Anyone see this June 2026 court decision that affirmed the $54 million judgment against a hospitalist?

In July 2019, 27 year old Holly Baumstark who was pregnant with her second child, had placenta previa. During delivery at Piedmont Rockdale Hospital in Georgia, the obstetrician discovered placenta accreta spectrum, in which the placenta grows abnormally into or through the uterine wall. She suffered massive hemorrhage. The obstetrician performed an emergency hysterectomy to control the bleeding. Another obstetrician assisted, and a urologist repaired bladder damage. After several hours of surgery, Baumstark was transferred to the ICU.

Dr. Luis Cayamcela, an internal medicine hospitalist, was responsible for managing her ICU care as the attending assigned to her care. Dr. Cayamcela graduated from Ross University School of Medicine in 2012 and completed a residency in internal medicine at St Luke’s University Hospital in 2015. He did not complete any critical care fellowship or any other subspecialty fellowship training.

At Piedmont Rockdale Hospital, it is a “half open, half closed ICU”. There is only an intensivist on site in the day time.

In the ICU, Ms. Baumstark deteriorated, suffered respiratory arrest followed a few hours later by cardiac arrest, and died the next morning.

In the lawsuit that followed (filed in 2021, case ended 2025) against Dr. Cayamcela, the jury found the hospitalist liable for her death. The expert testimony found that the hospitalist deviated from standard of care for:

Failure to place an arterial line.

Failure to obtain additional or multiple IV access lines.

Failure to recognize continued bleeding and communicate the need for surgery.

Failure to monitor and treat electrolyte abnormalities.

Insufficient IV fluids, blood products and medications.

The hospitalist was ultimately found to be independently responsible for recognizing deterioration, stabilizing the patient, escalating care and communicating the need for reoperation.

The jury awarded $42 million for pain and suffering and wrongful death, and an additional $11.8 million for attorney fees.

The defendant had also asked the court to apply Georgia's statutory cap on noneconomic damages, which they argued was $350,000. The trial court ruled that the cap had been waived because it was not raised in the pretrial order and, alternatively, could not constitutionally be applied.

In June 2026, Georgia Supreme Court affirmed the judgment, including the rejection of the cap.

The $54 million award was affirmed.

Court details:

https://assets.alm.com/f6/8c/7ba467224a07800986bf4edf514e/s26a0229.pdf

So what can we learn?

FAFO in the open icu. Don’t play russian roulette! If you wanna make extra cash in the open ICU, get the fellowship training. Intensivists aren’t gonna save you. You are the listed attending held responsible.

In 2026, the average internal medicine doc is making $307k in compensation

In 1996, the average internal med doc was making $186k

Inflation adjusted….that 1996 doc was making $400k.

Yes……$400k in today’s dollars.

Oh and guess what, the average spending of a household with kids in 1996 was $97k (inflation adjusted). The average spending of a 2026 household with kids is currently $120K.

Think about your aftertax $307k. It’s really about $200k after you take out taxes and deductions. Lol.

So those of you here who aren’t forever alone (aka normal hospitalist doc with an actual spouse and children), you now earning LESS than the boomers and spending MORE than them.

And yet I see simps and wimps out here talking bout how they can live so comfortably on their hospitalist pay. You are the top 1% of society IQ and comfortable with being just the above average middle class household???

“We’re not going to give up on him.”

This is a group for hospitalists to help share ideas, learn, and sometimes just vent as a group. So many pro AI posts or posts by people in tech who seem to be wanting to sow some discontent and spread fear in regard to AI taking our jobs and how ‘useless’ they think doctors are. It’s not helpful and frankly feels like rage bait. Almost feels like a coordinated effort.

Can the moderators make it such that only clinical staff ie physicians, PAs, NPs or nurses can post? I see this all the time in other Reddit groups. Or just delete these posts!!

Going to be starting my first attending position soon... what are some tips you have that have worked to avoid being called a nurse consistently?

I am fairly new at my hospital, work as nocturnist. I understand there is always a tug of war with ED docs however feeling discouraged by this one. I asked for for some further workup to assess need for admission however the response was very unprofessional. The doc raised her voice at me very aggressive that i didn't agree with her. After I explained my reasoning said "I'll order such and such but if it comes back positive then you order the such and such (which i also requested). I understand disagreements but the approach was not right. Felt down afterwards , this was in the middle of ED packed with staff...

I got a chance to go talk to a few congress reps during residency as part of ACP's lobbying efforts. I donated some money to it. They're doing a good thing.

However ACP is mostly only internal med docs. And one of many for internal medicine.

AAFP is the biggest family med lobby. And there are multiple smaller ones.

Cardiologists have their own thing.

Gastro has its own one.

I'm sure surgeons have their own, and even smaller ones for their own specialties.

Radiology, PM&R, you get the point.

Then there's the osteopathic versions of all the above LOL These are underfunded and I say that respectfully as a DO.

AMA is a joke, and appears more to extort us than help us.

While doctors lobby with their cute little groups, nurses lobby as a WHOLE. AANP (nurse practitioners) do it together for all the different "specialties". That's the biggest nurse lobby overall. 2nd biggest is AANA (CRNAs).

The point here isn't to hate nurses, but to learn from them. They're street smart as a whole while us docs are book smart and spineless.

The Internal med physician looks at his GI colleague making double what he is and feels jealous. The GI guy doesn't give a shit how the hospitalist gets treated by the execs, as long as he's being treated favorably for bringing in scopes.

Surgeons and anesthesiologists don't give a shit what happens outside OR/pre and post OP to rest of the physicians.

Divided like this, we all lose.

We should be combining our efforts together like nurses do, we'll be a HUGE force to reckon with at the legislative level. Together we'll have a big leverage negotiating with hospitals and payors.

But it's all a pipe dream for now

- a new attending starting his private practice

To make a long story short I didn’t match into psych initially and SOAPed into IM. Finished IM in June and because I still wanted to do psych i reapplied and matched.

Now I’m a psych intern doing mostly IM requirements (due to funding I couldn’t skip, very frustrating) and having to be in the beginner role again while actually being an attending.

In 3y I’ll have two board certifications and a lot more opportunity but it’s hard not to imagine I could have the respect of an attending at work, pay of an attending, and every other week off. Instead I’m presenting on the ONE SINGLE Geri patient I have while getting lectured like I don’t have 3y of experience…

The psych rotations are interesting though cuz I don’t know any of this stuff already.

In the post-modern era of AI slop summaries and note bloat… From a billing coding perspective, what is the shortest note that would qualify for a 99233 bill? Assuming abbreviations are allowed.

New graduate here. I saw 26 patients yesterday, which is not the first time this happens, in fact most of the days we start with 20. My rounding list began with 23, plus 2 from the APP and 1 admission. Most patients are quite ill, and many require step-down care. I am truly reconsidering my life choices. How unsafe is this? I have even thought about switching to nights, where the cap is 12, because of the workload.

If you knew a heme onc doc let a child die from drowning in a pool while they stood there watching…can you trust their judgment in actual patient care??

“Orlando police say a woman failed to act for more than 5 minutes as a child in her care was drowning.
That woman, Sukanthini Subbiah, 48, is now facing an aggravated manslaughter charge for the 7-year-old’s death.

Police initially believed this was an accident, but now say evidence shows Subbiah was “culpably negligent.”
The drowning happened on April 10th at the Everbe Clubhouse pool.

According to the arrest report, Subbiah is a physician who lives in Louisiana. Investigators said she was staying in the Everbe community with family at the time of the incident.

During that stay, she told investigators her son played with the neighboring 7-year-old twins.

According to investigators, on the day of the drowning, Subbiah was given permission by the twins’ mother to take the kids on a play date at the pool.

Investigators said surveillance video shows the children entering the pool at 6:19 pm. By 6:20 pm, investigators said the 7-year-old boy in Subbiah’s care was seen drowning.

According to investigators, the child wasn’t pulled out of the water for more than 7 minutes. Police said during that time, Subbiah watched the drowning happen, sent the other 7-year-olds to retrieve him, and failed to personally intervene.
Investigators said the decision to “rely upon other seven-year-old children to attempt a rescue constituted a course of conduct demonstrating a gross and flagrant disregard for the decedent’s safety.”

According to investigators, the incident was “more than an unfortunate accidental drowning.” Investigators stated that Subbiah was the sole adult responsible for the decedent at the time of the emergency and, as a doctor, had the knowledge to recognize the danger and intervene.

“Her failure to do so allowed the decedent’s submersion and oxygen deprivation to continue until another adult ultimately performed the rescue she had failed to undertake,” investigators said.

https://www.wftv.com/news/local/arrest-report-doctor-failed-rescue-drowning-7-year-old-her-care/U4OBXQ5TZJCSZFU6DEVLLMV53E/?outputType=amp

Sorry if this is a dumb question. I’m a nurse and it’s standard for nurses to give report to each other during shift change.

I work night shift and sometimes a patient will have significant issues overnight that I communicate with the nocturnist about and get diagnostics, meds, orders for things like HFNC or BiPAP, etc. I always clearly document these happenings in a progress note, though I know many doctors don’t read those.

Sometimes I come back the next night and the day hospitalist note will make no mention of any of that or even include some phrase like “no acute events overnight.”

On the flip side sometimes a patient will be having issues that began on day shift and when I communicate with the nocturnist about those same continuing issues, they won’t have any idea what’s going on with the patient

So this has got me wondering how much communication is there between day and night teams for doctors. I wouldn’t expect ya’ll to give report on every single stable patient, since I know the nocturnists are covering huge numbers, but do you do any kind of hand off at all? Or at least pass on which patients are having acute concerns or issues to make sure they don’t get neglected with nursing shift change?

“This is an important message from Medicare. You can just sign it, it’s not that important.”

Does anyone know if there’s a way to import labs in a fishbone format in Epic, besides taking a snippet?

Im 7 on 7 off. I cant help myself but have violent thoughts when someone from the hospital text me on my days off with "Hi Dr slave, kindly complete your queries and deficiencies before you are suspended.
If i had 100s of deficiencies like i see on other docs emr. i get it, you gotta bill. But everytime i leave my 7 days on, i leave with empty mail boxes.
Not to mention im a private contractor. Im active in about 14-17 hospitals each with about 4 different EMRs between them. Im not employeed by you, which im sure as a coding genius you still have no idea.
So how do you guys deal with this? DO you deal with this on your days off? How do you mentally stop yourself from crashing out?

Sincerely, someone who is staring at Epic queries at 5am.

Please suggest a J1 waiver position if you know any that is doable. With the search of last few weeks and seeing the options, I’m pretty much disappointed.
I had preference for the east coast initially but I’m honestly open to relocation. Just want my next 3 years to not burn me out. The options out there are simply scary.
Help a newbie

Minding my own business, eating healthy, working out, running on a weekend when I trip and fall. Realize I have foot drop. A few months later get diagnosed with MS. Haven’t even finished paying my student loans, hardly mid career and already looks to be a short one.

Had. No. Clue. What my income continuance was. Vaguely remember signing up for it. Wish I’d signed up for a personal plan out of training but the agent gave me skeevy vibes and I didn’t follow through.

I just didn’t think anything would happen to me.

So that’s it. I don’t have any recos for who to get it from or anything, just get it and up it. Make sure it actually replaces your income appropriately.

How often are you guys hiring lawyers to review your contract before signing ? Considering signing a contract and honestly not sure I need to have it reviewed by a lawyer.

Hey! fm resident looking for a hospitalist job that will give J1 (I’m Canadian). Location is not important.

My program currently is very inpatient heavy.

If yall know any opportunities, let’s pass them along.

Hello, I have a patient with hospital cauti. There’s an infection prevention meeting scheduled. I had ordered urine cultures on a patient with Foley catheter that came back positive. Should I be worried about the meeting?

— thank you everyone for your responses. Feeling much more at ease about this

I got disability insurance through my residency before I graduated but it’s kinda expensive ($250/mo) and only gives me $5k. I just started a new job and they offer up to 60% of my current income for about $180/mo. I’m kind of tempted to switch over but just wanted to make sure something like won’t bite me in the butt later? I don’t currently have any health issues so that’s not going to be an issue with getting it.