Malpractice at Kansas and Missouri health centers cost taxpayers $21 million since 2018 | KCUR 89.3

Silvia Garcia’s 14-year-old son was permanently disabled and confined to a wheelchair after a health center doctor in New Mexico was unable to diagnose appendicitis after complaining of severe stomach pain. The teenager’s appendix ruptured before he could reach the hospital, and complications led to septic shock.

Akimbee Burns had a Pap smear that showed abnormal cells at a public health center in Georgia. However, the results were not told to him. About eight months later, she was diagnosed with cervical cancer that had spread to her lymph nodes. Within two years she died at the age of 38.

Rhonda Jones’ baby suffered brain damage because the Chicago area medical team, including community health center doctors, could not perform an emergency cesarean section quickly enough, despite Jones being at high risk for birth complications.

As alleged in court documents as part of malfeasance cases, these three incidents are one of 485 payments made nationwide covering community health centers from 2018 to 2021. , according to federal data released to KHN through a public records request.

Three of these payments were made to Kansas health centers and 12 to Missouri health centers, totaling approximately $21 million between the two states. The Betty Jean Kerr community health center in St. Louis made the seventh-largest payout among those analyzed by KHN, with a $9 million payout last year.

However, none of these health centers and none of the doctors paid anything. US taxpayers got the bill.

The 1,375 federally qualified health centers that treat 30 million low-income Americans in the country are mostly private establishments. They still receive $6 billion in federal grants a year and their legal obligations under federal law are met by the government, just like those of the US Department of Veterans Affairs and the Indian Health Service. This means centers and their staff can be exempted from medical malpractice lawsuits, and the federal government will pay for any settlement or court order.

As a result, the public is often unaware of allegations of misconduct against these centres. Health centers and their employees are not named as defendants in the lawsuits, and the state does not disclose when cases are finalized or court orders will be paid.

Rhonda Jones stands on the stone and brick steps outside her Crown Point, Indiana home in a black short-sleeved shirt, a necklace with a large wheelchair disability symbol charm, large hoop earrings, and a black headband.

Rhonda Jones in front of her home in Crown Point, Indiana, southeast of Chicago. Jones gave birth to daughter Alayna by emergency cesarean section in December 2016. Alayna was injured during childbirth and suffered cerebral palsy. (Taylor Glascock for KHN)

“People need to know if these doctors or centers are harming their patients,” said Deirdre Gilbert, national director of the National Association for Medical Malpractice Advocacy, a consumer advocacy group and nonprofit.

In addition, attorneys representing plaintiffs in lawsuits against health centers say federal rules handcuff patients with a short statute of limitations (two years) and do not allow for punitive damages.

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“The deck is stacked in the government’s favor,” said Regan Safier, a Philadelphia attorney who won a $41.6 million court order in a birth injury lawsuit involving a community health center doctor in 2018.

Invisible Tragedies

According to data from the Health Resources and Services Administration, which oversees community health centers, the median payout for maltreatment deals or decisions involving health centers was $225,000 from 2018 to 2021. The total was at least $1 million in 68 of 485 payments.

Analyzed by KHN, Missouri’s median payout for 12 malpractice agreements or decisions was $1.68 million. In Kansas, the median was $191,666.

Most lawsuits against health centers involved allegations of misdiagnosis or dental errors. The biggest prizes were for birth injuries or cases involving children.

Silvia Garcia brought one of these cases. In December 2015, she took her 14-year-old son to First Choice Community Healthcare in Albuquerque, New Mexico, to be treated for severe stomach pain and fever, according to a lawsuit she filed against the government.

According to the family’s claim, the doctor felt the child’s stomach but did not order any diagnostic tests. The doctor advised Garcia to take the child to the hospital if the pain worsened.

Two days later, she took him to the emergency room of a hospital. There, doctors found that his appendix had ruptured. He had developed septic shock, which resulted in brain damage and acute injury to his kidneys.

The teenager remained in the hospital for eight months.

Garcia settled the case for $6.8 million, most of which went to a private fund that could be paid for future medical expenses.

First Choice and Garcia declined to comment. The government said the deal was not an admission of error.

Community health centers pushed and won for government malpractice protection in the 1990s. They argued that their income was limited and that malpractice insurance would divert money that could be better used for patient care.

The centers differ from other health clinics in that they receive a federal grant each year. They also receive higher reimbursements from Medicaid and Medicare than private doctors. In contrast, centers are not allowed to turn anyone away, and fees for low-income patients are on a volatile scale. About half of the patients in the centers are covered by Medicaid and 20% are uninsured.

Nonprofit federally funded health centers are a cornerstone in the nation’s health care safety net as they treat the medically underserved. Average profit margin is 5%, but some have posted 20% or more in three of the last four years.

Malpractice lawsuits are a risk to all healthcare providers and are only a barometer of the quality of care. Conciliations and court decisions against health centers do not measure the overall performance of clinics.

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Even lawyers who sue on behalf of health care patients acknowledge the importance of the facilities. The Rhode Island plaintiff’s attorney, Amato DeLuca, said health centers serve a vital role in the healthcare industry and found “a lot of really great, extraordinarily talented people who are doing a really good job” at the centers.

Still, DeLuca said, everyone should be held accountable for mistakes.

Akimbee Burns’ case is an example of an overlooked diagnosis, according to her lawsuit against the U.S. government. Burns, who earns $11 an hour at a utility company, had a Pap smear done in 2016 at the South Central Primary Care Center, a community health center in Ocilla, Georgia. The test results showed abnormal cells, but he was not informed about the results, according to the complaint. He asked about the test several times in the following months, but claimed he was still not informed about the results.

About eight months later, staff at a different healthcare facility diagnosed advanced cervical cancer. He filed a lawsuit alleging that the community health center acted negligently. He had radiation and chemotherapy. However, he died in April 2019, leaving behind two children, one of whom is a minor.

After his death, the government and his estate settled for $2.1 million.

The South Central Primary Care Center did not respond to requests for comment, and the government denied any wrongdoing.

Barricades for Patients

A patient who claims medical malpractice by a healthcare facility must first submit their claim to the U.S. Department of Health and Human Services for review. The government can offer a settlement or reject the claim. If the claim is denied or cannot be resolved, or if the six-month review period expires, the patient may file a lawsuit in federal court under the Federal Claims Act or the FTCA.

To obtain this federal protection, healthcare centers must have quality improvement and risk management programs and demonstrate to regulators that their doctors and other clinicians have reviewed their professional credentials, malpractice claims, and licensing status.

Ben Money, senior vice president of the National Association of Community Health Centers, said the process has improved care and redirected scarce operating dollars towards patients’ needs instead of costly malpractice coverage.

“There are stringent measures in place to ensure that health center grantees follow the rules and patients receive the best care,” he said. “FTCA is making health centers more mindful of quality, not less.”

Christy Choi, spokesperson for the Health Resources and Services Administration, said that as of September, about 86% of community health centers fall under the FTCA due to medical malpractice coverage.

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He said the government has implemented “strong quality improvement and patient safety efforts” as part of the program.

Lawyers involved in lawsuits against health centers said the system made it more difficult for patients to collect compensation than if they went to state courts for malpractice lawsuits. In addition to the ban on punitive damages, such cases are decided by federal judges rather than juries. They added that the absence of a jury was important because judges are less likely to be affected by emotions, which could mean lower dollar amounts in prizes.

Plaintiffs are also at a disadvantage because the federal government has unlimited resources to defend cases, unlike patients and their lawyers, said Christopher Russomanno, a Miami-based attorney.

“These cases cost us hundreds of thousands of dollars to prepare for court,” said Jack Beam, Illinois attorney representing Rhonda Jones. “Our record in case costs was $900,000.”

Rhonda-Jones23.jpgRhonda Jones smiles to daughter Alayna Hike at their home in Crown Point, Indiana.  Alayna wears a colorful apron and pompoms in her hair.

Taylor Glascock / Taylor Glascock

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Rhonda Jones smiles to daughter Alayna Hike at their home in Crown Point, Indiana, southeast of Chicago. Alayna was injured during childbirth and suffered cerebral palsy. (Taylor Glascock for KHN)

All these factors can prevent patients from finding a lawyer.

Deborah Dodge, a Missouri attorney, said some attorneys are reluctant to take cases because the government has limited their fees to 25% of the settlement amount. By contrast, plaintiff attorneys typically take about 40% of successful state court misconduct cases.

Rhonda Jones was one of the deals. According to her lawsuit, her baby was transported to a children’s hospital in December 2016, just after she was delivered by emergency cesarean section at West Suburban Medical Center in the Chicago area. The baby, named Alayna, was treated for brain damage caused by lack of oxygen and is currently suffering from cerebral palsy.

When Jones arrived at the hospital at about 39 weeks pregnant, she showed signs of high-risk labor: She was 40, this was her 11th child, and had severe preeclampsia and possibly gestational diabetes.

Alayna’s case alleges that she was not adequately monitored at the hospital and that the surgery was not performed in a timely manner to avoid Alayna’s injury.

Jones agreed to a $21 million settlement, $15 million of which was paid for by the federal government because some of the doctors involved were employed by the PCC Community Wellness Center. The health center and hospital declined to comment. In court filings, the government and hospital denied guilt.

The money, most of which is in a custody overseen by the court, provides a livelihood for Alayna, who will be in need of care for the rest of her life.

“Before what happened to Alayna, I loved them,” Jones said of the health center that Alayna went to for many of her previous pregnancies. “They were great for me as they were open late at night when I was working.”

“Still, I would tell someone to go to the PCC because maybe when they go to have their baby, they’ll find the right doctors,” Jones added.

This story was originally published by KHN. Alander Rocha and KHN reporter Colleen DeGuzman contributed to this article.



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