Closing of Las Vegas Trauma Center Could Signal National Problem

The decision last week to close the trauma center at the University of Nevada Medical Center -- the only trauma center in Las Vegas -- after doctors at the facility could not find affordable medical malpractice insurance may be a bellwether for "more such shutdowns of trauma facilities" nationwide, the Washington Times reports. According to some hospital industry representatives, "sharply rising" malpractice insurance rates could prompt other trauma center closures. Rick Wade, senior vice president of the American Hospital Association, said, "In some single-hospital communities, the liability crisis could push some" trauma centers "to the edge."

The UMC Case
UMC closed last week after 11 of 13 general trauma surgeons and 57 of 58 orthopedic surgeons resigned from trauma care responsibilities over malpractice insurance costs, Dr. John Fildes, medical director of the 10-year-old trauma unit, said (Howard Price, Washington Times, 7/7). In March, more than 1,400 physicians at UMC resigned as a result of malpractice insurance premium increases of as much as 300% (Kaiser Daily Health Policy Report, 7/3). Cheryl Persinger, a spokesperson for UMC, said that the hospital has a liability cap of $50,000, while high-risk specialists, such as obstetricians and neurosurgeons, must pay $150,000 to $175,000 per year for malpractice insurance. Fildes added, "Doctors cannot buy" malpractice insurance for "over $1 million, yet the average settlement (in the Las Vegas area) has been over $1 million for the past seven years. ... Doctors become personally liable" (Howard Price, Washington Times, 7/7). The Clark County Commission, which also serves as the UMC hospital board, offered to extend UMC's $50,000 liability cap to physicians who work in the trauma center and emergency room or serve indigent patients, but orthopedic surgeons on July 1 rejected the proposal (Kaiser Daily Health Policy Report, 7/3). Doctors have asked state officials to enact malpractice insurance reforms, such as a cap on the amount of damages that juries may award in liability lawsuits, to address the problem. Gov. Kenny Guinn (R) has set a July 26 deadline for doctors, malpractice insurers and trial lawyers to reach an agreement on the issue. After July 26, the Times reports that Guinn may "come up with his own strategy" and could call a special session of the state Legislature next month to consider the proposal (Washington Times, 7/7).