Dartmouth-Hitchcock Medical Center is one of the defendants in what may be the first case of a patient suing his health maintenance organization in New Hampshire, and the lawyers on both sides are Dartmouth alumni.
Paul Hodes '72 is representing the plaintiff, and Jim Bassett '78 is defending DHMC.
The patient, Lawrence B. Martin of Manchester, is suing his HMO, physician Philip Bernini, The Hitchcock Clinic, Inc. and DHMC for $4 to $5 million plus enhanced damages. Martin claims the Matthew Thornton Health plan mismanaged the coordination of treatment between his local doctors and specialists for his crippling spine injuries from 1988 to 1990.
Martin alleges doctors in Hanover had X-rays and magnetic resonance imaging scans showing possible bone growth around his spine, but did not know he was experiencing severe pain in his back and muscle spasms in his legs -- information that was available to his doctors in Manchester. Likewise, his Manchester physicians did not know about the results of the tests, Martin claims.
"I hope it serves as a wake-up call to the health care industry in this state," Hodes said.
Hodes said he does not feel like he is harming his alma mater by suing DHMC -- which is loosely affiliated with the College.
"I don't feel like I'm going against Dartmouth itself," he said. "Philosophically for me, when I take on cases for clients, my job is to take them wherever they lead."
Martin is seeking up to $4 million for the costs of his injuries and lost work time, plus another $1 million for the cost of home health care presently provided by his wife.
He is also asking for enhanced compensatory damages, but he must prove the defendants acted recklessly and with indifference towards the consequences of their actions.
The trial began on Oct. 20 at the Hillsborough County Superior Court in Manchester and is expected to continue through mid-November.
Two weeks ago, Dr. Paul Bronston, chairman of the Ethics Committee of the American College of Medial Quality and an emergency physician in Los Angeles, testified about the ways in which managed care companies control costs and quality of care.
Bronston said Matthew Thornton's system was defective because the quality assurance people reviewing patient care were separate from the group tracking the numbers and types of tests and procedures ordered by doctors.
He also testified that the practice of paying doctors a fixed amount per patient and limits on the amount they are reimbursed for tests and procedures give doctors a financial incentive to undertreat patients.
Although most of his 26 different doctors and health care professionals concluded that his symptoms resulted from his cerebral palsy, a stable condition, Martin said his condition was clearly getting worse.
He alleges his doctors prescribed over 19 different drugs, but ignored his pleas for tests and coordinated care.
Martin also claims the surgery performed by Dr. Bernini was botched, and that rods and wires inserted in his back had to be later removed.
Matthew Thornton, Bernini, The Hitchcock Clinic, and DHMC have denied the allegations.
Bassett said the judge has asked all parties to refrain from commenting on the case.
The other attorney working with Bassett is Bill Chapman; both lawyers represent Orr & Reno, which is based in Concord. Hodes, the plaintiff's lawyer, represents Shaheen and Gordon, also based in Concord.
A spokesman for DHMC on Thursday declined to comment on the litigation.
