Lawyers

Lawyers out of control in south Texas.

By Chris Rangel MD ⋅ April 18, 2002 ⋅  Email this post ⋅  Print this post ⋅ Post a comment

Lawyers out of control in the RGV - Medical Economics has a nice article that summarizes the recent explosion of medical malpractice cases in the Rio Grande Valley of south Texas. From 1999 to 2001 medical malpractice suits filed in Hidalgo County went from 131 to over 750 claims according to the Texas State Board of Medical Examiners. Did health care in Hidalgo County suddenly collapse? Not at all. Trial lawyers across Texas discovered that Juries in the RGV (usually made up of lower economic class minorities who tend to be easily swayed by plaintiff lawyers to rule against the big bad rich doctors) had been handing out a few multi-million dollar judgments in concert with Judges who tend to have dangerously close relationships with trial lawyers. One of the eager-beaver lawyers who jumped on this band wagon is Raymond Garcia, former Democratic party chairman of . . . . . . you guessed it . . . Hidalgo County! This position had allowed him to heavily influence the party financing of candidates for county judgeships. Judge Mario Ramirez was one who’s rulings were consistently favorable to Garcia (of course the $5,000 that Garcia gave to Judge Ramirez’s campaign didn’t hurt). OK, so “dirty” politics is nothing new to the valley, but what came next made me want to vomit. In 1998, Leonel Garza developed complications during angioplasty performed by his cardiologist Dr. Hector Urrutia and had to have emergency by-pass surgery by cardiac surgeon Francisco Bracamontes at McAllen Medical Center. The complication rate during angioplasty is low (about 1%) but there is a risk and that’s why there needs to be a nearby cardiac surgery unit. The patient was appropriately transferred for surgery but unfortunately this patient died. Garcia was hired by the family to sue the doctors and the hospital. Did lawyer Garcia find gross negligence? Did he find that procedures were incorrectly done or that the proper informed consent was not given? Well, no, actually Mr. Garcia found what all lawyers love, a technicality. Dr. Bracamontes was NOT board certified in cardiothoracic surgery! Does this mean that he should never have been practicing medicine at all!? Well, no, being board certified in any field of medicine is all about better reimbursement from insurances and prestige and as such many hospitals require their staff to be board certified (it’s a money thing, not a safety thing). Bracamontes did do his actual surgical training at Denton Cooley Texas Heart Institute in Houston but because he did his initial surgical training in Mexico he was ineligible for board certification. He was fully licensed by the state of Texas to practice medicine and surgery and apparently had such an impressive résumé the hospital’s executive committee approved him for a staff position despite their own by-laws requiring staff to be board certified. Now keep this in mind: there is nothing magical about being board certified that makes one a better physician (or that not being certified make one a poor physician). Bracamontes was not certified only because he had his initial training outside the U.S. and not because he had failed to pass the certification exam.

Enter Mr. Garcia stage left. It appears that he based his entire suit on this “technicality” rather than any evidence of actual negligence. Then with blood in the water the feeding frenzy began. Houston attorney Michael Caddell filed a class action lawsuit against Bracamontes, the cardiologist Dr. Urrutia, and McAllen Medical Center (MMC) on behalf of EVERY PATIENT treated by Dr. Bracamontes while he was on staff at MMC! Lawyer Garcia went suit happy and actually solicited hundreds of Dr. Bracamontes patients with a letter stating, “If you or your loved one were not accurately informed about Dr. Bracamontes’ [lack of qualifications] before consenting to heart surgery by him . . . you may have a claim for pain and suffering, mental anguish, and other personal injury or economic damages.” Keep in mind what I said about being board certified. This is not a “lack of qualifications” and I don’t believe that Dr. Bracamontes was ever proven to be any less qualified than any other cardiac surgeon. This legal blood bath was so sloppy and aggressive that several suits were dismissed when absolutely no evidence of negligence could be found and several patients had never even been treated nor seen by Dr. Urrutia and/or Dr. Bracamontes and a few never even gave their consent to sue! To my knowledge neither Raymond Garcia nor Michael Caddell have been investigated by the Texas Bar for ethics violations and both are still practicing. In fact, lawyer Garcia is running for Hidalgo county judge!

The cynical person may not care what happens in legal battles between “privileged”, rich, doctors and lawyers but cases such as these have a chilling effect on health care in general. Areas such as the RGV that are poor and rural tend to have enough trouble attracting physicians and now that the RGV has obtained a reputation for such lawsuit bombardments as these the situation can only get worse. If you think that it’s hard to get an appointment to see your doctor now just imagine what impact these suits will have on communities in the future. Insurance rates are already astronomical based on the work of Garcia and others like him. Lawyers like him seem to cast a blind eye to whatever consequences these frivolous suits will have on the quality of and access to health care of communities. Their lawsuits have the appearence of only caring about making money for themselves and their client at whatever cost. Case in point: Cardiac angioplasty is a great non-surgical treatment for coronary artery disease and heart attacks. However, because of the risks involved there needs to be nearby surgical cardiothorasic support in the case of a complication. Should Dr. Bracamontes and other cardiothorasic surgeons be driven out by these lawsuits patients in the RGV will be deprived of this valuable and often live-saving procedure and have no choice but to be transported 200 miles north to Corpus Christi for any hope of treatment. There are consequences.

America. . . . you have been warned! Thanks to my dad Lionel Rangel MD of Weslaco Texas for alerting me to this article.