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At least 217 records · Page 12Linked to original sources
PubMed1990

Patient personal injury litigation against dermatology residency programs in the United States, 1964-1988. Implications for future risk-management programs in dermatology and dermatologic surgery.

A national survey reviewing patient injury litigation against US dermatology residency programs revealed that 50% of the respondents had experienced at least one lawsuit between 1964 and 1988. The northeast region reported the most legal activity. Fifty percent of the lawsuits related to therapeutic or surgical complications. Plaintiffs were successful in 37.9% of the lawsuits. The mean award was $26,505, and the largest reported award of $200,000 was for failing to diagnose herpes simplex in an immunocompromised patient. In view of several recent trends in dermatology, the amount of litigation against dermatologists may increase.

Dermatology↗
PubMed1988

"Magical thinking," suicide, and malpractice litigation.

Prospective clinical assessment of suicidality differs significantly from that used retrospectively in malpractice litigation. In the latter context, the judge or jury may be susceptible to hindsight reasoning and a disproportionate emphasis on the specific method of suicide, exaggerating its foreseeability and "magically" linking the means of death to the treating clinician, especially in the case of suicide by an overdose of prescribed medication. Such magical thinking, moreover, is rooted in the clinical context of suicide: The errors of reasoning observed in the courtroom exhibit striking parallels with the mind-set of the suicidal patient. An understanding of these dynamics suggests appropriate precautions for the clinician and thus contributes to the prevention both of suicide and of malpractice litigation.

Humans↗
PubMed1983

Contingent fees in medical malpractice litigation - a qualitative assessment.

The medical profession has experienced high liability insurance premiums accompanied by widespread use of contingent fees in medical malpractice litigation. It is worthwhile, therefore, to assess qualitatively the merits of contingent fees, the evidence suggesting that they are associated with unjustified litigation and their implications for the medical and legal professions.

Fees and Charges↗
PubMed1995

Chronic pain in litigation. What is the relationship?

The legal system is often as random and capricious as the very accident itself. The present tort system is fault-based and is vulnerable to the pressures of lawyers and patients who exploit subjective symptomatology for primary and secondary gain. Jury awards for noneconomic damages have little consistency and have produced astronomic awards for subjective pain and suffering. The surge in fraudulent claims exposes the weaknesses of the current system. This article is not intended to convey the notion that all cases of CPS in litigation are fraudulent, but rather suggests that unraveling this association is a formidable task that must be done owing to the huge economic burden to society. Prospective studies are urgently needed to more accurately define the natural history of individuals with CPS in litigation.

Accidents↗
PubMed1994

Silicone breast implant litigation (Part 1).

Silicone breast implant litigation has escalated in the past couple of years with the Food and Drug Administration (FDA) investigation of silicone gel implants which resulted in finally removing the silicone gel implants from the market. Plaintiffs have linked various medical problems to the presence of silicone in the body. The FDA has stated that there is no medical evidence that silicone causes autoimmune disease. Silicone has never been shown to cause breast cancer. Breast implants can result in complications such as capsule contracture, gel bleed, implant rupture, calcifications around the implants, and possibly interference with mammography in the diagnosis of breast cancer. Plaintiffs have claimed that the implant manufacturers knew of the defects in the silicone shell implant covering, and covered up the facts. The product liability action has become a class action, and a proposed settlement has been made in terms of which implant recipients with any problems will be reimbursed. Furthermore, there will be coverage for future implant problems over the next 30 years. There will still be some litigation by those patients who have opted out of the settlement agreement.

Breast Implants↗
PubMed1994

Attitudes of physicians in northern Ontario to medical malpractice litigation.

OBJECTIVE: To survey medical practitioners' experience with and attitudes toward litigation alleging medical malpractice. DESIGN: A survey using a questionnaire. SETTING: The Sudbury and Manitoulin Health District of Northern Ontario. PARTICIPANTS: Medical practitioners in the area. RESULTS: Physicians are sometimes negligent; malpractice is not simply created by entrepreneurial lawyers and patients with unrealistic expectations. At present malpractice is restrained by both the threat of civil litigation and the disciplinary committee of the Ontario College of Physicians and Surgeons. CONCLUSION: We must address the fear of malpractice suits if the North is to attract and retain the physicians it needs to provide modern standards of medical care.

Adult↗
PubMed1993

Litigation, sleep, symptoms and disabilities in postaccident pain (fibromyalgia)

Twenty-four patients with chronic postaccident pain were studied with self-rating symptom checklists, polysomnography and disability questionnaires. All except one had fibromyalgia. Eight had litigation resolved (R) while 16 had medicolegal claims still unresolved (UR). Patients from the R group were older, with a longer duration of symptoms and more occupation handicap compared to those from the UR group. There were no significant differences between the 2 groups in other demographic data, nature of accident, symptoms, polysomnographic findings and disability. Medicolegal claim status in these patients did not differentiate the outcome of their symptoms. Implications for litigation, treatment and further studies are discussed.

Accidents↗
PubMed1993

The doctor-patient relationship and medical malpractice litigation.

Little empirical data support the allegation that a good doctor-patient relationship prevents litigation. However, physicians--including psychiatrists--should be alert to critical events that generate anxiety in both doctor and patient and thus disrupt the equilibrium of their relationship. The author discusses reactions in doctor and patient that may lead to further disequilibrium, the outcome of which may be litigation.

Attitude of Health Personnel↗
PubMed1997

Practice guidelines & medical malpractice litigation.

In 1973, the United States Congress enacted legislation requiring physicians to initiate Peer Review Organizations to monitor utilization and quality of hospital and physician services in the federally funded Medicare program. A hardly noticed provision of the statute intimated the desirability of formulating guidelines for medical treatment. What was originally intended to simplify and universalize general standards by which quality of care could be objectively measured has more recently escalated into formalized projects, subsidized by government, to create "practice parameters". The impetus to define clinical conditions and methods of treatment for specific medical conditions (practice parameters) and standards of practice to avoid or defend malpractice claims (risk management protocols) are part of the movement in the United States for tort reform. If the vague "reasonable man" standard of care in negligence law can be supplanted by a scientifically developed, particularized medical practice standard, it is anticipated that spurious claims and defensive medical practice will be discouraged, quality improved, iatrogenic injury and malpractice litigation diminished. Many U.S. states undertook tort reform in the last decade. A few have embarked on medical-legal reform. One state is conducting a five-year medical liability project that calls for the development of practice parameters and risk management protocols in four medical specialties. The parameters will have the effect of law and may be introduced as evidence in medical malpractice trials. How the parameters are established, their effect on the strategies of litigation, the resultant trial problems in the introduction of evidence and in the burden of proof and their potential for acceptance by a significant number of jurisdictions-are the issues to be explored in this paper.

Humans↗
PubMed1998

Escalating health care costs: costs of litigation.

Although controlling the risks and costs of litigation is difficult, that goal is worth pursuing. Trumped-up malpractice claims, direct litigation costs, and defensive medicine contribute to the accelerating costs of U.S. health care but are not their driving force.

Health Care Costs↗
PubMed1999

The tobacco industry and underage youth smoking: tobacco industry documents from the Minnesota litigation.

OBJECTIVE: To learn how underage youth have been regarded by the major tobacco companies, as revealed in industry documents during the Minnesota litigation. DATA SOURCES: Documents from Brown & Williamson Tobacco Corp, Lorillard Tobacco Co, Philip Morris Inc, and R. J. Reynolds Tobacco Co. STUDY SELECTION: Documents available from the State of Minnesota and Blue Cross and Blue Shield of Minnesota v Philip Morris Inc et al during the discovery process of the trial. Hundreds of industry documents related to youth, teenagers, and young adults were examined. A sample of documents are referenced as illustrations of key points. CONCLUSIONS: Underage youths are viewed by the tobacco industry as critical to its future. Underage youth smoking patterns were examined for decades. Reductions in youth smoking rates were seen by tobacco companies as a negative trend for the companies. Specific marketing campaigns were directed at underage youth and were successful with this age group. Tobacco industry practices should continue to be carefully scrutinized.

Adolescent↗
PubMed1992

Causes of breast cancer malpractice litigation. A 20-year civil court review.

To determine objectively the patient and physician factors that lead to breast cancer malpractice litigation, a review was undertaken of all cases tried in the US federal and state civil court system over a 20-year period from 1971 through 1990. Forty-five cases were identified and all involved a delayed diagnosis of breast cancer (the mean delay was 15 months). The patients were young (mean age, 40 years). Of 45 cases studied, the majority of patients (37 [82%]) found a painless mass by self-examination of the breast. Only 22 patients (49%) had further workup, mostly by mammography (20 [44%]). The results of 16 mammograms (80%) were read as normal. Obstetricians and gynecologists were involved in the greatest number of cases (21 [50%]), followed by family practitioners and internists (17 [41%]), general surgeons (12 [28%]), and radiologists (4 [10%]).

Adult↗
PubMed2000

ERISA litigation and physician autonomy.

The Employee Retirement Income Security Act (ERISA), enacted in 1974 to regulate pension and health benefit plans, is a complex statute that dominates the managed care environment. Physicians must understand ERISA's role in the relationship between themselves and managed care organizations (MCOs), including how it can influence clinical decision making and physician autonomy. This article describes ERISA's central provisions and how ERISA influences health care delivery in MCOs. We analyze ERISA litigation trends in 4 areas: professional liability, utilization management, state legislative initiatives, and compensation arrangements. This analysis demonstrates how courts have interpreted ERISA to limit physician autonomy and subordinate clinical decision making to MCOs' cost containment decisions. Physicians should support efforts to amend ERISA, thus allowing greater state regulatory oversight of MCOs and permitting courts to hold MCOs accountable for their role in medical decision making.

Delivery of Health Care↗
PubMed1999

Developing profiles of risk for parental abduction of children from a comparison of families victimized by abduction with families litigating custody.

This study systematically compared parents in abducting families with families litigating custody. Findings indicate that risks for parental abduction of children are multidetermined by: (1) a heightened concern about very young children being exposed to neglectful, endangering, or criminal environments by the other parent; (2) unsubstantiated allegations of sexual abuse; (3) heightened distrust of and less respect for law and authority; and (4) a reluctance to seek help from the courts. Abducting families were also predominantly socially and economically disadvantaged: parents were less likely to have been married to one another; they had lower incomes, were more poorly educated, and were disproportionately members of minority racial and ethnic groups. The social policy dilemmas of identifying these differences as risk factors are discussed together with suggestions for risk management.

Adult↗
PubMed2006

Vexatious litigants and unusually persistent complainants and petitioners: from querulous paranoia to querulous behaviour.

Querulous paranoia was once of considerable clinical and academic interest in psychiatry. Over the last 40 years, however, it has virtually disappeared from the professional landscape. This decline occurred at the very time that a proliferation of complaint organizations and agencies of accountability were drawing more and more people into asserting their individual rights through the pursuit of claims and grievances. Querulous behaviour, as a result, far from declining, is on the increase, bringing with it suffering for the querulous and disruption to the organizations through which they seek their vision of justice. This article examines querulous behaviour in the vexatious litigant and in abnormally persistent complainants and petitioners. The phenomenological and nosological issues are outlined and the risks of the emergence of threatening and violent behaviour is emphasized. Threats should not be ignored, for a variety of reasons. Approaches to managing querulous behaviour in the courts and the complaint organizations are discussed, together with the utility of individual therapy. Querulous behaviour should once more take its place among the legitimate concerns of mental health professionals. Those caught up in a querulous pursuit of their notion of justice are amenable to management that can ameliorate their suffering and reduce the disruption they create.

Cognition Disorders↗
PubMed2004

Blinded review of Papanicolaou smears in the context of litigation.

BACKGROUND: Blinded review has been endorsed by several cytology and pathology organizations as the most appropriate method for the review of cervicovaginal specimens in the context of litigation. Methods for determining the statistical validity of this method were evaluated. METHODS: First, the authors calculated the sample size needed to detect various differences in case difficulty or ease of interpretation, in which ease of interpretation is defined as the percentage of the time a case could be identified as abnormal by routine screening. Very easy cases could be identified most reliably, whereas more difficult cases were detected less regularly and less reliably. Using construct sample sizes, the authors calculated the number of abnormal reviews that may be helpful to conclude that the case's difficulty or ease of interpretation was statistically significantly different from another case of a specified difficulty. Finally, they examined the effect of using two separate cutoff parameters to make these distinctions. RESULTS: Depending on the threshold chosen, it was determined that improvements in the statistically meaningful distinctions may be made using 15 or 20 reviews. To distinguish between routine false-negative cases (ease of detection, 40%) and routine cases (ease of detection, 80%), the thresholds may be set at 5 of 10 reviews (a case that would not be detected regularly and reliably in any given laboratory) and 7 of 10 reviews (defining a case that would be identified regularly and reliably), respectively. CONCLUSIONS: The authors provide data that can be used to interpret the results of a blinded review in a statistically appropriate manner. To improve the utility of blinded reviews, the standards are defined explicitly.

Data Interpretation, Statistical↗
PubMedDate not supplied

The new wave of employee benefits litigation.

Forecasters warn of storm clouds on the horizon in the form of increased benefits litigation for employers. The threat is real, but taking precautions now can reduce the risk.

Health Benefit Plans, Employee↗
PubMed1988

Litigating a right to treatment: Woe is me.

The right to treatment was first proposed by Birnbaum in 1960. While its constitutional basis may still be in doubt, it has found significant acceptance in state legislation and in lower court decisions. Defining, implementing, and quantifying this right remain elusive. For well over a decade, the case of Walter Woe has been litigated in the federal courts of New York. It represents a continuing effort to obtain a level of care for patients involuntarily hospitalized in the public sector equal to that provided for those admitted voluntarily to general and private hospitals. A precommitment right to refuse inadequate treatment is a novel extension of the right to treatment, with potentially significant implications, and is part of the continuing legal battle.

Commitment of Persons with Psychiatric Disorders↗