08 Mar 2003

It was to be expected that lawyers would cynically take advantage of the organ transplant mistake at Duke University Hospital. Neither is it surprising that Cynthia Tucker ("Girl's death may dim view of tort reform", Atlanta Journal-Constitution, 2 March 2003) and many others in the press have joined in.

Jesica Santillan, a 17-year-old Mexican girl, died last week at Duke University Hospital after receiving a heart and lung transplant of the wrong blood type, followed by another corrective transplant of another heart and lung. The girl's tiny size and helplessness added to the melodrama of this quite real tragedy.

However predictable these attacks on medical malpractice tort reform, the lack of objectivity in Ms. Tucker's column is distressing. Ms. Tucker called this a "mistake in the operating room"; other stories talked about "operating room errors" and "botched operations." None of the stories I've read had details on where the blood typing error occurred, so perhaps the press doesn't know. It seems unlikely, however, that the error occurred in the operating room. The term "operating room error" pointlessly strengthens the false picture of surgeons as careless butchers.

Ms. Tucker's greater offense is to use the incident to attack tort reform. She feels that medical malpractice should continue to be dealt with by allowing unlimited lawsuits against doctors and hospitals. To arrive at Ms. Tucker's conclusion, one would need to assume:
1. That a surgeon, who has chosen medicine as a career and has dedicated 8-10 years of post-secondary training to achieve this, won't care if his patient dies unless he is threatened by a lawsuit;
2. That a malpractice lawyer, who lives on the multithousand-dollar contingencies from malpractice suits and hopes for the multimillion-dollar jackpot case, genuinely wants to reduce medical malpractice.
It's surprising enough that anybody could believe these assumptions, but the press regularly starts here in discussions of medical malpractice.

Cost, not medical malpractice, is the biggest problem in medicine in the United States, and indeed, in the world. Lawyers are increasing the costs, not reducing malpractice. Most of us can live much longer without lawyers than we can without doctors, and the lawyers are forcing us to make this choice.