Lawsuit accuses hospital of overworking doctor

A Pittsburgh-area couple has accused a local physician of negligent care after the stillborn birth of their baby. But they also accuse the hospital that employed the doctor of overworking him, claiming that the ob-gyn's busy schedule contributed to the adverse outcome.

In a lawsuit separate from the medical malpractice case filed against the physician, Rose and James Thompson accuse Westmoreland Regional Hospital of "maintaining a health care practice with an unmanageable number of patients" and referring too many patients to the obstetrician-gynecologist. The lawsuit also contends the hospital did not address the doctor's concerns about his work schedule.

While liability lawsuits commonly expand their reach beyond physicians to include the deeper pockets of hospitals and medical groups, attorneys said this claim of corporate negligence related to work hours is a unique strategy.

Some also said the approach could further damage an already reeling liability system in Pennsylvania. The state is one of 20 that the American Medical Association has declared to be in crisis because high liability insurance premiums are forcing doctors to retire early, avoid high-risk procedures or move to a different state.

"What I see is this ever-expanding view of what people think malpractice is," said Jim Saxton, who chairs the health care litigation group for Stevens & Lee in Lancaster, Pa. "This complaint strikes me as one that is really reaching. We have enough problems with liability without creating another avenue for patients and families to sue our health care providers."

Deposition reveals busy schedule

The original lawsuit accuses Robert K. Greene, MD, an ob-gyn on staff at Westmoreland, of providing negligent care to Rose Thompson during the late stages of her pregnancy.

Dr. Greene could not be reached for comment, and his attorney did not return calls seeking comment. But according to the lawsuit against Dr. Greene, Thompson reported feeling fewer fetal movements when she was 37 weeks pregnant in late 2003. She was told to visit the hospital for a non-stress test and biophysical profile. The lawsuit alleges the profile results indicated Thompson needed further examination, but Dr. Greene, after learning of the lab results, "gave instructions to discharge" her.

A week later, Thompson was experiencing labor pains when she arrived at Dr. Greene's office for a regularly scheduled appointment, the lawsuit said. The baby was delivered with no signs of life.

During his deposition, Dr. Greene testified he typically saw about 85 patients per day, delivered more than 400 babies per year, and performed between 450 and 500 surgeries annually, according to the complaint against the hospital.

The idea of a physician out of his residency working such a hectic schedule was startling, said Harry S. Cohen, a Pittsburgh attorney who represents the Thompsons in both cases.

The lawsuit involving the hospital claims that Dr. Greene testified during his deposition that the medical center forced him to see the high volume of patients each day. The complaint also alleges Dr. Greene approached hospital administrators with concerns about the work load and environment, but they were not addressed.

"The idea of corporate liability of a hospital for its policies is not all that novel, but in terms of specifics, I have not seen a case where a doctor was required to work like this," Cohen said.

But Cohen said the case is akin in many ways to the debate regarding resident work hours. The idea behind the Accreditation Council for Graduate Medical Education's work-hour limits is to prevent medical errors by residents and interns that are caused by fatigue.

A spokesperson for Excela Health, which runs Westmoreland Hospital, declined to comment on the case. The hospital had not filed a response to the lawsuit before press time.