Italian Medical Malpractice Lawsuits: Insurance Firms Concerned
Italian Medical Malpractice Lawsuits: Insurance Firms Concerned
“A doctor who fails to prescribe diagnostic texts may be found guilty of manslaughter”. This entry on the treccani.it/diritto website poses a problem: is it better to be fined by the Ministry for prescribing too many clinical tests, or to risk being sued by the relatives of a deceased patient and being ordered to pay millions of euros in damages for not having performed every test possible? The more outspoken doctors, criticising the torrent of legal suits against them personally and the public health system as a whole, say that Beatrice Lorenzin did the right thing in establishing criteria to regulate the abuse of prescribed treatments, x-rays, tests and drugs. Defensive medicine costs up to €13bn a year: three times what the state receives in property tax on family homes. In other words, a fortune.
Doctor’s liability
There is however another side to the problem, namely long-awaited legislation to govern the issue of liability in the case of medical malpractice. The issue is akin to a burst blister, and has serious consequences. The figures issued by the National Association of Insurance Companies are indicative: in the space of 20 years, from 1994 to 2013, legal action against doctors accused of making more or less serious mistakes quadrupled from 3222 to 12,036. The problem is so serious, that according to a recent dossier by the Association, entitled “Malpractice, utter chaos”, insurers are “on the retreat, due to increases in litigation and the difficulty of assessing risk”. It is a disaster for public accounts, an unknown quantity for insurance companies, a nightmare for doctors, and big business for some legal firms, which in recent years have engaged in absurd advertising campaigns. A case in point is the poster showing a buxom woman with a dynamite fuse emerging from her bra, a clock, and the pay-off “Carcinogenic, defective implants”. There is no doubt that some doctors commit unforgivable errors as a result of sloppiness or inability, and they should be hit hard. But what is the sense in showing two figures wearing surgical caps and masks under the title “The silent killer” on the homepage of an associated law firm?
The insurance business
“The thousands of civil and criminal actions brought against doctors,” according to a document of the Italian Board of Surgeons (CIC), “end up with 98% of acquittals in the criminal courts and 80% in the civil courts”. But this is not enough to make the situation more bearable. “I am an orthopaedic surgeon, and so far have a completely clean sheet, in the sense that I have never been convicted or indeed even sued for damages,” explained Maurizio Maggiorotti, of AMAMI, the Association of Doctors Wrongly Accused of Malpractice, “yet I have to pay insurance premiums of €10,000 a year. And I have colleagues who pay twice that”. “I receive take-home pay of €5500 a month, and as a consultant surgeon, they want €24,000 a year to insure me,” complained the obstetrician Nicola Surico, chairman of the CIC. “Either they change the rules or the whole system will collapse: you can’t ask people to pay four or five months’ salary in insurance just to be able to work without worries”. That’s without mentioning of course the case mentioned above: a sentence of the Italian Supreme Court that in 2011 convicted a neurologist at the headache unit of a local health authority for manslaughter (even though he had already been acquitted in the Court of Appeal due to “no criminal omission being established”) because, when dealing with a patient with a bad headache, he had failed to realise that the person had an aneurysm. For the Court, this was something that he could have diagnosed if he had prescribed “a CAT scan, EEG, MRA and cerebral angiography”. It came to this conclusion despite the fact that the medical report of the emergency room “stated that the patient ‘does not suffer from headaches. He complains of a sudden headache that came on around three hours ago’”. “And as for cases where doctors have been found ‘guilty’ of not having prescribed tests that are now on the money-wasting blacklist,” Nicola Surico said, “we have cartloads of them”.
Read the rest of the story here: http://www.corriere.it/english/15_settembre_25/medical-malpractice-lawsuits-insurance-firms-concerned-c4411cfc-6364-11e5-9954-7c169e7f3b05.shtml
