“Have you ever been sued?”

 

…inspired by a friend named in two law suits for patients he never met.
Every credentialing hospital and malpractice insurer asks this question. Technically, I still check “no,” but spiritually, the answer is different. Most pivotal moments in life aren’t planned or predicted, and neither was my week in front of a jury in 2006.

In 2004 a young man I’ll call Mr. A arrived in the emergency department at around 4am. I was the attending working with a resident and an intern. Every formal space in the 25+ bed ER was occupied, so Mr. A was triaged to a hall stretcher among others. He was involved in a rollover car accident, but was conversant and had been walking at the scene.

I was in damage control mode, roving from bed to bed just to get people off backboards and medicated. I saw Mr. A within 20 minutes, requested a head CT, neck and back X-rays, and some pain medication. We got him off the backboard properly, and moved on to the next patient. CT and X-rays were eventually done and viewed by a radiologist. At some point Mr. A described the sensation of lost feeling and strength in his arms and legs. By 7am his exam had worsened significantly, and I asked the oncoming senior resident to make Mr. A his first patient.

The resident walked to radiology and noted that the night radiologist had read the X-rays as normal, but because of Mr. A’s deterioration, we ordered an MRI and called neurosurgery. My replacement arrived and I signed over the ER. During sign out we were informed that the radiologist had misread the X-ray and that there actually was a serious injury, a broken neck. Shortly afterwards I went home exhausted, but feeling relieved for having seen, X-rayed, and medicated Mr. A early on.

The next night I was told that Mr. A had gone for his MRI around 3pm, and then to surgery around 9pm that night. He would likely be a quadriplegic. I felt terrible for him, but at least comfortable I’d done what I could.

Malpractice Insurance Professional Liability

Fast-forward a year. Whenever your boss says “hey do you remember a case when…” the hairs on your neck usually get sharp. Apparently this case was being reviewed for malpractice. While I wasn’t personally named, my recollection would be critical for the defense. More months passed before I was deposed.

Yet another year passed and the case remained unsettled. It turned out that a jury trial was a possibility. I was told the hospital had gone to trial only twice in the five years prior, and this would be number three. The plaintiff’s lawyer represented a large fraction of the hospital’s malpractice cases at that time, and this was a chance to fight back.

I was told that someone is typically chosen to represent the defense, and in this case they chose me. I would be the University’s face. In retrospect, it was a good strategy from their perspective. It’s easy for a jury to find guilt in a corporate entity, or the big county hospital, but more difficult when the accused has a face and damp eyeballs. So I spent a week listening to remarkably high paid medical experts from around the country accusing me of everything from malpractice to deceit to fraud. (For one part of the chart I used black ink, and completed the chart on a different day in blue ink. This was considered evidence that I’d falsified the chart. We countered with “What kind of idiot uses another color pen to falsify a record?”)

A number of times between witnesses the plaintiff’s lawyer, Mr. S, taunted me with statements like “you really don’t like me do you,” or “you know, you really do remind me of my son.” I just stared. I went running in the wee hours each night of the trial through the frozen dark to settle my mind, while plotting some sort of verbal revenge.

The plaintiff’s expert ER doc from Chicago also got my stare. It amazes and even frightens me what thoughts went through my head. He was a true slime ball. I still have a visceral anger when I think of him and other doctors who choose to make massive revenue this way. The plaintiff’s neurosurgical expert was a little different. He hadn’t practiced neurosurgery for 2 years because, bizarrely, he had suffered his own neck injury and was now making a living as a medical expert. He approached me and offered a feeble apology. I gave him the benefit of a nod.

After a week of quietly stewing I finally took the stand. My hands trembled and at first I could hardly speak. The coaching beforehand just amplified my anxiety. As the questions came my way though, I felt more at ease. When the examination ended I went back to my seat. One of my colleagues left the courtroom crying. However, our defense lawyers seemed positively buoyant, and I could feel my rage dissipate which was surprising.

Before any verdict, but after all the interrogations I recall standing in the hall as Mr. S walked by. I had a list of parting shots for him, but from somewhere else came this: “Whatever it’s worth, if you show up in the ER, I’ll still take care of you.” He thanked me, and I’ve never seen him again.

The jury found no negligence and no malpractice. A party ensued at my house and I got handshakes and high fives on my next shifts. The hospital VP wrote me a letter of congratulations. The department paid me $3,000 for my troubles. But despite the celebration, the back of my mind kept saying: “Congratulations… Sam – 1, Quadriplegic – 0.”

Subsequent shifts were miserable, and I could picture every chart expanded to courtroom wall size from that point on. Within 3 months I resigned and my path changed course.

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