Jeffrey Segal, MD, JD

Families are pivotal in helping patients recover. They advocate for their loved ones. They give encouragement to rehabilitate. They provide reasons to push harder to live. What happens when a patient deteriorates in front of the family and a code is called? Sometimes the family is ushered out of the room. Sometimes they are pushed to the side – allowed to stay as long as they do not get in the way.

A recent California case suggests that if close family members witness negligence in implementing a code – or calling a code too late – not only can the patient sue, so can the family.

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In his sixth year of neurosurgical residency at Stanford, Dr. Paul Kalanithi developed night sweats, back pain, and cough. His weight dropped precipitously. In May, 2013, he was diagnosed with stage 4 non-small cell EGFR positive lung cancer. He had never smoked.

He was treated and went back to work.

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As medical innovation evolves, someone is the first person to do a procedure. If the results are great – wonderful. What happens if the results are great most of the time, but one patient out of 100 has a horrible complication? If that patient sues for malpractice, he will argue you were not following the standard of care, and that failure caused damages. That is the hallmark of a medical negligence suit.

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Recently, co-pilot Andreas Lubitz locked himself in the cockpit of a Germanwings plane and intentionally caused the plane to crash, killing himself and 149 passengers and crew. We are learning new information daily. Apparently, he had a doctor’s note declaring him unfit for flying on the date he crashed. And, he apparently sought help in the past for a psychiatric condition. Details are scarce. Still, no one in close proximity to Lubitz said they saw this coming. Everyone expressed shock and surprise.

Will Lubitz’s doctors be blamed, in part or in full? And, if so, what kind of liability might that trigger?

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What’s the difference between an optimist and a pessimist?

An optimist believes these are the best of times.

A pessimist is afraid he’s right.

It’s an old joke. But, it exemplifies how we expect things will turn out.

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A handful of states mandate that medical malpractice cases first be reviewed by panels of experts. These panels rule on the merits of a case. They conclude the standard of care was violated or it wasn’t.

In the states that use such panels, such as Indiana and New Mexico, the panel’s decision is not binding. A plaintiff’s attorney can ignore a smack-down and take the case to trial. But, the panel gives a strong signal as to how the winds will blow. Many – but not all – plaintiff’s attorneys take the hint.

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Dr. Orlito Trias was sued for negligence. The lower court awarded $4 million in damages.

A summary of the case was presented on the Connecticut State Medical Society website.

The case claimed that during a preoperative consultation for the removal of fibroid tumors, Dr. Trias failed to “strongly advise” the plaintiff that her family history of breast cancer greatly increased her risk for developing ovarian cancer. Although clear from the medical records that the risk of ovarian cancer was discussed, the plaintiff claimed that she was not “strongly advised” to undergo removal of her ovaries. The plaintiff subsequently developed ovarian cancer.

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We continue with our series of general educational articles penned by one attorney, an MD, JD, giving you a view of the world through a malpractice plaintiff attorney’s eyes. This attorney is a seasoned veteran.  The series includes a number of pearls on how to stay out of harm’s way. While I do not necessarily agree with 100% of the details of every article, I think the messages are salient, on target, and fully relevant.  Please give us your feedback – and let us know if you find the series helpful.

We previously addressed who can determine treatment for the minor patient (addressed her in Part 1). We now move to confidentiality / records access issues for the minor patient in Part 2.

1. Confidentiality issues and access to records.

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We continue with our series of general educational articles penned by one attorney, an MD, JD, giving you a view of the world through a malpractice plaintiff attorney’s eyes. This attorney is a seasoned veteran.  The series includes a number of pearls on how to stay out of harm’s way. While I do not necessarily agree with 100% of the details of every article, I think the messages are salient, on target, and fully relevant.  Please give us your feedback – and let us know if you find the series helpful.

The pitfalls in treating minors tend to fall into two areas: who can determine treatment for the minor patient (addressed here in Part 1); and confidentiality / records access issues (which will be addressed later in Part 2).

I. Treatment decisions.

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We continue with our series of general educational articles penned by one attorney, an MD, JD, giving you a view of the world through a malpractice plaintiff attorney’s eyes. This attorney is a seasoned veteran.  The series includes a number of pearls on how to stay out of harm’s way. While I do not necessarily agree with 100% of the details of every article, I think the messages are salient, on target, and fully relevant.  Please give us your feedback – and let us know if you find the series helpful.

A physician recently asked about the following case: a midwife committed serious, wrongful acts in the care of a patient in premature labor with twins. The patient was initially discouraged from going to the hospital; a naturopathic doctor at the midwife’s birthing center was not competent to treat the labor medically; an outside midwife recommended the patient be transferred to the hospital but the patient was again discouraged from doing so; there was no equipment to resuscitate one twin born at the birthing center; and CPR was applied incompetently. That twin later died.  The midwife also lied to paramedics about the mother’s care and tried to conceal that the mother was, in fact, still in the birthing center, was still laboring and was bleeding profusely. The midwife was charged with manslaughter for the death of the twin delivered at her facility.

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