Malpractice deal hits rough water but survives as lawmakers complete second day

While the Senate debated a lengthy series of amendments to the proposed malpractice reform bill, the Assembly plowed ahead and pushed the plan through committee and to a vote on the floor Tuesday night.

As the Assembly convened at 9:30 p.m., Majority Leader Barbara Buckley, D-Las Vegas, said the bill would be approved before midnight.

The speedy action by the Assembly sends essentially the same bill worked out by doctors and lawyers and supported by Gov. Kenny Guinn to the Senate, which has already made a number of changes in the plan.

The biggest change made by the Assembly was to strengthen language requiring reporting of medical errors.

Speaker Richard Perkins, D-Henderson, said the Assembly was assured by Robert Byrd who heads the Nevada Medical Liability Association and insurance industry lobbyist Jim Wadhams that the measure will help relieve the malpractice crisis in southern Nevada by stabilizing insurance rates and, in the long run, controlling any increases if not reducing them.

"I'm disappointed it does not have insurance reform but I believe this is a good bill," he said.

And Buckley said she is confident the cap limiting potential non-economic damages to the amount of a doctor's insurance policy will pass a constitutional challenge because, among other things, it provides exemptions from the damages cap for "gross malpractice" resulting in catastrophic injuries such as death, brain damage or the loss of a limb. She said that is the judgment of legislative attorneys who have reviewed the language in the bill.

She said the opposition by some doctors to the measure was being drummed up by "a couple of individuals trying to derail the deal." She referred to a national insurance official who said it would do nothing and to a fellow legislator who sent out a letter saying the legislature was passing a plan that would allow a judge to override a jury verdict.

Guinn later in the day named Assemblywoman Barbara Cegavske, R-Las Vegas, as that legislator.

The bill doesn't cap economic damages -- provable costs and losses ranging from medical and rehabilitation bills to loss of income. But it does cap pain and suffering awards at $350,000 except in cases of gross malpractice.

Doctors and insurance industry officials questioned whether the exemptions included to make the measure constitutional in fact opened them up to practically unlimited damage judgments -- the situation which they say forced the special session of the Nevada Legislature in the first place. They called for those exemptions to be either removed or sharply limited.

They found support in the Senate, which reviewed their requested amendments late into the night. Among the changes approved were expanding the $50,000 cap on damages a doctor in a public trauma center can be forced to pay to include all emergency rooms in the state.

The differences between the Senate and Assembly versions of the measure will have to be worked out before final approval.

Guinn like Perkins and Buckley said he believes the bill will stabilize the medical malpractice insurance market in southern Nevada.

The special session was called after skyrocketing malpractice insurance rates hit southern Nevada doctors over the past six months -- increases of more than 100 percent in some risky specialties such as surgery. Doctors said without tort reform to help control their insurance rates, they couldn't continue practicing in southern Nevada. A number threatened to leave the state for places such as California which has a $250,000 cap on non-economic damages and the only major trauma center in Las Vegas was closed down for a week because doctors said they couldn't risk practicing there.