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Medical records in litigation: the Dalkon Shield story.

The Dalkon Shield was manufactured by A.H. Robins Inc. in the early and mid seventies, before it was withdrawn from sale because of the influx of lawsuits against the manufacturers. The case has become the largest tort case in history, with approximately 200,000 claimants worldwide and will not be wound up for years to come. Slater and Gordon is an Australian firm of solicitors with offices in three states. They have the largest Dalkon Shield practice in the world and represent almost 3,000 claimants. One of their most difficult tasks in preparing the cases is the gathering of medical evidence to substantiate claimants' assertions. This entails collecting relevant medical records from across the country and around the world going back almost twenty years for almost 2,000 women. The project has magnified the importance of accurate and complete documentation, kept intact and made accessible. The influence of medical record administrators is highlighted.

Australia↗

Protection against malpractice litigation.

Malpractice insurance costs are based on loss experience and defenses of expenses. Physicians in the high-risk category are in that position because, as a group, they have a high frequency of claims, a high average cost, or both. True, "defensive medicine" is the best way to minimize the risks. This does not mean ordering unnecessary tests or refusal of essential treatment. Rather, it is the habit of exercising extra care and foresight to avoid medical hazards and to apply prompt remedial measures when they occur. It means being aware of the patient's personality and needs. It means taking time to talk to the patient about proposed procedures and their risks. This kind of "defensive medicine" offers the best hope for reducing the frequency and cost of claims that result in the present critical malpractice problems.

Communication↗

DTP vaccine litigation.

Information provided by the three commercial manufacturers of diphtheria and tetanus toxoids and pertussis vaccine, adsorbed (DTP vaccine) indicates a striking increase in the number of lawsuits filed against them alleging damage caused by the vaccine. Only one such case was filed in 1978, whereas 73 were filed in 1984. During the seven-year period from 1978 to 1984, the average amount claimed per suit has risen from $10 million to $46.5 million. If the current trend continues, suits will pose an increasing threat to the availability of DTP vaccines in the United States.

Diphtheria Toxoid↗