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Missouri Insurer Won’t Pay for Medical Mistakes

Posted by Todd Hendrickson in Medical Malpractice

A Missouri medical insurer has announced that it will no longer pay hospitals for certain types of medical errors, such as performing surgery on the wrong part of the body or leaving objects in the patient after surgery. This new policy has been reported in the St. Louis Post Dispatch and Forbes.By setting this policy, Anthem Blue Cross Blue Shield has effectively declared that certain occurrence, which they refer to as adverse events, are clearly the result of medical malpractice and that they, the insurer, shouldn’t have to pay for that malpractice. Included in the list of adverse events is:

  • Wrong site surgery
  • Surgery performed on the wrong patient
  • Air embolism or blockage
  • Blood incompatibility
  • Decubitus (pressure) ulcers, otherwise known as bed sores
  • Fractures, burns, crush injuries and other injuries caused by falls or drops in the hospital
  • and others
  • While this may seem like a good idea for the insurer, the question for patients who have been the victim of such medical negligence, is: “If my insurer doesn’t pay, then who will?” In nearly twenty years of representing victims ofmedical malpractice, I can confirm that the list above covers a good portion of the common types of medical malpractice cases prosecuted. However, in nearly every case, the doctors and hospitals have defended cases that arise from these types of mistakes, and have defended them vigorously. If the medical insurer doesn’t pay, the patients, will be dealing not only with the problems created by the mistake, but by the bills generated by those mistakes. And often, the doctor or hospital who caused the mistake, is only the first in a long line of treaters who will work to try to correct the mistake. After a severe medical mistake, patients will often (and correctly so) seek treatment from a different doctor or hospital to diagnose and treat the injuries resulting from the medical malpractice. Those secondary treaters haven’t done anything wrong, and the patient needs the treatment. If Anthem Blue Cross Blue Shield refuses to pay those secondary health care providers, the victims of medical malpractice will be victimized again, and again.While the attempt to improve patient safety is certainly laudable, this may not be the best course for the patient. The risk of causing more harm to those already harmed by clear malpractice is simply too great.

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