Bronx-Lebanon Obstetricians Face Malpractice

Bronx-Lebanon Obstetricians Face Malpractice & Insurance Cut-Off

A malpractice insurance group has warned obstetricians at a South Bronx hospital that it is considering cutting off their insurance, which could force surrounding hospitals to absorb hundreds, and perhaps thousands, of baby deliveries a year.

The group, Medical Liability Mutual Insurance Company, sent a letter on Feb. 10 to 8 of the 13 doctors who handle births at Bronx-Lebanon Hospital Center, saying that its underwriting committee had recommended not renewing their coverage.

The letter said the “method of practice” and “practice environment” among those doctors was “predictive of future claims in excess of the norm, and makes insuring you an unreasonable burden to the other policyholders.”

Bronx-Lebanon delivers more than 2,700 babies a year, many to poor women whose pregnancies are risky because they are teenagers or have diabetes, high blood pressure or other medical problems, hospital officials said. The eight doctors all deal specifically with high-risk pregnancies. The letter did not say how many times each of the doctors had been sued for malpractice.

The hospital defended its reputation, saying that regardless of the high-risk population it treats, its services compare favorably with those at other hospitals.

State health and insurance officials were also working with the hospital to try to resolve the problem, said Claudia Hutton, a spokeswoman for the State Health Department. The letter sent a shudder through surrounding hospitals, where officials said they were bracing for an influx of patients if the insurance company made good on its threat. The doctors are entitled to appeal before the decision would become final in July.

“We don’t have the capacity currently to handle these babies,” said Dr. Gary Kalkut, senior vice president and chief medical officer of Montefiore Medical Center, another Bronx hospital. “I look at it now as a boroughwide problem. We’d have to come together with the other providers to figure out what to do.”

Hospital officials used the letter as an occasion to lobby for two malpractice insurance changes proposed by Gov. Andrew M. Cuomo’s task force on Medicaid overhaul: a cap on noneconomic damages, like pain and suffering, for malpractice suits, and an indemnity fund for neurologically damaged infants. Both measures have been vigorously opposed by trial lawyers, who argue that poor people would be most hurt by efforts to limit their ability to sue for damages.

Kenneth E. Raske, president of the Greater New York Hospital Association, said: “Without being hyperbolic, this is a potential public health crisis, and it is precipitated by the current malpractice climate, particularly related to obstetrics. We could be within a cancellation notice away from a major access problem for a large number of New Yorkers.”

Insurance premiums for obstetricians in the Bronx are among the highest in New York and among the highest in the medical profession in the state, according to Edward J. Amsler of New York State Medical Liability Mutual Insurance Company. He said the highest obstetrical premiums were $187,000 a year for $1.3 million in insurance, in Nassau and Suffolk Counties; the Bronx was second at $177,000 for the same coverage. In Manhattan, premiums were $145,000 for the same coverage.