Monday, April 08, 2019

Hot Coffee and Dr. Death

People lead busy lives.  In a representative democracy citizens are able to delegate the making and interpretation of laws to elected officials and impartial judges. When elected officials don't represent the people and judges are not impartial it can take significant time (decades..possibly never) for the impact of lawmakers and judges actions to be recognized by a significant number of citizens.

In addition to not having time, citizens are hard pressed to find useful information in a media environment where profits come from titillating, click-worthy snippets of mostly useless information.

Citizens are also stymied in becoming informed by massive amounts of propaganda intended to shape public opinion to support the rich and powerful in their ongoing efforts to become more rich and powerful. This propaganda can be as overt as what we see on Fox, as insidious as a popular TV show like 24 used to inculcate the public into believing torture of enemies is acceptable, or the militarization of sporting events, and as widespread as all public relations / advertising encouraging people to buy some thing to make them happy/sexy/virile etc.


So...what's the point?

Assume you have time, a somewhat open mind, and the ability to parse through information to unwrap some of the complexity. By complexity I mean who paid for it, what biases may be present, and the accuracy of the information.

I've been in that situation now for a few years and I can't help but think if I presented some of my viewpoints to my old working self, or most busy working people, they'd think I was a conspiracy nut or a hyper-partisan who's only looking at one side of the story.

I'd say somewhat tongue in cheek that if you think things are bad - you are probably underestimating the scope of the problem. If you can stand a healthy dose of pessimism and skepticism, a contemporary thinker like Chris Hedges has some interesting things to say.

If I sometimes sound like a conspiracy minded nut, I like to think it's partly because I've had the ability, time and inclination to do a fair amount of independent research.

Of course I'm talking about abstractions here - things are great for me and my immediate family. It's a great liberal tradition - telling other people how unhappy they are or should be. Maybe it's a Christian thing, but I can't help thinking about other people. I'd be a better person, Christian or otherwise, if I could say I can't help doing things for other people.

There are reasons we don't talk about politics in polite society.

I think it mainly has to do with an individual not being able to determine another persons depth and source of knowledge. If you and I don't have some commonality when it comes to depth or source we probably are just wasting time and risking hurt feelings.

Words are tricky things and we use a lot of words as symbols that have meaning to an individual or a group of individuals but lack any common understanding. For example the word conservative means nothing, ditto for liberal, democrat, republican. These words are used as tribal tattoos, or maybe to point to some hazy concept, and not of much use in a good faith exchange of ideas.

Walter Lippmann wrote about this in his 1921 book Public Opinion -

"To the infant there is precious little difference between his own toes, his father's watch, the lamp on the table, the moon in the sky, and a nice bright yellow edition of Guy de Maupassant. To many a member of the Union League Club there is no remarkable difference between a Democrat, a Socialist, an anarchist, and a burglar, while to a highly sophisticated anarchist there is a whole universe of difference between Bakunin, Tolstoi, and Kropotkin."

It's interesting to consider that successful cooperation between people of different races, nationalities, sex, sexual preferences or religions, often occurs in scientific or engineering endeavors where symbols used to communicate are clearly identified, understood and agreed upon.


Back to the title of this post - Hot Coffee and Dr. Death.

Hot Coffee is a documentary about so-called Tort reform. So-called because depending on who's doing the talking it's either reform or another case of our political and legal systems being corrupted by money. I don't know what it is but it doesn't smell very good.

Dr. Death is the name given by the media to the neurosurgeon Christopher Duntsch.

From an Arkansas Times  article by Max Brantley -
"Christopher Duntsch, now in prison, operated on 37 people during two years in practice in Dallas. 33 were injured, many grievously. Two died. The quality of his work and his apparent abuse of drugs were no secret, but the butchery continued. Why?"
Yes why?

I listened to the podcast Dr Death on a long road trip and kept asking myself that question. I kept wondering why the civil justice system didn't prevent what happened in Texas and why his fellow doctors had to prod the criminal justice system to eventually bring his reign of terror to a close. It seemed that Duntsch and the hospitals who employed him were unconcerned about liability. Why weren't there multi-million dollar lawsuits acting as a check on this kind of negligence?

Max Brantley provides an answer in his article from the Arkansas Times -
"Thanks to Texas' "tort reform" law to limit damages in malpractice cases, civil court restitution was limited if available at all to the patients and families. Save this article for the next time Chamber of Commerce boss Randy Zook, the medical and nursing home lobbies and others try again to make Arkansas a legal safe haven for butcher doctors and negligent nursing homes."
Laura Bell writes in ProPublica -
"When Duntsch’s patients tried to sue him for malpractice, many found it almost impossible to find attorneys. Since Texas enacted tort reform in 2003, reducing the amount of damages plaintiffs could win, the number of malpractice payouts per year has dropped by more than half."

Bush Jr. and Grover Norquist stood with the U.S. Chamber of Commerce on the forefront of those selling the idea that frivolous lawsuits are causing unnecessary burdens for corporations and increasing consumer costs. "Grass roots" organizations made up of concerned citizens sprang up all over the country to help fight the good fight. Many of these concerned citizens have ties to the banking, insurance and medical industries.

The name of the documentary Hot Coffee refers to the 1994 case where a 79 year old woman named Stella Liebrick sued McDonald's over burns she received from spilling a cup of coffee on her lap. She was initially given a settlement of 2.6 million dollars in a jury trial.

This case was like pennies from heaven for the tort reformers. The media treated it as the perfect example of a frivolous lawsuit. The facts of what happened to Stella Liebrick and how McDonald's reacted were overlooked because the story seemed so cut and dried on the surface - some ne're-do-well was trying to take advantage of a corporation's deep pockets.

The story was more complicated. Stella suffered third degree burns that required skin grafts and spent 8 days in the hospital. She asked McDonald's for $20,000 to cover her medical costs and loss of work, they offered $800 so she sued them.

You still think...yeah but we all know hot coffee can burn.

McDonald's coffee wasn't just hot it was extra hot. McDonald's required franchisees to hold coffee at 180-190F. This was 20 degrees hotter than other coffee tested in the area and hot enough to produce 3rd degree burns requiring skin grafts in 3 seconds. Over a period of ten years McDonald's had received 700 complaints from customers burned to varying degrees by their coffee.

How hot should coffee be? According to a study by the National Institute of Health, "The preferred drinking temperature of coffee is specified in the literature as 140+/-15 degrees F (60+/-8.3 degrees C) for a population of 300 subjects." Starbucks serves coffee at 145-165 degrees F. McDonald's thought it would be a good idea to give people in cars a super heated cup of coffee because they probably weren't going to drink it right away.

I wouldn't take the documentary Hot Coffee at face value (it's biased and one of the subjects may be less then completely credible) but it has real people talking about what happened to them. You could use it as a jumping off point for doing your own research.

Finally I'd say the story in the documentary from Colin Gurley's parents is maddening and heart wrenching. Perhaps so much so that it would spur citizens, politicians and power brokers to search for real solutions for real people? We can only hope. Colin's case is summarized by the NY Center for Justice and Democracy -

"Colin Gourley suffered terrible complications at birth as a result of a doctor’s negligence. He has cerebral palsy. He cannot walk. He could not speak until he was five. Irregular brain waves and the amount of time he has spent in a wheelchair have affected his bone growth. He has been through five surgeries and needs to sleep in a cast every night to prevent further orthopedic problems. His twin brother, Connor, survived without injury.A jury ruled that Colin was a victim of medical negligence, finding that $5.625 million was needed to compensate him for his medical care and a lifetime of suffering. Last month, the Nebraska Supreme Court upheld a cruel Nebraska law that severely cut this jury verdict to one quarter of what Colin will need. As a result, Colin will have to rely on the state for assistance for the rest of his life."