Friday, June 28, 2002 | 11:15 a.m.
Jennifer David checked into a University Medical Center for outpatient surgery two years ago and ended up wheelchair-bound for life.
David silenced Clark County commissioners Thursday when she wheeled up to the microphone and offered her take on the board's seven-point plan to protect UMC physicians during the medical malpractice insurance crisis.
The plan -- designed to keep UMC's trauma center open -- would keep the hospital's liability cap at $50,000 and limit physicians' share of judgments to their percentage of responsibility as determined by a court.
"When you start talking about caps," said David, whose bladder and intestines were punctured during what was scheduled to be a 30-minute pelvic operation, "be careful about who you're helping and who you're hurting."
With a flood of doctors leaving, UMC has threatened to close its trauma center -- the only level-one center in the state -- next week.
The board's plan was approved by the commission at a special meeting Thursday.
The meeting was called after 56 of UMC's 58 orthopedic surgeons resigned from practicing at the hospital because of skyrocketing medical malpractice insurance rates. The surgeons, on-call specialists at UMC, would keep their private practices.
David was concerned that the proposal would cap liability.
For a $1 million lawsuit in which a judge determines the physician was 10 percent responsible, UMC would pay $50,000 and the physician would pay $100,000. Under existing laws, the victims can seek the remaining judgment -- $950,000 -- from the doctor. Commissioners have also suggested a combined $50,000 liability cap for doctors and the hospital.
David's husband, Ted, compared a $150,000 payout on a $1 million judgment to liability insurance on an automobile.
"Liability coverage on a car is more than $200,000," he said. "We're talking about a human being."
County officials hope the proposed bill would help decrease medical malpractice insurance premiums and keep the trauma center open. Because victims can go after deeper pockets -- those of physicians -- and UMC has a low cap, insurance companies have jacked up their premiums.
But Dr. Ikram Khan said the county's action Thursday won't necessarily keep the trauma center open. He doubts physicians will treat patients under the $50,000 cap because courts have yet to determine whether the cap is constitutional and could potentially overturn it, subjecting doctors to hefty lawsuits.
"I believe in miracles, but I don't depend on them," Khan said today, referring to the chances of the trauma center remaining open.
If the trauma center closes, victims of severe car accidents, for example, would likely be stabilized at a local hospital and airlifted to California emergency centers.
"No other facility in this town is equipped to take care of trauma patients," Khan said.
In an attempt to keep physicians working at UMC, the board also gave Chief Executive Officer Bill Hale authority to extend contracts and increase specialty call rates. He said trauma and emergency room physicians might stay if they made about $2,000 more per call.
If that offer is extended to the orthopedic surgeons, it would cost the county $365,000; if it is offered to all the hospitals emergency and trauma doctors, the county would pay upwards of $5 million from its already-tight general fund.
Commissioner Erin Kenny said even if county programs have to be cut, money should not be the reason UMC's trauma center closes.
"This is literally a life or death situation," Kenny said. "I for one am not willing to put that on the table. We need to pay whatever money the doctors need to keep the trauma center open."
Renee Williams scoffed at the hour-discussion about how to appease doctors. Williams' 20-year-old daughter was checked into a hospital to give birth; she came out an invalid who has never been able to bond with her newborn.
Williams said her daughter should have been given a blood transfusion, but wasn't and fell into a coma. She has since suffered from strokes and cannot walk.
"She's just laying in a vegetable state and all I hear about is the poor doctor," Williams said.
David said all she hears about is "doctors making more money and their insurance.
"What about the victims?" David asked. "I used to ski; I'll never ski again. I used to fish; I'll never fish again. This doctor decided to play God and destroyed my world."
The commissioners' plan clearly didn't please all stakeholders in the controversy -- the insurance companies, doctors and victims of malpractice. Commission Chairman Dario Herrera acknowledged it wasn't "perfect," but was all the board could do.
"If we don't act now, the trauma center closes," he said.
Other elements of the plan include asking legislators to amend liability cap laws to allow emergency and trauma doctors that treat but do not bill indigent patients to be immune from medical malpractice lawsuits.
Dr. Dan McBride, a general surgeon who resigned from UMC and has his own private practice, said the only answer is for Nevada to follow California's lead and adopt the Medical Injury Compensation Reform Act, which places a $250,000 cap on non-economic damages.
"If the trauma center closes, the county should apply its money to helicopters because you'll need them to transport patients to California," McBride said.
The board urged Gov. Kenny Guinn to call a special session and work on long-term solutions for the crisis.
Wende Nostro said she was pleased with the board's decisions, with the exception of the liability caps. Nostro's husband went in to the doctor for a biopsy in January 2001, but died when his aorta was ruptured during the procedure.
"I lost my husband, the greatest thing in my life," said Nostro, whose lawsuit is pending. "The doctor needs to feel the impact of that. If doctors were held accountable, we wouldn't have these lawsuits and we all wouldn't have been here today."
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