The first name of the director of the Federation of State Medical Boards was incorrect in an article yesterday. He is Dr. Bryant Galusha. (Published 1/12/88)
A physician has been sued by patients eight times. Medical authorities must be watching him, right?
Not necessarily. Until two years ago the Commission on Medical Discipline had no system for finding out about doctors named in malpractice suits.
Of the 10 doctors sued most often in Maryland in the past decade, two have been disciplined. Neither the commission nor the state medical society will comment on whether the practices of the other eight have ever been reviewed.
Medical professionals point out that some very good physicians get sued often -- for example, surgeons on the frontiers of medical advances, or cancer specialists willing to try highly aggressive or even radical treatments in cases that conservative practitioners would write off as hopeless.
Frequent lawsuits do not necessarily mean that a physician needs to be disciplined, but experts on issues related to physician competence say a large number of lawsuits against a physician should at least raise a red flag with medical authorities.
"One or two suits may mean nothing, but one suit along with the revocation of hospital privileges may be serious," said Brian Galusha, director of the Federation of State Medical Boards, a national clearinghouse of information about disciplinary actions. "Multiple suits raise suspicions."
Until 1986, the commission had no mechanism for finding out which doctors were named in lawsuits. As a result of legislation passed that year, the state Health Claims Arbitration Office, which adjudicates medical malpractice suits, must notify the commission when a doctor is sued.
In fiscal 1987, the commission was notified of 311 malpractice cases, according to commission data.
Under the same bill, the Medical and Chirurgical Faculty of Maryland, the state medical society, is required to tell the commission when it learns of any doctor sued three times or more in five years.
The commission will not count suits filed before the law went into effect in July 1986, however.
An examination by The Washington Post of more than 90 malpractice lawsuits filed against the 10 Maryland doctors sued most often in the past decade reveals that all 10 have been sued more than three times in five years.
Some of those who have not been disciplined have been sued a number of times for alleged errors in performing the same medical procedure.
For example, Dr. Fitzpatrick Wilson, a Baltimore obstetrician/gynecologist, has been sued nine times in the past decade, four times for alleged injuries occurring during relatively minor exploratory pelvic surgery.
Wilson's insurer agreed to settlements in three of the cases, including one in which the patient died. The fourth suit was dismissed.
Of the five other suits against Wilson, four were dismissed and the fifth was settled without any payment by Wilson's insurer.
Wilson, an attending physician at Liberty Medical Center, refused to discuss any case history or answer questions about whether his practice has been reviewed by the commission or the medical society. "Most of the cases are dropped," he said.
"This is a kind of intrusion into my privacy."
Eight of the 10 doctors sued most often are in two high-risk specialties: Three are surgeons and five are obstetricians/gynecologists who often perform surgical procedures.
As a result of multiple malpractice lawsuits, Dr. Romeo Ferrer, an ob/gyn, ended up in a court fight with the state's leading malpractice insurer over whether the company could drop his coverage.
By law, the company, Medical Mutual Liability Society of Maryland, is required to offer insurance to virtually any licensed physician in the state.
Ferrer, who has an office and an abortion clinic in Glen Burnie, has been sued nine times in the past decade, according to records on file with the arbitration office.
Six of the lawsuits against Ferrer involved allegedly faulty treatment or diagnoses early in pregnancy; in four of those cases the plaintiffs alleged that he wrongly diagnosed whether or not they were pregnant, resulting in treatment that had negative consequences later.
Ferrer has lost two of the cases, including a birth defect case that resulted in a $1.5 million jury award last year.
That case is on appeal.
Three of the cases were settled, and four cases were dismissed.
"I'm a very competent doctor," said Ferrer, explaining that he sees more patients than the typical doctor and therefore is "at higher risk" for lawsuits.
Neither the commission nor the medical society would comment on whether Wilson or Ferrer has ever been investigated or whether either has been a subject of any informal, confidential sanction by the commission.
In general, commissioners say they take such actions frequently, and they report that in fiscal 1987 they dealt confidentially with 84 physicians, giving them advice, admonishment or instructions.
Among the 10 doctors sued most often, two have been disciplined -- Dr. George Richards, a Baltimore radiologist who has been sued more than 30 times, and Dr. Richard Buyalos, a Baltimore ob/gyn who has been sued seven times.
Each was found incompetent by the commission, which ordered probationary conditions for their continued practice.