Medico-Legal News

January 12, 2009

State of Neglect: Texas Law Lets Hospitals Hide Problems

Hospital companies in Texas, many of which collect millions in state and federal funds, operate with minimal public disclosure of deficiencies. The state keeps information on complaints and inspections largely private because influential health care corporations want it that way, and Texas legislators have obliged.

As a result, it is next to impossible for the public to determine whether state enforcement works properly. Hospital lobbyists designed much of this system.

The Texas Department of State Health Services provides, on its Web site, a small amount of data on hospital fines. The department also furnishes limited and heavily redacted violation records to anyone who makes a formal open-records request, pays in advance and sometimes waits months for delivery.

December 27, 2008

Texas Medical Board Update

by Dr. Shezad Malik

The Texas Medical Board (TMB) is charged with licensing physicians and enforcing the Texas Medical Practices Act. During the 2007 session and interim, TMB has been under intense legislative scrutiny for administrative, enforcement, and licensure issues. Last session, lawmakers increased the agency’s appropriation by $3.4 million — to $18.4 million for the biennium — so it can better manage the backlog of license applications. In exchange, the board was directed to cut the average processing time for a new license to 51 days. TMB reports it has met this goal and initiated an online application process to further speed up licensure.

December 26, 2008

Texas Medical Board Falling Behind On Complaints

by Dr. Shezad Malik

Medical malpractice reform enacted five years ago succeeded in cutting the number of lawsuits against doctors and increasing the number of physicians working in Texas.

But state medical board investigators say it also left them with an unbearable workload.

While the Texas Medical Board’s staffing increased 28 percent from 112 employees in fiscal 2002 to 143 in fiscal 2008, physician and patient settlements through the board have increased 202 percent, according to the board’s statistics.

In next year’s legislative session, the TMB will be asking for 11 additional full-time workers to help with investigating and resolving complaints against doctors.

December 24, 2008

Texas Nursing Jurisprudence Exam

by Dr. Shezad Malik

There are 50 items on the nursing jurisprudence examination (NJE). You must correctly answer 75% of the questions to pass the NJE. You will have two (2) hours to complete the NJE. Displayed in the upper right hand corner of the computer screen will be a digital clock and the question number so you can monitor your progress throughout the NJE.

You are permitted to access the Board of Nursing (BON) website and other resource material throughout the exam to locate the answers to questions. The NJE will run in another window, thereby leaving this window open to access reference materials on the BON website.

A Passing Result will be posted and recorded to the BON system when all 50 questions are answered and a minimum of 38 questions are answered correctly. A certificate will be available for printing at the end of the examination process. Once a passing result is recorded, Board Staff will be notified and the jurisprudence exam requirement will be updated as completed in your BON file. Keep the certificate for your records. Do not mail the certificate to the BON.

December 22, 2008

Texas Medical Board Implements New Rules

by Dr. Shezad Malik

Rule Changes Adopted
The board adopted the following rule changes that were published in the Texas Register:

Chapter 163, Licensure, amendments to §163.5, Licensure Documentation.

Chapter 165, Medical Records, amendments to §165.1, Medical Records; §165.5, Transfer and Disposal of Medical Records.

Chapter 166, Physician Registration, amendments to§166.2, Continuing Medical Education; and §166.6, Exemption from Registration Fee for Retired Physician Providing Voluntary Charity Care.

December 21, 2008

Texas Medical Board Disciplines 59 Doctors and Issues 479 Physician Licenses

by Dr. Shezad Malik

Since its last board meeting, the Texas Medical Board took disciplinary action against 59 licensed physicians. The actions included 13 violations based on quality of care; two actions based on unprofessional conduct; three actions based on violations of probation or prior orders; three actions based on other states’ actions; six actions based on inadequate medical records; four actions based on impairment due to alcohol or drugs or mental/physical condition; two actions based on nontherapeutic prescribing; two actions based on failure to properly supervise or delegate; one action based on a criminal conviction; three voluntary surrenders; two violations of failure to obtain required continuing medical education; two administrative agreed orders; and 12 licensees agreed to enter into administrative orders with the board for minimal statutory violations.

December 11, 2008

Florida Med-Mal Case With Punitive Damages Claim

by Dr. Shezad Malik

A Florida man, who is suing two Broward County doctors for malpractice in a rare case allowing a punitive damages claim.

The man claims his plastic surgeon later lied about his detached role in the botched surgery, created two sets of medical records to hide the truth and still billed his insurance company for performing surgery.

The Broward Circuit Judge issued an order in July putting punitive damages in play, and Florida’s 4th District Court of Appeal on Sept. 29 denied a petition for a writ of certiorari on the issue. The trial is set for March 2.

December 11, 2008

Texas Medical Board Temporarily Restricts Doctor’s License

by Dr. Shezad Malik

A panel of the Texas Medical Board temporarily restricted the license of a doctor based in Conroe, after determining that the doctor’s unrestricted practice of medicine presents a continuing threat to the public welfare.

The action was based on the panel’s findings that the doctor was responsible for violations in the standard of care, nontherapeutic prescribing, prescribing to persons who were known or should have been known to be engaged in substance abuse or diversion, and his failing to adequately supervise the activities of persons operating under his supervision. These findings were made as the result of a criminal investigation involving patients who had obtained narcotics prescriptions from clinics under the doctor’s medical direction.

December 10, 2008

Scott AFB Doctor Liable in $8.6 M Judgment

by Dr. Shezad Malik

The U.S. government must pay $8.6 million in damages because a military doctor at Scott Air Force Base failed to diagnose a case of flesh-eating bacteria according to a federal magistrate judge’s ruling.

The former wife of an Air Force captain, testified that she sought treatment at the base hospital emergency room for pain and swelling in her right arm in 2002.

According to court documents, the doctor was concerned the woman was a drug addict wanting a prescription, advised her to go home and take Motrin.

A month later, the situation got progressively worse and the woman was taken to the emergency room. The woman was then diagnosed with necrotizing fasciitis, a strep infection that decays soft tissue.

December 9, 2008

State Medical Boards Want Transparency

by Dr. Shezad Malik

More than a decade ago, Massachusetts became the first state to mandate its medical board to post physician profiles online. Patients could find a physician’s hospital affiliations, hospital and medical board disciplinary actions, medical malpractice payments and other data.

The Massachusetts board’s idea to display physician data on an easily accessible Web site was novel in 1996. Many physicians were skeptical in the beginning, resulting in a heated debate of how to post information that was useful to the public and fair to doctors.

“It has worked out reasonably well,” said Massachusetts Medical Society President. “It is an opportunity for patients to step up and see information such as where a physician has received training, whether they are board certified, whether they have malpractice suits against them and whether or not the suit falls in what one might expect in that specialty.”