Nevada Dodges Malpractice Bullet

Malpractice Insurance, GD, 020408
Nevada's only top-level trauma center reopened Saturday morning, 10 days after it shut down because of soaring malpractice insurance rates.

"We are back in business," Louise Burns, nursing supervisor at University Medical Center in Las Vegas, said Saturday. "It's very good news."

The county-run trauma center closed July 3 after all but one of the medical center's 58 orthopedic doctors resigned because they said they couldn't afford rising malpractice insurance premiums. Physicians say some medical malpractice insurance premiums have jumped from $40,000 to $200,000 annually.

To put the trauma center back in business, 10 to 15 private practice orthopedic surgeons agreed to become Clark County employees for 45 days, meaning they will be covered by the hospital's $50,000 liability cap.

Gov. Kenny Guinn said those 45 days will give him time to call a special legislative session to consider a law to cap jury awards in malpractice lawsuits. He is expected to call the session the week of July 29. "This will set a very, very positive tone for our special session," he said.

Nevada is one of 12 states with the greatest lack of medical malpractice insurance coverage, according to the American Medical Association, which released a 50-state analysis last month.

When the University Medical Center trauma center closed, Las Vegas became the nation's largest metropolitan area without a trauma center, which is distinguished from an emergency room by its teams of specialist surgeons staffing the center around the clock.

The Las Vegas center serves a 10,000-square-mile area, including southern Nevada and parts of California, Utah and Arizona. The closure meant patients with gunshot or life-threatening injuries were treated at hospital emergency rooms instead. University Medical Center officials said they had no estimate on the number of patients diverted.

Dr. Michael Daubs, an orthopedic surgeon, said the Legislature must find a solution.

"If we do not fix the problem, ... there will be a mass exodus, a lot of doctors leaving this community," he said. "I just hope that everybody looks at this seriously."

Dr. Donald Palmisano, president-elect of the American Medical Association, has called for Nevada to model medical malpractice tort reform on California's 25-year-old Medical Injury Compensation Reform Act. It limits attorney fees and caps jury awards at $250,000 for pain and suffering in medical cases.

The medical malpractice crisis came after the largest insurance carrier in the state, the St. Paul Insurance Companies of Minnesota, facing losses of nearly $1 billion, announced in December it was pulling out of the malpractice insurance business worldwide. Its departure meant 60 percent of Nevada's doctors would be left uninsured.

Other companies have pulled out of Nevada as well, and those that remained raised rates, citing the high cost of settling malpractice claims in a state with no cap on jury awards.

In April, Guinn created a state-underwritten insurance fund to help surgeons and other physicians in high-risk fields.