Malpractice ; Medical Lawsuits Increase Here

April Strang-Kutay thinks she knows when and why medical malpractice lawsuits began to rise in Lancaster County.

On Dec. 13, 2010, a local jury ordered Dr. John Schantz and Plastic Surgery Associates of Lancaster to pay $2.7 million to a man who said the doctor had severed one of the man's nerves during surgery. The verdict was announced on the front page of the local newspapers, and Strang-Kutay - the attorney who represented the plaintiff in the case - began fielding calls from lawyers outside the county.

What happened?

How'd she do it?

Lancaster County had a reputation as a bad place to file a malpractice suit - too conservative, with juries too deferential to doctors. But the verdict "started to change the way Lancaster County juries are viewed," said Strang-Kutay, who works for Goldberg Katzman's Medical Negligence Division. "A greater number of lawyers became interested in evaluating potential Lancaster cases."

And that's resulted in more lawsuits.

Through the first 10 months of 2014, 51 medical malpractice cases have been filed here - a record, surpassing the previous mark of 41, set just last year.

In fact, malpractice suits have increased four years in a row here - since 2010. Statewide, malpractice cases have dropped by more than 43 percent since the Supreme Court of Pennsylvania enacted reforms in the early 2000s to curb lawsuit abuse.

Lancaster County, by contrast, has seen a sevenfold spike - the biggest increase of any county in Pennsylvania.

There might be other factors besides a realization that Lancaster County juries can be generous. County demographics are changing - newcomers might be more apt to file suits - and medicine itself is evolving, becoming more institutional.

"If you've been dealing with one family doctor for 40 years, you're less apt to sue that person," said attorney Thomas Hall, a partner with Atlee Hall LLP in Lancaster. "There is this feeling now that you're not suing Marcus Welby - you're suing a faceless entity."

No one doctor, practice or hospital has been targeted so far in 2014. While nine suits have named Lancaster General Health as a defendant, that's down from 21 in 2013.

LG Health spokesman John Lines said the health system doesn't track countywide trends. "We do, however, carefully examine each of our malpractice cases to identify whether a clinical process, policy or environment is responsible for a series of incidents and should be changed," he said.

Ephrata Community Hospital has been named as a defendant three times so far in 2014; Heart of Lancaster was named in one case.

Orthopedists have been the most oft-sued specialists this year; five suits have been filed against orthopedic practices here.

Providers say they're not certain why lawsuits have risen county wide.

Dr. Karen Rizzo, a Lancaster otolaryngologist, is president of Pennsylvania Medical Society. She thinks the statewide reforms enacted a decade ago might have led to more cases here.

One rule required malpractice actions to be brought in the county where the cause of action occurred. That meant fewer cases were filed in Philadelphia, where cases often had been filed due to the generosity of Philadelphia juries.

From 2000-2002, an average of 1,204 cases were filed in Philadelphia; in 2013, just 382 were.

"Cases that were previously tried in Philadelphia no longer are and instead are (tried) in Lancaster," Rizzo said.

Lancaster County averaged a mere seven malpractice lawsuits per year between 2000-2002. By 2006, that figure had jumped to 40, before falling back to 12 in 2010. Now the numbers are surging again.

Katherine Kravitz, a partner at the Lancaster law firm Barley Snyder, has defended malpractice suits. She said that while newcomers to the county might be more likely to file a suit, even those who have always lived here might have changed the way they view medicine.

"Health care in general is undergoing such a huge overhaul," Kravitz said. "People have insurance changes and have to change doctors, or people talk about how their doctor only has 15 minutes for them."

All of it, she says, may alienate patients - consumers - from the system.

That's not unique to Lancaster County; that's universal. But here, it might be more jarring to traditionalists who see the doctor- patient relationship as sacrosanct - and disrupted by what attorney Hall calls the "corporatization" of medicine.

"Look at Lancaster County: You can't swing a dead cat without hitting a new health-care facility, whether it's an urgent care facility, something at the health campus (LG Health'sSuburban Outpatient Pavilion in East Hempfield). People are starting to say, 'I'm not a bad guy for bringing a lawsuit here --I'm actually trying to stop them from cutting corners.

"The people who want to sue, one of the very first things they all say to me is, 'I don't want anyone else to go through what I've gone through.' "

But attorney Strang-Kutay, who filed four of the 51 cases here this year, says a change in the attitude of juries, and not just plaintiffs, likely plays a role.

"Of the $2.7 million awarded (in the 2010 case), $700,000 was for economic loss and $2 million was strictly for pain and suffering," she said. "This was a big wake-up call. ... Lancaster County understands pain and hardship better than anyone thought."