S.B. 2
Senate Bill No. 2–Senators Raggio, Titus, Amodei, Care, Carlton, Coffin, Jacobsen, Mathews, McGinness, Milburn, O’Connell, O’Donnell, Paulk, Rawson, Rhoads, Schneider, Shaffer, Townsend, Washington and Wiener
July 29, 2002
____________
Referred to Committee of the Whole
SUMMARY—Makes various changes related to medical and dental malpractice. (BDR 3‑13)
FISCAL NOTE: Effect on Local Government: No.
Effect on the State: No.
~
EXPLANATION
– Matter in bolded italics is new; matter
between brackets [omitted material] is material to be omitted.
Green numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).
AN ACT relating to malpractice; limiting the liability of certain medical providers for negligent acts under certain circumstances; establishing a limitation on the amount of noneconomic damages that may be awarded in an action for medical malpractice or dental malpractice; providing for several liability of a defendant for noneconomic damages in an action for medical malpractice; making various changes concerning the payment of future economic damages in actions for medical malpractice; providing for the mandatory dismissal of an action for medical malpractice or dental malpractice under certain circumstances; repealing the provisions pertaining to the use of screening panels for an action for medical malpractice or dental malpractice; revising the statute of limitations for filing an action for medical malpractice or dental malpractice; making various other changes concerning actions for medical malpractice or dental malpractice; requiring certain district judges to receive training concerning the complex issues involved in medical malpractice litigation; requiring courts to impose certain sanctions on attorneys in certain circumstances; making various changes relating to the reporting of claims of malpractice or negligence; and providing other matters properly relating thereto.
Whereas, The State of Nevada is experiencing extreme difficulties attracting and maintaining a sufficient network of physicians to meet the needs of the residents of this state; and
Whereas, The Nevada Legislature has determined that the shortage of physicians and the inability to attract new physicians to this state pose a serious threat to the health, welfare and safety of the residents of the State of Nevada; now, therefore,
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
1-1 Section 1. Chapter 41 of NRS is hereby amended by adding thereto a
1-2 new section to read as follows:
1-3 1. Except as otherwise provided in subsection 2 and NRS 41.505:
1-4 (a) A hospital which has been designated as a center for the treatment
1-5 of trauma by the administrator of the health division of the department of
1-6 human resources pursuant to NRS 450B.237 and which is a nonprofit
1-7 organization;
1-8 (b) An employee of a hospital described in paragraph (a) who renders
1-9 care or assistance to patients;
1-10 (c) A physician or dentist licensed under the provisions of chapter
1-11 630, 631 or 633 of NRS who renders care or assistance in a hospital
1-12 described in paragraph (a), whether the care or assistance was rendered
1-13 gratuitously or for a fee; and
1-14 (d) A physician or dentist licensed under the provisions of chapter
1-15 630, 631 or 633 of NRS:
1-16 (1) Whose liability is not otherwise limited pursuant to NRS 41.032
1-17 to 41.0337, inclusive; and
1-18 (2) Who renders care or assistance in a hospital of a governmental
1-19 entity that has been designated as a center for the treatment of trauma by
1-20 the administrator of the health division of the department of human
1-21 resources pursuant to NRS 450B.237, whether or not the care or
1-22 assistance was rendered gratuitously or for a fee,
1-23 that in good faith renders care or assistance necessitated by a sudden,
1-24 unexpected situation or occurrence resulting in a serious medical
1-25 condition demanding immediate medical attention, for which the patient
1-26 enters the hospital through its emergency room or trauma center, may
1-27 not be held liable for more than $50,000 in civil damages as a result of
1-28 any act or omission in rendering that care or assistance if the care or
1-29 assistance is rendered in good faith and in a manner not amounting to
1-30 gross negligence or reckless, willful or wanton conduct.
1-31 2. The limitation on liability provided pursuant to this section does
1-32 not apply to any act or omission in rendering care or assistance:
1-33 (a) Which occurs after the patient is stabilized and is capable of
1-34 receiving medical treatment as a nonemergency patient, unless surgery is
1-35 required as a result of the emergency within a reasonable time after the
1-36 patient is stabilized, in which case the limitation on liability provided by
1-37 subsection 1 applies to any act or omission in rendering care or
1-38 assistance which occurs before the stabilization of the patient following
1-39 the surgery; or
1-40 (b) Unrelated to the original medical emergency.
1-41 3. For the purposes of this section, “reckless, willful or wanton
1-42 conduct,” as it applies to a person to whom subsection 1 applies, shall be
1-43 deemed to be that conduct which the person knew or should have known
1-44 at the time he rendered the care or assistance would be likely to result in
1-45 injury so as to affect the life or health of another person, taking into
1-46 consideration to the extent applicable:
2-1 (a) The extent or serious nature of the prevailing circumstances;
2-2 (b) The lack of time or ability to obtain appropriate consultation;
2-3 (c) The lack of a prior medical relationship with the patient;
2-4 (d) The inability to obtain an appropriate medical history of the
2-5 patient; and
2-6 (e) The time constraints imposed by coexisting emergencies.
2-7 Sec. 2. Chapter 41A of NRS is hereby amended by adding thereto the
2-8 provisions set forth as sections 3 to 9, inclusive, of this act.
2-9 Sec. 3. “Economic damages” includes damages for medical
2-10 treatment, care or custody, and loss of earnings.
2-11 Sec. 4. “Noneconomic damages” includes damages to compensate
2-12 for pain, suffering, inconvenience, physical impairment, disfigurement
2-13 and other nonpecuniary damages.
2-14 Sec. 5. 1. Except as otherwise provided in subsection 3, in an
2-15 action for damages for medical malpractice or dental malpractice, the
2-16 noneconomic damages awarded to each plaintiff must not exceed
2-17 $350,000.
2-18 2. In an action for damages for medical malpractice or dental
2-19 malpractice, in the circumstances and types of cases described in
2-20 subsection 3, the noneconomic damages awarded to a plaintiff must not
2-21 exceed the greater of $350,000 or the amount of money remaining under
2-22 the professional liability insurance policy limit covering the defendant
2-23 after subtracting the economic damages awarded to that plaintiff.
2-24 Irrespective of the number of plaintiffs in the action, in no event may any
2-25 single defendant be liable to the plaintiffs in the aggregate in excess of
2-26 the professional liability insurance policy limit covering that defendant.
2-27 3. In an action for damages for medical malpractice or dental
2-28 malpractice, the limitation on noneconomic damages set forth in
2-29 subsection 1 does not apply in the following circumstances and types of
2-30 cases:
2-31 (a) Organic brain damage;
2-32 (b) Hemaplegia, paraplegia or quadraplegia;
2-33 (c) Death of a parent, spouse or child;
2-34 (d) Total blindness;
2-35 (e) Actual physical loss of a limb, including a foot or hand;
2-36 (f) Permanent loss or damage to a reproductive organ resulting in
2-37 sterility;
2-38 (g) A case in which the conduct of the defendant is determined to
2-39 constitute gross malpractice; or
2-40 (h) A case in which, following return of a verdict by the jury, the court
2-41 determines, by clear and convincing evidence, that an award in excess of
2-42 $350,000 for noneconomic damages is justified under the circumstances.
2-43 4. For the purposes of this section:
2-44 (a) “Gross malpractice” means failure to exercise the required degree
2-45 of care, skill or knowledge which amounts to:
2-46 (1) A conscious indifference to the consequences which may result
2-47 from the gross malpractice; and
3-1 (2) A disregard for and indifference to the safety and welfare of the
3-2 patient.
3-3 (b) “Organic brain damage” means the person has documented
3-4 organically caused, permanently impaired cognitive capacity rendering
3-5 him incapable of making independent, responsible life decisions or
3-6 permanently incapable of independently conducting the activities of the
3-7 person’s normal daily living.
3-8 (c) “Total blindness” means a person’s visual acuity with correcting
3-9 lenses does not exceed 20/200 in the better eye, or whose vision in the
3-10 better eye is restricted to a field which subtends an angle of not greater
3-11 than 20°.
3-12 Sec. 6. In an action for damages for medical malpractice, each
3-13 defendant is liable for noneconomic damages severally only, and not
3-14 jointly, to the plaintiff only for that portion of the judgment which
3-15 represents the percentage of negligence attributable to the defendant.
3-16 Sec. 7. 1. Upon the motion of any party or upon its own motion,
3-17 unless good cause is shown for the delay, the court shall, after due notice
3-18 to the parties, dismiss an action involving medical malpractice or dental
3-19 malpractice if the action is not brought to trial within:
3-20 (a) Three years after the date on which the action is filed, if the action
3-21 is filed on or after October 1, 2002, but before October 1, 2005.
3-22 (b) Two years after the date on which the action is filed, if the action
3-23 is filed on or after October 1, 2005.
3-24 2. Dismissal of an action pursuant to subsection 1 is a bar to the
3-25 filing of another action upon the same claim for relief against the same
3-26 defendants.
3-27 3. Each district court shall adopt court rules to expedite the
3-28 resolution of an action involving medical malpractice or dental
3-29 malpractice.
3-30 Sec. 8. If an action for medical malpractice or dental malpractice is
3-31 filed in the district court, the district court shall dismiss the action,
3-32 without prejudice, if the action is filed without an affidavit, supporting
3-33 the allegations contained in the action, submitted by a medical expert
3-34 who practices in an area that is substantially similar to the type of
3-35 practice engaged in at the time of the alleged malpractice.
3-36 Sec. 9. 1. In an action for medical malpractice or dental
3-37 malpractice, the plaintiff, the defendant, the representative of the
3-38 physician’s or dentist’s insurer and their respective attorneys shall attend
3-39 and participate in a settlement conference before a district judge, other
3-40 than the judge assigned to the action, to ascertain whether the action
3-41 may be settled by the parties before trial.
3-42 2. The judge before whom the settlement conference is held:
3-43 (a) May, for good cause shown, waive the attendance of any party.
3-44 (b) Shall decide what information the parties may submit at the
3-45 settlement conference.
3-46 3. The judge shall notify the parties of the time and place of the
3-47 settlement conference.
4-1 4. The failure of any party or his attorney to participate in good faith
4-2 in the settlement conference is grounds for sanctions against the party or
4-3 his attorney, or both.
4-4 Sec. 10. NRS 41A.003 is hereby amended to read as follows:
4-5 41A.003 As used in this chapter, unless the context otherwise requires,
4-6 the words and terms defined in NRS 41A.004 [to 41A.013, inclusive,] and
4-7 41A.009 and sections 3 and 4 of this act have the meanings ascribed to
4-8 them in those sections.
4-9 Sec. 11. NRS 41A.097 is hereby amended to read as follows:
4-10 41A.097 1. Except as otherwise provided in subsection [2,] 3, an
4-11 action for injury or death against a provider of health care may not be
4-12 commenced more than 4 years after the date of injury or 2 years after the
4-13 plaintiff discovers or through the use of reasonable diligence should have
4-14 discovered the injury, whichever occurs first, for:
4-15 (a) Injury to or the wrongful death of a person[,] occurring before
4-16 October 1, 2002, based upon alleged professional negligence of the
4-17 provider of health care;
4-18 (b) Injury to or the wrongful death of a person occurring before
4-19 October 1, 2002, from professional services rendered without consent; or
4-20 (c) Injury to or the wrongful death of a person occurring before
4-21 October 1, 2002, from error or omission in practice by the provider of
4-22 health care.
4-23 2. Except as otherwise provided in subsection 3, an action for injury
4-24 or death against a provider of health care may not be commenced more
4-25 than 3 years after the date of injury or 2 years after the plaintiff discovers
4-26 or through the use of reasonable diligence should have discovered the
4-27 injury, whichever occurs first, for:
4-28 (a) Injury to or the wrongful death of a person occurring on or after
4-29 October 1, 2002, based upon alleged professional negligence of the
4-30 provider of health care;
4-31 (b) Injury to or the wrongful death of a person occurring on or after
4-32 October 1, 2002, from professional services rendered without consent; or
4-33 (c) Injury to or the wrongful death of a person occurring on or after
4-34 October 1, 2002, from error or omission in practice by the provider of
4-35 health care.
4-36 3. This time limitation is tolled[:
4-37 (a) For] for any period during which the provider of health care has
4-38 concealed any act, error or omission upon which the action is based and
4-39 which is known or through the use of reasonable diligence should have
4-40 been known to him.
4-41 [(b) In any action governed by the provisions of NRS 41A.003 to
4-42 41A.069, inclusive, from the date a claimant files a complaint for review
4-43 by a screening panel until 30 days after the date the panel notifies the
4-44 claimant, in writing, of its findings. The provisions of this paragraph apply
4-45 to an action against the provider of health care and to an action against any
4-46 person, government or political subdivision of a government who is alleged
4-47 by the claimant to be liable vicariously for the medical or dental
4-48 malpractice of the provider of health care, if the provider, person,
4-49 government or political subdivision has received notice of the filing of a
5-1 complaint for review by a screening panel within the limitation of time
5-2 provided in subsection 1.
5-3 3.] 4. For the purposes of this section, the parent, guardian or legal
5-4 custodian of any minor child is responsible for exercising reasonable
5-5 judgment in determining whether to prosecute any cause of action limited
5-6 by subsection 1[.] or 2. If the parent, guardian or custodian fails to
5-7 commence an action on behalf of that child within the prescribed period of
5-8 limitations, the child may not bring an action based on the same alleged
5-9 injury against any provider of health care upon the removal of his
5-10 disability, except that in the case of:
5-11 (a) Brain damage or birth defect, the period of limitation is extended
5-12 until the child attains 10 years of age.
5-13 (b) Sterility, the period of limitation is extended until 2 years after the
5-14 child discovers the injury.
5-15 [4.] 5. As used in this section, “provider of health care” means a
5-16 physician licensed under chapter 630 or 633 of NRS, dentist, registered
5-17 nurse, dispensing optician, optometrist, registered physical therapist,
5-18 podiatric physician, licensed psychologist, chiropractor, doctor of Oriental
5-19 medicine, medical laboratory director or technician, or a licensed hospital
5-20 as the employer of any such person.
5-21 Sec. 12. NRS 41A.100 is hereby amended to read as follows:
5-22 41A.100 1. Liability for personal injury or death is not imposed upon
5-23 any provider of medical care based on alleged negligence in the
5-24 performance of that care unless evidence consisting of expert medical
5-25 testimony, material from recognized medical texts or treatises or the
5-26 regulations of the licensed medical facility wherein the alleged negligence
5-27 occurred is presented to demonstrate the alleged deviation from the
5-28 accepted standard of care in the specific circumstances of the case and to
5-29 prove causation of the alleged personal injury or death, except that such
5-30 evidence is not required and a rebuttable presumption that the personal
5-31 injury or death was caused by negligence arises where evidence is
5-32 presented that the personal injury or death occurred in any one or more of
5-33 the following circumstances:
5-34 (a) A foreign substance other than medication or a prosthetic device was
5-35 unintentionally left within the body of a patient following surgery;
5-36 (b) An explosion or fire originating in a substance used in treatment
5-37 occurred in the course of treatment;
5-38 (c) An unintended burn caused by heat, radiation or chemicals was
5-39 suffered in the course of medical care;
5-40 (d) An injury was suffered during the course of treatment to a part of the
5-41 body not directly involved in the treatment or proximate thereto; or
5-42 (e) A surgical procedure was performed on the wrong patient or the
5-43 wrong organ, limb or part of a patient’s body.
5-44 2. Expert medical testimony provided pursuant to subsection 1 may
5-45 only be given by a provider of medical care who practices in an area that
5-46 is substantially similar to the type of practice engaged in at the time of
5-47 the alleged negligence.
6-1 3. As used in this section, “provider of medical care” means a
6-2 physician, dentist, registered nurse or a licensed hospital as the employer of
6-3 any such person.
6-4 Sec. 13. NRS 42.020 is hereby amended to read as follows:
6-5 42.020 1. Except as otherwise provided in subsection 2, in any action
6-6 for damages for medical malpractice, the amount of damages, if any,
6-7 awarded in the action must be reduced by the amount of any prior payment
6-8 made by or on behalf of the provider of health care against whom the
6-9 action is brought to the injured person or to the claimant to meet reasonable
6-10 expenses of medical care, other essential goods or services or reasonable
6-11 living expenses.
6-12 2. In any action described in subsection 1 in which liability for medical
6-13 malpractice is established or admitted, the court shall, before the entry of
6-14 judgment, hold a separate hearing to determine if any expenses incurred by
6-15 the claimant for medical care, loss of income or other financial loss have
6-16 been paid or reimbursed as a benefit from a collateral source. If the court
6-17 determines that a claimant has received such a benefit, the court shall
6-18 reduce the amount of damages, if any, awarded in the action by the amount
6-19 of the benefit. The amount so reduced must not include any amount for
6-20 which there is a right of subrogation to the rights of the claimant if the right
6-21 of subrogation is exercised by serving a notice of lien on the claimant
6-22 before the settlement of or the entry of judgment in the action. Notice of
6-23 the action must be provided by the claimant to any statutory holder of a
6-24 lien.
6-25 3. If future economic damages are awarded in an action for medical
6-26 malpractice, the [award must be paid, at the election of the claimant:] court
6-27 may, at the request of the claimant, order the award to be paid:
6-28 (a) In a lump sum which has been reduced to its present value as
6-29 determined by the trier of fact and approved by the court; or
6-30 (b) Subject to the provisions of [subsection 5,] subsections 5 and 6 and
6-31 the discretion of the court, in periodic payments either by an annuity
6-32 purchased to provide periodic payments[.] or by other means if the
6-33 defendant posts an adequate bond or other security to ensure full
6-34 payment by periodic payments of the damages awarded by the judgment.
6-35 As used in this subsection, “future economic damages” includes damages
6-36 for future medical treatment, care or custody, and loss of future earnings.
6-37 4. If the claimant [elects to receive] receives periodic payments
6-38 pursuant to paragraph (b) of subsection 3, the award must not be reduced to
6-39 its present value. The amount of the periodic payments must be equal to the
6-40 total amount of all future damages awarded by the trier of fact and
6-41 approved by the court. The period for which the periodic payments must be
6-42 made must be determined by the trier of fact and approved by the court.
6-43 Before the entry of judgment, each party shall submit to the court a plan
6-44 specifying the recipient of the payments, the amount of the payments and a
6-45 schedule of periodic payments for the award. Upon receipt and review of
6-46 the plans, the court shall specify in its judgment rendered in the action the
6-47 recipient of the payments, the amount of the payments and a schedule of
6-48 payments for the award.
7-1 5. If an annuity is purchased pursuant to paragraph (b) of subsection 3,
7-2 the claimant shall select the provider of the annuity. Upon purchase of the
7-3 annuity, the claimant shall:
7-4 (a) Execute a satisfaction of judgment or a stipulation for dismissal of
7-5 the claim with prejudice; and
7-6 (b) Release forever the defendant and his insurer, if any, from any
7-7 obligation to make periodic payments pursuant to the award.
7-8 6. If the defendant posts a bond or other security pursuant to
7-9 paragraph (b) of subsection 3, upon termination of the payment of
7-10 periodic payments of damages, the court shall order the return of the
7-11 bond or other security, or as much as remains, to the defendant.
7-12 7. As used in this section:
7-13 (a) “Benefit from a collateral source” means any money, service or
7-14 other benefit which is paid or provided or is reasonably likely to be paid or
7-15 provided to a claimant for personal injury or wrongful death pursuant to:
7-16 (1) A state or federal act which provides benefits for sickness,
7-17 disability, accidents, loss of income or workers’ compensation;
7-18 (2) A policy of insurance which provides health benefits or coverage
7-19 for loss of income;
7-20 (3) A contract of any group, organization, partnership or corporation
7-21 which provides, pays or reimburses the cost of medical, hospital or dental
7-22 benefits or benefits for loss of income; or
7-23 (4) Any other publicly or privately funded program which provides
7-24 such benefits.
7-25 (b) “Medical malpractice” has the meaning ascribed to it in NRS
7-26 41A.009.
7-27 Sec. 14. NRS 1.360 is hereby amended to read as follows:
7-28 1.360 Under the direction of the supreme court, the court administrator
7-29 shall:
7-30 1. Examine the administrative procedures employed in the offices of
7-31 the judges, clerks, court reporters and employees of all courts of this state
7-32 and make recommendations, through the chief justice, for the improvement
7-33 of those procedures;
7-34 2. Examine the condition of the dockets of the courts and determine
7-35 the need for assistance by any court;
7-36 3. Make recommendations to and carry out the directions of the chief
7-37 justice relating to the assignment of district judges where district courts are
7-38 in need of assistance;
7-39 4. Develop a uniform system for collecting and compiling statistics
7-40 and other data regarding the operation of the state court system and
7-41 transmit that information to the supreme court so that proper action may be
7-42 taken in respect thereto;
7-43 5. Prepare and submit a budget of state appropriations necessary for
7-44 the maintenance and operation of the state court system and make
7-45 recommendations in respect thereto;
7-46 6. Develop procedures for accounting, internal auditing, procurement
7-47 and disbursement for the state court system;
8-1 7. Collect statistical and other data and make reports relating to the
8-2 expenditure of all public money for the maintenance and operation of the
8-3 state court system and the offices connected therewith;
8-4 8. Compile statistics from the information required to be maintained
8-5 by the clerks of the district courts pursuant to NRS 3.275 and make reports
8-6 as to the cases filed in the district courts;
8-7 9. Formulate and submit to the supreme court recommendations of
8-8 policies or proposed legislation for the improvement of the state court
8-9 system;
8-10 10. On or before January 1 of each year, submit to the director of the
8-11 legislative counsel bureau a written report compiling the information
8-12 submitted to the court administrator pursuant to NRS 3.243, 4.175 and
8-13 5.045 during the immediately preceding fiscal year; [and]
8-14 11. On or before February 15 of each odd-numbered year, submit to
8-15 the governor and to the director of the legislative counsel bureau for
8-16 transmittal to the next regular session of the legislature a written report
8-17 compiling the information submitted by clerks of courts to the court
8-18 administrator pursuant to NRS 630.307 and section 30 of this act which
8-19 includes only aggregate information for statistical purposes and excludes
8-20 any identifying information related to a particular person; and
8-21 12. Attend to such other matters as may be assigned by the supreme
8-22 court or prescribed by law.
8-23 Sec. 15. Chapter 3 of NRS is hereby amended by adding thereto a new
8-24 section to read as follows:
8-25 The supreme court shall provide by court rule for mandatory
8-26 appropriate training concerning the complex issues of medical
8-27 malpractice litigation for each district judge to whom actions involving
8-28 medical malpractice are assigned.
8-29 Sec. 16. NRS 7.085 is hereby amended to read as follows:
8-30 7.085 If a court finds that an attorney has:
8-31 1. Filed, maintained or defended a civil action or proceeding in any
8-32 court in this state and such action or defense is not well-grounded in fact or
8-33 is not warranted by existing law or by an argument for changing the
8-34 existing law that is made in good faith; or
8-35 2. Unreasonably and vexatiously extended a civil action or proceeding
8-36 before any court in this state,
8-37 the court [may] shall require the attorney personally to pay the additional
8-38 costs, expenses and attorney’s fees reasonably incurred because of such
8-39 conduct.
8-40 Sec. 17. NRS 49.245 is hereby amended to read as follows:
8-41 49.245 There is no privilege under NRS 49.225 or 49.235:
8-42 1. For communications relevant to an issue in proceedings to
8-43 hospitalize the patient for mental illness, if the doctor in the course of
8-44 diagnosis or treatment has determined that the patient is in need of
8-45 hospitalization.
8-46 2. As to communications made in the course of a court-ordered
8-47 examination of the condition of a patient with respect to the particular
8-48 purpose of the examination unless the court orders otherwise.
9-1 3. As to written medical or hospital records relevant to an issue of the
9-2 condition of the patient in any proceeding in which the condition is an
9-3 element of a claim or defense.
9-4 4. In a prosecution or mandamus proceeding under chapter 441A of
9-5 NRS.
9-6 5. As to any information communicated to a physician in an effort
9-7 unlawfully to procure a dangerous drug or controlled substance, or
9-8 unlawfully to procure the administration of any such drug or substance.
9-9 6. As to any written medical or hospital records which are furnished in
9-10 accordance with the provisions of NRS 629.061.
9-11 7. As to records that are required by chapter 453 of NRS to be
9-12 maintained.
9-13 8. [In a review before a screening panel pursuant to NRS 41A.003 to
9-14 41A.069, inclusive.
9-15 9.] If the services of the physician are sought or obtained to enable or
9-16 aid a person to commit or plan to commit fraud or any other unlawful act in
9-17 violation of any provision of chapter 616A, 616B, 616C, 616D or 617 of
9-18 NRS which the person knows or reasonably should know is fraudulent or
9-19 otherwise unlawful.
9-20 Sec. 18. Chapter 630 of NRS is hereby amended by adding thereto a
9-21 new section to read as follows:
9-22 A physician licensed pursuant to this chapter shall not practice
9-23 medicine in this state unless he maintains professional liability insurance
9-24 in an amount of:
9-25 1. Not less than $1,000,000 per person; and
9-26 2. Not less than $3,000,000 per occurrence.
9-27 Sec. 19. NRS 630.130 is hereby amended to read as follows:
9-28 630.130 1. In addition to the other powers and duties provided in this
9-29 chapter, the board shall:
9-30 (a) Enforce the provisions of this chapter;
9-31 (b) Establish by regulation standards for licensure under this chapter;
9-32 (c) Conduct examinations for licensure and establish a system of
9-33 scoring for those examinations;
9-34 (d) Investigate the character of each applicant for a license and issue
9-35 licenses to those applicants who meet the qualifications set by this chapter
9-36 and the board; and
9-37 (e) Institute a proceeding in any court to enforce its orders or the
9-38 provisions of this chapter.
9-39 2. On or before February 15 of each odd-numbered year, the board
9-40 shall submit to the governor and to the director of the legislative counsel
9-41 bureau for transmittal to the next regular session of the legislature a
9-42 written report compiling:
9-43 (a) Disciplinary action taken by the board during the previous
9-44 biennium against physicians for malpractice or negligence; and
9-45 (b) Information reported to the board during the previous biennium
9-46 pursuant to NRS 630.3067, subsections 2 and 3 of NRS 630.307 and NRS
9-47 690B.045.
10-1 The report must include only aggregate information for statistical
10-2 purposes and exclude any identifying information related to a particular
10-3 person.
10-4 3. The board may adopt such regulations as are necessary or desirable
10-5 to enable it to carry out the provisions of this chapter.
10-6 Sec. 20. NRS 630.267 is hereby amended to read as follows:
10-7 630.267 1. Each holder of a license to practice medicine must, on or
10-8 before July 1 of each alternate year:
10-9 (a) Submit the statement required pursuant to NRS 630.197; [and]
10-10 (b) Submit a list of all actions filed or claims submitted to arbitration
10-11 or mediation for malpractice or negligence against him during the
10-12 previous 2 years; and
10-13 (c) Pay to the secretary-treasurer of the board the applicable fee for
10-14 biennial registration. This fee must be collected for the period for which a
10-15 physician is licensed.
10-16 2. When a holder of a license fails to pay the fee for biennial
10-17 registration and submit the statement required pursuant to NRS 630.197
10-18 after they become due, his license to practice medicine in this state is
10-19 automatically suspended. The holder may, within 2 years after the date his
10-20 license is suspended, upon payment of twice the amount of the current fee
10-21 for biennial registration to the secretary-treasurer and submission of the
10-22 statement required pursuant to NRS 630.197 and after he is found to be in
10-23 good standing and qualified under the provisions of this chapter, be
10-24 reinstated to practice.
10-25 3. The board shall make such reasonable attempts as are practicable to
10-26 notify a licensee:
10-27 (a) At least once that his fee for biennial registration and the statement
10-28 required pursuant to NRS 630.197 are due; and
10-29 (b) That his license is suspended.
10-30 A copy of this notice must be sent to the Drug Enforcement Administration
10-31 of the United States Department of Justice or its successor agency.
10-32 Sec. 21. NRS 630.3062 is hereby amended to read as follows:
10-33 630.3062 The following acts, among others, constitute grounds for
10-34 initiating disciplinary action or denying licensure:
10-35 1. Failure to maintain timely, legible, accurate and complete medical
10-36 records relating to the diagnosis, treatment and care of a patient.
10-37 2. Altering medical records of a patient.
10-38 3. Making or filing a report which the licensee knows to be false,
10-39 failing to file a record or report as required by law or willfully obstructing
10-40 or inducing another to obstruct such filing.
10-41 4. Failure to make the medical records of a patient available for
10-42 inspection and copying as provided in NRS 629.061.
10-43 5. Failure to [report any claim for malpractice or negligence filed
10-44 against the licensee and the subsequent disposition thereof within 90 days
10-45 after the:
10-46 (a) Claim is filed; and
10-47 (b) Disposition of the claim.] comply with the requirements of NRS
10-48 630.3067.
11-1 6. Failure to report any person the licensee knows, or has reason to
11-2 know, is in violation of the provisions of this chapter or the regulations of
11-3 the board.
11-4 Sec. 22. NRS 630.3067 is hereby amended to read as follows:
11-5 630.3067 [Under the provisions of NRS 690B.045, the]
11-6 1. The insurer of a physician licensed under this chapter and the
11-7 physician must report to the board any action filed or claim submitted to
11-8 arbitration or mediation for malpractice or negligence against the
11-9 physician and the settlement, award, judgment or other disposition
11-10 [thereof.] of the action or claim within 30 days after:
11-11 (a) The action was filed or the claim was submitted to arbitration or
11-12 mediation; and
11-13 (b) The disposition of the action or claim.
11-14 2. The board shall report any failure to comply with subsection 1 by
11-15 an insurer licensed in this state to the division of insurance of the
11-16 department of business and industry. If, after a hearing, the division of
11-17 insurance determines that any such insurer failed to comply with the
11-18 requirements of subsection 1, the division may impose an administrative
11-19 fine of not more than $10,000 against the insurer for each such failure to
11-20 report. If the administrative fine is not paid when due, the fine must be
11-21 recovered in a civil action brought by the attorney general on behalf of
11-22 the division.
11-23 Sec. 23. NRS 630.307 is hereby amended to read as follows:
11-24 630.307 1. Any person, medical school or medical facility that
11-25 becomes aware that a person practicing medicine or respiratory care in this
11-26 state has, is or is about to become engaged in conduct which constitutes
11-27 grounds for initiating disciplinary action shall [forthwith] file a written
11-28 complaint with the board[.] within 30 days after becoming aware of the
11-29 conduct.
11-30 2. Any hospital, clinic or other medical facility licensed in this state, or
11-31 medical society, shall [forthwith] report to the board any change in a
11-32 physician’s privileges to practice medicine while the physician is under
11-33 investigation and the outcome of any disciplinary action taken by that
11-34 facility or society against the physician concerning the care of a patient or
11-35 the competency of the physician[.] within 30 days after the change in
11-36 privileges is made or disciplinary action is taken. The board shall report
11-37 any failure to comply with this subsection by a hospital, clinic or other
11-38 medical facility licensed in this state to the health division of the
11-39 department of human resources. If, after a hearing, the health division
11-40 determines that any such facility or society failed to comply with the
11-41 requirements of this subsection, the division may impose an
11-42 administrative fine of not more than $10,000 against the facility or
11-43 society for each such failure to report. If the administrative fine is not
11-44 paid when due, the fine must be recovered in a civil action brought by the
11-45 attorney general on behalf of the division.
11-46 3. The clerk of every court shall [forthwith] report to the board any
11-47 finding, judgment or other determination of the court that a physician,
11-48 physician assistant or practitioner of respiratory care:
11-49 (a) Is mentally ill;
12-1 (b) Is mentally incompetent;
12-2 (c) Has been convicted of a felony or any law governing controlled
12-3 substances or dangerous drugs;
12-4 (d) Is guilty of abuse or fraud under any state or federal program
12-5 providing medical assistance; or
12-6 (e) Is liable for damages for malpractice or negligence[.] ,
12-7 within 45 days after such a finding, judgment or determination is made.
12-8 4. The board shall keep information received pursuant to this section
12-9 confidential unless a court of competent jurisdiction issues a subpoena
12-10 compelling the release of such information.
12-11 5. On or before January 15 of each year, the clerk of each court
12-12 shall submit to the office of court administrator created pursuant to NRS
12-13 1.320 a written report compiling the information that the clerk reported
12-14 during the previous year to the board regarding physicians pursuant to
12-15 paragraph (e) of subsection 3.
12-16 Sec. 24. NRS 630.364 is hereby amended to read as follows:
12-17 630.364 1. Any person or organization who furnishes information
12-18 concerning an applicant for a license or a licensee in good faith and
12-19 without malicious intent in accordance with the provisions of this chapter
12-20 is immune from any civil action for furnishing that information.
12-21 2. The board and any of its members and its staff, counsel,
12-22 investigators, experts, committees, panels, hearing officers and consultants
12-23 are immune from any civil liability for:
12-24 (a) Any decision or action taken in good faith and without malicious
12-25 intent in response to information acquired by the board.
12-26 (b) Disseminating information concerning an applicant for a license or a
12-27 licensee to other boards or agencies of the state, the attorney general, any
12-28 hospitals, medical societies, insurers, employers, patients and their families
12-29 or any law enforcement agency.
12-30 [3. A screening panel or any of its members, acting pursuant to NRS
12-31 41A.003 to 41A.069, inclusive, that initiates or assists in any proceeding
12-32 concerning a claim of malpractice against a physician is immune from any
12-33 civil action for that initiation or assistance or any consequential damages, if
12-34 the panel or members acted without malicious intent.]
12-35 Sec. 25. Chapter 631 of NRS is hereby amended by adding thereto a
12-36 new section to read as follows:
12-37 A dentist licensed pursuant to this chapter shall not practice dentistry
12-38 in this state unless he maintains professional liability insurance in an
12-39 amount of:
12-40 1. Not less than $1,000,000 per person; and
12-41 2. Not less than $3,000,000 per occurrence.
12-42 Sec. 26. Chapter 633 of NRS is hereby amended by adding thereto the
12-43 provisions set forth as sections 27 to 30, inclusive, of this act.
12-44 Sec. 27. An osteopathic physician licensed pursuant to this chapter
12-45 shall not practice osteopathic medicine in this state unless he maintains
12-46 professional liability insurance in an amount of:
12-47 1. Not less than $1,000,000 per person; and
12-48 2. Not less than $3,000,000 per occurrence.
13-1 Sec. 28. 1. On or before February 15 of each odd-numbered year,
13-2 the board shall submit to the governor and to the director of the
13-3 legislative counsel bureau for transmittal to the next regular session of
13-4 the legislature a written report compiling:
13-5 (a) Disciplinary action taken by the board during the previous
13-6 biennium against osteopathic physicians for malpractice or negligence;
13-7 and
13-8 (b) Information reported to the board during the previous biennium
13-9 pursuant to NRS 690B.045, section 29 of this act and subsections 2 and 3
13-10 of section 30 of this act.
13-11 2. The report must include only aggregate information for statistical
13-12 purposes and exclude any identifying information related to a particular
13-13 person.
13-14 Sec. 29. 1. The insurer of an osteopathic physician licensed under
13-15 this chapter and the osteopathic physician must report to the board any
13-16 action filed or claim submitted to arbitration or mediation for
13-17 malpractice or negligence against the osteopathic physician and the
13-18 settlement, award, judgment or other disposition of the action or claim
13-19 within 30 days after:
13-20 (a) The action was filed or the claim was submitted to arbitration or
13-21 mediation; and
13-22 (b) The disposition of the action or claim.
13-23 2. The board shall report any failure to comply with subsection 1 by
13-24 an insurer licensed in this state to the division of insurance of the
13-25 department of business and industry. If, after a hearing, the division of
13-26 insurance determines that any such insurer failed to comply with the
13-27 requirements of subsection 1, the division may impose an administrative
13-28 fine of not more than $10,000 against the insurer for each such failure to
13-29 report. If the administrative fine is not paid when due, the fine must be
13-30 recovered in a civil action brought by the attorney general on behalf of
13-31 the division.
13-32 Sec. 30. 1. Any person, medical school or medical facility that
13-33 becomes aware that a person practicing osteopathic medicine in this state
13-34 has, is or is about to become engaged in conduct which constitutes
13-35 grounds for initiating disciplinary action shall file a written complaint
13-36 with the board within 30 days after becoming aware of the conduct.
13-37 2. Any hospital, clinic or other medical facility licensed in this state,
13-38 or medical society, shall report to the board any change in an osteopathic
13-39 physician’s privileges to practice osteopathic medicine while the
13-40 osteopathic physician is under investigation and the outcome of any
13-41 disciplinary action taken by that facility or society against the osteopathic
13-42 physician concerning the care of a patient or the competency of the
13-43 osteopathic physician within 30 days after the change in privileges is
13-44 made or disciplinary action is taken. The board shall report any failure to
13-45 comply with this subsection by a hospital, clinic or other medical facility
13-46 licensed in this state to the health division of the department of human
13-47 resources. If, after a hearing, the health division determines that any
13-48 such facility or society failed to comply with the requirements of this
13-49 subsection, the division may impose an administrative fine of not more
14-1 than $10,000 against the facility or society for each such failure to
14-2 report. If the administrative fine is not paid when due, the fine must be
14-3 recovered in a civil action brought by the attorney general on behalf of
14-4 the division.
14-5 3. The clerk of every court shall report to the board any finding,
14-6 judgment or other determination of the court that an osteopathic
14-7 physician or osteopathic physician’s assistant:
14-8 (a) Is mentally ill;
14-9 (b) Is mentally incompetent;
14-10 (c) Has been convicted of a felony or any law governing controlled
14-11 substances or dangerous drugs;
14-12 (d) Is guilty of abuse or fraud under any state or federal program
14-13 providing medical assistance; or
14-14 (e) Is liable for damages for malpractice or negligence,
14-15 within 45 days after such a finding, judgment or determination is made.
14-16 4. The board shall keep information received pursuant to this section
14-17 confidential unless a court of competent jurisdiction issues a subpoena
14-18 compelling the release of such information.
14-19 5. On or before January 15 of each year, the clerk of every court
14-20 shall submit to the office of court administrator created pursuant to NRS
14-21 1.320 a written report compiling the information that the clerk reported
14-22 during the previous year to the board regarding osteopathic physicians
14-23 pursuant to paragraph (e) of subsection 3.
14-24 Sec. 31. NRS 633.471 is hereby amended to read as follows:
14-25 633.471 1. Except as otherwise provided in subsection 3 and in
14-26 NRS 633.491, every holder of a license issued under this chapter, except
14-27 a temporary or a special license, may renew his license on or before
14-28 January 1 of each calendar year after its issuance by:
14-29 (a) Applying for renewal on forms provided by the board;
14-30 (b) Submitting the statement required pursuant to NRS 633.326;
14-31 (c) Paying the annual license renewal fee specified in this chapter; [and]
14-32 (d) Submitting a list of all actions filed or claims submitted to
14-33 arbitration or mediation for malpractice or negligence against him
14-34 during the previous year; and
14-35 (e) Submitting verified evidence satisfactory to the board that in the
14-36 year preceding the application for renewal he has attended courses or
14-37 programs of continuing education approved by the board totaling a number
14-38 of hours established by the board which must not be less than 35 hours nor
14-39 more than that set in the requirements for continuing medical education of
14-40 the American Osteopathic Association.
14-41 2. The secretary of the board shall notify each licensee of the
14-42 requirements for renewal not less than 30 days before the date of renewal.
14-43 3. Members of the Armed Forces of the United States and the United
14-44 States Public Health Service are exempt from payment of the annual
14-45 license renewal fee during their active duty status.
14-46 Sec. 32. NRS 633.511 is hereby amended to read as follows:
14-47 633.511 The grounds for initiating disciplinary action pursuant to this
14-48 chapter are:
14-49 1. Unprofessional conduct.
15-1 2. Conviction of:
15-2 (a) A violation of any federal or state law regulating the possession,
15-3 distribution or use of any controlled substance or any dangerous drug as
15-4 defined in chapter 454 of NRS;
15-5 (b) A felony;
15-6 (c) A violation of any of the provisions of NRS 616D.200, 616D.220,
15-7 616D.240 or 616D.300 to 616D.440, inclusive; or
15-8 (d) Any offense involving moral turpitude.
15-9 3. The suspension of the license to practice osteopathic medicine by
15-10 any other jurisdiction.
15-11 4. Gross or repeated malpractice, which may be evidenced by claims
15-12 of malpractice settled against a practitioner.
15-13 5. Professional incompetence.
15-14 6. Failure to comply with the requirements of section 29 of this act.
15-15 Sec. 33. NRS 690B.045 is hereby amended to read as follows:
15-16 690B.045 Except as more is required in NRS 630.3067[:] and section
15-17 29 of this act:
15-18 1. Each insurer which issues a policy of insurance covering the
15-19 liability of a practitioner licensed pursuant to chapters 630 to 640,
15-20 inclusive, of NRS for a breach of his professional duty toward a patient
15-21 shall report to the board which licensed the practitioner within 30 days
15-22 each settlement or award made or judgment rendered by reason of a claim,
15-23 if the settlement, award or judgment is for more than $5,000, giving the
15-24 name and address of the claimant and the practitioner and the
15-25 circumstances of the case.
15-26 2. A practitioner licensed pursuant to chapters 630 to 640, inclusive, of
15-27 NRS who does not have insurance covering liability for a breach of his
15-28 professional duty toward a patient shall report to the board which issued his
15-29 license within 30 days of each settlement or award made or judgment
15-30 rendered by reason of a claim, if the settlement, award or judgment is for
15-31 more than $5,000, giving his name and address, the name and address of
15-32 the claimant and the circumstances of the case.
15-33 3. These reports are public records and must be made available for
15-34 public inspection within a reasonable time after they are received by the
15-35 licensing board.
15-36 Sec. 34. NRS 690B.050 is hereby amended to read as follows:
15-37 690B.050 1. Each insurer which issues a policy of insurance
15-38 covering the liability of a physician licensed under chapter 630 of NRS or
15-39 an osteopathic physician licensed under chapter 633 of NRS for a breach
15-40 of his professional duty toward a patient shall report to the commissioner
15-41 within 30 days each settlement or award made or judgment rendered by
15-42 reason of a claim, giving the name and address of the claimant and
15-43 physician and the circumstances of the case.
15-44 2. The commissioner shall report to the board of medical examiners[,]
15-45 or the state board of osteopathic medicine, as applicable, within 30 days
15-46 after receiving the report of the insurer, each claim made and each
15-47 settlement, award or judgment.
16-1 Sec. 35. NRS 41A.0043, 41A.005, 41A.008, 41A.013, 41A.016,
16-2 41A.019, 41A.023, 41A.024, 41A.026, 41A.029, 41A.033, 41A.036,
16-3 41A.039, 41A.043, 41A.046, 41A.049, 41A.051, 41A.053, 41A.056,
16-4 41A.059, 41A.069 and 631.377 are hereby repealed.
16-5 Sec. 36. The amendatory provisions of sections 1 to 6, inclusive, and
16-6 11 of this act apply only to a cause of action that accrues on or after
16-7 October 1, 2002.
16-8 Sec. 37. The amendatory provisions of sections 7, 8, 12 and 17 apply
16-9 only to an action filed on or after October 1, 2002.
16-10 Sec. 38. 1. Notwithstanding the repeal of NRS 41A.0043, 41A.005,
16-11 41A.008 and 41A.013 to 41A.069, inclusive, if a claimant has filed a
16-12 complaint with the division of insurance of the department of business and
16-13 industry pursuant to NRS 41A.039 before October 1, 2002, and a
16-14 determination has not been made by the screening panel as provided in
16-15 NRS 41A.003 to 41A.069, inclusive, before October 1, 2002, the claimant
16-16 may elect:
16-17 (a) To have a determination made by the screening panel as provided in
16-18 NRS 41A.003 to 41A.069, inclusive. If the claimant elects to have a
16-19 determination made by the screening panel, the provisions of NRS
16-20 41A.003 to 41A.069, inclusive, shall be deemed to continue to apply to the
16-21 claim and to any subsequent action filed in the district court. If the claimant
16-22 wishes to elect to have a determination made by the screening panel, the
16-23 claimant must, before December 1, 2002, file written notice of that fact
16-24 with the division. If the claimant fails to provide such written notice, the
16-25 claimant shall be deemed to have elected to have no further action taken by
16-26 the screening panel concerning the complaint.
16-27 (b) To have no further action taken by the screening panel concerning
16-28 the complaint. If the claimant elects to have no further action taken by the
16-29 screening panel concerning the complaint, the division and the screening
16-30 panel shall not take any further action with respect to the complaint, and
16-31 the claimant may file an action in the district court.
16-32 2. Notwithstanding the repeal of NRS 41A.0043, 41A.005, 41A.008
16-33 and 41A.013 to 41A.069, inclusive, and the amendment of paragraph (b) of
16-34 subsection 2 of NRS 41A.097, if a claimant elects:
16-35 (a) To have a determination made by the screening panel, the tolling of
16-36 the time limitation provided for review of the complaint by the screening
16-37 panel pursuant to NRS 41A.097 shall be deemed to continue to apply until
16-38 30 days after the date on which the screening panel notifies the claimant, in
16-39 writing, of its findings.
16-40 (b) To have no further action taken by the screening panel concerning
16-41 the complaint, the tolling of the time limitation provided for review of the
16-42 complaint by the screening panel pursuant to NRS 41A.097 ceases on
16-43 December 1, 2002.
16-44 3. If a claimant:
16-45 (a) Elects to have no further action taken by the screening panel
16-46 concerning the complaint;
16-47 (b) Files an action in the district court; and
16-48 (c) Prevails at the trial of the action,
17-1 the claimant is entitled to tax, as costs, the fee paid to the division pursuant
17-2 to NRS 41A.039 for filing the complaint.
17-3 Sec. 39. On or before March 1, 2003, pursuant to subsection 3 of
17-4 section 7 of this act, each district court in this state shall adopt court rules
17-5 to expedite the resolution of an action involving medical malpractice or
17-6 dental malpractice.
17-7 Sec. 40. This act becomes effective on October 1, 2002.
17-8 LEADLINES OF REPEALED SECTIONS
17-9 41A.0043 “Dentist” defined.
17-10 41A.005 “Division” defined.
17-11 41A.008 “Health care records” defined.
17-12 41A.013 “Physician” defined.
17-13 41A.016 Submission of case to screening panel required before suit
17-14 may be filed; admissibility in court of findings of screening panel.
17-15 41A.019 Creation of tentative screening panels.
17-16 41A.023 Designation of members.
17-17 41A.024 Courses of instruction for members.
17-18 41A.026 Election of chairmen; applicability of rules.
17-19 41A.029 Requirements regarding open meetings do not apply to
17-20 meetings of screening panels.
17-21 41A.033 Administrative duties and powers of division.
17-22 41A.036 Deposit of money received by division with state
17-23 treasurer; payment of administrative costs of screening panel.
17-24 41A.039 Submission of claim to screening panel: Complaint;
17-25 answer; response to answer; service of pleadings; fees.
17-26 41A.043 Selection of members for particular screening panel.
17-27 41A.046 Subpoenas: Powers and duties of division; enforcement.
17-28 41A.049 Hearing by screening panel: Time for holding; materials
17-29 for consideration; findings.
17-30 41A.051 Hearing by screening panel: Preferential scheduling for
17-31 certain elderly claimants and claimants who suffer from terminal
17-32 illness or condition.
17-33 41A.053 Early disclosure of medical or dental records prohibited;
17-34 penalty.
17-35 41A.056 Effect of decision of screening panel.
17-36 41A.059 Conference for settlement of claim: Attendance; powers
17-37 and duties of judge; effect of failure to settle.
17-38 41A.069 Instructions to jury.
17-39 631.377 Screening panel immune from civil action.
17-40 H