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At least 469 records · Page 26Linked to original sources
PubMed2003

Teaching malpractice litigation in a mock trial setting: a center for perinatal medicine and law.

OBJECTIVE: To describe a novel center for perinatal medicine and law in a school of medicine and assess its inaugural presentation of the role of expert witnesses in a mock trial setting. METHODS: The center's first program was an obstetrics and gynecology Grand Rounds that staged an abbreviated mock trial. The case summary was read. An attorney then conducted the direct examination of the plaintiff's obstetrics and gynecology and neonatal expert witnesses. The audience acted as the jury and anonymously voted electronically after the direct examination. The plaintiff's attorney then conducted the cross-examination of the defense experts on issues pertaining to possible bias and expert compensation with only a limited inquiry into substantive medical issues. A second vote was taken. A posttrial panel discussion and questionnaire evaluated the importance of this program to medical education. RESULTS: The first vote indicated 86% of the jury decided that negligent obstetric management contributed substantially to the infant's injury, and 82% of the attendees felt that negligent neonatal care was a substantial factor in the infant's injury. After the cross-examination, 63% of the jurors now felt that negligent obstetric management contributed to the brain damage; whereas only 39% of the participants concluded that negligent newborn care was responsible for the injury. During posttrial discussion, the audience suggested that cross-examination of defense experts on issues of bias rather than medical care negatively affected their perception of the examining attorney's case. CONCLUSION: Analysis of the questionnaire showed that the attendees strongly appreciated experiencing this abbreviated mock trial and indicated that the center was a welcome addition to medical education.

Adult↗
PubMedDate not supplied

Overlooked physical diagnoses in chronic pain patients involved in litigation.

This study followed the course of 60 chronic pain patients, from referral to a pain diagnostic center through the formulation of complete discharge diagnoses. The most common referral "diagnoses" were really descriptions or vague explanations, such as "chronic pain," "psychogenic pain," "cervical strain," or "lumbar strain." The most commonly missed diagnoses were 1) myofascial disease, 2) facet disease, 3) peripheral nerve entrapment, 4) radiculopathy, and 5) thoracic outlet syndrome. Seventy percent of the laboratory studies ordered by the clinic had significant abnormalities. The authors determined that the overall rate of inaccurate or incomplete diagnosis at referral was 66.7%.

Adult↗
PubMedDate not supplied

Overlooked physical diagnoses in chronic pain patients involved in litigation, Part 2. The addition of MRI, nerve blocks, 3-D CT, and qualitative flow meter.

This study followed 120 chronic pain patients referred to a multidisciplinary pain center. The referral diagnosis for many patients, such as "chronic pain," "psychogenic pain," or "lumbar strain," was frequently found to be incomplete or inaccurate (40%) following a multidisciplinary evaluation that used appropriate diagnostic studies, including magnetic resonance imaging, computed tomography, nerve blocks, and qualitative flowmeter. Significant abnormalities were discovered in 76% of the diagnostic tests. An organic origin for pain was found in 98% of these patients. The patients were discharged with objective verification of diagnoses including facet disease, nerve entrapment, temporomandibular joint disease, thoracic outlet syndrome, and herniated discs.

Adolescent↗
PubMed1997

Cerebral palsy and thrombi in placental vessels of the fetus: insights from litigation.

Fetal vessels in the placentas of 11 of 15 infants with cerebral palsy contained thrombi. An alternate basis for the injury was identified in the four placentas without thrombi. Autopsy findings in one infant who died at age 1 month confirmed the presence of cerebral thrombi and infarcts. It is concluded that thrombotic events in utero may explain the pathogenesis of many instances of cerebral palsy and that identification of a coagulopathy in parents could potentially identify those at risk and provide a basis for preventive treatment during pregnancy.

Cerebral Palsy↗