Lack of malpractice insurance limits claims vs CHC

In 2004, an 18-year-old boy had a tracheotomy done at the Commonwealth Health Center. As he was getting ready to go home, his mother called for one of the doctors to come and adjust her son’s tracheotomy tube as it was protruding at an angle.

The doctor, allegedly without looking at the patient’s medical file, forced the tube down the boy’s throat, which caused bleeding and an infection that eventually killed the boy.

Because the doctor was an employee of the Commonwealth government and acted in this capacity at the time the tragic event happened, the case pitted the family versus the Commonwealth. The case was actually scheduled to be heard in court this month but it did not make it to trial.

According to lawyer George Hasselback, an aid of judgment of $50,000 was offered to the family of the deceased, which they accepted. The aid of judgment is a tool that defendants can use to make an offer to settle a case.

Although the doctor was eventually found guilty of medical malpractice in this case, Hasselback said the family was only awarded $50,000 for the wrongful death of their son.

This is because doctors employed at CHC are not covered by medical malpractice insurance. Also, the hospital has put a cap on the amount it will give out to settle malpractice cases. Lawyer Michael Dotts said that the Commonwealth is only responsible for damages of up to $50,000 for wrongful death or $100,000 for personal injury.

“What the government should really do is get medical malpractice insurance for their doctors,” Dotts said. “Instead, what CHC did was put a limit on their liability.”

A proposal had been made not long ago to require Commonwealth doctors to have medical malpractice insurance; however, this proposal did not pass.

Dotts said that medical malpractice insurance does two things: “If we require our doctors to have medical malpractice insurance, it will ensure good doctors as it screens them before anything. Another thing it does is it removes the $50,000 cap for wrongful death and $100,000 for personal injury, providing a more reasonable amount of money to compensate the person who suffered the accident.”

Dotts spoke of a case a few years back between a certain De Guzman and an obstetrician/gynecologist at CHC.

“What happened was the woman’s water broke. And normally, within 72 hours you have to induce labor. However, a week later, this woman was still in the hospital, pregnant. Eventually her baby got infected and then ended up being delivered dead,” Dotts said.

DeGuzman was awarded $80,000 in this case.

Dotts said that as the case was going on, it was discovered that the doctor actually had his medical license suspended in California for gross malpractice. His license was also suspended in Indiana but “they [Department of Public Health] went ahead and hired him anyway.”

The doctor remained at CHC even after the DeGuzman case until he resigned over a year ago.

“There has been so many medical malpractices at CHC, just so many. If we required our doctors to have medical malpractice insurance, we will not be able to hire somebody like [name redacted],” Dotts said.

Public Health Secretary Joseph Kevin Villagomez said that all government hired physicians and other medical staff are indemnified by the CNMI government whenever malpractice cases crop up.

Moreover, “all non-government physician need to show proof of medical liability coverage should they want to practice at the government-run hospital (i.e., CHC),” Villagomez said.

He said that since one of the major issues with private providers is that there is no readily available medical malpractice insurance coverage carrier in the CNMI or Guam, there is a compromise to request all private physicians that want to work at CHC to show purchase of a bond for up to $100,000 or show asset (either monetary or goods) that is also at the $100,000 level.”

Dotts said that just because medical malpractice insurance is not “readily available, that does not mean it cannot be bought. Legal malpractice insurance [for lawyers] is not readily available but we have them. If lawyers can find it, our hospital can find it,” Dotts said.

He added that, “If they have to pay $50,000 for medical policy, it’s cheaper not to have anything because the limit on their liabilities are so low.”

Hasselback said “It does seem illogical at first but I think the way the law is being looked at is, if the person is dead, he’s dead. He will not need continuing care or medicine or treatment, and there is no more suffering from the person.”

However, he added that the downside of this is “if a doctor commits malpractice which the person would have to live with for the next 50 years of his life and he would need $100,000 for medical treatment in one year, he is out of luck for the next 49 years because the Commonwealth is only responsible for $100,000.”

Dotts said that, although “it is true that the CNMI economy does not have that much money, people are still very dependent on CHC.”

“I think if we are going to fund anything properly, it really should be health care. We should not be cheap in our medical care and we should really get good doctors,” Dotts said.