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PubMedDate not supplied

Strategies for reducing the risk of malpractice litigation in perinatal nursing.

Perinatal nurses are involved in malpractice litigation most often as employees of a hospital being sued. Contemporary case examples from malpractice claims provide the foundation for examining how perinatal nurses can become the focus of such litigation. Increasing demand for individual nurse accountability, cost containment strategies that require nurses to broaden their scope of practice and to supervise unlicensed assistive personnel, increasing use of medical technologies, and the reality of compromised newborns and unexplained outcomes place perinatal nurses at risk for continued malpractice vulnerability. Specific strategies for risk reduction can be used by the individual nurse and the institution in relation to hospital policies and procedures, application of the nursing process, documentation, birth videos, and delegation of tasks to unlicensed assistive personnel.

Communication↗
PubMed2006

Tobacco industry use of judicial seminars to influence rulings in products liability litigation.

OBJECTIVES: This paper examines the tobacco industry's efforts to influence litigation by sponsoring judicial seminars. METHODS: Thousands of internal tobacco documents were examined, including memos, reports, presentations, and newsletters. Connections to outside organisations were corroborated by examining tobacco industry financial records, budgets, and letters pledging funds. Facts about outside organisations were triangulated through examining their websites and publicly-filed financial records, and verifying facts through their representatives' statements in newspaper and law review articles. RESULTS: There are direct financial ties between the tobacco industry and groups that organise judicial seminars in an effort to influence jurisprudence, and judges who attend these seminars may be breaching judicial ethics either by not inquiring about the source of funding or by ignoring funding by potential litigants. CONCLUSIONS: The tobacco industry's attempts to clandestinely influence judges' decisions in cases to which they are a party endangers the integrity of the judiciary.

Codes of Ethics↗
PubMed1984

Physicians' self-reports of reactions to malpractice litigation.

The authors devised a survey as a first step in assessing physicians' perceptions of the impact of medical malpractice litigation on their professional practice and personal lives. Subjects were a sample of physicians in Cook County, Ill., who had been sued during 1977-1981. Many respondents reported changes in how they practiced their profession. Two clusters of self-reported symptoms in reaction to the litigation also emerged. Further studies, including clinical interviews, are needed to clarify the impact of medical malpractice suits on the sociological reality of medical practice.

Adjustment Disorders↗
PubMedDate not supplied

The pathologist in litigation: a scientist's perspective.

Escalation of myriad litigious facets of our society can be found in almost any large city newspaper, especially in the United States, and, in particular, in the Yellow Pages of the telephone directory listing of personal injury (toxic tort) lawyers--many with full-page advertisements offering a cornucopia of services replete with free consultation and contingency "no-fee" offers if litigation proceedings are undertaken and fail to be financially productive. With such inducements, it is little wonder that such an environment essentially guarantees that many pathologists such as yourselves will be increasingly drawn into litigation at some stage in his/her career, especially in the area of product (toxic tort) liability.

Expert Testimony↗
PubMedDate not supplied

Verbal expressions of probability in informed consent litigation.

Informed consent litigation provides a forum in which probabilistic evidence is elicited from physicians as parties or as expert witnesses. The authors reviewed over 450 medical informed consent opinions reported by both trial and appellate courts in all 50 states over 40 years to determine 1) the extent to which verbal expressions of probability were used by testifying physicians to characterize the risks of medical procedures; 2) when such expressions were used, whether consistent numeric interpretations of the terms were being applied by the physicians; 3) whether the choice of expression was influenced by the severity of the consequences associated with the particular risk; and 4) whether the use of such terms was correlated with trial outcomes, inasmuch as the duty to disclose a risk is said to increase with the magnitude of the risk and probability is one measure of such magnitude. It was found that subjective verbal expressions of probability are used in the litigation setting, and that such expressions represent broad ranges of numeric probabilities. There was some correlation between the expression and the represented numeric probabilities. In general, expressions such as "extremely low" and "low" corresponded to probabilities lower than those represented by terms such as "high" and "very high." Further, verbal expressions appeared to be influenced by the severity of the consequences associated with the risks, but whether this increases or decreases the ambiguity of verbal expressions in the communication process warrants further research. The authors suggest a syntax of verbal expressions of probability as a means to reduce the numeric ambiguity of these terms.

Choice Behavior↗
PubMed1988

Psychiatric and legal aspects of persistent litigation.

There is a paucity of literature in English about those people who persistently complain. In Germany and in Scandinavia, a diagnosis of querulent paranoia may be made, although this interesting and uncommon syndrome is rarely recognised in the UK. Five cases of litigiousness or persistent complaining are reported, to illustrate the typical psychopathology and the types of diagnosis that occur. Four of these people are barred from further litigation by the courts (vexatious litigants) and were contacted directly for the purpose of this study.

Adult↗
PubMed1996

Medical practice guidelines in malpractice litigation: an early retrospective.

The role of practice guidelines in malpractice litigation has been discussed in some theoretical detail. Little information is available, however, on how courts use guidelines or on the effort of state legislatures to explicitly link guideline compliance with malpractice defenses. We review all relevant case law and legislative enactments to shed light on the influence of medical malpractice on guidelines. We also use data from a nationwide survey of malpractice attorneys to supplement our legal analysis. Although guidelines are being used for both inculpatory and exculpatory purposes in common-law litigation (a two-way street), legislatures are interested in applying them only for exculpatory purposes (a one-way street).

Expert Testimony↗
PubMed1995

Malpractice and radiologists in Cook County, IL: trends in 20 years of litigation.

OBJECTIVE: The purpose of this article is to report the prevalence and nature of malpractice litigation involving radiology over a 20-year period and to identify trends among types of lawsuits filed. By recognizing where medicolegal risks lie in radiology, risk-management processes can be developed to minimize malpractice exposure and to improve patient care. MATERIALS AND METHODS: We conducted a retrospective study of all malpractice lawsuits (18,860) filed against physicians in the greater Chicago area between January 1, 1975, and December 31, 1994. About twelve percent (2219) involved radiologic procedures or radiologists. These lawsuits were divided into six groups: slip-and-fall, radiation oncology, failure to order a radiologic examination, complications, missed diagnoses, and miscellaneous. The yearly percentage of each category relative to the total number of radiology-related suits was determined, and then each group was further divided by specific diagnosis or incident. RESULTS: Along with all medical malpractice lawsuits, radiology-related suits rose dramatically until 1985, when there was a marked but temporary decline caused by tort reform measures enacted in Illinois. Since then, lawsuits have resumed their annual upward climb, although the overall percentage related to radiology has remained relatively constant (10-15%). The relative number of radiology-related lawsuits in specific categories has changed over the past two decades: the percentages of slip-and-fall, radiation oncology, and miscellaneous cases have decreased, but percentages for the remaining three groups have increased. Lawsuits related to missed diagnoses, which account for the largest category of radiology-related cases, have increased from 34% to 47% of the total. The greatest increase in this category is for breast cancer. Lawsuits claiming injury from complications, the largest subgroup of which is angiography, have grown slightly, but cases alleging failure to order a radiologic examination have shown the greatest percentage increase in the 20-year period, growing from 20% in 1975-1979 to 30% in 1990-1994. This rise is attributed to the greater number of claims involving mammography, CT, MR imaging, and angiography. The growth in failure-to-order lawsuits will have important ramifications as managed care and health reform proposals attempt to limit use of radiologic services. CONCLUSIONS: Notwithstanding the fact that tort reform measures in Illinois decreased the frequency of malpractice litigation temporarily in 1985 and will likely do so again in 1995, medical malpractice is likely to continue to plague radiologists unabatedly for many years to come.

Chicago↗
PubMed1990

Neuropsychological false positives in litigation: trail making test findings.

100 workers' compensation claimants with no known history of brain injury and no claim for neuropsychological impairment were administered a generally accepted neuropsychological screening instrument, the Trail Making Test, to consider the possibility that the presence of litigation may be reflected in neuropsychological test scores. On Trails A and B, respectively, 40% and 36% of subjects scored in the impaired range. Clinicians are urged to interpret the results of the Trail Making Test cautiously when a patient is in litigation. Suggestions for research are offered.

Adult↗
PubMed2003

The rise of litigation in human subjects research.

Owing to widespread public concern about the adequacy of protections for human research subjects and recent instances of serious injury to subjects at several major research institutions, lawsuits against investigators, institutional review boards, and academic institutions are becoming increasingly common. Several claim-promoting conditions are ripe to promote the further growth of this litigation and raise the stakes for research institutions. While this litigation may serve a valuable compensation function for injured subjects, it will also have profound effects on institutional review boards, leading to a more legalistic, mechanistic approach to ethical review that does not further the interests of human subjects or scientific progress.

Biomedical Research↗
PubMed1991

Uncertain litigation and liability insurance.

Legal penalties and liability insurance seem to have counteracting effects on the incentives of a potential injurer to take due care. However, if legal penalties are set efficiently and implemented perfectly, unrestricted access to insurance can be optimal. In contract, if the standards of guilt assessment are uncertain, the size of the legal penalties may act as a spur to litigation. Therefore, the penalties required to maintain incentives when access to insurance is unlimited may provoke too much litigation, and as a consequence, the costs of ensuring due care may decline when insurance is restricted by mandate.

Contract Services↗
PubMed1994

Health and welfare benefit litigation under ERISA.

Denial of health benefits may result in devastating financial problems for the consumer. Given the complexities of the system, more and more employees turn to attorneys for help. Litigation and the resultant costs, in turn, further exacerbate the cost of providing benefits to employees and the burden to the employer. The law governing employer-paid health care and benefit plans is a blend of third party beneficiary contract law, trust law and administrative law. This article provides an overview of the federal litigation resulting from a third party payer's denial of coverage.

Health Benefit Plans, Employee↗
PubMedDate not supplied

Minimizing employee benefits litigation through effective claims administration procedures.

With the marked increase in employee benefits litigation, employers and benefit plan sponsors are searching for ways to avoid such lawsuits, minimize their exposure in such lawsuits, and maximize their ability of prevailing in such lawsuits. Benefit claim processing and administration have become fertile areas for lawsuits. Consequently, improving benefit claim processing and administration obviously becomes important, and an area where affirmative actions by the employer and plan sponsor will produce many litigation-related benefits. This article will discuss, in a very simple and straightforward manner, various actions an employer or plan sponsor can take which will decrease the number of lawsuits, minimize the potential exposure if a lawsuit is filed, and maximize the ability of prevailing if a lawsuit is filed.

Decision Making, Organizational↗
PubMed1996

ERISA litigation: what every trustee should know.

ERISA litigation is complex and requires knowledgeable counsel. Trustees must have some working knowledge of ERISA litigation in order to understand the tactics and procedure involved. At a minimum, they should be able to determine whether fund counsel is adequately protecting the interests of both the trustees and the fund.

Employee Retirement Income Security Act↗
PubMed1986

Litigation risk management. Home care challenge.

Although realizing the potential for proliferation of liability litigation, home care administrators are not fully cognizant of the numerous ways that exposure manifests itself and the necessary methods of responding to this risk. Implementing a Litigation Risk Management (LRM) program will provide a comprehensive approach to decrease the agency's risk in all areas of exposure: clinical care, personnel management, financial management, criminal activities and indirect care-related activities.

Financial Management↗
PubMed1985

The physician and malpractice litigation.

Malpractice litigation alleging failure to practice responsibly and competently against an increasing number of doctors in America cannot be viewed simply as a legal or insurance problem. It affects the doctor in a highly personal way and in most cases generates emotional and/or physical symptoms for at least a limited period during the process. Intellectual and emotional understanding of the nature of litigation is necessary not only within the medical community but also within the community at large because of its potential for long range negative effects on healthcare.

Adaptation, Psychological↗
PubMed1989

Health care litigation: the arbitration alternative for dispute resolution.

This is the second in a series of articles on health care litigation. This article focuses on the benefits of arbitration as an alternative dispute mechanism for health care providers. The use of arbitration offers speed and economy to the parties. For the health care provider, arbitration can reduce litigation expense and the likelihood of "runaway" jury verdicts.

California↗