- The Washington Times - Wednesday, July 17, 2002

We reported on this page last week on the crisis situation in Las Vegas, where one of the busiest Level-I trauma centers in the country and one of the first lines of defense in the event of a terrorist attack was forced to shut its doors July 3 due to escalating malpractice insurance costs. We recommended an exemption from existing malpractice laws for trauma centers due to the terrorist threat.

The facility, located at the University of Nevada Medical Center (UMC), closed after most of its surgeons resigned, saying they risked bankrupting their families if they continued to practice and were hit with a seven-figure lawsuit by one of the city's increasingly aggressive malpractice lawyers. Local physicians and emergency rescue personnel said the shutdown left the Las Vegas area, home to roughly 1.5 million people and destination of 36 million tourists a year, unprepared to face a catastrophic terrorist attack.

When our editorial was published last Thursday, the trauma center had been closed for more than a week, and officials were pessimistic that negotiations to reopen the facility would bear fruit any time soon. Just 24 hours later, however, local officials and some of the surgeons reached an agreement to temporarily reopen the UMC trauma center on Saturday, 10 days after the liability crisis had forced it to close. The accord limits doctors' liability in malpractice lawsuits for at least 45 days. Meanwhile, Gov. Kenny Guinn has called on the legislature to convene in a special session July 29 to take up a reform measure that would place permanent caps on jury awards in malpractice cases despite an intense campaign against it by state trial lawyers.

In an interview yesterday with The Washington Times, Nevada Sen. John Ensign warned that seriously injured patients face "potential loss of life" if insurance problems force the facility to close once again. Asked specifically about the possibility that such a closure could hamper the Las Vegas area's ability to respond to a terrorist attack, he responded: "Let's hope we don't have to find out." Mr. Ensign said he was heartened by the fact that Nevada's insurance crisis has drawn "national attention," referring specifically to last Thursday's editorial in The Times and columnist George Will's commentary on ABC's "This Week."

And Nevada is just the tip of the iceberg. According to the American Medical Association (AMA), 11 other states are "in the throes of a medical liability crisis." Aside from Nevada, the AMA lists the states in the most precarious condition as being Florida, Georgia, Mississippi, New Jersey, New York, Ohio, Oregon, Pennsylvania, Texas, Washington and West Virginia. In these states, doctors "are leaving … retiring early or abandoning high-risk services because they can't afford or can't find liability insurance," the organization says. Another 30 states and the District of Columbia are also "seeing signs of problems," the AMA adds.

The Level-II trauma center at Brandywine Hospital in Coatesville, Pa., closed June 10, because of rising malpractice insurance rates, the Las Vegas Sun reported last week. Area trauma patients are now being transported more than 30 miles away to hospitals in Philadelphia and Lancaster. "I believe lawyers have a better ability to lobby," Brandywine spokeswoman Evelyn Walker told the Sun when asked about the state legislature's failure to enact tort reform, which includes damage caps for pain and suffering. "Hospitals and doctors are not as diligent when it comes to lobbying."

This is a situation that needs to change right away. Trauma centers are an essential component of America's defense against terrorist attack. At a minimum, it's time that the medical community gets serious about carving out some form of war or terrorism-related exemption, at the national, state and local levels, for doctors and other health-care facilities that will be on the front lines when terrorists strike here once again.

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