In a clear sign of Nevada's deepening malpractice crisis, the trauma center at 504-bed University Medical Center, Las Vegas closed its doors this morning after dozens of specialists resigned because of liability risks.
The hospital is diverting patients to nearby emergency rooms that do not offer specialized trauma services. The most severely injured patients will be airlifted to trauma centers in Phoenix or San Bernadino, Calif., an official said. UMC has not set a timetable for reopening its trauma center, although officials say it will do so once enough replacement physicians have been recruited.
Officials said 56 of 58 on-call orthopedic specialists at UMC resigned despite the medical center's offer of additional money and liability protection. The medical center has launched a national search for orthopedic surgeons, who will be offered full-time employment. As a county-operated hospital, UMC claims sovereign immunity, which limits liability for on-staff doctors to $50,000.
Private physicians, who constitute about 75% of all the doctors at UMC, rejected a promise by hospital administrators to extend that protection to them, questioning whether it would hold up in court.
UMC operated the only Level I trauma center within a 10,000-square-mile radius, serving the 1.5 million people who live in southern Nevada and tens of thousands of residents in parts of Arizona, Utah and California. It is the fourth-busiest center in the nation, handling about 11,400 patients last year.
Dale Pugh, UMC's assistant administrator, said that while the nine hospitals in the Las Vegas metropolitan area will "pull together, everyone is in agreement that we will not have the highest caliber of care available anymore for those patients who are critically injured."
UMC's trauma center medical director, John Fildes, M.D., was quoted in a local newspaper as saying: "It's very likely that some lives will be lost."
Pugh said physicians have insisted they won't return until the state Legislature enacts a tort reform measure limiting attorneys' fees and capping jury awards for pain and suffering at $250,000. "They have told the hospital that nothing short of tort reform will bring them back," Pugh said.
Nevada is one of only nine states without any kind of tort reform, a hospital official said.
It also is one of a dozen states cited last month by the American Medical Association as suffering a "crisis" in medical malpractice. Rates have skyrocketed, doubling and tripling in some cases, leading the state to form its own malpractice insurance company to help stem what some officials described as an exodus of physicians from Nevada.
Gov. Kenny Guinn plans to call a special session of the Legislature next month to address the problem. "We are all concerned by the developments at UMC, and the medical malpractice situation that has left the trauma center physicians feeling that leaving the hospital is a viable option" Guinn said in a written statement released by his office. "UMC and our other area hospitals are working hard to ensure the best care possible for our residents and visitors who need emergency services at this time."
Long-term solutions to the state's medical malpractice crisis will require action by the Legislature, he said.
A somewhat similar scenario is playing out at 425-bed Memorial Hospital, Gulfport, Miss., where 36 physicians -- including 15 emergency-room doctors -- may lose malpractice coverage over the next two months because their current carriers are no longer writing or renewing policies in the state. Without insurance, the doctors can't treat patients at Memorial.