Silvia Garcia’s 14-year-old son was permanently disabled After a New Mexico community doctor failed to diagnose him with appendicitis, he was forced to use a wheelchair. He also had severe stomach pains. The teenager’s appendix ruptured before he could get to a hospital, and complications led to septic shock.
Akimbee Burns underwent a Pap smear in Georgia at a community hospital. It revealed abnormal cells. She was not informed of the results. About eight months later, she Was diagnosed with cervical cancer The disease had spread to her lymph nodes. She Age 38, died in less than two years.
Rhonda Jones’ baby Was left brain damaged after her Chicago-area medical team, which included community health center doctors, failed to perform an emergency cesarean section quickly enough even though Jones was at high risk for labor complications.
These three incidents — alleged in court documents as part of malpractice lawsuits that were settled without admission of wrongdoing — are among 485 payouts made nationwide involving community health centers from 2018 through 2021. According to federal data that was made public and released to KHN by a public records request, the judgments and settlements reached $410 million. They were paid to patients and their families.
However, neither the health centers nor the doctors paid any money. The bill was paid by the U.S. taxpayers.
The nation’s 1,375 federally qualified health centers, which treat 30 million low-income Americans, are mostly private organizations. They receive $6 billion in federal grants each year, and their legal liabilities are covered under federal law. This is similar to the U.S. Department of Veterans Affairs or the Indian Health Service. The federal government will pay any settlements or court judgements, and immunity is granted to the centers and their staff.
The public is often unaware that there are malpractice claims against such centers. The plaintiffs in lawsuits don’t name health centers or employees, and the government doesn’t disclose when it pays to settle cases.
“People should know if these doctors or centers are harming their patients,” said Deirdre Gilbert, national director of the nonprofit National Medical Malpractice Advocacy AssociationA consumer advocacy group,.
In addition, attorneys who have represented plaintiffs in lawsuits against health centers say federal rules handcuff patients with a short statute of limitations — two years — and do not allow punitive damages.
“The deck is stacked in the government’s favor,” said Regan Safier, a Philadelphia attorney who won a $41.6 million court judgment in 2018 in a case of a birth injury involving a community health center doctor.
Tragedies Hidden From View
From According to data from the Health Resources and Services Administration (which oversees community health centers), the median settlement or judgment for malpractice involving health centers was $225,000 between 2018 and 2021. The sum was more than $1 million in 68 out of 485 payouts.
Many lawsuits against hospitals were based on allegations of misdiagnosis and dental errors. Large awards were given for cases involving children or birth injuries.
Silvia Garcia brought one. According to a lawsuit she filed against government, Silvia Garcia took her 14-year old son, who was suffering from severe stomach pains and fever, to First Choice Community Healthcare in Albuquerque.
The doctor felt the boy’s abdomen but ordered no diagnostic tests, the family alleged. Garcia was advised by the doctor to go to the hospital if the pain continues to worsen.
He was taken to the hospital emergency room two days later. Doctors discovered that his appendix had burst. He He had suffered from septic shock, which caused brain damage and severe injury to his kidneys.
The teenager spent eight months in hospital.
Garcia settled for $6.8million. The majority of the money went into a special account that can be used to pay future medical expenses.
First Choice and Garcia refused to comment. The government claimed that the settlement was not an admission by Garcia or First Choice.
Community health centers pushed for — and won — government malpractice protection in the 1990s. They claimed that their revenues were low and that malpractice insurance would take money away from patients.
Because they receive a federal grant each fiscal year, the centers are different than other health clinics. They also get higher reimbursements from Medicare and Medicaid than private doctors. They are also not permitted to refuse patients with low incomes and charge a sliding-scale fee. Nearly half of the centers’ patients are covered by Medicaid, and 20% are uninsured.
Malpractice lawsuits can be a risk to all health care providers. They are not a barometer for quality of care. The settlements and court judgments against the health centers don’t measure the clinics’ overall performance.
Even lawyers who have sued for patients at health centers recognize the importance of these facilities. Rhode Island plaintiff attorney Amato DeLuca said that the health centers serve a vital role in the health industry and that he had found “a lot of really wonderful, extraordinarily capable people that do a really good job” at the centers.
DeLuca said that mistakes must be made by everyone.
Akimbee Burns’ case is an example of a missed diagnosis, according to the lawsuit she filed against the U.S. government. Burns, who was earning $11 per hour at a utility firm, underwent a Pap smear at South Central Primary Care Center in Ocilla in 2016. According to the complaint, the test results revealed abnormal cells but Burns was not told about the results. She She claimed that she inquired about the test multiple times over the next months, but was still not informed about its results.
Eight months later, staff at a new health care facility discovered advanced cervical cancer. She The lawsuit alleged that the community hospital had been negligent. She She underwent chemotherapy and radiation. However, she passed away in April 2019.
After Her death, the government and her estate Settlement for $2.1 Million.
South Central Primary Care Center declined to comment on requests and denied any wrongdoing.
Patients facing roadblocks
To file a claim against a U.S. Department of Health and Human Services regarding medical malpractice, a patient must first make alleged claims. The government can either make a settlement offer, or deny the claim. The patient can sue the federal court if the claim is not settled or denied, or the six-month review period has expired. Federal Tort Claims Act, or FTCA.
To get that federal protection, health centers must have quality improvement and risk management programs and must show regulators that they’ve reviewed the professional credentials, malpractice claims, and license status of their physicians and other clinicians.
“There are rigorous safeguards in place to ensure that health center grantees are in compliance and that patients are getting the very best care,” he said. “FTCA makes health centers more vigilant on quality and not less.”
According to Christy Choi, spokesperson for the Health Resources and Services Administration, 86% of community-based health centers were covered by the FTCA for medical negligence coverage as of September.
She said the government has implemented “robust quality improvement and patient safety efforts” as part of the program.
Attorneys representing patients in malpractice cases against health centers said that the system makes it more difficult to collect damages. These cases are not decided by juries and, in addition to the prohibition on punitive damages being awarded, federal judges decide them. They emphasized that the absence of a jury was important because judges are less likely be influenced by emotion, which can lead to lower awards.
Plaintiffs also suffer because the federal government is able to defend all cases without limitation, which is not the case for patients or their lawyers. Christopher RussomannoMiami attorney.
“These cases cost hundreds of thousands of dollars for us to get ready for trial,” said Jack Beam, the Illinois attorney who represented Rhonda Jones. “Our record was $900,000 in case costs.”
Patients may find it difficult to find a lawyer because of all these factors.
Deborah DodgeA Missouri lawyer said that some lawyers are reluctant to accept cases due to the fact that the government caps their fees at 25%. However, successful state court malpractice cases often result in plaintiff attorneys taking around 40%.
Rhonda Jones was one among the people who received a settlement. Her baby was transported to a children’s hospital soon after being born by emergency cesarean section at West Suburban Medical Center in the Chicago area in December 2016, according to her lawsuit. Alayna was admitted to West Suburban Medical Center in Chicago for brain damage caused by a lack of oxygen. She now has cerebral palsy.
Jones was almost 39 weeks pregnant when she arrived at the hospital. She She was 40 years old. This was her 11th child. She had severe preeclampsia, possibly gestational diabetes, and was in the fourth trimester.
Her Plaintiff claimed that she was not properly monitored in the hospital and that Alayna was not treated in time.
Jones agreed to be a $21 million Settlement$15 million, which was paid for by the federal government. Some of the doctors involved were employees of PCC Community Wellness Center. Both the hospital and the health center declined to comment. Court filings show that both the government and hospital have denied any wrongdoing.
The money — most of which is in a trust overseen by the court — provides for Alayna, who will require care throughout her life.
“Before what happened to Alayna, I loved them,” Jones said of the health center where she had gone for several of her previous pregnancies. “They were great for me because they would be open late at night when I was working.”
“I still would tell someone to go to PCC because maybe they will get the right doctors when they go to have their baby,” Jones added.
Colleen DeGuzman, KHN reporter, contributed to this article.