March 18th, 2008

Why Patients Call Lawyers

There are several different reasons that patients (or next of kin) call lawyers regarding potential medical malpractice. Understanding the motivation for the call is important in evaluating the merits of a case during the vetting process.

Two of those reasons are on display now at NY Emergency Medicine, in an extraordinary post by Dr. Brian Fletcher, a fourth year emergency medicine resident recounting a story from his internship. It involves a horrifying code that occurred while he was doing a bedside procedure on a 70 year old man who had undergone surgery some days before. Read that post and come back. It’s very much worth a few minutes of your time.

OK, welcome back. Two possible reasons why a medical malpractice attorney might be consulted popped right out at me during the story, and I’ve added two more to a short list below.

1. An unexpected result and a betrayal of trust: We don’t know from the story about what transpired after the code with respect to the patient’s family. It is strictly a post through the eyes of the young doctor that went through it. But if a family isn’t leveled with, if they think information is being held back from them, then a family may feel a betrayal of trust. It’s pretty darn rare to get a call from someone that trusts their doctor, so something must have happened not only with respect to the medicine but with respect to the personal relationship between doctor and patient. (This is one reason doctors are urged to apologize for errors.) One of the most important questions any lawyer asks a potential client regarding the prospect of litigation is, “What will the other side say is the reason this happened?” This will often lead to clues as to whether the matter is worth the time and money to investigate further by paying for the medical records.

2. The hospital rumor mill. A substantial number of calls are generated by nurses, technicians, doctors or others whispering into the ears of the family about what they heard and urging that a lawyer be consulted. As can be seen from Dr. Fletcher’s story, a lot of people with no first hand knowledge like to talk. It’s old fashioned gossip that often should be appropriately discounted. The important question here is trying to find out what the storyteller really knows.

3. Money, money, money. This is not part of Dr. Fletcher’s story, but it tacked on here because I’m rounding up the reasons for the initial inquiry to the lawyer. Money is an easy motivation to discover because, during the initial consult before you even have a chance to evaluate the case, the person asks, “What’s the case worth?” Anyone with a lick of common sense knows that all parts of the story must then be appropriately discounted, and if the client’s testimony is essential to proving the case (as opposed to being documented on medical records) it is likely a case not worth taking.

4. Outrage. This is usually motivated by a desire to make sure that other patients don’t undergo the same fate. The Dennis Quaid case of his twins getting overdosed with heparin is a classic example. Nobody expects that the Quaids need the money from any suit. They have a point to make. And they are not alone. Many, many people, struck by tragedy from the loss of a close family member or injury to a child, will make the call based on nothing less than raw emotion.

Since investigating and litigating potential medical malpractice cases is long, expensive and difficult, any lawyer that is doing their job properly is declining inquiries at a rate of 95-98%. But that initial call is how it all starts.

Other posts on the subject:

Addendum 3/19/08 — From TortsProf Sheila B. Scheuerman: “Sorry Works!” – Apology to Prevent Med Mal Claims

Addendum 3/21/08: Why we’ve never been sued for medical malpractice (Ralph Caldroney @ Medical Economics via Kevin, M.D.)

 

March 18th, 2008

Recusal In the High Court…For Fantasy Baseball?

If the high court takes this case, an interesting question is posed: Can participating in a fantasy baseball league require Unites States Supreme Court judges to recuse themselves? In particular, will Justices Samuel Alito or John Paul Stevens find themselves watching this suit from the sidelines if it goes up to the high court?

Stock investment, we know from the recently decided 4-4 decision in the Rezulin drug case (Warner-Lambert v. Kent), can cause a conflict of interest recusal, as Chief Justice John Roberts didn’t participate due to a $15,000 stock investment in Pfizer, parent company of Warner-Lambert. The subjects of recusal and the problems of a 4-4 split have been discussed by many, including Howard Bashman (advocating an appellate judge sit by designation), Drug and Device (the problem of forum shopping due to splits in the Circuits, and its impact on multi-district litigation), and SCOTUSblog (noting that this is a rare occurrence). It had previously been discussed by Eugene Volokh (sell your stock judge!) and Stephen Bainbridge.

That recusal may now come up again, not due to stock holdings, but quite oddly in an altogether different manner: The subject of Rotisserie Baseball (a/k/a “roto” or fantasy baseball) is now before the court on a petition for certiori to determine if baseball statistics are owned by Major League Baseball or are free to the world under the First Amendment (see Above the Law, Sports and the Law: Supreme Court Might Hear Dispute Over Fantasy Sports Property Rights, CBC v. Major League Baseball).

Here’s how it impacts players of the game, which could easily include one on or more high court judges: Fantasy team owners draft real players from around the league at the start of the season to form their own teams in their own leagues, and use those very real statistics as their own to compete and trade against other team owners in their fantasy league. But it’s not just a few bucks in gambling money at stake for the winner. Those statistics are complied by various services that make them available to the public for a fee. So even if you aren’t in a roto money league, you still need the stat service to compile the data to determine which fantasy team has more homers, RBIs, stolen bases, etc. than the other teams in your league. And Major League Baseball wants a cut of that money by licensing the information out.

If you play roto you know this drill well. Now heading into my 20th season, I haven’t yet won, despite the heroic efforts of my brother that does 99% of the heavy lifting. But if you have to pay more money at the beginning of the season for the right to use those stats then there will be real economic issues for every single team owner. We fantasy team owners don’t want to pay money to the multi-millionaire real team owners just to have our fun.

Setting up dates for the start-of-the-year drafts are going on now across America as the season prepares to open. These fantasy leagues are very popular, with a considerable industry devoted to it (hence the litigation). So this leads us to this oddball question with its constitutional issues: Are any of the Supremes fantasy team owners? If so, they have an interest in the outcome of the suit. What does that lead us to?

Free league or not? Does fair use of the statistics come into play if the league is non-money, meaning no gambling fees, but you still need to pay for the stats? Will free leagues still be required to pay a fee for use of the stats if the court were to decide that Major League Baseball owned them or does the First Amendment protect them? Is it different for leagues with money involved?

Oh, I know what you think, this a silly long shot. But read this from US News and World Report on Justice Samuel Alito:

“A longtime Philadelphia Phillies fan, he uses sports metaphors in speeches. As a child, he played second base and dreamed of becoming a baseball commissioner. As an adult, he coached his son’s Essex County Little League team, and his wife once sent him to a fantasy Phillies baseball camp where he played second base alongside professional ballplayers.”

Reviewing a photograph of the chambers of Justice John Paul Stevens, I see a signed Cal Ripkin baseball, a picture of The Babe and a 1932 Word Series scorecard. You gotta be a pretty big fan to have a framed scorecard in your chambers.

Roto in the high court? Seems like a possibility.

Either Alito or Stevens (or others) might have to consider recusal since they may be forced to pay money to buy the stats if the case is decided in favor of Major League Baseball.

As ballplayers limber up in Florida and Arizona for the coming season, the issue of money hangs over the heads of fans who play fantasy baseball. Or at least, it will hang over their heads if the Supremes take the matter and render an unfavorable decision.

Last: The petition for certiori, now pending, may tell the tale of whether one or more recusals are in the works.

 

March 14th, 2008

John Ritter Medical Malpractice Trial — Defense Verdict

A defense verdict was handed down by a California jury today in a medical malpractice trial concerning the death of actor John Ritter from an aortic dissection. (Previously: The Medical Malpractice Trial of John Ritter)

The family had previously settled with other defendants for $14M, according to press reports, and had continued on with respect to a radiologist that had done a study two years before his sudden death, and a cardiologist in the emergency room.

The jury found with respect to the radiologist that he had been advised two years earlier to follow up after the study (but also alleged that it wouldn’t have made a difference.) The case against the cardiologist revolved around the failure to do a radiological study that had been ordered when he presented to the emergency room.

When I wrote about the case a few weeks back, I noted:

My personal view: Suits against emergency departments are very difficult, though not impossible. Jurors will, if given half a chance, give the benefit of the doubt to emergency room physicians, often times even if their own protocols are violated. I have no idea what will happen in this particular case since I won’t be in the courtroom hearing the evidence, but I say with some confidence that the scenario presented in the news media presents a difficult factual pattern if the hospital was the culprit in failing to get the CT scan done.

(hat tip to TortsProf)

More: Ritter Lawsuit Demonstrates How Medical Malpractice Caps Discriminate On Basis Of Wealth (David Lowe, InjuryBoard:Milwaukee)

 

March 14th, 2008

Jury Duty in New York: A Guest Blog

My brother Dan, a screenwriter, sat jury duty this week in New York. He live-blogged the experience, for publication when it was over:
—————————————————–
Tales From The Juror
Thoughts, observations, and ramblings, from the jury room at 111 Centre Street.

8 AM
In an effort to make sure I’m there on time, I get there before the building is even open. Big mistake. Have to wait out on the sidewalk. The day is not off to a good start.

9 AM
In my seat in the holding pen, verify that there is indeed free wifi access. The day gets slightly better.

9:30 AM
The woman running the show, giving instructions:

“You’ll notice, on my right, are vending machines, where you can buy snacks. We do not own these vending machines, so if you put your money in, and your snack does not come out, we are not responsible. And there is no number on the machine for you to call. But if it happens, we do allow you to shake the machines a little.”

9:45 AM
Ed Bradley (who died 16 months ago), and Diane Sawyer narrate the introduction film, which is supposed to make us feel better about being here. But it’s March 12, and half the people here are sniffling, wheezing and coughing. It’ll be a miracle if I get out of here alive. I think it was jury duty that did in Bradley.

10:00 AM
There is a severe lack of hot-looking women in this room. All those years of watching courtroom based TV shows, I was lied to! How could TV let me down so badly? There will be no amusing stories to tell my children years from now about how I met their mother while we sent some guy to the chair. (Do we still use Old Sparky in this state?)

If I get picked on a criminal case, and the A.D.A. isn’t smokin’ hot, I’m going to kick Dick Wolf’s ass.

(For those, like my brother, who probably don’t know who he is, Dick Wolf is the creator of “Law & Order,” a show which usually features an actress playing an A.D.A who looks like she was cast from a Victoria’s Secret catalog.)

10:05 AM
My brother e-mails me the following note:

“DO NOT TELL ME ANYTHING ABOUT DETAILS OF THE CASE IF YOU ARE PICKED UNTIL IT IS DONE!”

Apparently my brother thinks I’m an idiot. I’d find him guilty so fast.

10:16 AM
First call for criminal jury selection.

10:18 AM
I didn’t get called. Bastards.

10:23 AM
A cell phone goes off in the room. We were told to turn them off. The offender doesn’t get yelled at. Damn. I thought it might be the first chance at some drama here.

10:28 AM
Civil selection call.

10:33 AM
Not called

10:35 AM
Next call. This group is going to another building. 60 Centre Street.

10:39 AM
Not called. Good. Don’t feel like moving. If I’m going to be asked to hand out justice, let me do it without having to put my coat on.

10:40 AM
The guy behind me is loudly crunching through a bag of potato chips. He’s driving me nuts!

10:41 AM
Civil panel being called.

10:45 AM
Not called again.

God help me if I every have to rely on some of these folks to decide my fate.

10:53 AM
My bit to help the system run smoothly includes instant messaging with my 18 year-old niece on spring break in Florida. How did people ever stand jury duty without computers?

11:17 AM
Working on my latest screenplay. The guy behind me is starting to read over my shoulder. He thinks I don’t notice, but I do. Time to cause a scene? Humm…how bored am I?

11:21 AM
Taking a break from writing to do what jury duty is truly useful for: preparing for my upcoming rotisserie baseball draft!

11:29 AM
Another criminal panel call.

11:31 AM
I’m picked!!!

1:53 PM
Back from lunch. It’s amazing how easy it is to get out of serving. The judge asks “is there anyone here who can’t be impartial?” and 1/4 of the people raise their hands. All they have to do is say their name and declare “I can’t be impartial,” and they’re gone. Wow. Of course most of them are full of it. You end up hoping those people get arrested for something and have to rely on a jury some day.

There is one prosecutor, and he is not hot. Dick Wolf, watch your ass.

11:00 PM
Home.
So I was sitting there in the voir dire, one of 16 in the box, and we find out what the case is. It’s a drug case. Two Hispanic males from Harlem are caught in an apartment with 20 kilos of cocaine. That’s a lot of coke. There’s also an unloaded gun and a minor in the apartment, both of which add to the charges. Some jurors have already been chosen, they’re looking for more.

All the lawyers seem determined to remind us this isn’t CSI or Law & Order, it’s real life. I’m not sure if they’re being prudent or treating us all like idiots.

When the two defense attorneys started to question us, I was toast. One was hung up on the concept of using “entrapment” as a defense. Do we think it’s a legit defense? My response was, it’s meaningless as long as the cops followed all the rules they’re supposed to follow, and didn’t break any laws. At the end of the day, each person, no matter what situation they find themselves in, gets to decide if they’re going to be honest and law abiding, or dishonest and crooked. I pretty much knew that would get me tossed. Not that it was my goal to get tossed, I just didn’t like this guys’ angle, and felt like speaking my mind. The other defense lawyer was pushing the line that the cops went in without a warrant, how did we feel about that. Of course it was mentioned that this was an issue for the judge to decide, that if he says the cops didn’t need a warrant, then it was OK. But he got some people to say they felt funny about it.

Midway through the questioning, one of the court officers, an older gentleman, dozes off, with his hand on his gun. It did not inspire confidence. A few of us joked about it at lunch break, while waiting to go back in.

In the end, of the 16 of us questioned first, two were selected. I was not among them. So it’s back to the holding pen tomorrow.

The good news is, we don’t have to show up till 10 AM. Hot damn!

Day 2

9:50 AM
The holding pen is packed, but I find a seat in the front row. Time to sit and wait. Finally finish off the Sunday Times Magazine.

10:22 AM
They take attendance.

10:26 AM
Attendance over. They didn’t call me, and a bunch of others who were in my voir dire yesterday. The woman says they’ll try and track down our juror ballots. You do that.

10:45 AM
The missing juror ballots are found. I am now officially here. Oh boy.

10:54 AM
Casting my first jury duty vote: Snickers or M&M’s?

10:56 AM
Rotoworld.com says Orioles pitcher Adam Loewen was scratched from his scheduled start Friday because of a sore shoulder. The team president says it’s a normal result of his having undergone elbow surgery 9 months ago. I don’t care, I’m still not going to buy him at the draft.

Such is the excitement of jury duty.

11:01 AM
It’s amazing how quiet a room with well over 100 people can get. Reminds me of taking tests back in college.

The first day of jury duty, you actually look forward to getting selected. (at least I did) A little bit of excitement. A chance to do your civic duty. A chance to throw a bad guy in the slammer, or decide who really cheated who in some business deal gone bad.

The second day, all that crap goes out the window. Please, oh please don’t call my name. Just let the clock run out and let me go home.

11:36 AM
First panel called. 19 people. Not me. Good.

2:25 PM
Back from lunch. The immediate area definitely needs a better selection of eateries.

Only a couple of hours to go, and my time as a good citizen is over. Which is great, as the guy behind me in the packed jury holding pen is snoring something fierce.

4:00 PM
It’s over! With only one panel called all day, they’ve decided to cut us all loose. The guy setting us free decides to work on his standup routine.

“Some of you will be sad to be going home. (big laughs) Some of you will be glad. Just remember this: the last two days you had two-hour lunches. Tomorrow, it’s back to grabbing a sandwich at your desk. Today, you strolled in at 10. Tomorrow, it”s back to getting up at 7 AM.”

So there it is. My two-day odyssey through our judicial system has come to a close. I didn’t get to send any bad guys to the old gray-bar hotel, like I hoped. Nor did I set free any wrongly accused innocents, as my brother reminded me was also a possibility. No courthouse romances, no shootouts, nobody in handcuffs, no weeping family members, no mobs of reporters looking for courthouse steps sound bites. No courthouse steps, for that matter, at 111 Centre Street. All in all a thoroughly boring two days, interrupted briefly by a quick story about 20 kilos of coke.

And to think; sometime soon, some lucky jurors will get to sit in the box and hear about the ex-governor’s whoring around. I bet that won’t be a boring jury duty experience. Why couldn’t I get called then?