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An Ounce of Prevention

After a brush with medical incompetence, Les noticed how little information was available about doctors and malpractice. Then he did something about it.

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It's almost lunchtime in room 801 of the Daley Center, and Les is busily flipping through six inches of court documents in the file of a medical-malpractice lawsuit. "Let's see what happened with this guy," he says, tearing off a mouthful of bologna on toast. "Colon cancer!" He picks at the document with a staple remover, feeds each page into a portable scanner, then recollates, restaples, and refiles the pages.

Three days a week at 8:30 AM the 44-year-old former building engineer arrives at the Cook County Circuit Court Clerk's Law Division and claims a spot on the counter where he can set up his battery-powered laptop amid stacks of files he's ordered on doctors, hospitals, nursing homes, and HMOs. In the last two and a half years he's collected documents from about 5,500 medical-malpractice suits filed in the county court in the last decade and summarized almost a quarter of them on his fledgling Web site, www.malpracticeweb.com. It's a numbing catalog of alleged diagnostic errors, surgical disasters, and caregiver klutziness--with the occasional ghastly photo of oral cancer or toxic epidermal necrolysis.

Les--a wiry, balding, lifelong Lincoln Park guy who laughs a lot--doesn't want to use his last name and says he has good reason. "Every once in a while you hear about a doctor who hires usually a cop or an FBI agent to kill his wife," he says. "I wouldn't want to take a chance at having a Molotov cocktail come through the window or a brick or anything. Because not all people are nice. I want to live as much as the next guy."

Les insists he doesn't dislike doctors or hospitals. He just thinks that if they've been sued, people have the right to know about it. "A lot of mistakes could be prevented by asking questions," he says. "I hope people learn something."

He also hopes lawyers looking for potential plaintiffs will pay to link their Web sites to his. But it's not just the profit motive that drives him to suffer the county's antiquated, error-riddled computer database, the indifference of patronage clock punchers who frequently fetch incomplete files, and the tedium of distilling thousands of complicated cases into a reader-friendly format. It's the grudges he's nursing.

First, there was his alcoholic mother, who was prescribed barbiturates and then fell off a hospital gurney and never recovered. There was his grandmother, a nursing-home resident who was found covered with bruises and bedsores when she was admitted to the hospital following a heart attack. Les himself was once given the wrong antibiotic for an earache, and by the time another doctor got him on the right stuff he was oozing pus and blood. He also had to design and build an arch support to relieve a foot problem after it had stumped two doctors.

And then there was the time he almost died. He'd been mugged, breaking his finger in three places and taking a knock on the head. The hospital he went to treated the finger, but brushed off his headache. He went home and slept for 14 hours, and when he woke up he knew something was wrong. He went to another hospital, where doctors spotted a subdural hematoma and opened his skull to drain the blood. He says that after the surgery he was unconscious for six days.

Then the bills from the first hospital began arriving. "I kept throwing them in the garbage, saying, 'Well, fuck them--they're not gonna get a penny out of me,'" he says. "Then one day I got a call from the billing department. I said, 'Look, I goddamn near died, and you guys were gonna let me. If you motherfuckers ever call me again I will sue you.' And that's the last thing I ever heard."

He's never seen a lawyer about his string of rotten luck, and he doesn't know whether it's unusual. But after 20 years as a janitor, a pharmacy technician, and a building engineer at two hospitals, he's seen enough problems to make him worry. He says that about four years ago he was called to his hospital's operating room to repair a malfunctioning thermostat while surgery was being done. He donned scrubs and got busy. "Just before I was done I heard somebody say, 'Oh, fuck!' or 'Oh, shit!' or something like that. I looked around, and blood was just shooting out of this patient. I thought, 'Oh, I gotta stick around a little while and pretend to work on the thermostat.' And then somebody came up to me and kicked me out of the OR."

He never learned the patient's fate, but the incident piqued his interest in the ways doctors and hospitals try to protect themselves from liability. At the time he was getting fed up with how stressful and thankless his job was. He believes many hospital workers feel the same way because of constant consolidation and staff cutbacks, and says, "I would never recommend anybody get a job at a hospital. Kitchen workers and janitors get worked like slaves." When a few coworkers lost their jobs to belt tightening, he started cutting his own expenses and looking for a way out.

He decided to try his hand at real estate and bought a subscription to the Chicago Daily Law Bulletin so he could check its foreclosure notices and then pull the case files at the Daley Center. But he was more interested in the malpractice cases he read about in the paper, and he started looking at those files too. "At first I just wanted to see what was going on. Lots of hypoxic birth injuries, the late C-section--kid winds up a vegetable. Seizures. Cancer misdiagnoses. Some of them were horrible. I found many cases where the doctor's in there doing a surgery, and they nick a vein or cut something they're not supposed to."

He also noticed the enormous settlements paid out to plaintiffs. "I said, 'Wow, these lawyers are making a lot of money on this,' and I had the idea that maybe I could link up lawyers and plaintiffs." He gave up on real estate, quit the hospital, and began living on his savings and going to the Daley Center every morning.

He started by searching the county's database using the names of hospitals, but soon realized the searches weren't comprehensive. So he went back to the first case in 1993, then scrolled through the Law Division suits one by one in the order they were filed, noting the party names and case numbers whenever he ran across a malpractice suit. He thought he'd find only a few hundred, but soon he had thousands.

Each morning he'd check the county's computer for new cases and new documents filed in pending cases. Then he'd order a bunch of files from the clerks and scan the documents into his laptop until his feet hurt too much to stand anymore. At home he'd download the files, print them out, then write one- or two-paragraph summaries of the allegations. If a jury had reached a verdict or a case had been settled he'd include that information, along with the amount paid if it was listed. Frequently it wasn't. "Doctors," he says, "are very shy about letting people know how much they've given up in a settlement."

Well aware that he could get sued, Les stresses that he's posting only allegations, not undisputed facts, and that they remain allegations even if the defendants settle. He's also careful to identify by name only doctors and hospitals, not plaintiffs. He says that's because many plaintiffs receive huge settlements: "I don't want them to end up being targets."

He estimates that he now has about 145,000 documents stored in five filing cabinets in his kitchen. So far he's managed to post summaries of only about 1,400 cases on his site, which went on-line January 3. Some of the cases had hit the headlines, including the ones against Rush-Presbyterian-Saint Luke's Dr. Bennett Braun, who was suspended for allegedly eliciting false confessions of murder and satanic ritual abuse from women he'd diagnosed with multiple-personality disorder. Les has also posted a summary of the case against Edgewater Medical Center's Dr. Andrew Cubria, who recently pleaded guilty to a medicare fraud scheme in which he'd performed unnecessary angioplasties that resulted in two deaths.

Most of the doctors on Les's site aren't celebrities. They're still practicing, and they're grappling with just one or two lawsuits. Yet a few have had dozens of cases filed against them. He hasn't been able to catch up with all of those doctors yet. "There are some doctors I think are just plain dangerous," he says. "Just because he graduated from school doesn't mean he's good."

Some of his summaries are short on details, which he says is because the information in the file is limited. He guesses that's an indication of how good the case is--the more detailed ones seem to be stronger. Or more horrific. A man placed on a ventilator died after his anesthesiologist inserted the breathing tube into his esophagus instead of his trachea. A surgeon failed to inform a patient that he'd accidentally removed his left testicle during a routine hernia surgery. An obstetrician left a towel inside a patient after delivering her son. A child was burned during laser surgery when a plastic tube in his throat caught fire. A man alleged that he'd been improperly treated for priapism--a perpetual erection--and left impotent.

Les has thousands more files to go through, but he hopes to have a complete record of the medical-malpractice cases in the county some day. He says that if he ever makes any money at this he'll hire employees and cover the nation. That way anyone could just log on, search for specific doctors or hospitals, and take a measure of their history.

That's a long way off. For now, he's offering law firms a free two-year link. So far two have signed on. Bruce Pfaff says his firm typically shies away from advertising, getting most of its business from referrals. He says he didn't spend a lot of time looking at the site and didn't expect much from it, but he figured it was a harmless association. Stephen Lane wasn't very familiar with the site either, but he says clients are getting used to on-line shopping and that anything that connects them with competent counsel can't be bad. Both agree that publicizing verdicts and settlements is a good thing for consumers.

But at a time when lawsuits and malpractice insurance rates are putting many doctors out of business, driving up the cost of health insurance for everyone, and forcing the hospital cutbacks Les decries, couldn't his site contribute to the rampant litigiousness? The site also lacks context. Some specialties attract more malpractice claims than others, so is it fair to tar doctors who may have many cases filed against them because they take on difficult problems? What about frivolous lawsuits? What about cases that were settled not because the doctor was at fault but because his insurance company decided it was cheaper to throw in the towel? While his tone is indisputably pro-plaintiff, Les insists that nobody "who has a brain in their head" would get a distorted picture of the medical establishment from reading his site. He considers it simply a rebuttal to the warm-and-fuzzy commercials hospitals broadcast on television.

Of course consumers who are interested in researching lawsuits against their doctors, hospitals, or HMOs could visit the Daley Center themselves. But it isn't easy. The clerks can be surly or comatose, other visitors can be short-tempered, computers are slow, and important documents are often missing. Les says many missing papers have been misfiled or haven't yet been routed to the case file. When he can't get a file he simply checks back another time, or if the case is on trial he'll go to the courtroom and check it out himself. But he believes that occasionally there's a more sinister explanation. "In some cases I'm sure they're being stolen," he says. "You don't even have to steal them. One day I was down there, I found a bunch of paperwork in the garbage can. Someone had thrown it there intentionally."

Les says that poring over thousands of medical-malpractice case files has made him more cynical about the medical establishment, but he doesn't completely mistrust doctors. "I'd say I'm very wary of them," he says. "I know they're there to make a buck. That's what they do."

Art accompanying story in printed newspaper (not available in this archive): photos/Lloyd DeGrane.

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