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Our View: A doctor from the Range

Dr. Anthony J. Cortese has no end of impressive credentials. President of the Federation of State Medical Boards, chairman of the United States Medical Licensing Examination, twice president of the Oregon Board of Medical Examiners and president ...

Dr. Anthony J. Cortese has no end of impressive credentials. President of the Federation of State Medical Boards, chairman of the United States Medical Licensing Examination, twice president of the Oregon Board of Medical Examiners and president of the American College of Osteopathic Obstetricians and Gynecologists, to name only a few.

He also was a Duluth News Tribune paperboy.

"I delivered it in 1938 and '40," he said by phone this week from his home outside of Portland, Ore.

"I went to school with Rudy Perpich. We went to junior college together," he added of the late Minnesota governor and fellow Iron Ranger.

Born in Hibbing, Cortese, 80, served in the Army Air Force in World War II. He went to medical school in Chicago and began his ob-gyn practice there before moving to Oregon in 1961. He has delivered probably 10,000 babies, a recent visitor to his home told the News Tribune, and his den is filled with cards from former patients.

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But the purpose of the call from the newspaper wasn't to walk down memory lane; it was to ask about the 10 malpractice suits against him. In a search of 150 former Minnesota doctors who relocated to Oregon, which posts malpractice data online, the News Tribune found 31 who had been sued. Nearly half were sued only once, but two doctors led the pack with 10 lawsuits each. Cortese is one of them.

"I can tell you about one of the cases against me," he began. "There was a general practitioner who put an obstetric patient in the hospital. She was waiting to deliver. The baby's heartbeat started to disappear. I got called in in consultation."

The baby's heart stopped and Cortese got it going again, he said. "Then the mother started bleeding. I took care of the mother. The baby, because of the length of time it had no heartbeat, just didn't make it. It lived five days.

"A year and a half later, I got sued. The general practitioner got sued. And an intern got sued," he said, explaining that each doctor had a different insurance company. "My insurance company said, 'The [plaintiffs] want to settle for $150,000 -- $50,000 from each insurance company. If we go to trial, then one attorney is going to say it's Dr. Cortese's fault, another will say it's the intern's fault and the other it's the general practitioner's fault. We know you didn't do anything wrong. We just don't want to take a chance on taking it to trial.' I signed off on it and so did the other two."

A few months later, Cortese said, "I was in the office and my secretary said the mother had made an appointment [just] to talk. I went to talk to her and she started crying. She said, 'I know you saved my life. I know you did a fantastic job. But my attorneys wouldn't have taken this case unless we filed against everybody. After that trial I can't even sleep. I start crying because I know we did something wrong against you.' "

In another case, Cortese said, a patient he'd never seen before arrived in an emergency room late at night. She left before a test came back indicating a tubal pregnancy.

"She had given a false address and I couldn't get ahold of her. She ended up going to another emergency room. The doctor told her I should have known she had an ectopic pregnancy. It didn't make any difference that I couldn't get ahold of her."

The case was settled for $5,000.

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A third case -- an emergency Caesarean section -- also began late at night in an emergency room with a patient Cortese said he had never seen before.

"The surgery went fine," he continued, saying the woman later divorced and then remarried a man who wanted to have children.

"A Kaiser Insurance doctor did a workup on her. He said, 'You can't get pregnant because your tubes are tied,' which I didn't do. They figured I had done it, so they sued me.

"We went to trial. The mistake she made was after I did the C-section, she went to two other doctors [who] took her history and asked her what kind of surgery she had. She said, 'I had a C-section and I had a tubal ligation.' The jury had a unanimous verdict in my favor."

So far, then, it's 3-0. The records indicate dismissals in three other cases, documented as "alleged CP as a result of forceps delivery," "abdominal cyst following a laparoscopy" and "baby born with congenital deformities and died." Of the remaining four, Cortese accepts responsibility for three.

"There are only three cases of mine that something went wrong that basically it might have been my fault," he said.

He did not elaborate.

Cortese, again, is not just any doctor. His fingerprints are on the rulebook for the modern profession, overseeing its national licensing body and the über-authority of state medical boards. He spent 17 years on the Oregon Board of Medical Examiners. And to put the 10 malpractice suits in context, they came over 37 years and he always was able to remain insured.

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"Whenever there's a case filed against [a] doctor, a committee of doctors from the Oregon Medical Society meets," he said. "They determine whether a doctor did something wrong or not. If they did and you had three bad cases, they would not give you any insurance.

"They are my insurance company. They're protecting me now," he said.

He retired in 1994.

"Yeah," he said. "The premiums got too high. In 1986, I wanted to cut my obstetric cases down to about 60 a year. I was only charging $1,500 for total obstetric care. If I kept on delivering babies after 1986, malpractice insurance would be $60,000 a year. I'd be losing about $400 on every baby I delivered."

Economics aside, is Cortese in favor of making information about malpractice cases available to the public, as his state does?

"If they investigate a case and find the doctor who did something wrong and sue him, not two other guys, I'd be all in favor of telling the public," he said, addressing an issue of tort reform more than public disclosure.

But had Oregon not posted his cases online, and the Minnesota board not listed his current address, his story, especially his side of it, would not have been told here for the folks back on the Range.

Tomorrow: Mistakes -- and fixes. A search for solutions.

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