In a clear sign of Nevada's deepening malpractice crisis, the trauma center at 504-bed University Medical Center, Las Vegas-the only Level I trauma center in the state-closed its doors 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 no timetable for reopening its trauma center, although officials said 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 limits liability for on-staff doctors to $50,000.
Privately employed physicians, who make up 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 1.5 million people who live in southern Nevada and tens of thousands of residents in parts of Arizona, Utah and California. It was 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."
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.