Memoirs of a Malpractice Suit

For over 4 years from the time that the patient was injured until the jury verdict absolving me, I was involved in a malpractice suit. It has been estimated that 1 out of 20 psychiatrists will be sued every year; the ratio for analysts is smaller but, as we find ourselves working in more-diverse settings, the number of suits will no doubt rise, just as the number of such suits in all specialties keeps rising. I would like to report on my experiences during these 4 years, and my progress from relative innocence to relative sophistication. I say relative innocence because I never thought much about malpractice, tried to provide good care, and no one close to me had had such an experience. I also say relative sophistication because although I have learned much about the law and the insurance business, I have hardly scratched the surface.

About 2 years before the injury occurred, I began to provide psychiatric consultations in a small community hospital. Those of you who have consulted in general hospitals know that most of the work concerns determining competency in the aged, checking whether psychiatric patients admitted for medical or surgical care require special attention during hospitalization, helping to manage patients who have developed psychiatric problems during their hospital stays, and evaluating suicide risk.

I was in the hospital to see an elderly patient for a competency evaluation on my way from home to work early in the morning. As I was about to leave, I was intercepted as I passed the emergency room (ER) and was asked to see a newly arrived 40-year-old woman who had made a suicide attempt. Almost immediately after taking a bottle of imipramine, she had a change of heart. She wakened her husband who brought her to the hospital, gave a report of what had happened, and left to look after their 6-year-old daughter. When I saw her, she was about 2 hours postingestion