What Constitutes Medical Malpractice?

The Iowa Board of Appeals recently unanimously approved paying $3.7 million to settle three malpractice lawsuits filed against the University of Iowa Hospitals and Clinics (UIHC).

Although the state denies the allegations, Iowa's Attorney General's Office recommended a two-million-dollar settlement with the family of a woman who died on December 9, 2017 after receiving a feeding tube.

According to the lawsuit filed by the woman's husband and children, she was admitted to UIHC on Nov. 12, 2017. UIHC practitioners examined her esophagus, stomach, and small intestine and placed a feeding tube.

However, the lawsuit alleged that the tube was improperly placed in the esophagus rather than the stomach and that post-procedure X-rays to confirm placement were not performed. The suit further alleged that the woman received feedings without X-rays being taken and the feedings caused aspiration pneumonia in her lungs. Experts say that the pneumonia caused the woman's death.

The lawsuit claimed that "breach of the standard of care" was the probable cause of the woman's pneumonia and death.

UI Physicians, a multi-specialty medical and surgical group representing 1,000 UI physicians, will pay $500,000 of the settlement. The remaining $1.5 million will be paid by the state's general fund.

In the second lawsuit, the state will pay one million dollars to a man and his wife who accused UIHC of failing to obtain "informed consent" before performing back surgery on the man in Feb. 2015. The suit further alleged that UI physicians improperly diagnosed and treated the conditions caused by the back surgery, which led to the man becoming a paraplegic.

The couple filed suit against UIHC, claiming its providers "negligently performed a spinal fusion resulting in significant neurological injury." The state's general fund will pay half of the settlement and UI physicians will pay the other half.

The third malpractice lawsuit alleged that a 74-year-old woman was healthy when a UI physician diagnosed her with a non-cancerous tumor in the lining of her brain in 2015. The lawsuit claimed that the physician recommended surgical removal, even though there was no documented growth, neurological defects, or cerebral edema associated with the tumor.

UIHC claimed that both options were discussed, as well as the risk of surgery, and that the patient decided on surgery.

The lawsuit further accused the UI physician of failing to treat the Staphylococcus aureus that was discovered in a preoperative test with antibiotics before surgery. The woman allegedly developed an infection that led to additional surgeries—during one of which she suffered a stroke—a stay in ICU, and time in skilled recovery.

The lawsuit claimed the woman now suffers from neurological deficits, significant memory loss, and vision problems that cause her to fall and is no longer able to live independently.

The woman's daughters filed the suit, which UI Physicians will pay $700,000 to settle. Vanessa Miller "State agrees to $3.7 million in settlements for alleged UIHC malpractice" thegazette.com (December 7, 2020).

Commentary and Checklist

The American Board of Professional Liability Attorneys is an organization that certifies attorneys to prosecute professional malpractice, including medical malpractice. The ABPLA states that malpractice occurs when:

“…a hospital, doctor or other health care professional, through a negligent act or omission, causes an injury to a patient. The negligence might be the result of errors in diagnosis, treatment, aftercare or health management.”

Negligence involves a violation of the standard of care. Medical providers must provide care that meets the medical standards that would be considered acceptable by a reasonably prudent health care professional.

Second, the injury must be caused by negligence to constitute malpractice. The patient must show that the injury would not have occurred in the absence of the negligent act.

Third, the injury must result in significant damages, such as disability; loss of income; unusual pain, suffering, and hardship; or significant medical bills.

To prevent a malpractice lawsuit, you must train all individuals who work with patients on the standard of care and the need to take all possible precautions to prevent negligence.

Here are some types of negligence that could lead to a malpractice lawsuit, according to the ABPLA:

  • Failure to diagnose or misdiagnosis
  • Misreading or ignoring laboratory results
  • Unnecessary surgery
  • Surgical errors or wrong site surgery
  • Improper medication or dosage
  • Poor follow-up or aftercare
  • Premature discharge
  • Disregarding or not taking appropriate patient history
  • Failure to order proper testing
  • Failure to recognize symptoms
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