OccupyTheED

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So much as the title of this thread implies, I'm being sued. Brand new attending as of one month ago, its for a case that happened at the end of my PGY III year. Got served with the papers during my first shift at my full time job while in the middle of stabilizing and transferring a massive ICH on coumadin. Has anyone else here been sued while in training? Anything I should be doing aside from my talks with risk management? I trained at a state institution so I'll be represented by the attorney general's office. Unfortunately can't discuss the specifics of the case given the active litigation.
 

Vandalia

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Basically you do nothing. That is what the lawyers get paid to handle. The state's lawyers will let you know where/when any depositions will take place. That is it.
 

Rendar5

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I was served papers in my 3rd year of residency for a case from my 2nd year. Also state-run institution. 4.5 years later I was finally dismissed from the suit (as were several other residents involved in the case), leaving only the attendings to deal with it in court. It does suck and it does mess with you in the head for awhile, and you do have to explain it to all future jobs until dismissed. But the state itself does hve sufficient resources and I was in the distant background of the case the entire 5 years. I spoke with the state only once or twice in those years to go over teh case and to review my charts. I luckily didn't even end up testifying. Hopefully the same happens for you (in less than a 5 year time span hopefully)
 

Rendar5

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I was served papers in my 3rd year of residency for a case from my 2nd year. Also state-run institution. 4.5 years later I was finally dismissed from the suit (as were several other residents involved in the case), leaving only the attendings to deal with it in court. It does suck and it does mess with you in the head for awhile, and you do have to explain it to all future jobs until dismissed. But the state itself does hve sufficient resources and I was in the distant background of the case the entire 5 years. I spoke with the state only once or twice in those years to go over teh case and to review my charts. I luckily didn't even end up testifying. Hopefully the same happens for you (in less than a 5 year time span hopefully)
 

WilcoWorld

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I was named as a respondent in a case I saw as a PGY-2. Eventually I was dropped, but up to that point the plaintiff's attorney kept the option open to name me as a defendant - mainly as a way of making sure I'd show up to depositions.

My advice is to be honest and cooperative (but self-interested). Unless you went directly against your faculty or went way off the reservation, it's highly unlikely you'll "loose" the case. They're probably just naming everyone on the record in hopes of finding something that will stick.

Good luck!
 
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Angry Birds

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Unless you did something egregious, don't sweat it. It's part of the game unfortunately.
 
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OccupyTheED

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Thanks for the replies all. I think medically my attending and I did the right things for the patient in question and it definitely meets the standard of care. Just a little un nerved by it all. @Jlaw no they didnt get back to the patient care office but they found their way to administration where I was paged overhead multiple times after 4 calls to the unit secretary stating that I needed to get down there emergently. The fact that I was caring for a critical patient at the time apparently doesn't mean much lol. Score another one for administrators understanding the day to day of an ER doc.
 

swamprat

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I know of one resident that graduated from my program that was named in her 3rd year. I don't necessarily know if this is true or not but I was told that they usually stay away from interns but as you get more senior as a resident your chances of being named as a resident in a case increase exponentially.
 
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Stabilizing a massive ICH on Coumadin?

Sounds like that person was dead. Shouldn't have even transferred them.
 

Birdstrike

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So much as the title of this thread implies, I'm being sued. Brand new attending as of one month ago, its for a case that happened at the end of my PGY III year. Got served with the papers during my first shift at my full time job while in the middle of stabilizing and transferring a massive ICH on coumadin. Has anyone else here been sued while in training? Anything I should be doing aside from my talks with risk management? I trained at a state institution so I'll be represented by the attorney general's office. Unfortunately can't discuss the specifics of the case given the active litigation.
Unfortunately, all of us either have been, or will go, through this and likely more than once in a career. Read something I wrote not too long ago on the subject: http://epmonthly.com/blog/it-didnt-feel-like-a-win/

I'll be writing Part 2, in a few months, if you know what I mean. Lol.

Bottom line: Welcome to the club. You're in good company. And you're a good doctor. You're just caught in the middle between two lawyers fighting to get money from an insurance company. That's all it is. Win or lose, it will have no lasting effect on your life, ability to work, or financial status, other than to possibly harden you a little bit and make you a little more cynical. Hopefully not too much, though. Whether you win the case, lose, settle or get dropped, it makes no difference. Stay positive and welcome to the big leagues. You're not alone.
 
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BAM!

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Whether you win the case, lose, settle or get dropped, it makes no difference. Stay positive and welcome to the big leagues. You're not alone.
Can you clarify this some more? Seems like it could make a difference if you lose. Especially depending on the award and future job opportunities.
 

Vandalia

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Can you clarify this some more? Seems like it could make a difference if you lose. Especially depending on the award and future job opportunities.
This is the biggest myth of younger physicians and those in residency. I have been on hiring committees and have been making hiring decisions for close to 20 years. (And years before that working with the JAG and DoJ as liaison for military malpractice cases.) Let me tell you, NO ONE cares about your malpractice record. Unless you are losing 20 cases a year, I and those who I have worked with over this time frame have paid no attention to how many malpractice cases you have, or if you won or lost them.

Now some people are concerned about losing a case for above their malpractice limits. This might have happened once or twice in the US this century, but it is incredibly rare. Your malpractice carrier has a duty to make a settlement offer within policy limits. Now, you may have also heard that in the "American system" each side is responsible for their own attorney fees. There are a couple of exceptions to this, and one has to deal with "offers of settlement." Lets say that your insurance carrier makes an offer to settle for $250K, and the plaintiff rejects it. Then the jury comes back with a judgement for the plaintiff in the amount of $200K. On the surface, it looks like the plaintiff won this case. However, in this scenario, the PLAINTIFF will be required to pay the defendant's attorney fees since they rejected a settlement offer and then received a less favorable judgement. Since the malpractice insurance companies attorney's fees are probably more than the amount awarded by the jury, the plaintiff's lawyer (if they are on a contingency basis) could end up not only being out their costs, but also stuck with a six-figure judgement against them. The bottom line is that a settlement offer is almost always accepted by the plaintiff. Especially since there is little money in them trying to recover anything past settlement limits anyways.

I have a general principle that I have lived by: I don't care what people who I don't respect say about me. I don't care that some attorney who knows nothing about medicine thinks that my care was negligent. I also don't care what a jury of "12 people so dumb they couldn't get out of jury duty" think about the care I delivered. Finally, I don't care what anonymous "reviewers" on the internet think about me. I do know physicians who get all tied up in knots about this kind of stuff. I think they are idiots and have told them that to their faces.

So to summarize: Unless you are getting 20 suits a year, or the suits are linked with another problem (you faked your residency graduation, or you have a substance abuse problem) no one cares about them when it comes to hiring.* It is also incredibly rare for a judgement to come back above policy limits. (If it does, you will have a good case against your malpractice insurance carrier.) Yes, you can point to a case or two where it happened, but there are also cases of someone getting $1M because the sun flashed off your watch-face and caused them to run into a pre-school. Finally, don't worry about what idiots say about you. You will be much happier.

*OK, like the above judgement jury verdicts, there are probably a hospital or two out there with a low-level employee who might screen these out, but it is rare, and when they are found out, they are usually fired. But the general principle still holds, it is incredibly rare, and you probably wouldn't want to work there anyway.
 
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OccupyTheED

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@canigetawhatwhat yeah, I don't anticipate that she was going to do well. But she was completely functional until the head bleed, pretty well educated family that understood what the prognosis was and wanted to give it a shot. So I wasn't gonna not resuscitate her, and we dont have neuro or neurosurg in house. I'm not a believer in the "half-resus". Either I'm doing nothing and calling it or I'm gonna do a full resus/stabilization. The other side of this that I didn't really consider as a resident 2 months ago is what my medical director looks back and sees: a chart where I did nothing against a family's wishes and a bunch of complaints OR a chart with 3 procedures and 90 minutes of critical care time documented

@Birdstrike Good read. I look forward to writing my own in due time. One of the most eye opening experiences I had was serving on a jury in a medical case. Some of these scumbags, I mean lawyers, can be pretty convincing to a jury of people who know nothing about medicine.
 
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WilcoWorld

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Stabilizing a massive ICH on Coumadin?

Sounds like that person was dead. Shouldn't have even transferred them.
The manufacturers of KCentra, the FDA and my Neurosurgery consultants would appear to disagree with you.

Which is not to say that you're wrong...
 
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OccupyTheED

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@WilcoWorld got the INR back after the fact, turns out it was only 1.8. By that time she had already gotten 5000 units kcentra and 10 of vitamin K, amongst a host of other things. But yeah, grade IV IVH not gonna do well no matter what I did or didn't do.
 
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aProgDirector

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ONe thing to know is that these processes take a LONG time. Expect this to take over 5 years to resolve. There will be month (or year) long spans where nothing happens (that you can see). The slow pace is one of the most frustrating parts -- most people just want it decided one way or the other.
 
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Birdstrike

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Can you clarify this some more? Seems like it could make a difference if you lose. Especially depending on the award and future job opportunities.
Good answer by Vandalia, above. I can't really improve on his/her post. In summary, it makes little difference if you win or lose a case, except maybe to your own ego, if you allow it. Winning or losing doesn't reverse whatever bad patient outcome occurred to trigger the whole case. It's already happened and done, for better or worse and money changing hands won't reverse any poor medical outcome that I've ever seen.

You really should think of yourself as being there to help your insurance company not lose a lot of money. Don't think of it as them coming to help you defend yourself. It's not really. Because if you lose, they pay, not you. So, it's really them losing, not you. You're there to testify well to help them not get soaked for lots of money, more so than them being there to defend your pride or malpractice "record," if it even makes sense to call it that.

Also, like Vandalia said, there is some number where you're such an outlier in the number of cases brought against you that no one wants to touch you, but as he said its a hell of a lot closer to double digits, than it is to one or two, or even 5. Why? Because we all get sued eventually, we all know how warped the system is and how it's mostly about money and attorneys cashing in on bad outcomes, and little if anything to do with policing and maintaining quality practice standards.
 
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The White Coat Investor

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I received a notice of claim for a patient I saw in my first month of residency. Then I received another one for a patient I saw in my second month of residency. Taken off both relatively early. Nothing since. But I'm sure it affected my psyche and style of practice, for better or for worse.
 

gro2001

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I haven't been sued (yet), so maybe my faux wisdom is completely useless, but maybe framing this somewhat differently could help.

We often worry whether externalities, like being sued or having to settle a stupid claim, or have judgements made against us, mean we are bad doctors. Of course they don't, we tell each other, but often when you are the one being criticized, you still suspect it might not be quite true and people are just saying that. But consider the inverse: if your worst fears were true, and you were actually a truly bad doctor, should winning a case/successfully convincing a lawyer to drop it/whatever make you feel like a great doctor? If not, then why should being sued make you feel like a bad one?
 
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gro2001

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This is the biggest myth of younger physicians and those in residency. I have been on hiring committees and have been making hiring decisions for close to 20 years. (And years before that working with the JAG and DoJ as liaison for military malpractice cases.) Let me tell you, NO ONE cares about your malpractice record. Unless you are losing 20 cases a year, I and those who I have worked with over this time frame have paid no attention to how many malpractice cases you have, or if you won or lost them.

Now some people are concerned about losing a case for above their malpractice limits. This might have happened once or twice in the US this century, but it is incredibly rare. Your malpractice carrier has a duty to make a settlement offer within policy limits. Now, you may have also heard that in the "American system" each side is responsible for their own attorney fees. There are a couple of exceptions to this, and one has to deal with "offers of settlement." Lets say that your insurance carrier makes an offer to settle for $250K, and the plaintiff rejects it. Then the jury comes back with a judgement for the plaintiff in the amount of $200K. On the surface, it looks like the plaintiff won this case. However, in this scenario, the PLAINTIFF will be required to pay the defendant's attorney fees since they rejected a settlement offer and then received a less favorable judgement. Since the malpractice insurance companies attorney's fees are probably more than the amount awarded by the jury, the plaintiff's lawyer (if they are on a contingency basis) could end up not only being out their costs, but also stuck with a six-figure judgement against them. The bottom line is that a settlement offer is almost always accepted by the plaintiff. Especially since there is little money in them trying to recover anything past settlement limits anyways.

I have a general principle that I have lived by: I don't care what people who I don't respect say about me. I don't care that some attorney who knows nothing about medicine thinks that my care was negligent. I also don't care what a jury of "12 people so dumb they couldn't get out of jury duty" think about the care I delivered. Finally, I don't care what anonymous "reviewers" on the internet think about me. I do know physicians who get all tied up in knots about this kind of stuff. I think they are idiots and have told them that to their faces.

So to summarize: Unless you are getting 20 suits a year, or the suits are linked with another problem (you faked your residency graduation, or you have a substance abuse problem) no one cares about them when it comes to hiring.* It is also incredibly rare for a judgement to come back above policy limits. (If it does, you will have a good case against your malpractice insurance carrier.) Yes, you can point to a case or two where it happened, but there are also cases of someone getting $1M because the sun flashed off your watch-face and caused them to run into a pre-school. Finally, don't worry about what idiots say about you. You will be much happier.

*OK, like the above judgement jury verdicts, there are probably a hospital or two out there with a low-level employee who might screen these out, but it is rare, and when they are found out, they are usually fired. But the general principle still holds, it is incredibly rare, and you probably wouldn't want to work there anyway.
This response is what SDN is all about. Thank you for sharing.
 

swamprat

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Bumping an old thread. Got served papers from a case when I was a newly minted PGY2. I am a co-defendent with a bunch of other physicians. Do I contact my malpractice carrier (that i had at the time i was a resident) via phone and let them know? I'm assuming they will want a fax of the textbook of papers/documents that was sent to me. Anything else I should do?
 

southerndoc

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More than likely they already know about it. Usually when an attorney requests certified records, the hospital will give the malpractice carrier a heads up (they know who your malpractice carrier is since it's required for credentialing) or they will forward to their in-house legal team (more likely this is the case since you were a resident). Nonetheless, you should reach out to the hospitals legal department.

*** DO NOT DISCUSS THE CASE WITH ANYONE, INCLUDING ANONYMOUSLY ON THE NET (LIKE THIS FORUM). ANYTHING YOU DISCUSS CAN BE DISCOVERABLE AND ADMISSIBLE *** I cannot emphasize this enough. Too many docs get sued and like to ask their colleagues for second opinions, if they did anything wrong, etc. or they email details of the case to their malpractice carrier/representative. The details of the case should ONLY be discussed with your assigned attorney. The attorney can discuss it with the malpractice carrier, but not you.
 
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VA Hopeful Dr

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More than likely they already know about it. Usually when an attorney requests certified records, the hospital will give the malpractice carrier a heads up (they know who your malpractice carrier is since it's required for credentialing) or they will forward to their in-house legal team (more likely this is the case since you were a resident). Nonetheless, you should reach out to the hospitals legal department.

*** DO NOT DISCUSS THE CASE WITH ANYONE, INCLUDING ANONYMOUSLY ON THE NET (LIKE THIS FORUM). ANYTHING YOU DISCUSS CAN BE DISCOVERABLE AND ADMISSIBLE *** I cannot emphasize this enough. Too many docs get sued and like to ask their colleagues for second opinions, if they did anything wrong, etc. or they email details of the case to their malpractice carrier/representative. The details of the case should ONLY be discussed with your assigned attorney. The attorney can discuss it with the malpractice carrier, but not you.
Worth mentioning that you can discuss it with your spouse and be OK
 
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migm

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I wonder what they expected you to do for the patient? She must have had a little trauma as 1.8 is sub therapeutic.
i think the coumadin bleed was the contemporaneous patient whose care was being interrupted by the OP getting served papers from a prior case. The details of the prior case are not (and should not be) available
 
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OccupyTheED

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Bumping an old thread. Got served papers from a case when I was a newly minted PGY2. I am a co-defendent with a bunch of other physicians. Do I contact my malpractice carrier (that i had at the time i was a resident) via phone and let them know? I'm assuming they will want a fax of the textbook of papers/documents that was sent to me. Anything else I should do?
Nothing to do for now. Update to my original post, its been two years from me and aside from a brief conversation with my assigned attorney no updates. People weren't kidding when they said this is a slow process. Try not to sweat it too much.

I wonder what they expected you to do for the patient? She must have had a little trauma as 1.8 is sub therapeutic.
Update on this patient, shockingly she actually did really well and had a nearly full return to baseline functionality. Unfortunately she expired 18 months after from an unrelated illness (ironically I took care of her that time as well) but her family was really grateful for the extra time they got to spend with her.
 

dchristismi

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I got served all the time at my old gig... To the point that the process server and I joked around quite a bit, but she always waited until I had a minute (and it never took more than a minute.) Now, these were all testifying for the state, usually in sexual assault cases, sometimes child abuse. When I knew I'd be leaving, I made sure they had my home address.
 
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BoardingDoc

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Unless the heart, kidneys, and corneal were melted off by coumadin, ya, I'd transfer
Depends on the bleed. Is it a big IPH but not a ton of shift? KCentra, BP ctrl, +/- keppra depending on the type of bleed (and your local neurosurgeon's preference) and go. Fixed pupils and massive herniation on the scan? No transfer. CMO. Call family. Call NSGY to review images and confirm this plan if you're concerned.
 
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I was sued for a case in residency. They were really after the admitting cardiologist. I was dropped and got a free trip back home for the deposition. But it was a pain, and jobs (crappy jobs- the good ones never seem to care) did ask about it.
 
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I'm a little rusty, but at least in Texas the limits you could sue for were much lower.