Malpractice bill would require disclosure of medical errors

By Carol M. Ostrom
Seattle Times staff reporter

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OLYMPIA — It's been more than a year since his 31-year-old fiancée went to the hospital to deliver their third child and ended up with grave injuries, but Chris Mirisciotta says he still doesn't know exactly what happened.

It took a lawsuit, more than 70 depositions and more than $200,000 worth of investigative work to find out that her anesthesiologist had a drug problem. His fiancée, Kim Jones, is now in a persistent vegetative state.

Filing a lawsuit against the Richland hospital and the doctor was "the only way we found out what happened," Mirisciotta told a state Senate committee yesterday.

Mirisciotta spoke on behalf of proposed legislation to require doctors and other health-care providers to inform patients or their families when mistakes result in harm.

Hospitals would be required to designate a specific person to tell patients and their families about "adverse incidents." The bill, SB 6209, says such conversations would not be construed as admission of liability, and it would exempt them from being used as evidence in lawsuits.

Malpractice measures Several committees in the House and Senate are hearing bills addressing issues related to medical-malpractice insurance premiums, including patient safety, insurance reform and civil-liability reform. Among them are bills that would: • Allow hospitals to more freely share information. • Protect whistle-blowers who report unprofessional conduct or medical errors by providers. • Evaluate the effectiveness of health-professional-disciplinary systems. • Give providers more notice when an insurer cancels policies. • Establish a supplemental malpractice-insurance program to help doctors, hospitals and other providers purchase "excess coverage" (the governor's budget includes $10 million of "seed" money). • Require (or allow) health providers to tell patients about medical mistakes and prevent the admission from being part of a lawsuit. • Limit noneconomic damages, such as pain and suffering, in medical-malpractice lawsuits. • Require mediation of disputes For more information: www.leg.wa.gov/wsladm/bills.cfm

The bill is one of more than two dozen being heard this short session to attempt to address issues related to medical malpractice. They include provisions that would reform insurance regulations, place limits on liability in civil lawsuits and address patient-safety issues.

What doctors say — or don't — about medical errors has long been a sore subject among many patients and their families, researchers say.

Dr. Thomas Gallagher, an assistant professor of medicine at the University of Washington who has studied the disclosure of medical errors, says patients expect far more information than doctors generally provide. Patients expect not only information and an apology but emotional support, Gallagher said.

"Physicians want to apologize to patients when harmful medical errors occur but worry that doing so might increase their legal liability," Gallagher said.

Sen. Alex Deccio, the chairman of the committee, said he, too, had run into the problem. When his wife spent 84 days in a hospital a year ago, "I had to be my own detective, my own lawyer, to ferret out what happened," he said at the hearing.

Judy Massong, president of the Washington State Trial Lawyers Association, who spoke in support of the bill, said patients who come to lawyers' offices to commence lawsuits often say: "I don't want it to happen to anyone else," and, "No one said they were sorry; no one told me (what happened) — I had to spend my time and money to find out."

While SB 6709 focused on disclosure of medical errors, many doctors are focused on rising medical-malpractice premiums.

For two years, doctors have hammered this home to legislators, saying if they don't pass limits on jury awards for pain and suffering in medical-malpractice lawsuits, increasing premiums will force doctors to leave the state or the practice of medicine altogether.

The Washington State Medical Association has threatened legislators with tough re-election battles if they don't support caps on noneconomic damages.

Democratic leaders in the House, however, say they won't go for caps because they penalize the most vulnerable patients and they don't address the real issues.

Deccio, despite his own experiences, said he was skeptical that any of the bills would solve the issues involving medical-malpractice insurance premiums or lawsuits.

Though a bill that would require doctors to talk to patients "makes you feel warm and fuzzy," said the veteran lawmaker, the problem is complex and requires solutions that address the underlying issues. "I don't want to take an emotional approach," he said.

At the heart of the issue, Deccio said, are medical errors themselves.

"The medical profession has a lot of soul-searching as to how to deal with medical errors," he said. "I don't think the medical profession is policing its own ranks as well as they should be."

Copyright © 2004 The Seattle Times Company