Thursday, October 08, 2009
Most malpractice suit juries find in favor of the physician

By Dr. Anthony Policastro
One of the things discussed in the health care reform debate is medical malpractice. I suspect that if you asked a non-medical person what malpractice means you would get a variety of definitions, most related to a bad result from a medical procedure. Most of those definitions would be wrong. Medical malpractice has a series of components with a specific definition. When a malpractice suit is filed, it often does not have all the necessary components. Therefore, most malpractice suits that actually get to a jury are found in favor of the physician. You may wonder then what all the fuss is about related to malpractice. The fuss is related to two things. The first and most important is the emotional trauma that a physician goes through during a malpractice action. The physician has to face a variety of emotions that often continue even after the case is settled. Many times it takes years to come to a settlement, which makes fighting a malpractice suit expensive the second reason why malpractice causes so much fuss. Many times the suit is settled long before it comes to trial to avoid further expense. In order for a malpractice suit to be successful, the plaintiff needs to prove four things. The first is that there is a specific standard of care or agreement on the correct way to treat something. Next is that the physician did not follow that standard of care. The last two items include harm to the patient and that the harm occurred because the physician did not follow the standard. You need to prove all four of these parts which is quite difficult. For example, there are usually several different ways to treat a single condition and, for that reason, experts support different ways of treatment making it hard to decide if there even is a standard. Sometimes, it is easy to show that the standard was not followed. For example, cutting off the wrong leg clearly is not following the standard. However, other times it is not so clear. Some procedures are so intricate that it is hard to prove if the standard was or was not followed. The third thing has to do with injury. If a physician does not follow the standard of care, the patient might get lucky and not be injured. Therefore, there is no malpractice even though the physician did the wrong thing. The fourth piece is related to proving that something that was done incorrectly caused the injury. Injury might occur without it being related to things being done wrong. For example, if a patient has a diagnosis, a certain medication might be needed. That medication is prescribed correctly. The physician correctly asks the patient if they have ever had an allergic reaction to that medication. That patient answers "no." The medication is prescribed and the patient has a severe allergic reaction. The result is bad but this is not malpractice. Many malpractice suits are filed with the hope of settlement before a trial. All of the components may not be present to prove malpractice but that does not matter if settlement is reached before trial. Settlements do not prevent the emotional trauma that goes with the lawsuit until it is settled. They do not make all the legal costs disappear. At the Delaware Board of Medical Practice meetings, we review all the malpractice settlements in the state. In most cases, the settlements are not for bad medicine but bad results. It is unfortunate that the patient suffered a bad result. However, it is not usually related to actual malpractice.

Seasonal flu shots offered It's time to get your seasonal flu shot. Influenza is a serious disease that affects many people, including the elderly and those with serious, long-term health problems. Nanticoke Memorial Hospital will be offering seasonal flu shots to individuals 18 and older at Nanticoke Occupational Health, 743 Shipley Street, Suite F, Seaford, from: 9 a.m. - 12:30 p.m. and 4 p.m. - 7:30 p.m. on Wednesdays, Oct. 14, Oct. 21, Oct. 28 and Nov. 4; and 9 a.m. - 1 p.m. on Fridays, Oct. 16, Oct. 23, Oct. 30, and Nov. 6. Cost is $10 per adult. Medicare Part B billing is available with proof of Medicare insurance. Pre-registration is required. Call Nanticoke Occupational Health at 629-6875 to pre-register and schedule an appointment.

New Hope Holiday workshop Delaware Hospice invites area children and teens who have lost a loved one to a New Hope Holiday Workshop on Tuesday, Oct. 27, from 6-7:30 p.m. at the Delaware Hospice Center, 100 Patriots Way, Milford. Participants will complete a holiday ornament in remembrance of their loved one, learn helpful coping skills to deal with the upcoming holidays, and meet other children who have had the same experiences that they have. The Holiday Workshop is free and open to the community, thanks to the generous support of donors and volunteers. Registration is required. To register, call Lezley Sexton, 302-856-7717, ext. 3104, by Oct. 19.

Bereavement support group A new bereavement support group will begin at Nanticoke Cancer Care Center on Tuesday, Oct. 20, at 10 a.m. Compassionate Care Hospice's Bereavement Coordinator, Mary Van House, will facilitate the monthly support group called, "The Next Step," in the conference room on the second floor of the Nanticoke Cancer Center. This group focuses on issues of loss that continue beyond the early stages of grief and is open to family members and friends who have lost a loved one to cancer or other causes. The group will continue to meet on the third Tuesday of each month at 10 a.m. To register for this free program, call Lisa at 629-6611, ext. 2378. For more information, call Mary Van House at 302-934-5900.

Family and Friends CPR course Peninsula Regional Medical Center is offering a "Family and Friends CPR" course from 6 to 9 p.m. on Wednesday, Oct. 14, in the Avery W. Hall Educational Center on the Peninsula Regional campus. The course is designed for all lay rescuers (grandparents, family members of patients at risk for heart attack, and those who want to learn rescue skills for loved ones) who want to learn CPR but do not need a course completion card. This one-time, three hour course teaches rescuers skills in CPR and relief of foreign body airway obstruction for adults, children and infants. The fee is $25. Pre-registration is required. For more information, call 410-543-7126.

Video conference at Nanticoke Thanks to live video conferencing technology, members of the Delaware Chapter of the National Multiple Sclerosis Society can stay close to home and still take part in the chapter's annual meeting on Saturday, Oct. 24, at the Ammon Medical Education Center on the campus at Christiana Hospital in Newark. For the first time, the video conference will include participants at a satellite location at Nanticoke Memorial Hospital in Seaford. Like the participants in Newark, Sussex County residents who attend the satellite location will also receive lunch, take part in the chapter's annual meeting and recognition awards ceremony, and enjoy a client-focused discussion about MS research. Cost is $5 per person, and anyone who wants to attend must register by Friday, Oct. 9, either online at or by calling 302-655-5610.

Dr. Pena joins NMH staff Nanticoke Memorial Hospital welcomes Ivan Pena, MD, FACC to its active medical staff. Dr. Pena, who joins Nanticoke Cardiology as a specialist in interventional cardiology, is accepting new patients at his practice located at 200 Federal Street in Seaford. Dr. Pena is Board Certified by the American Board of Internal Medicine for interventional cardiology, cardiovascular disease, and internal medicine. He completed his postdoctoral training in interventional cardiology, cardiovascular disease, and invasive cardiology through New York University. Dr. Pena has over 20 years of medical experience with nearly six years of experience concentrated in interventional cardiology. His professional memberships include the American College of Physicians, American Society of Echocardiography, American Medical Association, and fellowship with the American College of Cardiology. To reach Dr. Pena's office, call 302-629-9099.

Influenza activity increases The Delaware Division of Public Health (DPH) is reporting a modest increase in influenza activity in Delaware. Laboratory confirmed influenza isolations show a clear progression of novel H1N1 cases from the week of Sept. 6 when 14 cases of novel H1N1 were reported to the week of Sept. 20 when 48 cases were reported. Also, reports of influenza-like illness (ILI) have increased. DPH maintains a network sentinel healthcare providers who report cases of ILI weekly. During the week of Sept. 13, five sentinel providers reported an increase in ILI from 3 to 22 cases. This changes Delaware's assessment of influenza activity as reported to CDC from sporadic to widespread. It is important to note that this technical designation does not imply that Delaware is experiencing the same magnitude of influenza activity as had occurred this spring. DPH recommends the following preventive measures:
  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
  • Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
  • Avoid touching your eyes, nose or mouth. Germs spread this way.
  • Try to avoid close contact with sick people.
  • If you are sick with flu-like illness, stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.)
  • For more information, visit

Hospice welcomes staff members Delaware Hospice welcomes the following new staff members: Belinda Drummond, CNA, of Georgetown, as a certified nursing assistant. Francine Elliott, RN, of Harrington, as a registered nurse. Francine earned her nursing degree from Delaware Technical and Community College in Georgetown and has served as a nurse for Envoy Health of Denton, Md. Lona Elliott, RN, of Seaford, as a registered nurse. Lona attended MacQueen Gibbs Willis School of Nursing in Easton, Md., and has experience as an operating room and emergency room nurse, as well as in case management. Melody T. Jones, BSN, of Smyrna, as a case manager. Melody holds degrees in nursing from Delaware Technical and Community College in Georgetown and from Wilmington University. She has experience in ICU as well as in a step-down telemetry unit. Cherody McInnis, LPN, of Seaford, as a licensed practical nurse. Cherody has several years experience in medical surgical as well as hospice nursing. She graduated from Delaware Technical and Community College in Georgetown. Angela Turley, LCSW-C, of Dagsboro, as a social worker.

Free prostate cancer screenings If you're a male over 50, you're at risk for prostate cancer, the most frequently diagnosed cancer in men and the second leading cause of cancer death in men. And if you're African-American, your prostate cancer mortality rate just doubled: you should get screened beginning at age 40. Bayhealth Medical Center will offer a free prostate cancer screening on Monday, Oct. 12 from 5 to 6 p.m. at the Cancer Center at Milford, located at Milford Memorial Hospital, 21 W. Clarke Ave. in Milford. To register, call 302-744-7135 or 1-877-453-7107. Bayhealth's free two-part screening includes a blood test for prostate specific antigen (PSA) and a digital rectal exam (DRE) performed by a urologist.

Professional Caregiver Retreat Day Delaware Hospice's Family Support Center invites all those who work or volunteer in a helping profession to attend the Professional Caregiver Retreat Day on Friday, Nov. 13, from 8:30 a.m. to 4 p.m., at the Delaware Hospice Center, Milford. Dr. Judy Pierson, licensed clinical psychologist, published author and dynamic speaker, will discuss topics such as: the cost of caringassess your own well-being; understanding vicarious trauma and compassion fatigue; strategies for coping with the stress of this work; and creating your own personal self-care plan. The retreat is $99 per person (continental breakfast and lunch included). Application has been made for 6.0 continuing education hours for social workers and nurses. Participants will leave with information about the impact of their work, specific coping techniques, and a strategy for improving their work life tomorrow. Due to space limitations, early registration is recommended. To register and for more information, call Vicki Costa, associate director of the Family Support Center, 302-856-7717, ext. 1129.

Hospice offers Grief Support group Delaware Hospice is offering an eight-week group meeting for adults who have experienced the death of a loved one. The group will meet Wednesday afternoons from 5 to 6:30 p.m., beginning Oct. 14 through Dec. 2, at Nanticoke Memorial Hospital, 801 Middleford Road, Seaford. Find out what normal grief "looks" like; learn about the "tasks of mourning;" identify your coping style and develop coping skills that feel right for you; share as much or as little as you would like. This activity is provided free to the public by Delaware Hospice; however, registration is required. To register, call Paul Ganster at 302-357-7147.