Florida bill would limit liability for ER doctors

By Lisa Greene, Times Staff Writer
In print: Tuesday, March 18, 2008

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ADVERTISEMENT State Rep. Ed Homan is a surgeon who is on call for emergencies.

Check with the national board of neurosurgeons, and you'll find 12 neurosurgeons listed in St. Petersburg.

But how many are willing to be on call for emergencies at Bayfront Medical Center, Pinellas County's only trauma center? Three.

More of those doctors would be willing to be on call if they weren't afraid of being sued, say Florida emergency doctors, hospitals and health leaders who want to pass a bill protecting emergency health care workers and hospitals from large legal claims.

"We have to do something," said Dr. Larry Hobbs, president of the Florida College of Emergency Physicians. "We have to look at emergency care as a societal need."

But opponents say such protection would be unfair to injured patients, open the door to extending protection to doctors in non-emergency cases, and wouldn't bring doctors back to the emergency room anyway. Doctors have other reasons for not being on call, they said.

"I understand that doctors who work in emergency rooms work long hours, and they work hard," said lawyer Richard Shapiro, former president of the Florida Justice Association. "But the other side of the coin is, they have a responsibility to provide a certain level of care."

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State Rep. Ed Homan has a particular interest in the bill he's co-sponsoring to give doctors and other emergency care workers protection from lawsuits.

Homan, 65, is an orthopedic surgeon on staff at University Community Hospital in Tampa. The hospital has 25 active orthopedic surgeons on staff, but Homan is one of only four who are on call for emergencies.

Of the four, two are young doctors still required to cover the ER to be on the hospital staff, Homan said. Homan and the other doctor both are faculty members at the University of South Florida, and thus have special legal status.

"If it wasn't for that," Homan said, "I wouldn't do it."

Fear of lawsuits is just one of the reasons that hospitals can't find specialists, Homan said. Certain specialties just don't have enough doctors to go around. Doctors are getting older. Many don't want to spend time away from their families. But the lawsuit problem struck Homan as the one that could be changed.

The bill would make health care workers "agents of the state" when they are treating emergencies. It would include doctors, nurses, paramedics and hospitals. Any lawsuits against such workers would be limited to $200,000, unless legislators pass a special bill to authorize more. Such acts are increasingly rare.

The Florida College of Emergency Physicians, the Florida Medical Association and the Florida Hospital Association all support the bill, which also has an identical version filed in the Senate. A House committee is scheduled to hear the bill Wednesday.

In St. Petersburg, Bayfront Medical Center officials support the measure as well.

"This is one piece to help in the overall physician shortage," said spokeswoman Nancy Waite.

The hospital had to stop taking trauma patients several times over the past few weeks after two of its four neurosurgeons stopped being on call. On Monday, Waite said that one of those two, Dr. Thomas Stengel, is on call again.

Bill has opponents

Tequesta resident Sam Stone knows more than most Floridians about how the shortage of specialists can hurt a family. But he opposes the bill.

In 2003, Stone's 52-year-old wife, Mary, a pre-K teacher and mother of four boys, had a stroke. Stone took her to Jupiter Medical Center, but no neurosurgeons were on call, and the hospital couldn't find anyone to treat her elsewhere.

Mary Stone finally was flown to Shands HealthCare in Gainesville, but by the time she got into surgery, 13 1/2 hours had passed. She died 18 days later.

"Mary had to be flown … 260 miles for a service that should have been available in the hospital where she was at," her husband said.

Stone reached a confidential settlement with Jupiter Medical Center. While he believes hospitals need more specialists on call, he said giving emergency providers sovereign immunity is "creeping socialism."

"I'm just generally opposed to giving sovereign immunity to a private entity," he said. "It's opening Pandora's box. If you start with the doctors, where would it end? … Why not just turn the hospital into a state institution?"

A better solution, Stone said, is for hospitals to pay doctors, or pay them more, to be on call.

Many large Tampa Bay hospitals already pay on-call doctors. Hospital officials won't discuss what they pay, but it can be hefty. Homan said University Community pays orthopedic surgeons $750 a night and St. Joseph's Hospital, a trauma center with the area's busiest emergency room, pays $2,300.

What about losses?

Stone's case isn't the only one that advocates point out. Hobbs pointed to the record-breaking $217-million verdict against Tampa emergency doctors in 2006, for failing to diagnose that a patient was having a stroke. The patient, Allan Navarro, later settled to end the appeal.

"The No. 1 reason doctors don't want to go to the ER and see patients is because of the potential lawsuits," he said. "There's the risk of them totally losing everything they've worked for."

But Shapiro said such patients as Navarro should be compensated. Even large verdicts aren't enough to make up for paralysis or other disabilities, he said.

"There are genuine losses with genuine victims, who have genuine real needs," he said.

Lisa Greene can be reached at greene@sptimes.com or at (813) 226-3322.