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At least 19 recordsLinked to original sources
PubMed2001

The problems of medical malpractice litigation in Japan: the significant factors responsible for the tendency of patients to avoid litigation.

The present research has demonstrated that the Japanese tendency to avoid medical malpractice litigation can be ascribed to Japan's medical malpractice litigation system, and not the Japanese legal consciousness. From this standpoint, the present research has made clear the specific problem areas of the litigation system by looking at all cases from the last 10 years in the main district courts. The total average time taken for medical malpractice litigation is 3.0 years - much longer than the average time for normal litigation. Furthermore, the average amount of money needed to bring a medical malpractice complaint was 2,200,000 yen, far too much for the patient's family to bear. We have also demonstrated to what extent the amount is inversely related to the patient's age. Naturally, it is possible to bring a case without reliance on a lawyer, but in 90.0% of cases a lawyer was employed, and the success rate of litigants that had not employed a lawyer was 0%. Through the above discussion, we have show the present situation regarding time and costs in medical malpractice litigation, and it is suggested that these are the important reasons why medical malpractice disputants demonstrate a tendency to avoid litigation.

Journal Article↗
PubMed2001

Reasons for patients' discontent and litigation.

Introduction: Discontent and litigation among patients is a problem which increasingly preoccupies the medical profession. Aim: We aim to analyse the origin of discontent and litigation and to help avoiding these claims. Material: One hundred and seventy-eight medical expert opinions were evaluated, all made following examination of the complainant. Methods: Depending on the results of the clinical examination and the study of the files it was determined whether there was either a case of malpractice or insufficient informed consent, or no fault at all in a legal sense. In addition the patient and the surgeon were questioned as to their point of view regarding the procedure and their communication and relationship before and after treatment. Results: Frequent complaints were pain (either during treatment or afterwards), major swelling or bleeding, disturbances of trigeminal or facial nerve function, poor scar formation, loss of teeth or fixtures, faulty occlusion and discrepancies between the expected and the actual result of treatment. In 26 cases actual faults made during medical treatment were discovered. In 49 further cases, poor explanation of the proposed procedure was the reason for complaint. In the majority of remaining cases, neither faulty treatment nor insufficient information given to the patient lead to the complaint but the patient's expectations were unrealistically high. Conclusion: A considerable proportion of lawsuits originate from misunderstandings, and not treatment errors: The surgeons often concentrate on the legal requirements of informed consent and neglect to explain the practical consequences of the operation; the patients in turn tend not to ask about possible complications. Copyright 2001 European Association for Cranio-Maxillofacial Surgery.

Journal Article↗
PubMed1999

The litigant-patient: mental health consequences of civil litigation.

Civil litigation often has profound psychological consequences for plaintiffs and defendants alike. For those individuals who are involved in ongoing psychotherapy, or those who enter psychotherapy during litigation, the stress of litigation often adds to whatever issues produced the lawsuit. This article reviews the effects of that stress, the mechanisms through which it arises, and its manifestations in psychotherapy and offers suggestions to increase psychotherapist awareness of the influence of litigation stress on treatment.

Awareness↗
PubMed2003

Organizational downsizing and age discrimination litigation: the influence of personnel practices and statistical evidence on litigation outcomes.

The present study examined relationships between reduction-in-force (RIF) personnel practices, presentation of statistical evidence, and litigation outcomes. Policy capturing methods were utilized to analyze the components of 115 federal district court opinions involving age discrimination disparate treatment allegations and organizational downsizing. Univariate analyses revealed meaningful links between RIF personnel practices, use of statistical evidence, and judicial verdict. The defendant organization was awarded summary judgment in 73% of the claims included in the study. Judicial decisions in favor of the defendant organization were found to be significantly related to such variables as formal performance appraisal systems, termination decision review within the organization, methods of employee assessment and selection for termination, and the presence of a concrete layoff policy. The use of statistical evidence in ADEA disparate treatment litigation was investigated and found to be a potentially persuasive type of indirect evidence. Legal, personnel, and evidentiary ramifications are reviewed, and a framework of downsizing mechanics emphasizing legal defensibility is presented.

Age Distribution↗
PubMed1989

Effects of active and completed litigation on treatment results: workers' compensation patients compared with other litigation patients.

Outcomes of multidisciplinary pain treatment in workers' compensation claimants and in the claimants of other insurance companies were studied. Patients were also segregated as to state of completion of the litigation process. No differences were found between the groups in organic and psychologic pathology. Significant improvement in outcome measures was found for the total group, but the workers' compensation claimants with completed litigation failed to show any significant improvement in these measures. The system itself and legal factors can be obstacles to rehabilitation of the patient with chronic pain. Early intervention is recommended to improve treatment outcome.

Activities of Daily Living↗
PubMed2001

A radiation litigation causation analysis which achieves fairness to both litigants.

Very few, if any, radiation induced cancers should appear among nuclear workers in the United States. The existing safety standards and lifetime doses received under the operation of those safety standards are such that less than 1% of the cancers that appear in nuclear workers should be related to their occupational radiation exposure. This small numbers of valid claims is a tribute to the effectiveness of the federal safety standards and to the ALARA professional philosophy of achieving excellence in radiation protection which has marked the field of health physics since its inception.

Ethics↗
PubMed1990

Litigation and employment status: effects on patients with chronic pain.

In order to study the effects of compensation and litigation, 201 chronic pain patients were selected from a sample of 444: 99 were working, 15 were working and litigating, 53 were receiving Worker's Compensation, and 34 were receiving Worker's Compensation and litigating. Employment (working vs. Worker's Compensation) and litigation status (litigating vs. not litigating) were analyzed in a 2 x 2 factorial design with measures of pain, disability, psychological distress, and selected demographics as dependent variables. Compared to Worker's Compensation patients, working patients reported significantly less disability (down-time, days spent in bed, interference of pain in daily activities) and pain of a longer duration. Compared to litigating patients, non-litigating patients reported less pain (on the McGill Pain Questionnaire) and less disability (stopping activity, interference of pain in daily activities). On two measures of psychological distress (depression, anxiety), there were significant interactions: Worker's Compensation patients who were litigating reported less distress than non-litigants, while working patients who were litigating reported more distress than non-litigants. The results indicate clear differences in self-reports of disability associated with both employment and litigation status. They also suggest that litigation may function as a coping response for patients who are distressed by the adversarial nature of the Worker's Compensation system. Limitations of the study as well as suggestions for further research also are discussed.

Accidents, Occupational↗
PubMed2002

Employment and litigation: improved by work, assisted by verdict.

Previous research exploring the relationship between litigation status and the symptoms of the plaintiff has been inconsistent and limited by methodological difficulties. This longitudinal study addressed many of the methodological shortcomings of previous research and examined the relationship between litigation status, employment, depression, pain and disability over the duration of the compensation process. Two hundred chronic back pain participants were selected from patients who attended an initial assessment interview at a pain centre. According to their litigation and employment status these patients were divided into four groups, namely a non-litigating non-working group, a non-litigating working group, a litigating non-working group and a litigating working group. All participants completed three questionnaires, one at intake, one at a minimum of 2 years later (for litigants during the litigation process), with the final questionnaire completed at a minimum of 15 months thereafter (for litigants after they had settled their claim). Questionnaires contained measures of pain (Visual Analogue Scale, Short Form McGill Pain Questionnaire), depression (Zung Self-Rating Depression Scale), and disability (Oswestry Disability Questionnaire). Overall participants who were working scored lower on all the measures than did participants who were not working. On the other hand participants who were litigating scored higher on all the measures than did participants who were not litigating. There was a significant time effect on all measures but this was qualified on some measures by the interactions of time with litigation status and work status. The present research further demonstrated that both litigation and employment were significant factors influencing recovery from injury.

Adult↗
PubMed1996

The effect of litigation status on adjustment to whiplash injury.

STUDY DESIGN: This retrospective study examined the effect of civil litigation on reports of pain and disability in chronic pain patients who sustained whiplash injuries after a motor vehicle accident. OBJECTIVES: To examine the effect of litigation on adjustment to chronic pain. SUMMARY OF BACKGROUND DATA: A common methodologic weakness with many studies in this area is the composition of the nonlitigant group, which often includes individuals who have completed litigation as well as those who opted not to litigate. This introduces a confound in that litigant and nonlitigant groups differ not only with respect to litigation status but with respect to any factors that predispose one to litigate. METHODS: Questionnaire data were obtained from 41 patients (current litigants) in the process of litigation and 21 patients (postlitigants) who had completed litigation. Subjects completed self-report measures assessing demographic characteristics, psychological distress, sleep disturbance, employment status, and various pain indices. RESULTS: There were no significant group differences in demographic characteristics, employment status, or psychological distress. Litigants, however, reported more pain than did postlitigants. Group differences in pain reports remained statistically significant even after controlling for length of time since accident and initial severity of the injuries. CONCLUSIONS: That litigation status did not predict employment status suggests that secondary gain does not figure prominently in influencing the functionality of these patients. The rather robust effect of litigation status on pain reports is discussed with respect to the potential mediational role of the stress of litigation.

Adaptation, Psychological↗
PubMed1993

Litigation involving medical faculty and academic medical centers, 1950-1991.

An analysis is presented of 240 cases of litigation involving medical faculty, medical schools, and academic medical centers reported over the period 1950-1991. The number of reported cases increased dramatically over the study period in association with the expansion of the national medical educational enterprise. These cases can be conveniently divided by the issues they dealt with into three broad areas: general administration (89 cases), clinical affairs (108 cases), and research issues (43 cases). Cases of litigation related to general administration were most often concerned with the hiring, promotion and/or tenure, and discharge of faculty, with nearly half of these alleging discrimination. General administrative disputes also arose over allocation of departmental resources and responsibilities, faculty conduct, Veterans Affairs, relationships, employee benefits, system-wide discrimination, and collective bargaining. Courts generally supported the exercise of administrative discretion, yet examined procedures carefully. Litigation related to clinical affairs increased dramatically in recent years. Issues litigated reflect the complexity of the existing academic health care system and environment: sovereign immunity and/or malpractice, practice plans, staff privileges, indemnification, access to peer review records or other records, and conduct of practice. Outcomes of clinically related litigation through 1991 indicate substantial leeway for medical faculty, medical schools, and academic medical centers to innovate and advance their patient mission. Litigation related to medical research also accelerated recently. Issues litigated involved grants and/or personnel management, research risks, commercialization, research funding, ethics, and research animals. Litigation has paralleled (1) federal policy initiatives designed to stimulate collaboration between industry and academia and (2) the growth of regulations designed to monitor policy areas affecting research. The exposure of academic medical administrators and faculty to litigation has increased in the last 40 years. Medical schools and academic medical centers should take active steps to reduce future risks of litigation.

Academic Medical Centers↗
PubMed2003

News media reporting on civil litigation and its influence on civil justice decision making.

The news media have the potential to act as a powerful influence on the civil litigation system, influencing decision making in particular cases and on the system more generally as media reports influence the decision making of various participants in the system. This paper reviews the research that has examined the relationship between news media reporting and civil litigation and proposes a framework that integrates this work and provides guidance for future research efforts. Specifically, we discuss the nature of media reporting on civil litigation, perceptions of the civil litigation system held by the public and legal actors, and the potential influence of news reporting about civil litigation on the decision making of jurors, judges, civil litigants, and policymakers. Overall, the research suggests that news reporting of civil litigation presents a systematically distorted picture of civil litigation and that this reporting can influence perceptions and outcomes of civil litigation in various ways. However, there are many gaps in the existing research that need to be filled. The proposed organizational scheme helps to identify ways that future research can provide links between the findings of existing research and to identify ways in which this research can be extended to new areas.

Civil Rights↗