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Medical Malpractice Insurance Crisis in West Virginia a Result of Economic Cycle, Doctors Who Err, Study Finds

Jan. 23, 2003

Medical Malpractice Insurance Crisis in West Virginia a Result of Economic Cycle, Doctors Who Err, Study Finds

Public Citizen Report Details True Causes of Malpractice Crisis in West Virginia

CHARLESTON, W. Va. – The medical malpractice insurance crisis in West Virginia is not caused by the legal system but cyclical economics, according to a Public Citizen report released today. Frequent medical mistakes and a lack of doctor oversight and discipline jack up costs, are inhumane and threaten the quality of health care in West Virginia, the report concludes.

At a press conference held to unveil the report, Public Citizen President Joan Claybrook also released a letter from Public Citizen to the West Virginia Board of Medicine, asking the board to investigate 20 doctors who have lost or settled five or more medical malpractice cases but who have never been disciplined. One doctor settled 40 malpractice suits in four years; another settled 36 malpractice suits in two years.

“If medical boards are unwilling or unable to seriously discipline doctors with multiple malpractice payouts, the terrible human and financial costs will continue to lead to preventable deaths and injuries,” Claybrook said. “These repeat offenders are a significant factor in the malpractice situation facing the state today.”

Repeat offenders are responsible for most malpractice costs in West Virginia. Doctors who paid two or more malpractice claims are responsible for 62.2 percent of all payments between September 1990 and September 2002. Just 3.5 percent of the state’s doctors (all of whom made three or more malpractice payments) are responsible for 36.5 percent of all payments, according to Public Citizen research based on the federal government’s National Practitioner Data Bank. West Virginia ranks third worst among all 50 states and the District of Columbia in terms of its percentage of repeat offender doctors (those with three or more malpractice claims).

West Virginia has received national attention because some surgeons recently walked off the job to protest malpractice insurance rates. Contrary to what the state’s medical lobby says, though, the median amount of malpractice awards in West Virginia has remained the same – $145,000 – between 1997 and 2002. It has not increased. Adjusting for inflation, it actually represents a significant decrease. Only a handful of sizable jury verdicts have been awarded in recent years – there is no evidence of “runaway jury awards” – and the number of licensed doctors in the state is increasing, not decreasing.

“Doctors who stage walkouts are falsely demonizing America’s legal system. Capping damages, which doctors are calling for, will only hurt the patients they have injured the most,” Claybrook said. “Insurers are hiking malpractice rates for doctors because they have lost money on their investments, not because of lawsuits and payouts.”

According to Public Citizen’s report, Medical Misdiagnosis in West Virginia: Challenging the Medical Malpractice Claims of the Doctors’ Lobby:

  • Only 25.5 percent of doctors who have made five or more medical malpractice payouts between 1990 and 2002 have been disciplined by the state. Only 14.3 percent of doctors who made 10 or more payments have been disciplined.
  • Medical errors cause 283 to 630 preventable deaths in West Virginia each year. These errors cost families and communities $109 million to $186 million each year in lost wages, lost productivity and increased health care costs. In contrast, medical malpractice insurance costs West Virginia’s doctors less than $77 million annually.
  • Underpriced premiums, reckless cash-flow policies and involvement with Enron and asbestos subsidiaries forced St. Paul Companies, which once covered nearly a third of the state’s doctors, to stop offering malpractice insurance.
  • Insurance costs are increasing overall, not just for malpractice. In 2001-2002, increases for medical malpractice insurers ranged from 17.9 percent to 26.4 percent in West Virginia. Rate increases for health care insurance in the state varied between 20.7 and 23 percent in 2002. Increases in homeowners insurance premiums ranged from 5.8 percent to 27.5 percent.

In the letter to the board, Public Citizen listed details pertaining to the doctors but did not name them because their identities are not publicly available. Public Citizen’s information comes from the National Practitioner Data Bank. The repeat offenders include:

  • A doctor who settled 11 malpractice suits between 1994 and 2001 involving treatment, unnecessary surgery, medication administration, improper performance of surgery and more. The payouts totaled $3.2 million.
  • A doctor who settled 40 malpractice suits between 1998 and 2002. These involved two cases of improper surgery and 38 cases of improper use of equipment or a product and the failure to obtain patient consent. The payouts totaled $471,250.
  • A doctor who settled 36 malpractice suits between 1998 and 1999, each involving the improper use of equipment or a product and a failure to obtain consent. The payouts totaled $300,750.

Claybrook also testified before state lawmakers on Thursday, telling them that caps on damages are not the answer to their problems. Solutions lie in reducing medical errors, she said. In addition to effective doctor discipline, states should require hospitals and other health care providers to institute meaningful risk prevention programs. Hospitals should implement measures to curb errors, such as using computers to order and track prescriptions (these can cut errors by 55 percent), requiring proper hand-washing to reduce infections, addressing the nursing shortage and reducing the long hours of medical residents. Also, insurance risk should be spread, reducing the number of classifications of doctor specialties. Risk pools for some are too small and thus overly influenced by: 1) a few losses; and 2) the concentration in a few specialties of doctors handling the highest risk patients. To view the report, click here.