Nobody wins with the current medical malpractice system in the U.S.
That's the thesis of a new documentary -- produced by a physician and directed by two medical students -- that this summer.
It's called "" and it examines three medical malpractice cases with very different outcomes, illustrating just how difficult the system can be for all parties involved.
"It's a problem for doctors ... but the system is not fair to patients either. Medical malpractice fails everyone," said Mark Brady, MD, MPH, an assistant professor of emergency medicine at Brown University in Providence, Rhode Island, who served as executive producer on the documentary.
One of the three cases is that of the late Matthew Seaman, MD, an emergency medicine physician in Washington state who died by suicide while a medical malpractice case was pending against him.
His wife, Linda Seaman, MD, said her husband came home late in the afternoon after his deposition -- parts of which are included in the documentary -- saying he felt "worthless."
The next morning, Linda discovered that her husband had hung himself.
"He felt rejected, ashamed, humiliated, you name it, but he didn't know how else to feel better, so it's like he just gave up," she said.
Seaman isn't the only physician whose struggle is detailed in the film. The story of Gita Pensa, MD, also an emergency medicine physician at Brown, is woven through the three cases to share further insights.
Pensa spent 12 years fighting a medical malpractice lawsuit that she ultimately won, but she said she felt completely unprepared for the experience.
"Everybody talks about how to prevent a lawsuit, but no one ever said anything about, when you're sued, this is what you do," Pensa told 鶹ý. "I was in a bad place for a long time. I was miserable at home, I was miserable at work."
Her case went to trial in 2011 and she won, but the verdict was overturned in 2015 during an appeal. Pensa worked hard to prepare for her second trial in 2018.
"By the time I went to trial a second time, I was a totally different person," she said. "I was a consummate witness, I invited my residents to come watch me testify in court so they could learn. I considered myself expert at it."
She won that trial and there were no more appeals, she said.
Even patients who win their cases describe the experience as harrowing. The documentary opens with the case of Megan Barrett, who died from a stroke because of a "clear miss" by a radiologist.
In his deposition, the exasperated radiologist says, "I missed it. Hundred percent I missed it. ... It's caused me tremendous pain. I lost a lot of sleep over it."
Barrett's sister, Amanda Grieshop, led her medical malpractice case, saying it was one of the most difficult experiences of her life.
"This lawsuit was exceptionally emotionally draining. I was not as available to my family. It was a full-time job for me for 3 years and I was on multiple antidepressants for multiple years during the process," Grieshop said in the documentary. "It was by far the most stressful thing I've ever gone through in my life."
Brady, who has produced two other documentaries -- one on the that also aired on PBS, and one on that aired on the New York Times Op-Docs -- said the documentary is more descriptive than prescriptive. However, the third case is about a family that used a communication and resolution program (CRP) to air their grievances about their daughter's death.
CRPs are seen as alternatives to medical malpractice litigation, but not all health systems have them, and they're not always administered consistently across health systems, Brady said. Nonetheless, it worked for the case explored in the documentary.
"Their emotional state seemed to be a lot better than the first person, who had to go through a very contentious, adversarial system," Brady told 鶹ý. "It's horrible when bad things happen, but it's less horrible when you're not fighting against a very adversarial system."
Brady said he hopes the film, in part, shows doctors that they're not alone if they get sued for malpractice.
"If you're in medicine, there's a very good chance you're going to be sued at some point," he said. "It's not a reflection on you, it's a reflection of the system."
Pensa now involved in medical malpractice cases. She also hosts a podcast called "" and runs a medical malpractice preparedness course through a large insurer in the Northeast called the Litigation Education and Performance (LEAP) program.
"It fills a gap, but we still have a tremendous gap around this," Pensa said. "It remains a taboo topic in medicine and I think that helps perpetuate the shame around it."
Viknesh Kasthuri, one of the two medical school students, along with Alexander Homer, who directed the film, agreed that the stigma needs to be erased. He's heard from administrators that one reason they don't want to include litigation preparedness in medical school curriculum is that "we don't want to scare anyone."
"There are no other issues in healthcare where we take this approach," Kasthuri told 鶹ý. "We don't say, strokes are super-scary, we're not going to teach them."
Kasthuri and Homer spent 3 years working on the documentary, researching and finding sources, and traveling around the U.S. to interview them. Last year, the documentary appeared in 26 film festivals and won eight awards, Kasthuri said.
"We want to start a conversation about the system as it stands, and things we can do to make it better," he said.