while they are training. It is no wonder then that nearly 65% of ob-gyns decided to change their professional specialty due to the fear of liability claims or litigation.
The most common cause for malpractice lawsuits against ob-gyns is brain damage to infants, specifically in the occurrence of cerebral palsy. Although it sounds very cynical, especially given the fact that few cases of cerebral palsy are in any way even remotely connected to the birth process, but families who have a C.P. child will inevitably have substantial financial needs, for medical care, therapy, and other services for their special children. And since options for outside financial assistance are limited, it should come as no surprise that such families seek assistance from the courts. Most experts agree that there is very little that can be done to prevent cerebral palsy and at best all that can be done can result only in minimizing some of the risk factors in a very small percentage of cases. That accounts for the rate of caesarean deliveries in the U.S. which has soared over the last three decades partially due to the defensive tactics that doctors have been taking in an attempt to avoid birth related malpractice suits.
But unfortunately the rate of caesarean births 30% in 2005 nearly 5 times the rate in 1970 has not helped reduce the numbers of C.P. births – approximately 1 in every 500 births. The courts have become like a lottery for medical injury victims. Very few win large amounts, but most receive nothing. According to the Harvard Medical Practice Study based on data gathered from New York hospitals, there is no judicial reward for most birth injuries. Even where the plaintiffs are successful, nearly 60% of the money won will go to pay administrative costs such as lawyers, expert witnesses and many other costs, leaving the patients and their families the balance.
So we are now not surprised that the number of ob-gyn’s is rapidly decreasing throughout the U.S. at an alarming degree. Since obstetricians face liability for brain damage outcomes that they are powerless to prevent, this raises medical malpractice premiums, and it creates an environment which is distinctly unfavorable for doctors caring for pregnant women. Thus, a high percentage of obstetricians are opting out of the practice and fewer medical school graduates are pursuing ob-gyn as a specialty.
A case in point is the story of Dr. Ronald Uva, a member of an obstetrics group and chief obstetrician at the local hospital in Oswego, N.Y., who has dekivered over 7,000 babies in his 30 years in practice. According to Dr. Uva, “It is almost impossible for me or my colleagues to continue to practice obstetrics. I tried to stop practicing at age 55 to spend more time with family, but my group could not recruit a single obstetrician and my partners would have had to work every other night in the hospital. My group is still trying to recruit. No luck — not one decent candidate. There are really no obstetricians for hire. Also, high medical liability rates make it almost impossible for me to give care to the underserved.”
The consensus is that New York’s citizens and physicians should be better off than this predicament allows. One solution currently being discussed is a program jointly financed by insurance and public support which would provide wide-ranging monetary benefits to all eligible children who suffer from neurological injuries, based on an approach similar to worker’s compensation. This program would remove these cases from the judicial system.
It would work in the following way. Instead of filing a claim in court, all eligible families could obtain monetary assistance from this administrative system. To insure the efficacy of the system, oversight would be provided by reliable and independent experts, who would determine a rational process for awarding benefit payments. Every child would undergo case management evaluation in order to determine the level and degree of assistance that each family’s entitlement. Once determined eligible, the children would gain access to the services they required for the rest of their lives.
The program would also have a very decisive educational and disciplinary component. It would address patient safety (a task traditionally assumed by the courts), and would perform a detailed review of the competence of the medical care in each case. Where instances of malpractice were uncovered, those responsible and found negligent would be disciplined according to a set of established guidelines. The end result would be to provide the necessary teaching and education to all obstetrical caregivers in the state
This approach could actually distribute compensation more equitably on a state-wide basis to more children, more quickly and efficiently as is the case in Florida and Virginia which have similar programs. Programs in those two states have already reduced the costs of birth-related injuries. Administrators are convinced that granting this type of financial support will result in significant savings in the future. More important, it will also provide a lifetime of vital medical, social and other services to these needy children and will substantially reduce doctor’s insurance premiums and ultimately improve the quality of medical care throughout the state.
Legislation intended to begin formulating this type of program has already been introduced in the State Senate in Albany during the past session. It is now up to our elected officials to endorse this rational proposal and finally bring a sense of order to the obstetrics health care providers and to the families in the State of New York.