Lessons of malpractice litigation.(Guest Editorial)

Malpractice can happen to any of us, even if we practice great medicine. Consider what happened to me.

Early in my medical career I had a patient who, although of, hi in her mid-60s, was very frail owing to multiple illnesses. "Anna" had severe end-stage valvular heart disease, lupus, renal insufficiency, osteoporosis, chronic pain syndrome, and chronic abdominal pain.

I did the best I could to treat her, including referring her to a number of specialists, but I could provide little relief for her multiple problems. Finally, I referred her to the Mayo Clinic to obtain their help in her care.

During their exhaustive evaluation, they found an asymptomatic impacted right femoral neck fracture on the edge of a lumbar spine x-ray. Neither the origin nor the time of the fracture were known, but Anna's husband felt that it should have been discovered during her prior care.

Anna and her husband sued the local hospital for the missed diagnosis. In order to have a credible case, their lawyer advised them to sue the primary care provider as well. So began my introduction to malpractice litigation.

I was presented, at work, with the summons of malpractice by the county sheriff. I was devastated and embarrassed. How could I be that bad of a doctor? I began to look at every patient as a risk. My family was affected. I lost weight and couldn't sleep. I was too embarrassed to talk to my colleagues. Even now, I think of this as the darkest time in my life.

The pretrial portion of the suit lasted for 2 years. I had to write numerous reports, meet with my attorney, study the five volumes of ...