The Illinois Supreme Court is not yet issuing an opinion on whether the state's medical malpractice law is constitutional.

The court announced earlier this week it could rule Thursday on whether damage awards in medical mistakes may be capped.

But no opinion was released. Justices traditionally give no reason for the timing of their decisions.

The General Assembly adopted caps in 2005 as a way to keep doctors from fleeing the state because of rising insurance rates.

It limited what victims could collect for non-economic damages such as pain and suffering to $500,000 against doctors and $1 million against hospitals.

A Cook County judge ruled in 2007 that caps interfered with juries' power to award appropriate damage awards for medical errors.

The majority of medical malpractice claims in a study of seven states were closed without any compensation paid to those claiming a medical injury, the Justice Department's Bureau of Justice Statistics (BJS) reported.

BJS conducted a study of medical malpractice insurance claims that were closed from 2000 through 2004 in Florida, Illinois, Maine, Massachusetts, Missouri, Nevada and Texas. These states were identified as having comprehensive medical malpractice insurance claims databases, some of which extended back to the early 1990s.

About one-third of the medical malpractice insurance claims closed in Maine, Missouri and Nevada resulted in a payout. In Illinois about 12 percent of closed claims ended in a payout.

Few medical malpractice insurance claims produced payouts that exceeded $1 million. Less than 10 percent of the claims in Florida, Maine, Missouri and Nevada had payouts of $1 million or more. In Florida, Maine and Missouri, about two-thirds of the claims were closed with insurance payouts of less than $250,000.

Among persons receiving compensation, insurance payouts were highest for claimants who suffered lifelong major or grave permanent injuries. In Florida and Missouri, claimants with these types of injuries received median payouts ranging from $278,000 to $350,000. Insurance payouts were lowest for claimants who suffered temporary or emotional injuries. In Florida and Missouri, claimants who suffered these types of injuries received median payouts ranging from $5,000 to $79,000.

Medical malpractice insurance payouts increased as the insurance claims advanced through the legal system. Payouts were typically lowest for claims closed prior to the filing of a lawsuit and highest for claims closed after trial. In Florida, Nevada and Texas, claims decided by trial resulted in median payouts that were at least two and a half times larger than claims that were settled. Claims closed after a trial also cost more for insurance firms to defend than claims settled at or prior to a trial. In Florida, Nevada and Texas, 95 percent or more of medical malpractice claims were settled prior to a trial decision before a jury or judge.

The median damages paid to medical malpractice claimants have increased since the early to late 1990s. In Missouri, for example, the median insurance payouts grew from $33,000 in 1990 to $150,000 in 2004. During the various time periods covered by these insurance claim databases, median payouts also increased by 57 percent in Massachusetts, 49 percent in Illinois, 36 percent in Florida, 26 percent in Nevada and 27 percent in Texas.

In general, claimants did not file medical malpractice claims with insurance companies immediately after an injury. In Florida, Missouri and Texas, medical malpractice claims were filed with insurance companies an average of about 15 to 18 months after injury. After the claim was received, it took an average of 26 to 29 additional months to close the claim in these states.

It's been more than two weeks since Tennessee lawmakers vowed to press ahead with a compromise over medical malpractice lawsuits without support from health care lobbyists. The measure hasn't advanced much since then.

House Judiciary Chairman Rob Briley said frustration is rising among members of both parties who cobbled together a tentative compromise. The Tennessee Medical Association — a group the Nashville Democrat calls "organized medicine'' — has been pushing for stricter rules than Democrats wanted to accept.

"Efforts haven't been derailed, but they have been slowed down significantly since organized medicine got involved in trying to tinker with the proposal that the bill sponsors and I had worked out,'' Briley said.

Senate Republican Leader Mark Norris and Rep. Doug Overbey, R-Maryville, are the sponsors of the measure designed to limit frivolous lawsuits against doctors. They decided to leave the association out of earlier negotiations with Briley that resulted in an agreement to omit the group's long-standing demand to enact caps on lawsuit payouts.

Instead, lawyers suing doctors in medical malpractice cases would have to pre-certify the legitimacy of their claims by gaining approval from independent experts. They would be subject to penalties if they were later found to have filed frivolous lawsuits without proper vetting.

Attorneys found in violation could be forced to pay the court costs for defense lawyers and could be hit with other penalties. They could also have their names reported to the Board of Professional Responsibility.

Russ Miller, vice president of the Tennessee Medical Association, previously called a limit on non-economic damages the "linchpin'' of his organization's goals. Recognizing that caps are not likely to pass this year, Miller now says the group wants to make the rest of the measure stricter.

"We want to ensure we put some real meat on to efforts to weed out lawsuits that don't need to be clogging our legal system,'' he said.

Norris acknowledged some unhappiness among the health care lobbyists for having been left out of the original negotiations.

"I think that some of their feelings were hurt, and that there was a misunderstanding about who has legislative responsibility and who has lobbying responsibility,'' Norris said. "Once they got over that hurdle ... they began paying attention to the wording.''

Norris said the two sides are discussing the details of pre-certification and whether opposing lawyers should have more access to a plaintiff's medical information before a case gets under way.

"It used to be that if you put your own health at issue, there were no secrets _ the defense could get access to my medical records and talk to my doctors,'' Norris said. "That's no longer the case.''

Briley said it might have been a "tactical error'' on the Republicans' side to let the TMA back into the negotiations.

"Organized medicine has said 'if we don't get caps, we get everything else,''' Briley said.

Norris responded that both doctors and lawyers just want to make sure they don't lose too much.

"Each side is suspicious about the other side overreaching,'' Norris said.

Senate Speaker Ron Ramsey, R-Blountville, said he will defer to Norris on the negotiations is willing to move forward on the original proposal to impose caps if they fall apart.

"I'm prepared to move the bill forward with the caps if we can't work out some kind of compromise,'' said Ramsey. "But we'd be moving it forward realizing it's going to have a tough time in the House.''

Norris and Briley said they could bring the proposal before their chambers' respective Judiciary Committees next week.

House Speaker Jimmy Naifeh, D-Covington, has said he would consider Briley a "miracle worker'' if he could resolve the long-standing impasse over medical malpractice lawsuits.

A doctor and a nurse were separated from Bedford County Medical Center as defendants in a medical malpractice case that's sought at least $2.5 million over the death of a man who sought treatment at the hospital's emergency room.
The ruling came Thursday from Bedford County Circuit Court Judge Lee Russell in the case brought by the widow and children of Samuel Harrison Butcher III, who died on Sept. 4, 2004, three days before his 29th birthday, according to the complaint filed by the plaintiffs' attorney, Russell Thomas of Murfreesboro.

Named in the original complaint as defendants are Dr. Kent Clark, a nurse named only as L. Brashier in the complaint, the hospital, and Quorum Health Resources LLC which was the hospital's management service hired by Bedford County before the facility was sold in July 2005.

All defendants have denied wrong-doing, indicating they worked to provide good health care and their attorneys have stated that a jury trial would prove to be successful for their clients.

The latest development in the case was on a request from the hospital's attorneys who pointed out that doctors and, in this case, nurses are technically independent contractors who work at the facilities available at the hospital.

There was no opposition to the request from attorneys representing the hospital which is now owned by Community Health Services, a hospital holding and management business headquartered in Williamson County.

Russell's ruling eliminates what's called "vicarious responsibility" by the hospital, but other defendants can be added to cases as evidence is gathered during depositions and other aspects of the discovery process prior to trial.

In the original complaint, Thomas outlined the chain of events which led Butcher to the hospital and what's claimed to be the cause of his death.

Butcher was involved in a one-vehicle crash in which a truck overturned, Thomas wrote in the complaint. While medical treatment was not sought the day of the crash, a Sunday, Butcher went to the emergency room on the next Thursday. Having presented himself with a history of smoking and high blood pressure and after a motor vehicle accident, Butcher was seen subsequent to decisions made at the emergency room based on triage assessments of patients.

That was on Sept. 2, 2004 when Butcher was discharged to see his family physician. But a heart specialist was not mentioned, according to the complaint that alleges a breach of a standard of medical care that might be expected at a rural county hospital.

Butcher continued to experience pain and died two days later, according to the complaint in the case file.

Tracy Lynn Butcher is the widow of the man for whom wrongful death is alleged. Mrs. Butcher has two children; Chase Butcher, 4, and Samantha Butcher, 10.