The Impact of Incident Disclosure Behaviors on Medical Malpractice Claims.

Science.gov (United States)

Giraldo, Priscila; Sato, Luke; Castells, Xavier

2017-06-30

To provide preliminary estimates of incident disclosure behaviors on medical malpractice claims. We conducted a descriptive analysis of data on medical malpractice claims obtained from the Controlled Risk Insurance Company and Risk Management Foundation of Harvard Medical Institutions (Cambridge, Massachusetts) between 2012 and 2013 (n = 434). The characteristics of disclosure and apology after medical errors were analyzed. Of 434 medical malpractice claims, 4.6% (n = 20) medical errors had been disclosed to the patient at the time of the error, and 5.9% (n = 26) had been followed by disclosure and apology. The highest number of disclosed injuries occurred in 2011 (23.9%; n = 11) and 2012 (34.8%; n = 16). There was no incremental increase during the financial years studied (2012-2013). The mean age of informed patients was 52.96 years, 58.7 % of the patients were female, and 52.2% were inpatients. Of the disclosed errors, 26.1% led to an adverse reaction, and 17.4% were fatal. The cause of disclosed medical error was improper surgical performance in 17.4% (95% confidence interval, 6.4-28.4). Disclosed medical errors were classified as medium severity in 67.4%. No apology statement was issued in 54.5% of medical errors classified as high severity. At the health-care centers studied, when a claim followed a medical error, providers infrequently disclosed medical errors or apologized to the patient or relatives. Most of the medical errors followed by disclosure and apology were classified as being of high and medium severity. No changes were detected in the volume of lawsuits over time.

Malpractice in Radiology: What Should You Worry About?

Directory of Open Access Journals (Sweden)

Alessandro Cannavale

2013-01-01

Full Text Available Over recent years the professional role of the radiologist has been evolved due to the increasing involvement in the clinical management of the patient. Radiologists have thus been increasingly charged by new duties and liabilities, exposing them to higher risks of legal claims made against them. Malpractice lawsuits in radiology are commonly related to inappropriate medical care or to the poor physician-patient relationship. In the present paper, we provide overview of the basic principles of the medical malpractice law and the main legal issues and causes of legal actions against diagnostic and interventional radiologists. We also address some issues to help radiologists to reduce risks and consequences of malpractice lawsuits. These include (1 following the standard of care to the best of their ability, (2 cautious use of off-label devices, (3 better communication skills among healthcare workers and with the patient, and (4 ensuring being covered by adequate malpractice insurance. Lastly, we described definitions of some medicolegal terms and concepts that are thought to be useful for radiologists to know.

Malpractice in Radiology: What Should You Worry About?

International Nuclear Information System (INIS)

Cannavale, A.; Passariello, R.; Santoni, M.; Mancarella, P.; Arbarello, P.

2013-01-01

Over recent years the professional role of the radiologist has been evolved due to the increasing involvement in the clinical management of the patient. Radiologists have thus been increasingly charged by new duties and liabilities, exposing them to higher risks of legal claims made against them. Malpractice lawsuits in radiology are commonly related to inappropriate medical care or to the poor physician-patient relationship. In the present paper, we provide overview of the basic principles of the medical malpractice law and the main legal issues and causes of legal actions against diagnostic and interventional radiologists. We also address some issues to help radiologists to reduce risks and consequences of malpractice lawsuits. These include (1) following the standard of care to the best of their ability, (2) cautious use of off-label devices, (3) better communication skills among health care workers and with the patient, and (4) ensuring being covered by adequate malpractice insurance. Lastly, we described definitions of some medicolegal terms and concepts that are thought to be useful for radiologists to know.

Medical malpractice web advertising: a qualitative, cross-sectional analysis of plaintiff medical malpractice firms in Suffolk County, Massachusetts.

Science.gov (United States)

Ghobadi, Comeron W; Gevorgyan, Ofelya; Bednarski, Caroline E; Hayman, Emily L; Walter, Jessica R; Xu, Shuai

2017-01-01

Medical malpractice plaintiff firms play a central role in the prosecution of malpractice claims. There have been limited studies on the online advertising practices of plaintiff medical malpractice firms. The Martindale-Hubbell directory was used to identify all plaintiff medical malpractice firms in Suffolk County, Massachusetts. Each firm's website was individually mined for relevant data. Thirty-one unique medical malpractice law firms were identified. Seventy-seven percent of law firms advertised awards with the Martindale-Hubbell AV rating, AVVO, and Super Lawyer being the three most common. The second most common method of advertising was accomplished through descriptions of successful verdicts and settlements (61%). A total of 408 verdicts, settlements, and arbitrations collectively representing $1.4 billion dollars were advertised by all law firms. Median awarded values for verdicts was advertised as $4.5 million, while the median awarded values for settlements was $1.25 million. Defendants most commonly practiced obstetrics (18%), followed by primary care (14%). Law firms report treatment and diagnosis delay as the most common successful claim (50%), followed much further by misdiagnosis (8%), and communication error (4%). Our sample correlates with larger claims-based studies surrounding the most commonly sued specialties, however, median reported settlement and verdict values were significantly higher in our cohort. Considerations should be made to provide advertising guidelines for medical malpractice plaintiff firms. Copyright © 2017 by the National Legal Center for the Medically Dependent and Disabled, Inc.

Resolving Malpractice Claims after Tort Reform: Experience in a Self-Insured Texas Public Academic Health System.

Science.gov (United States)

Sage, William M; Harding, Molly Colvard; Thomas, Eric J

2016-12-01

To describe the litigation experience in a state with strict tort reform of a large public university health system that has committed to transparency with patients and families in resolving medical errors. Secondary data collected from The University of Texas System, which self-insures approximately 6,000 physicians at six health campuses across the state. We obtained internal case management data for all medical malpractice claims closed during 1 year before and 6 recent years following the enactment of state tort reform legislation. We retrospectively reviewed information about malpractice claimants, malpractice claims, and the process and outcome of dispute resolution. We accessed an internal case management database, supplemented by both electronic and paper records compiled by the university's Office of General Counsel. Closed claims dropped from 244 in 2001-2002 to an annual mean of 96 in 2009-2015, closures following lawsuits from 136 in 2001-2002 to an annual mean of 28 in 2009-2015, and paid claims from 60 in 2001 to an annual mean of 20 in 2009-2015. Patterns of resolution suggest efforts by the university to provide some compensation to injured patients in cases that were no longer economically viable for plaintiffs' lawyers to litigate. The percentage of payments relating to cases in which lawsuits had been filed decreased from 82 percent in 2001-2002 to 47 percent in 2009-2012 and again to 29 percent in 2012-2015, although most paid claimants were represented by attorneys. Unrepresented patients received payment in 13 cases closed in 2009-2012 (22 percent of payments; mean amount $60,566) and in 24 cases closed in 2012-2015 (41 percent of payments; mean amount $109,410). Even after tort reform, however, claims that resulted in payment remained slow to resolve, which was worsened for claimants subject to Medicare secondary payer rules. Strict confidentiality became a more common condition of settlement, although restrictions were subsequently relaxed

Malpractice Litigation and Nursing Home Quality of Care

Science.gov (United States)

Konetzka, R Tamara; Park, Jeongyoung; Ellis, Robert; Abbo, Elmer

2013-01-01

Objective. To assess the potential deterrent effect of nursing home litigation threat on nursing home quality. Data Sources/Study Setting. We use a panel dataset of litigation claims and Nursing Home Online Survey Certification and Reporting (OSCAR) data from 1995 to 2005 in six states: Florida, Illinois, Wisconsin, New Jersey, Missouri, and Delaware, for a total of 2,245 facilities. Claims data are from Westlaw's Adverse Filings database, a proprietary legal database, on all malpractice, negligence, and personal injury/wrongful death claims filed against nursing facilities. Study Design. A lagged 2-year moving average of the county-level number of malpractice claims is used to represent the threat of litigation. We use facility fixed-effects models to examine the relationship between the threat of litigation and nursing home quality. Principal Findings. We find significant increases in registered nurse-to-total staffing ratios in response to rising malpractice threat, and a reduction in pressure sores among highly staffed facilities. However, the magnitude of the deterrence effect is small. Conclusions. Deterrence in response to the threat of malpractice litigation is unlikely to lead to widespread improvements in nursing home quality. This should be weighed against other benefits and costs of litigation to assess the net benefit of tort reform. PMID:23741985

Trends in medical malpractice claims in patients with cleft or craniofacial abnormalities in the United States.

Science.gov (United States)

Rawal, Rounak B; Kilpatrick, Lauren A; Wood, Jeyhan S; Drake, Amelia F

2016-11-01

To describe medical malpractice trends in patients with cleft and/or craniofacial abnormalities. A modified Delphi approach was used to gather search terms. Search settings included "all jury verdicts and settlements", with jurisdiction of "all states" and "all federal courts" (by court and circuit). A retrospective review of WestLawNext legal database was conducted. Cases were excluded if they did not have a direct association from the patient's craniofacial anomaly or if they were not related to malpractice. Forty-two cases met inclusion criteria. Cases closed between 1981 and 2014 were included. The mean payment among claims with an indemnity payment was $3.9 million. Of cases brought to trial, 62% were in favor of the plaintiff. Amongst physicians named as co-defendants, pediatricians were most commonly named (24%), followed by plastic surgeons (16%), obstetricians (7.8%), and radiologists (7.8%). "Missed diagnosis" was the most common type of negligent claim (45%), followed by "surgical error" (21%), and "medication error" (17%). "Anoxic brain injury" resulted in the highest median indemnity payment for complication of patient management ($3.5 million), followed by "wrongful birth" ($1.03 million), and "minor physical injury" ($520,000). No specific type of negligent claim (p = 0.764) nor complication of patient management (p = 0.61) was associated with a greater indemnity payment. Mean indemnity payment was $920,000 prior to 2001 and $4.4 million after 2001 (p = 0.058). Mean indemnity payments were fourteen-fold greater in patients as compared to those in the overall population ($3.9 million versus $274,887) and seven-fold greater than those in the average pediatric population ($3.9 million versus $520,923). All healthcare providers should be aware of the associated medical malpractice claims that may be incurred when treating patients at risk for these conditions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Missed Diagnosis of Cardiovascular Disease in Outpatient General Medicine: Insights from Malpractice Claims Data.

Science.gov (United States)

Quinn, Gene R; Ranum, Darrell; Song, Ellen; Linets, Margarita; Keohane, Carol; Riah, Heather; Greenberg, Penny

2017-10-01

Diagnostic errors are an underrecognized source of patient harm, and cardiovascular disease can be challenging to diagnose in the ambulatory setting. Although malpractice data can inform diagnostic error reduction efforts, no studies have examined outpatient cardiovascular malpractice cases in depth. A study was conducted to examine the characteristics of outpatient cardiovascular malpractice cases brought against general medicine practitioners. Some 3,407 closed malpractice claims were analyzed in outpatient general medicine from CRICO Strategies' Comparative Benchmarking System database-the largest detailed database of paid and unpaid malpractice in the world-and multivariate models were created to determine the factors that predicted case outcomes. Among the 153 patients in cardiovascular malpractice cases for whom patient comorbidities were coded, the majority (63%) had at least one traditional cardiac risk factor, such as diabetes, tobacco use, or previous cardiovascular disease. Cardiovascular malpractice cases were more likely to involve an allegation of error in diagnosis (75% vs. 47%, p <0.0001), have high clinical severity (86% vs. 49%, p <0.0001) and result in death (75% vs. 27%, p <0.0001), as compared to noncardiovascular cases. Initial diagnoses of nonspecific chest pain and mimics of cardiovascular pain (for example, esophageal disease) were common and independently increased the likelihood of a claim resulting in a payment (p <0.01). Cardiovascular malpractice cases against outpatient general medicine physicians mostly occur in patients with conventional risk factors for coronary artery disease and are often diagnosed with common mimics of cardiovascular pain. These findings suggest that these patients may be high-yield targets for preventing diagnostic errors in the ambulatory setting. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Occlusion and temporomandibular disorders: a malpractice case with medical legal considerations.

Science.gov (United States)

Bucci, M B; Aversa, M; Guarda-Nardini, L; Manfredini, D

2011-01-01

Occlusion and temporomandibular The issue of temporomandibular disorders (TMD) diagnosis and treatment has become a matter of increasing interest in the medical legal field in recent years. The old-fashioned theories based on the occlusal paradigm was proven to be erroneous, and clinicians who still provide irreversible treatments to TMD patients have to be conscious of the potential legal consequences of their behavior. The present paper described an illustrative case report of a patient to whom extensive and irreversible occlusal therapies were performed with the unique aim to provide relief from TMD symptoms. The treatment was unsuccessful and the dental practitioner was called into cause for a professional liability claim. The clinician was judged guilty of malpractice on the basis of the lack of scientific evidence of the irreversible occlusal approaches to TMD, which were erroneously used and did not give the patient any benefit, thus forcing him to a non necessary financial and biological cost. The failure to satisfy the contract with the patient, which is usually not covered by any insurance company, forced the practitioner to give the money back to the patient. The ethical and legal implications of such case were discussed, with particular focus on the concept that medical legal advices need to satisfy the highest standards of evidence and have to be strictly based on scientific knowledge.

The current status of medical malpractice countersuits.

Science.gov (United States)

Sokol, D J

1985-01-01

The dramatic growth of medical malpractice litigation in recent decades has contributed significantly to an overall increase in health care costs in this country. Although lawmakers, physicians, and other responsible citizens have proposed numerous solutions in an effort to curb the crisis, these proposals have generally been ineffective. In this Article the Author endorses countersuits as the most appropriate response to frivolous medical malpractice actions. The Author also suggests that contingent fee systems, coupled with the economic motivation of private insurers to settle claims quickly, provide incentive for plaintiffs to initiate frivolous claims. This Article analyzes the general legal approaches available for countersuits, emphasizing recent successful actions based on malicious prosecution and abuse of process, and proposes more widespread use of these approaches.

An Analysis of the Number of Medical Malpractice Claims and Their Amounts.

Directory of Open Access Journals (Sweden)

Marco Bonetti

Full Text Available Starting from an extensive database, pooling 9 years of data from the top three insurance brokers in Italy, and containing 38125 reported claims due to alleged cases of medical malpractice, we use an inhomogeneous Poisson process to model the number of medical malpractice claims in Italy. The intensity of the process is allowed to vary over time, and it depends on a set of covariates, like the size of the hospital, the medical department and the complexity of the medical operations performed. We choose the combination medical department by hospital as the unit of analysis. Together with the number of claims, we also model the associated amounts paid by insurance companies, using a two-stage regression model. In particular, we use logistic regression for the probability that a claim is closed with a zero payment, whereas, conditionally on the fact that an amount is strictly positive, we make use of lognormal regression to model it as a function of several covariates. The model produces estimates and forecasts that are relevant to both insurance companies and hospitals, for quality assurance, service improvement and cost reduction.

Suicide medical malpractice: an educational overview.

Science.gov (United States)

Sher, Leo

2015-05-01

A malpractice lawsuit is in the legal category of an action in tort, which is a demand for compensation for the damages that have occurred. For a physician to be found liable to a patient for malpractice, four essential elements must be proved to sustain an assertion of malpractice: duty, negligence, harm, and causation. The incidence of malpractice litigation in the field of psychiatry is increasing. The most common malpractice claim related to psychiatric practice is the failure to provide reasonable protection to patients from killing themselves. A psychiatrist should be able to evaluate suicide risk on the basis of all available information, including patient responses to direct and indirect questions, known risk factors, information on how the patient behaved under similar circumstances in the past, and collateral information. Reasonable care necessitates that a patient who is either thought of being or established to be suicidal must be the subject of some precautions. A failure either to soundly assess a patient's suicide risk or to employ an appropriate safety plan after the suicide potential becomes foreseeable is likely to make a physician liable if the patient is harmed because of a suicide event. It is imperative for a psychiatric office or facility to have a good documentation. Careful documentation of evaluations and treatment interventions with a description of changes related to the patient's clinical condition indicates clinically and legally appropriate psychiatric care.

Medical malpractice lawsuits and the value of skilled and diverse legal counsel.

Science.gov (United States)

Lapuyade, Keith D; Sorkin, Alison C

2013-12-01

Medical malpractice claims against dermatologists and dermapathologists arise mostly out of claims for negligence--when a patient claims a provider owed a duty to a patient, breached that duty, and caused damages to the patient. When a health care provider files a claim with his or her insurance company, the insurance company will usually retain and pay an attorney for the health care provider. It is important to understand the role the attorney retained by the insurance company plays to evaluate whether a health care provider should seek the advice of independent or "personal" counsel.

Medical legal aspects of radiation oncology

International Nuclear Information System (INIS)

Wall, Terry J.

1996-01-01

The theoretical basis of, and practical experience in, legal liability in the clinical practice of radiation oncology is reviewed, with a view to developing suggestions to help practitioners limit their exposure to liability. New information regarding the number, size, and legal theories of litigation against radiation oncologists is presented. The most common legal bases of liability are then explored in greater detail, including 'malpractice', and informed consent, with suggestions of improving the specialty's record of documenting informed consent. Collateral consequences of suffering a malpractice claim (i.e., the National Practitioner Data Bank) will also be briefly discussed

[Guideline to prevent claims due to medical malpractice, on how to act when they do occur and how to defend oneself through the courts].

Science.gov (United States)

Bruguera, M; Arimany, J; Bruguera, R; Barberia, E; Ferrer, F; Sala, J; Pujol Robinat, A; Medallo Muñiz, J

2012-04-01

Claims due to presumed medical malpractice are increasing in all developed countries and many of them have no basis. To prevent legal complaints, the physicians should know the reasons why complaints are made by their patients and adopt the adequate preventive measures. In the case of a complaint, it is essential to follow the guidelines that allow for adequate legal defense and the action of the physician before the judge that inspires confidence and credibility. The risk of the claims can be reduced with adequate information to the patient, the following of the clinical guidelines, control of the risk factors and adoption of verification lists in each invasive procedure. In case of complication or serious adverse effect, explanations should be given to the patient and family and it should be reported to the facility where one works and to the insurance company. If the physician received a claim, he/she should report it to the insurance compare so that it can name a lawyer responsible for the legal defense who will advise the physician regarding the appearance in court before the judge. Copyright © 2011 Elsevier España, S.L. All rights reserved.

Liability for medical malpractice--recent New Zealand developments.

Science.gov (United States)

Sladden, Nicola; Graydon, Sarah

2009-03-01

Over the last 30 years in New Zealand, civil liability for personal injury including "medical malpractice" has been most notable for its absence. The system of accident compensation and the corresponding bar on personal injury claims has been an interesting contrast to the development of tort law claims for personal injury in other jurisdictions. The Health and Disability Commissioner was appointed in 1994 to protect and promote the rights of health and disability consumers as set out in the Code of Health and Disability Services Consumers' Rights. An important right in the Code, in terms of an equivalent to the common law duty to take reasonable care, is that patients have the right to services of an appropriate standard. Several case studies from the Commissioner's Office are used to illustrate New Zealand's unique medico-legal system and demonstrate how the traditional common law obligation of reasonable care and skill is applied. From an international perspective, the most interesting aspect of liability for medical malpractice in New Zealand is its relative absence - in a tortious sense anyway. This paper will give some general background on the New Zealand legal landscape and discuss recent case studies of interest.

American Academy of Pediatrics: Technical report: Alternative dispute resolution in medical malpractice.

Science.gov (United States)

Fraser, J J

2001-03-01

The purpose of this technical report is to provide pediatricians with an understanding of past crises within the professional liability insurance industry, the difficulties of the tort system, and alternative strategies for resolving malpractice disputes that have been applied to medical malpractice actions. Through this report, pediatricians will gain a technical understanding of common alternative dispute resolution (ADR) strategies. The report explains the distinctions between various ADR methods in terms of process and outcome, risks and benefits, appropriateness to the nature of the dispute, and long-term ramifications. By knowing these concepts, pediatricians faced with malpractice claims will be better-equipped to participate in the decision-making with legal counsel on whether to settle, litigate, or explore ADR options.

Revisiting Postoperative Vision Loss following Non-Ocular Surgery: A Short Review of Etiology and Legal Considerations

Directory of Open Access Journals (Sweden)

Ehud Mendel

2017-06-01

Full Text Available Postoperative vision loss (POVL following non-ocular surgery is a serious complication where the causes are not fully understood. Studies have identified several causes of POVL as well as risk factors and prevention strategies. POVL research is made difficult by the fact that cases are often subject to malpractice claims, resulting in a lack of public access to case reports. This literature review was conducted in order to identify legal issues as a major barrier to studying POVL and address how this affects current knowledge. Informed consent provides an opportunity to overcome legal challenges by reducing malpractice litigation through educating the patient on this outcome. Providing pertinent information regarding POVL during the informed consent process has potential to reduce malpractice claims and increase available clinical information.

Status of medical liability claims in Saudi Arabia

International Nuclear Information System (INIS)

Samarkandi, A.

2006-01-01

With the evolution of health services in Saudi Arabia, there has been increase in the number of medical practice litigations. The author analyzed the medical malpractice litigation that was referred to the National Medico-Legal Committee (MLC) in order to evaluate the magnitude and underlying factors of the problem in Saudi Arabia. A retrospective analysis of the official records of Medico-Legal malpractice over the period 1420H-1424H (199-2003) was performed. The incidence among different medical specialties, location, and final resolution of each claim were identified. Data analysis revealed an increasing trend in the total number of claims over the study period, with a sharp increase in the transition between 1422H and 1423H (2001-200). The distribution of claims over different medical specialties showed that obstetrical practice took the lead with 27%, followed by general surgery and subspecialties, represented by 17% each, internal medicine 13%, while pediatrics contributed 10% of claims: the fewest claims were in dentistry with 2.5%. The majority of claims were referred to the Ministry of Health and private sectors medical facilities. Most claims were from the Riyadh region over the period between 1420H to 1422H (1999-2001), while thereafter, during 1423 and 1424H (2002 and 2003), the Holy Capital had the highest number of claims referred to the MLC. Adherence to standards of medical practice is by far the best approach to avoid or reduce the incidence of litigation. (author)

Medical malpractice and hernia repair: an analysis of case law.

Science.gov (United States)

Walters, Amanda L; Dacey, Kristian T; Zemlyak, Alla Y; Lincourt, Amy E; Heniford, B Todd

2013-04-01

Litigation analysis and clinician education are essential to reduce the number and cost of malpractice claims. This study evaluates the clinical characteristics and legal outcomes of medical malpractice litigation initiated by patients having undergone a hernia repair operation. Published civil suits were obtained from a legal database for state and federal decisions constituting case law. The published material includes information on defendants, plaintiffs, allegations, outcomes, and a variety of legal issues. A retrospective review of 44 published cases from 25 states was performed. Complications were present in 20 of 44 (45%) suits, four (9%) of which were because of infection. Death occurred in five (11%) cases, and failure to obtain informed consent was alleged in seven (16%) of the suits. Retained foreign bodies were present in 7 of the 44 (16%) suits. Other allegations included incorrect surgical technique, insufficient need for surgery, and emotional distress. Most (64%) patients initiating malpractice litigation were male, and inguinal, hiatal, and ventral hernia repairs account for 39%, 27%, and 14% of cases, respectively. Most suits (40%) were initiated in Southern states. Surgical mesh was indicated in 5 of 44 (11%) suits but four of five were unrelated to the suit. One patient initiated litigation because of the fact that the surgeon did not use mesh during surgery, which was discussed preoperatively during the informed consent. The court ruled in favor of the plaintiff in 12 of 44 (27%) suits, with compensation ranging from roughly $19,000 to $8,000,000. Louisiana and New York had six and seven suits each, which appears disproportionate given their respective populations. Complications and death resulting from alleged clinical negligence play a significant role in both the initiation and the outcome of malpractice litigation. Retained foreign bodies and lack of informed consent account for roughly one-third of malpractice litigation associated with

Perspectives on medical malpractice self-insurance financial reporting.

Science.gov (United States)

Frese, Richard C; Kitchen, Patrick J

2012-11-01

Financial reporting of medical malpractice self-insurance is evolving. The Financial Accounting Standards Board Accounting Standards Codification Section 954-450-25 provides guidance for accounting and financial reporting for medical malpractice. Discounting of medical malpractice liabilities has been reassessed in recent years. Malpractice litigation reform efforts continue in several states. Accountable care organizations could increase the frequency of medical malpractice claims because of patients' heightened expectations regarding quality of care.

Medical malpractice reform: the role of alternative dispute resolution.

Science.gov (United States)

Sohn, David H; Bal, B Sonny

2012-05-01

Alternative dispute resolution (ADR) refers to techniques used to resolve conflicts without going to the courtroom. As healthcare and malpractice costs continue to rise, there is growing interest in tactics such as early apology, mediation, and arbitration in the medical arena. (1) Why is ADR needed? (2) Is ADR useful in health care? (3) What are the current legal and political developments favoring ADR? (4) What obstacles remain? We performed MEDLINE, PubMed, and Google Scholar searches with key words "medical malpractice", "ADR", and "alternative dispute resolution" to obtain public policy studies, law review articles, case analyses, ADR surveys, and healthcare review articles. Early apology and disclosure programs report 50% to 67% success in avoiding litigation as well as substantial reductions in the amount paid per claim. Mediation boasts 75% to 90% success in avoiding litigation, cost savings of $50,000 per claim, and 90% satisfaction rates among both plaintiffs and defendants. Arbitration is viewed as less satisfying and less efficient than mediation but still more time- and cost-effective than litigation. The current legal environment is favorable to ADR with recent court decisions upholding pretreatment arbitration clauses. The main obstacle to ADR is the mandatory reporting requirement of the National Practitioner Data Bank (NPDB). ADR has the potential to help reform the current tort system, reducing cost and increasing both parties' satisfaction. Easing the reporting requirements for the NPDB would lead to more widespread acceptance of ADR among physicians.

Defenses to malpractice: what every emergency physician should know.

Science.gov (United States)

Hudson, Michael Jason; Moore, Gregory P

2011-12-01

Emergency medicine is a high-risk specialty that carries a constant risk of malpractice litigation. Fear of malpractice litigation can lead to less-than-optimal patient care as well as impairments in physician quality of life. Although malpractice fear can be ubiquitous among emergency physicians, most receive little to no education on malpractice. Medical malpractice requires that 1) The physician had a duty, 2) The physician breached the duty, 3) There was harm to the patient, and 4) The harm was caused by the physician's breach of duty. Even if all four medical malpractice conditions are met, there are still special legal defenses that have been and can be used in court to exonerate the physician. These defenses include assumption of the risk, Good Samaritan, contributory negligence, comparative fault, sudden emergency, respectable minority, two schools of thought, and clinical innovation. These legal defenses are illustrated and explained using defining precedent cases as well as hypothetical examples that are directly applicable to emergency medical practice. Knowledge of these special legal defenses can help emergency physicians minimize their risk of litigation when caring for patients. Published by Elsevier Inc.

Basics of elder law and legal liabilities of negligence and malpractice for physicians as they apply to individuals with disabilities.

Science.gov (United States)

Ullman, David; Zuller, Michael E

2005-02-01

This article provides information regarding the issues that physicians face when dealing with elderly patients with cognitive deficits. It includes a discussion of basic legal terms and concepts that medical personnel should understand, various difficulties encountered by patients and families in crisis situations, and how the legal system deals with these issues. It concludes with a general discussion of the legal liabilities of negligence and malpractice.

Delayed Detection of Esophageal Intubation in Anesthesia Malpractice Claims: Brief Report of a Case Series.

Science.gov (United States)

Honardar, Marzieh R; Posner, Karen L; Domino, Karen B

2017-12-01

This retrospective case series analyzed 45 malpractice claims for delayed detection of esophageal intubation from the Anesthesia Closed Claims Project. Inclusion criteria were cases from 1995 to 2013, after adoption of identification of CO2 in expired gas to verify correct endotracheal tube position as a monitoring standard by the American Society of Anesthesiologists. Forty-nine percent (95% confidence interval 34%-64%) occurred in the operating room or other anesthesia location where CO2 detection equipment should have been available. The most common factors contributing to delayed detection were not using, ignoring, or misinterpreting CO2 readings. Misdiagnosis, as with bronchospasm, occurred in 33% (95% confidence interval 20%).

Court decisions on medical malpractice.

Science.gov (United States)

Knaak, Jan-Paul; Parzeller, Markus

2014-11-01

Recent studies on court cases dealing with medical malpractice are few and far between. This retrospective study, therefore, undertakes an analysis of medical malpractice lawsuits brought before regional courts in two judicial districts of the federal state of Hesse. Over a 5-year period (2006-2010), 232 court decisions on medical malpractice taken by the regional courts (Landgericht) of Kassel and Marburg were evaluated according to medical discipline, diagnosis, therapy, relevant level of care, charge of neglect of duty by the claimant party, outcome of the lawsuit, and further criteria. With certain overlaps, the disciplines most frequently confronted with claims of medical malpractice were accident surgery and orthopedics (30.2%; n = 70), dentistry (16.4%; n = 38), surgery (12.1%; n = 28), and gynecology and obstetrics (7.8%; n = 18), followed by the remaining medical disciplines (38.8%; n = 90). Malpractice allegations were brought against the practice-based sector in 35.8 % (n = 83) of cases, the hospital-based sector in 63.3% (n = 147) of cases, and other sectors in 0.9% (n = 2) of cases. The allegation grounds included false administration of treatment (67.2%; n = 156), false indication of treatment (37.1%; n = 86), false diagnosis (31.5%; n = 73), and/or organizational negligence (13.8%; n = 32). A breach of duty to inform was given as grounds for the claim in 38.8% (n = 90) of cases. A significant majority of 65.6% (n = 152) of cases ended in a court settlement. Of the cases, 18.9% (n = 44) were concluded by claim withdrawal, 11.2% (n = 26) by claim dismissal and 2.6% (n = 6) by criminal sentence. Of the cases, 1.7% (n = 4) were for purposes of securing evidence. Although there was no conclusive evidence of malpractice, two thirds of the cases ended in a court settlement. On the one hand, this outcome reduces the burden on the courts, but on the other, it can in the long term give

Managing examination malpractice in Nigerian University system ...

African Journals Online (AJOL)

Examination malpractice is as old as examination itself. However, the rate at which examination malpractices occurs in the Nigerian educational system is highly disturbing. The challenge therefore needs prompt attention. The phenomenon which has both moral and legal dimensions is considered as a hydra-headed ...

Legal liability and claims for the hotel industry

OpenAIRE

Dimcho Todorov

2017-01-01

The paper presents a review of various aspects of legal liability and claims to hotel management arising in the hotel industry in the context of the legal framework and possible legal consequences for hotels and other types of commercial accommodation establishments. The main reasons for accidents' occurrence in the hotel industry are chronologically traced. Possible claims to the hotel management are also presented in detail. The problem with workplace discrimination, which is considered as ...

Medical malpractice in endourology: analysis of closed cases from the State of New York.

Science.gov (United States)

Duty, Brian; Okhunov, Zhamshid; Okeke, Zeph; Smith, Arthur

2012-02-01

Medical malpractice indemnity payments continue to rise, resulting in increased insurance premiums. We reviewed closed malpractice claims pertaining to endourological procedures with the goal of helping urologists mitigate their risk of lawsuit. All closed malpractice claims from 2005 to 2010 pertaining to endourological procedures filed against urologists insured by the Medical Liability Mutual Insurance Company of New York were examined. Claims were reviewed for plaintiff demographics, medical history, operative details, alleged complication, clinical outcome and lawsuit disposition. A total of 25 closed claims involved endourological operations and of these cases 10 were closed with an indemnity payment. The average payout was $346,722 (range $25,000 to $995,000). Of the plaintiffs 16 were women and mean plaintiff age was 51.4 years. Cystoscopy with ureteral stent placement/exchange resulted in 13 lawsuits, ureteroscopic lithotripsy 8, percutaneous stone extraction 2 and shock wave lithotripsy 2. There were 17 malpractice suits brought for alleged operative complications. Failure to arrange adequate followup was implicated in 4 cases. Error in diagnosis and delay in treatment was alleged in 3 claims. Urologists are not immune to the current medical malpractice crisis. Endourology and urological oncology generate the greatest number of lawsuits against urologists. Most malpractice claims involving endourological procedures result from urolithiasis and alleged technical errors. Therefore, careful attention to surgical technique is essential during stone procedures to reduce the risk of malpractice litigation. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Malpractice paid losses and financial performance of nursing homes.

Science.gov (United States)

Zhao, Mei; Haley, D Rob; Oetjen, Reid M; Carretta, Henry J

2011-01-01

Florida's nursing home industry has experienced significant financial pressure over the past decade. One of the primary reasons is the dramatic increase in litigation activity for nursing home providers claiming negligent care and abuse. Although anecdotal reports indicate a higher cost because of malpractice in nursing facilities, few studies have examined the extent of malpractice paid losses and their effect on the financial performance of nursing homes. The purpose of this study was to examine the impact of malpractice paid losses on the financial performance of nursing homes. Medicare Cost Report data and Online Survey, Certification, and Reporting data for Florida skilled nursing facilities over the 6-year period from 2001 to 2006 were used to calculate the malpractice paid losses and the financial performance indicators as well as the nursing home organizational and market factors. Descriptive analysis and multivariate regression analysis were used to examine the effect of paid loss on financial performance. The paid loss for malpractice claims was strongly associated with financial performance. Nursing facilities with malpractice paid losses had consistently lower total margins over the study period. The threat of nursing home litigation may create an incentive for nursing homes to improve quality of care; however, large paid claims can also force nursing homes into a financial situation where the organization no longer has the resources to improve quality. Nursing home managers must assess their malpractice litigation risk and identify tactics to mitigate these risks to better provide a safe and secure environment for the older persons. In addition, this research offers support for local, state, and federal policymakers to revisit the issue of malpractice litigation and the nursing home industry through its insight on the relationship of nursing home margins and litigation.

Medico-legal claims against English radiologists: 1995-2006.

Science.gov (United States)

Halpin, S F S

2009-12-01

A list of claims against radiologists from 1995-2006 was obtained from the NHS Litigation Authority. It shows a total of 440 claims. The largest number of claims (199) related to delayed or missed diagnoses of cancer, and 73 claims related to breast radiology. There is a trend for a mild increase in the number of claims each year. 30 claims were made after a false-positive diagnosis of cancer. Just under pound8.5 million has so far been paid in damages, with a further pound5 million in legal fees. A claim for multiple missed diagnoses of breast cancer led to a pay-out of pound464 000 ( pound673 000 after legal fees); the largest sum awarded following a delay in the diagnosis of an individual cancer was pound300 000. The subtle legal distinction between error and negligence is reviewed here. The reason why breast radiologists are more likely to be sued than any other type of British radiologist is also discussed, along with the implications for UK radiological practice, particularly in light of the recent Chief Medical Officer's report on revalidation. A method is proposed that may protect radiologists from allegations of clinical negligence in the future.

A sense of self-suspicion: global legal pluralism and the claim to legal authority

Directory of Open Access Journals (Sweden)

Mariano Croce

2015-03-01

Full Text Available Legal pluralism has become common currency in many contemporary debates on law and globalization. Its main claim is that a form of global legal pluralism represents both the most accurate description of law in times of globalization and the best normative option. On the descriptive level, global legal pluralism is considered more reliable than state-based accounts. On the normative level, global legal pluralism is understood as a possibility to open up the legal realm to previously unheard voices. This article assesses these claims against the background of classic legal-pluralist scholarship. After reconstructing the emergence of global legal pluralism and then examining its epistemic and normative versions, the last two sections identify the shortcoming of this approach by underlining the absence of what the authors call ‘a sense of self-suspicion’ in drawing the map of legalities in the global sphere. The main argument put forward is that global legal pluralism is oblivious of a few key insights offered by the founding fathers of classic legal pluralism.

Medico-legal claims against English radiologists: 1995–2006

Science.gov (United States)

Halpin, S F S

2009-01-01

A list of claims against radiologists from 1995–2006 was obtained from the NHS Litigation Authority. It shows a total of 440 claims. The largest number of claims (199) related to delayed or missed diagnoses of cancer, and 73 claims related to breast radiology. There is a trend for a mild increase in the number of claims each year. 30 claims were made after a false-positive diagnosis of cancer. Just under £8.5 million has so far been paid in damages, with a further £5 million in legal fees. A claim for multiple missed diagnoses of breast cancer led to a pay-out of £464 000 (£673 000 after legal fees); the largest sum awarded following a delay in the diagnosis of an individual cancer was £300 000. The subtle legal distinction between error and negligence is reviewed here. The reason why breast radiologists are more likely to be sued than any other type of British radiologist is also discussed, along with the implications for UK radiological practice, particularly in light of the recent Chief Medical Officer's report on revalidation. A method is proposed that may protect radiologists from allegations of clinical negligence in the future. PMID:19470570

Review of Medical Malpractice Issues in Malaysia under Tort Litigation System

Science.gov (United States)

Hambali, Siti Naaishah; Khodapanahandeh, Solmaz

2014-01-01

Medical malpractice cases are a matter of much concern in many countries including Malaysia where several cases caught the attention of the public and authorities. Although comprehensive annual statistics on medical negligence claims are not available in Malaysia since such data are not collected systematically in this country there are indications of an upward trend. Medical malpractice cases have been publicized by the media, academic researchers and in government annual reports prompting government policy makers, oversight agencies and the medical profession itself to take appropriate action. The increasing dissatisfaction with the current tort litigation system requires exploring alternatives and new approaches for handling medical malpractice cases. This study aims to examine the difficulties inherent in the tort system in Malaysia for solving medical malpractice claims and evaluates the structure of this system from the perspective of effectiveness, fairness, compensation, accessibility, and accountability. PMID:24999124

Characteristics of claims in the management of septic arthritis in Japan: Retrospective analyses of judicial precedents and closed claims.

Science.gov (United States)

Otaki, Yasuhiro; DaSilva, Makiko Ishida; Saito, Yuichi; Oyama, Yasuaki; Oiso, Giichiro; Yoshida, Tomohiko; Fukuhara, Masakazu; Moriyama, Mitsuru

2018-03-01

Septic arthritis (SA) cases can result in claims or litigation because of poor prognosis even if it is unavoidable. Although these claims or litigation are useful for understanding causes and background factors of medical errors, the characteristics of malpractice claims associated with SA remain undetermined in Japan. This study aimed to increase our understanding of malpractice claims in the clinical management of SA. We analyzed 6 civil precedents and 16 closed claims of SA from 8530 malpractice claims processed between July 2004 and June 2014 by the Tokyo office of Sompo Japan Nipponkoa Insurance, Incorporated. We also studied 5 accident and 21 incident reports of SA based on project data compiled by the Japan Council for Quality Health Care. The rate of negligence was 83.3% in the precedents and 75.0% in closed claims. Two main malpractice claim patterns were revealed: SA in a lower extremity joint following sepsis caused by methicillin-resistant Staphylococcus aureus in newborns and SA in an injection site following joint injection. These two patterns accounted for 83.3% and 56.3% of judicial cases and closed claim cases, respectively. Breakdowns in care process of accident and incident reports were clearly differentiated from judicial cases or closed claim cases (Fisher's exact test, p < 0.001). It is important to pay particular attention to SA following sepsis in newborns and to monitor for any signs of SA after joint injection to ensure early diagnosis. Analysis of both malpractice claims and accident and incident reports is essential to ensure a full understanding of the situation in Japan. Copyright © 2017. Published by Elsevier Taiwan LLC.

A review of medical malpractice issues in Malaysia under tort litigation system.

Science.gov (United States)

Hambali, Siti Naaishah; Khodapanahandeh, Solmaz

2014-04-07

Medical malpractice cases are a matter of much concern in many countries including Malaysia where several cases caught the attention of the public and authorities. Although comprehensive annual statistics on medical negligence claims are not available in Malaysia since such data are not collected systematically in this country there are indications of an upward trend. Medical malpractice cases have been publicized by the media, academic researchers and in government annual reports prompting government policy makers, oversight agencies and the medical profession itself to take appropriate action. The increasing dissatisfaction with the current tort litigation system requires exploring alternatives and new approaches for handling medical malpractice cases. This study aims to examine the difficulties inherent in the tort system in Malaysia for solving medical malpractice claims and evaluates the structure of this system from the perspective of effectiveness, fairness, compensation, accessibility, and accountability.

Malpractice awareness among surgeons at a teaching hospital in Pakistan

Directory of Open Access Journals (Sweden)

Sheikh Asfandyar

2012-11-01

to disclose their error to the patient. The most common perceived reason for not disclosing the error was threat of a claim or assault (90.9%. Majority (68.3% believed that malpractice had a negative effect on reputation. Only 13(4.1% had received at least one legal claim for damages. Only about three-fourths (75.5% had the habit of frequently obtaining informed consent from the patients. 83(26.0% expressed reluctance in accepting a case that was deemed to be difficult. Financial gains and liabilities were responsible for biased approach in 8.5% and 12.2% of the respondents respectively. Conclusion There is a dire need of programs aimed at increasing awareness among practicing surgeons in our setup. Proactive measures are required for the formulation of an efficient system of litigation. Physician accountability will not only arouse a greater sense of responsibility in them, but will also augment the confidence placed by patients on the healthcare system.

Malpractice awareness among surgeons at a teaching hospital in Pakistan.

Science.gov (United States)

Sheikh, Asfandyar; Ali, Sajid; Ejaz, Sadaf; Farooqi, Marium; Ahmed, Syed Salman; Jawaid, Imran

2012-11-06

common perceived reason for not disclosing the error was threat of a claim or assault (90.9%). Majority (68.3%) believed that malpractice had a negative effect on reputation. Only 13(4.1%) had received at least one legal claim for damages. Only about three-fourths (75.5%) had the habit of frequently obtaining informed consent from the patients. 83(26.0%) expressed reluctance in accepting a case that was deemed to be difficult. Financial gains and liabilities were responsible for biased approach in 8.5% and 12.2% of the respondents respectively. There is a dire need of programs aimed at increasing awareness among practicing surgeons in our setup. Proactive measures are required for the formulation of an efficient system of litigation. Physician accountability will not only arouse a greater sense of responsibility in them, but will also augment the confidence placed by patients on the healthcare system.

Malpractice awareness among surgeons at a teaching hospital in Pakistan

Science.gov (United States)

2012-01-01

to the patient. The most common perceived reason for not disclosing the error was threat of a claim or assault (90.9%). Majority (68.3%) believed that malpractice had a negative effect on reputation. Only 13(4.1%) had received at least one legal claim for damages. Only about three-fourths (75.5%) had the habit of frequently obtaining informed consent from the patients. 83(26.0%) expressed reluctance in accepting a case that was deemed to be difficult. Financial gains and liabilities were responsible for biased approach in 8.5% and 12.2% of the respondents respectively. Conclusion There is a dire need of programs aimed at increasing awareness among practicing surgeons in our setup. Proactive measures are required for the formulation of an efficient system of litigation. Physician accountability will not only arouse a greater sense of responsibility in them, but will also augment the confidence placed by patients on the healthcare system. PMID:23126456

Educational Malpractice in Britain.

Science.gov (United States)

Khan, Anwar

1996-01-01

The English Court of Appeal found it difficult to establish standards of teachers' duty of care to establish the new tort of educational malpractice. However, the Court recently decided that claims based in negligence and alleging a failure on the part of teachers to identify and respond to the needs of certain learning-disabled students were not…

Association Between State Medical Malpractice Environment and Postoperative Outcomes in the United States.

Science.gov (United States)

Minami, Christina A; Sheils, Catherine R; Pavey, Emily; Chung, Jeanette W; Stulberg, Jonah J; Odell, David D; Yang, Anthony D; Bentrem, David J; Bilimoria, Karl Y

2017-03-01

The US medical malpractice system assumes that the threat of liability should deter negligence, but it is unclear whether malpractice environment affects health care quality. We sought to explore the association between state malpractice environment and postoperative complication rates. This observational study included Medicare fee-for-service beneficiaries undergoing one of the following operations in 2010: colorectal, lung, esophageal, or pancreatic resection, total knee arthroplasty, craniotomy, gastric bypass, abdominal aortic aneurysm repair, coronary artery bypass grafting, or cystectomy. The state-specific malpractice environment was measured by 2010 medical malpractice insurance premiums, state average award size, paid malpractice claims/100 physicians, and a composite malpractice measure. Outcomes of interest included 30-day readmission, mortality, and postoperative complications (eg sepsis, myocardial infarction [MI], pneumonia). Using Medicare administrative claims data, associations between malpractice environment and postoperative outcomes were estimated using hierarchical logistic regression models with hospital random-intercepts. Measures of malpractice environment did not have significant, consistent associations with postoperative outcomes. No individual tort reform law was consistently associated with improved postoperative outcomes. Higher-risk state malpractice environment, based on the composite measure, was associated with higher likelihood of sepsis (odds ratio [OR] 1.22; 95% CI 1.07 to 1.39), MI (OR 1.14; 95% CI 1.06 to 1.23), pneumonia (OR 1.09; 95% CI 1.03 to 1.16), acute renal failure (OR 1.15; 95% CI 1.08 to 1.22), deep vein thrombosis/pulmonary embolism (OR 1.22; 95% CI 1.13 to 1.32), and gastrointestinal bleed (OR 1.18; 95% CI 1.08 to 1.30). Higher risk malpractice environments were not consistently associated with a lower likelihood of surgical postoperative complications, bringing into question the ability of malpractice lawsuits to

Do Insurers Have to Pay for Bad Behaviour in Settling Claims? Legal Aspects of Insurers' Wrongful Claims Handling

OpenAIRE

Boom, Willem

2011-01-01

textabstractAbstract: This article presents a comparative legal analysis of wrongful claims handling by insurance companies in indemnity and liability insurance. From the outset, it is clear that it may be difficult to draw the line between legitimate claims denial and refusal to pay, on the one hand, and malicious protraction, procrastination and rejection of valid claims, on the other hand. Therefore, it is interesting to find that European legal systems diverge considerably in their stance...

Cleft Lip and Cleft Palate Surgery: Malpractice Litigation Outcomes.

Science.gov (United States)

Justin, Grant A; Brietzke, Scott E

2017-01-01

  This study examined malpractice claims related to cleft lip and cleft palate surgery to identify common allegations and injuries and reviewed financial outcomes.   The WestlawNext legal database was analyzed for all malpractice lawsuits and settlements related to the surgical repair of cleft lip and palate.   Inclusion criteria included patients undergoing surgical repair of a primary cleft lip or palate or revision for complications of previous surgery. Data evaluated included patient demographics, type of operation performed, plaintiff allegation, nature of injury, and litigation outcomes.   A total of 36 cases were identified, with 12 unique cases from 1981 to 2006 meeting the inclusion criteria. Six cases (50%) were decided by a jury and six by settlement. Five cases involved complications related to the specific surgery, and the other seven were associated with any surgery and perioperative care of children and adults. Cleft palate repair (50%) was the most frequently litigated surgery. Postoperative negligent supervision was the most common allegation (42%) and resulted in a payout in each case (mean = $3,126,032). Death (42%) and brain injury (25%) were the most frequent injuries reported. Financial awards were made in nine cases (after adjusting for inflation, mean = $2,470,552, range = $0 to $7,704,585). The awards were significantly larger for brain injury than other outcomes ($4,675,395 versus $1,368,131 after adjusting for inflation, P = .0101).   Malpractice litigation regarding cleft lip and palate surgery is uncommon. However, significant financial awards involving perioperative brain injury have been reported.

Legal assumptions for private company claim for additional (supplementary payment

Directory of Open Access Journals (Sweden)

Šogorov Stevan

2011-01-01

Full Text Available Subject matter of analyze in this article are legal assumptions which must be met in order to enable private company to call for additional payment. After introductory remarks discussion is focused on existence of provisions regarding additional payment in formation contract, or in shareholders meeting general resolution, as starting point for company's claim. Second assumption is concrete resolution of shareholders meeting which creates individual obligations for additional payments. Third assumption is defined as distinctness regarding sum of payment and due date. Sending of claim by relevant company body is set as fourth legal assumption for realization of company's right to claim additional payments from member of private company.

A study on the civil liability of radiological technologist in medical malpractice

International Nuclear Information System (INIS)

Lim, Chang Seon

1995-01-01

Recently the suits for medical malpractice are gradually increasing in this country. The main purpose of this study is to excavate the most suitable theories about civil liabilities on medical malpractice by radiological technologist. To solve the above-mentioned problems in medical malpractice, I have proceeded to make a survey of traditional theories and tried to excavate the most suitable theories for our medical circumstances among those theories. Both domestic and foreign relevant professional literatures and legal cases were investigated in this study. Several important findings of this study are as follows. First, the nature of legal interrelationship between radiological technologist and physician(or the representative of a hospital) is to define the content of employment. But in the eye of medical law, the interrelationship between radiological technologist and physician is written that radiological technologist should be directed by physician. Second, the nature of legal interrelationship between patient and physician(or the representative of a hospital) is to define the content of legal obligation of physician(or the representative of a hospital), and radiological technologist execute his obligation as proxy for physician. Therefore, patient can not clame any legal right to radiological technologist. Third, radiological technologist has the obligation of Due Care in medical practice. Fourth, on the medical malpractice by radiological technologist the civil liability can be treated as either tortious liability or contractual liability, and physician (or the representative of hospital) take the responsibility for the damage compensation. In this case, physician has the right of indemnity to radiological technologist. But it should be dinied or extremely limited

Legal liability and claims for the hotel industry

Directory of Open Access Journals (Sweden)

Dimcho Todorov

2017-10-01

Full Text Available The paper presents a review of various aspects of legal liability and claims to hotel management arising in the hotel industry in the context of the legal framework and possible legal consequences for hotels and other types of commercial accommodation establishments. The main reasons for accidents' occurrence in the hotel industry are chronologically traced. Possible claims to the hotel management are also presented in detail. The problem with workplace discrimination, which is considered as unrightfully actions from administration towards hospitably industry personnel and the connected consequences, is discussed. A definition is given of the various forms of discrimination and the obligations of management to provide a healthy work environment without problems for the personnel are stated, as well. Regulative measures and documents are also presented, regarding measures following possible labour law violations. Conclusions and recommendations are formulated and ways to prevent and overcome problems and accidents in various accommodation establishments and the hotel industry as a whole are shown

Surgical malpractice in California: res judicata.

Science.gov (United States)

Barthel, Erik R; Stabile, Bruce E; Plurad, David; Kim, Dennis; Neville, Angela; Bricker, Scott; Putnam, Brant; Bongard, Fred

2014-10-01

Medical negligence claims are of increasing concern to surgeons. Although noneconomic damage awards in California are limited by the Medical Injury Compensation Reform Act (MICRA) law to $250,000, the total amount of such settlements can increase significantly based on claims for economic damages. We reviewed negligence litigation involving California surgeons to determine outcomes and monetary awards through retrospective review of surgical malpractice cases published in a legal journal. This review was limited to actions involving general surgeons. Such litigation was voluntarily reported by either defense's or plaintiff's counsel at the conclusion of the litigation. Data reviewed included alleged damages incurred by the plaintiff; plaintiff's pretrial settlement demand, plaintiff or defense verdict, use of alternate means of resolution such as arbitration or mediation, and total monetary award to the plaintiff. A total of 69 cases were reported over a 20-month period: 32 (46%) were plaintiffs' verdicts, whereas 37 (54%) were in favor of the surgeon. Only 10 (31%) of the plaintiff verdicts were by jury trial, whereas the rest were settled by pretrial agreement, mediation, or arbitration. Of cases settled by alternate dispute resolution, the median settlement was $820,000 (n = 22) compared with a median jury trial award of $300,000 (n = 10).

Do fears of malpractice litigation influence teaching behaviors?

Science.gov (United States)

Reed, Darcy A; Windish, Donna M; Levine, Rachel B; Kravet, Steven J; Wolfe, Leah; Wright, Scott M

2008-01-01

Medical malpractice is prominently positioned in the consciousness of American physicians, and the perceived threat of malpractice litigation may push physicians to practice defensively and alter their teaching behaviors. The purposes of this study were to characterize the attitudes of academic medical faculty toward malpractice litigation and to identify teaching behaviors associated with fear of malpractice litigation. We surveyed 270 full-time clinically active physicians in the Department of Medicine at a large academic medical center. The survey assessed physicians' attitudes toward malpractice issues, fear of malpractice litigation, and self-reported teaching behaviors associated with concerns about litigation. Two hundred and fifteen physicians responded (80%). Faculty scored an average of 25.5 +/- 6.9 (range = 6-42, higher scores indicate greater fear) on a reliable malpractice fear scale. Younger age (Spearman's rho = 0.19, p = .02) and greater time spent in clinical activities (rho = 0.26, p Fear Scale. Faculty reported that because of the perceived prevalence of lawsuits and claims made against physicians, they spend more time writing clinical notes for patients seen by learners (74%), give learners less autonomy in patient care (44%), and limit opportunities for learners to perform clinical procedures (32%) and deliver bad news to patients (33%). Faculty with higher levels of fear on the Malpractice Fear Scale were more likely to report changing their teaching behaviors because of this perceived threat (rho = 0.38, p < .001). Physicians report changes in teaching behaviors because of concerns about malpractice litigation. Although concerns about malpractice may promote increased supervision and positive role modeling, they may also limit important educational opportunities for learners. These results may serve to heighten awareness to the fact that teaching behaviors and decisions may be influenced by the malpractice climate.

Electronic Health Record-Related Events in Medical Malpractice Claims.

Science.gov (United States)

Graber, Mark L; Siegal, Dana; Riah, Heather; Johnston, Doug; Kenyon, Kathy

2015-11-06

There is widespread agreement that the full potential of health information technology (health IT) has not yet been realized and of particular concern are the examples of unintended consequences of health IT that detract from the safety of health care or from the use of health IT itself. The goal of this project was to obtain additional information on these health IT-related problems, using a mixed methods (qualitative and quantitative) analysis of electronic health record-related harm in cases submitted to a large database of malpractice suits and claims. Cases submitted to the CRICO claims database and coded during 2012 and 2013 were analyzed. A total of 248 cases (<1%) involving health IT were identified and coded using a proprietary taxonomy that identifies user- and system-related sociotechnical factors. Ambulatory care accounted for most of the cases (146 cases). Cases were most typically filed as a result of an error involving medications (31%), diagnosis (28%), or a complication of treatment (31%). More than 80% of cases involved moderate or severe harm, although lethal cases were less likely in cases from ambulatory settings. Etiologic factors spanned all of the sociotechnical dimensions, and many recurring patterns of error were identified. Adverse events associated with health IT vulnerabilities can cause extensive harm and are encountered across the continuum of health care settings and sociotechnical factors. The recurring patterns provide valuable lessons that both practicing clinicians and health IT developers could use to reduce the risk of harm in the future. The likelihood of harm seems to relate more to a patient's particular situation than to any one class of error.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share thework provided it is properly cited. The work cannot be changed in any way or used

Sovereign immunity: Principles and application in medical malpractice.

Science.gov (United States)

Suk, Michael

2012-05-01

Tort law seeks accountability when parties engage in negligent conduct, and aims to compensate the victims of such conduct. An exception to this general rule governing medical negligence is the doctrine of sovereign immunity. Historically, individuals acting under the authority of the government or other sovereign entity had almost complete protection against tort liability. This article addressed the following: (1) the development of sovereign immunity in law, (2) the lasting impact of the Federal Tort Claims Act on sovereign immunity, and (3) the contemporary application of sovereign immunity to medical malpractice, using case examples from Virginia and Florida. I performed an Internet search to identify sources that addressed the concept of sovereign immunity, followed by a focused search for relevant articles in PubMed and LexisNexis, literature databases for medical and legal professionals, respectively. Historically, sovereign liability conferred absolute immunity from lawsuits in favor of the sovereign (ie, the government). Practical considerations in our democratic system have contributed to an evolution of this doctrine. Understanding sovereign immunity and its contemporary application are of value for any physician interested in the debate concerning medical malpractice in the United States. Under certain circumstances, physicians working as employees of the federal or state government may be protected against individual liability if the government is substituted as the defendant.

Educational Malpractice: Why the Courts Say No.

Science.gov (United States)

Hammes, Richard

1989-01-01

The courts have refused to award damages to litigants claiming educational malpractice. This article discusses recurring themes in the courts' rationale for their decisions. Discussion focuses on elements of negligence: the duty of care, the breach of duty, injury and proximate cause. (IAH)

Online E-cigarette Marketing Claims: A Systematic Content and Legal Analysis.

Science.gov (United States)

Klein, Elizabeth G; Berman, Micah; Hemmerich, Natalie; Carlson, Cristen; Htut, SuSandi; Slater, Michael

2016-07-01

Electronic nicotine delivery systems (ENDS), or e-cigarettes, are heavily marketed online. The purpose of our study was to perform a systematic identification and evaluation of claims made within ENDS retailer and manufacturer websites, and the legal status of such claims. We employed a systematic search protocol with popular search engines using 6 terms: (1) e-cigarettes; (2) e-cigs; (3) e-juice; (4) e-liquid; (5) e-hookah; and (6) vape pen. We analyzed English-language websites where ENDS are sold for implicit and explicit health-related claims. A legal analysis determined whether such claims are permissible under the US Food and Drug Administration's regulations. The vast majority of ENDS manufacturer (N = 78) and retailer (N = 32) websites made at least one health-related claim (77% and 65%, respectively). Modified risk claims and secondhand smoke-related claims were most prevalent, with an average of 2 claims per site. Health-related claims are plentiful within ENDS manufacturer and retailer websites. Results demonstrate that these sites focus on potential benefits while minimizing or eliminating information about possible harmful effects of ENDS. These claims are subject to the current regulatory authority by the FDA, and pose a risk of misinforming consumers.

The causes of medical malpractice suits against radiologists in the United States.

Science.gov (United States)

Whang, Jeremy S; Baker, Stephen R; Patel, Ronak; Luk, Lyndon; Castro, Alejandro

2013-02-01

To determine the most frequent causes of malpractice suits as derived from credentialing data of 8401 radiologists. This study was approved by the Institutional Review Board of New Jersey Medical School. A total of 8401 radiologists in 47 states participating in the network of One-Call Medical, a broker for computed tomographic/magnetic resonance studies in workers' compensation cases, were required to provide their malpractice history as part of their credentialing application. Of these, 2624 (31%) radiologists had at least one claim in their career. In each enrollee's credentialing file, if there was a claim against the enrollee there was a narrative regarding each malpractice case from which, in most instances, a primary allegation could be discerned. Among the 4793 cases, an alleged cause could be derived from the narrative in 4043 (84%). Statistical analysis was performed with Stata 12 (2011; Stata, College Station, Tex) software. The most common general cause was error in diagnosis (14.83 claims per 1000 person-years [95% confidence interval {CI}: 14.19, 15.51]). In this category, breast cancer was the most frequently missed diagnosis (3.57 claims per 1000 person-years [95% CI: 3.26, 3.91]), followed by nonspinal fractures (2.49 claims per 1000 person-years [95% CI: 2.28, 2.72]), spinal fractures (1.32 claims per 1000 person-years [95% CI: 1.16, 1.49]), lung cancer (1.26 claims per 1000 person-years [95% CI: 1.11, 1.42]), and vascular disease (1.08 claims per 1000 person-years [95% CI: 0.93, 1.24]). The category next in frequency was procedural complications (1.76 claims per 1000 person-years [95% CI: 1.58, 1.96]), followed by inadequate communication with either patient (0.40 claim per 1000 person-years [95% CI: 0.32, 0.50]) or referrer (0.71 claim per 1000 person-years [95% CI: 0.60, 0.84]). Radiologists had only a peripheral role in 0.92 claim per 1000 person-years (95% CI: 0.77, 1.10). Failure to recommend additional testing was a rare cause (0.41 claim

Malpractice liability and defensive medicine: a national survey of neurosurgeons.

Directory of Open Access Journals (Sweden)

Brian V Nahed

Full Text Available BACKGROUND: Concern over rising healthcare expenditures has led to increased scrutiny of medical practices. As medical liability and malpractice risk rise to crisis levels, the medical-legal environment has contributed to the practice of defensive medicine as practitioners attempt to mitigate liability risk. High-risk specialties, such as neurosurgery, are particularly affected and neurosurgeons have altered their practices to lessen medical-legal risk. We present the first national survey of American neurosurgeons' perceptions of malpractice liability and defensive medicine practices. METHODS: A validated, 51-question online-survey was sent to 3344 practicing U.S. neurosurgeon members of the American Association of Neurological Surgeons, which represents 76% of neurosurgeons in academic and private practices. RESULTS: A total of 1028 surveys were completed (31% response rate by neurosurgeons representing diverse sub-specialty practices. Respondents engaged in defensive medicine practices by ordering additional imaging studies (72%, laboratory tests (67%, referring patients to consultants (66%, or prescribing medications (40%. Malpractice premiums were considered a "major or extreme" burden by 64% of respondents which resulted in 45% of respondents eliminating high-risk procedures from their practice due to liability concerns. CONCLUSIONS: Concerns and perceptions about medical liability lead practitioners to practice defensive medicine. As a result, diagnostic testing, consultations and imaging studies are ordered to satisfy a perceived legal risk, resulting in higher healthcare expenditures. To minimize malpractice risk, some neurosurgeons have eliminated high-risk procedures. Left unchecked, concerns over medical liability will further defensive medicine practices, limit patient access to care, and increase the cost of healthcare delivery in the United States.

Malpractice liability and defensive medicine: a national survey of neurosurgeons.

Science.gov (United States)

Nahed, Brian V; Babu, Maya A; Smith, Timothy R; Heary, Robert F

2012-01-01

Concern over rising healthcare expenditures has led to increased scrutiny of medical practices. As medical liability and malpractice risk rise to crisis levels, the medical-legal environment has contributed to the practice of defensive medicine as practitioners attempt to mitigate liability risk. High-risk specialties, such as neurosurgery, are particularly affected and neurosurgeons have altered their practices to lessen medical-legal risk. We present the first national survey of American neurosurgeons' perceptions of malpractice liability and defensive medicine practices. A validated, 51-question online-survey was sent to 3344 practicing U.S. neurosurgeon members of the American Association of Neurological Surgeons, which represents 76% of neurosurgeons in academic and private practices. A total of 1028 surveys were completed (31% response rate) by neurosurgeons representing diverse sub-specialty practices. Respondents engaged in defensive medicine practices by ordering additional imaging studies (72%), laboratory tests (67%), referring patients to consultants (66%), or prescribing medications (40%). Malpractice premiums were considered a "major or extreme" burden by 64% of respondents which resulted in 45% of respondents eliminating high-risk procedures from their practice due to liability concerns. Concerns and perceptions about medical liability lead practitioners to practice defensive medicine. As a result, diagnostic testing, consultations and imaging studies are ordered to satisfy a perceived legal risk, resulting in higher healthcare expenditures. To minimize malpractice risk, some neurosurgeons have eliminated high-risk procedures. Left unchecked, concerns over medical liability will further defensive medicine practices, limit patient access to care, and increase the cost of healthcare delivery in the United States.

An introduction to medical malpractice in the United States.

Science.gov (United States)

Bal, B Sonny

2009-02-01

Medical malpractice law in the United States is derived from English common law, and was developed by rulings in various state courts. Medical malpractice lawsuits are a relatively common occurrence in the United States. The legal system is designed to encourage extensive discovery and negotiations between adversarial parties with the goal of resolving the dispute without going to jury trial. The injured patient must show that the physician acted negligently in rendering care, and that such negligence resulted in injury. To do so, four legal elements must be proven: (1) a professional duty owed to the patient; (2) breach of such duty; (3) injury caused by the breach; and (4) resulting damages. Money damages, if awarded, typically take into account both actual economic loss and noneconomic loss, such as pain and suffering.

Malpractice suits in chest radiology: an evaluation of the histories of 8265 radiologists.

Science.gov (United States)

Baker, Stephen R; Patel, Ronak H; Yang, Lily; Lelkes, Valdis M; Castro, Alejandro

2013-11-01

The aim of this study was to present rates of claims, causes of error, percentage of cases resulting in a judgment, and average payments made by radiologists in chest-related malpractice cases in a survey of 8265 radiologists. The malpractice histories of 8265 radiologists were evaluated from the credentialing files of One-Call Medical Inc., a preferred provider organization for computed tomography/magnetic resonance imaging in workers' compensation cases. Of the 8265 radiologists, 2680 (32.4%) had at least 1 malpractice suit. Of those who were sued, the rate of claims was 55.1 per 1000 person years. The rate of thorax-related suits was 6.6 claims per 1000 radiology practice years (95% confidence interval, 6.0-7.2). There were 496 suits encompassing 48 different causes. Errors in diagnosis comprised 78.0% of the causes. Failure to diagnose lung cancer was by far the most frequent diagnostic error, representing 211 cases or 42.5%. Of the 496 cases, an outcome was known in 417. Sixty-one percent of these were settled in favor of the plaintiff, with a mean payment of $277,230 (95% confidence interval, 226,967-338,614). Errors in diagnosis, and among them failure to diagnose lung cancer, were by far the most common reasons for initiating a malpractice suit against radiologists related to the thorax and its contents.

The concept of error and malpractice in radiology.

Science.gov (United States)

Pinto, Antonio; Brunese, Luca; Pinto, Fabio; Reali, Riccardo; Daniele, Stefania; Romano, Luigia

2012-08-01

Since the early 1970s, physicians have been subjected to an increasing number of medical malpractice claims. Radiology is one of the specialties most liable to claims of medical negligence. The etiology of radiological error is multifactorial. Errors fall into recurrent patterns. Errors arise from poor technique, failures of perception, lack of knowledge, and misjudgments. Every radiologist should understand the sources of error in diagnostic radiology as well as the elements of negligence that form the basis of malpractice litigation. Errors are an inevitable part of human life, and every health professional has made mistakes. To improve patient safety and reduce the risk from harm, we must accept that some errors are inevitable during the delivery of health care. We must play a cultural change in medicine, wherein errors are actively sought, openly discussed, and aggressively addressed. Copyright © 2012 Elsevier Inc. All rights reserved.

The Practice of Cranial Neurosurgery and the Malpractice Liability Environment in the United States

Science.gov (United States)

Wong, Kendrew; MacKenzie, Todd A.

2015-01-01

Object The potential imbalance between malpractice liability cost and quality of care has been an issue of debate. We investigated the association of malpractice liability with unfavorable outcomes and increased hospitalization charges in cranial neurosurgery. Methods We performed a retrospective cohort study involving patients who underwent cranial neurosurgical procedures from 2005-2010, and were registered in the National Inpatient Sample (NIS) database. We used data from the National Practitioner Data Bank (NPDB) from 2005 to 2010 to create measures of volume and size of malpractice claim payments. The association of the latter with the state-level mortality, length of stay (LOS), unfavorable discharge, and hospitalization charges for cranial neurosurgery was investigated. Results During the study period, there were 189,103 patients (mean age 46.4 years, with 48.3% females) who underwent cranial neurosurgical procedures, and were registered in NIS. In a multivariable regression, higher number of claims per physician in a state was associated with increased ln-transformed hospitalization charges (beta 0.18; 95% CI, 0.17 to 0.19). On the contrary, there was no association with mortality (OR 1.00; 95% CI, 0.94 to 1.06). We observed a small association with unfavorable discharge (OR 1.09; 95% CI, 1.06 to 1.13), and LOS (beta 0.01; 95% CI, 0.002 to 0.03). The size of the awarded claims demonstrated similar relationships. The average claims payment size (ln-transformed) (Pearson’s rho=0.435, P=0.01) demonstrated a positive correlation with the risk-adjusted hospitalization charges but did not demonstrate a correlation with mortality, unfavorable discharge, or LOS. Conclusions In the present national study, aggressive malpractice environment was not correlated with mortality but was associated with higher hospitalization charges after cranial neurosurgery. In view of the association of malpractice with the economics of healthcare, further research on its impact is

Legal action against health claims on foods and beverages marketed to youth.

Science.gov (United States)

Rutkow, Lainie; Vernick, Jon S; Edwards, Danielle M; Rodman, Sarah O; Barry, Colleen L

2015-03-01

The prevalence of obesity among US children raises numerous health concerns. One pathway to reduce childhood obesity is by decreasing energy intake through the ingestion of fewer calories. Yet, food and beverage manufacturers often promote energy-dense items for children via varied health claims. Deceptive health claims are prohibited, and may be addressed through litigation or governmental regulatory efforts. While the amount of legal action against these potentially deceptive claims has increased, no comprehensive assessment has been conducted. This article, which analyzes litigation and governmental regulatory activities, considers key factors that may influence decisions to take legal action against potentially deceptive health claims on foods and beverages, including scientific support, forum selection, selection of plaintiffs, and potential public health impact.

Legal issues of computer imaging in plastic surgery: a primer.

Science.gov (United States)

Chávez, A E; Dagum, P; Koch, R J; Newman, J P

1997-11-01

Although plastic surgeons are increasingly incorporating computer imaging techniques into their practices, many fear the possibility of legally binding themselves to achieve surgical results identical to those reflected in computer images. Computer imaging allows surgeons to manipulate digital photographs of patients to project possible surgical outcomes. Some of the many benefits imaging techniques pose include improving doctor-patient communication, facilitating the education and training of residents, and reducing administrative and storage costs. Despite the many advantages computer imaging systems offer, however, surgeons understandably worry that imaging systems expose them to immense legal liability. The possible exploitation of computer imaging by novice surgeons as a marketing tool, coupled with the lack of consensus regarding the treatment of computer images, adds to the concern of surgeons. A careful analysis of the law, however, reveals that surgeons who use computer imaging carefully and conservatively, and adopt a few simple precautions, substantially reduce their vulnerability to legal claims. In particular, surgeons face possible claims of implied contract, failure to instruct, and malpractice from their use or failure to use computer imaging. Nevertheless, legal and practical obstacles frustrate each of those causes of actions. Moreover, surgeons who incorporate a few simple safeguards into their practice may further reduce their legal susceptibility.

Do Insurers Have to Pay for Bad Behaviour in Settling Claims? Legal Aspects of Insurers' Wrongful Claims Handling

NARCIS (Netherlands)

W.H. van Boom (Willem)

2011-01-01

textabstractAbstract: This article presents a comparative legal analysis of wrongful claims handling by insurance companies in indemnity and liability insurance. From the outset, it is clear that it may be difficult to draw the line between legitimate claims denial and refusal to pay, on the one

Medical error, malpractice and complications: a moral geography.

Science.gov (United States)

Zientek, David M

2010-06-01

This essay reviews and defines avoidable medical error, malpractice and complication. The relevant ethical principles pertaining to unanticipated medical outcomes are identified. In light of these principles I critically review the moral culpability of the agents in each circumstance and the resulting obligations to patients, their families, and the health care system in general. While I touch on some legal implications, a full discussion of legal obligations and liability issues is beyond the scope of this paper.

Closed medical negligence claims can drive patient safety and reduce litigation.

Science.gov (United States)

Pegalis, Steven E; Bal, B Sonny

2012-05-01

Medical liability reform is viewed by many physician groups as a means of reducing medical malpractice litigation and lowering healthcare costs. However, alternative approaches such as closed medical negligence claims data may also achieve these goals. We asked whether information gleaned from closed claims related to medical negligence could promote patient safety and reduce costs related to medical liability. Specifically, we investigated whether physician groups have examined such data to identify error patterns and to then institute specific patient treatment protocols. We searched for medical societies that have systematically examined closed medical negligence claims in their specialty to develop specific standards of physician conduct. We then searched the medical literature for published evidence of the efficacy, if any, related to the patient safety measures thus developed. Anesthesia and obstetric physician societies have successfully targeted costs and related concerns arising from medical malpractice lawsuits by using data from closed claims to develop patient safety and treatment guidelines. In both specialties, after institution of safety measures derived from closed medical negligence claims, the incidence and costs related to medical malpractice decreased and physician satisfaction improved. Tort reform, in the form of legislatively prescribed limits on damages arising from lawsuits, is not the only means of addressing the incidence and costs related to medical malpractice litigation. As the experience of anesthesia and obstetric physicians has demonstrated, safety guidelines derived from analyzing past medical malpractice litigation can achieve the same goals while also promoting patient safety.

Use of Nondisclosure Agreements in Medical Malpractice Settlements by a Large Academic Health Care System.

Science.gov (United States)

Sage, William M; Jablonski, Joseph S; Thomas, Eric J

2015-07-01

Honesty and transparency are essential aspects of health care, including in physicians' and hospitals' responses to medical error. Biases and habits associated with medical malpractice litigation, however, may work at cross-purposes with compassion in clinical care and with efforts to improve patient safety. To determine the frequency of nondisclosure agreements in medical malpractice settlements and the extent to which the restrictions in these agreements seem incompatible with good patient care. We performed a retrospective review of medical malpractice claim files, including settlement agreements, for claims closed before (fiscal year 2001-2002), during (fiscal year 2006-2007), and after (fiscal years 2009-2012) the implementation of tort reform in Texas. We studied The University of Texas System, which self-insures malpractice claims that involve 6000 physicians at 6 medical campuses in 5 cities. Nondisclosure provisions in medical malpractice settlements. During the 5 study years, The University of Texas System closed 715 malpractice claims and made 150 settlement payments. For the 124 cases that met our selection criteria, the median compensation paid by the university was $100,000 (range, $500-$1.25 million), and the mean compensation was $185,372. A total of 110 settlement agreements (88.7%) included nondisclosure provisions. All the nondisclosure clauses prohibited disclosure of the settlement terms and amount, 61 (55.5%) prohibited disclosure that the settlement had been reached, 51 (46.4%) prohibited disclosure of the facts of the claim, 29 (26.4%) prohibited reporting to regulatory agencies, and 10 (9.1%) prohibited disclosure by the settling physicians and hospitals, not only by the claimant. Three agreements (2.7%) included specific language that prohibited the claimant from disparaging the physicians or hospitals. The 50 settlement agreements signed after tort reform took full effect in Texas (2009-2012) had stricter nondisclosure provisions than the

The effect of medical malpractice liability on rate of referrals received by specialist physicians.

Science.gov (United States)

Xu, Xiao; Spurr, Stephen J; Nan, Bin; Fendrick, A Mark

2013-10-01

Using nationally representative data from the United States, this paper analyzed the effect of a state’s medical malpractice environment on referral visits received by specialist physicians. The analytic sample included 12,839 ambulatory visits to specialist care doctors in office-based settings in the United States during 2003–2007. Whether the patient was referred for the visit was examined for its association with the state’s malpractice environment, assessed by the frequency and severity of paid medical malpractice claims, medical malpractice insurance premiums and an indicator for whether the state had a cap on non-economic damages. After accounting for potential confounders such as economic or professional incentives within practices, the analysis showed that statutory caps on non-economic damages of $250,000 were significantly associated with lower likelihood of a specialist receiving referrals, suggesting a potential impact of a state’s medical malpractice environment on physicians’ referral behavior.

Effects of health information technology on malpractice insurance premiums.

Science.gov (United States)

Kim, Hye Yeong; Lee, Jinhyung

2015-04-01

The widespread adoption of health information technology (IT) will help contain health care costs by decreasing inefficiencies in healthcare delivery. Theoretically, health IT could lower hospitals' malpractice insurance premiums (MIPs) and improve the quality of care by reducing the number and size of malpractice. This study examines the relationship between health IT investment and MIP using California hospital data from 2006 to 2007. To examine the effect of hospital IT on malpractice insurance expense, a generalized estimating equation (GEE) was employed. It was found that health IT investment was not negatively associated with MIP. Health IT was reported to reduce medical error and improve efficiency. Thus, it may reduce malpractice claims from patients, which will reduce malpractice insurance expenses for hospitals. However, health IT adoption could lead to increases in MIPs. For example, we expect increases in MIPs of about 1.2% and 1.5%, respectively, when health IT and labor increase by 10%. This study examined the effect of health IT investment on MIPs controlling other hospital and market, and volume characteristics. Against our expectation, we found that health IT investment was not negatively associated with MIP. There may be some possible reasons that the real effect of health IT on MIPs was not observed; barriers including communication problems among health ITs, shorter sample period, lower IT investment, and lack of a quality of care measure as a moderating variable.

Changing the Medical Malpractice Dispute Process: What Have We Learned from California's MICRA?

National Research Council Canada - National Science Library

2004-01-01

In 1975, amid growing concern over the price and availability of medical malpractice insurance, California changed the laws that govern how personal injury claims arising from health care treatment...

Evaluating the medical malpractice system and options for reform.

Science.gov (United States)

Kessler, Daniel P

2011-01-01

The U.S. medical malpractice liability system has two principal objectives: to compensate patients who are injured through the negligence of healthcare providers and to deter providers from practicing negligently. In practice, however, the system is slow and costly to administer. It both fails to compensate patients who have suffered from bad medical care and compensates those who haven't. According to opinion surveys of physicians, the system creates incentives to undertake cost-ineffective treatments based on fear of legal liability--to practice "defensive medicine." The failures of the liability system and the high cost of health care in the United States have led to an important debate over tort policy. How well does malpractice law achieve its intended goals? How large of a problem is defensive medicine and can reforms to malpractice law reduce its impact on healthcare spending? The flaws of the existing system have led a number of states to change their laws in a way that would reduce malpractice liability--to adopt "tort reforms." Evidence from several studies suggests that wisely chosen reforms have the potential to reduce healthcare spending significantly with no adverse impact on patient health outcomes.

Proof of Causation in Medical Malpractice Cases in the Czech Republic

Czech Academy of Sciences Publication Activity Database

Doležal, Adam; Doležal, Tomáš

2015-01-01

Roč. 5, č. 3 (2015), s. 195-205 ISSN 1805-8396 R&D Projects: GA ČR GAP408/12/2574 Institutional support: RVO:68378122 Keywords : causation * liability * medical malpractice cases Subject RIV: AG - Legal Sciences

The practice of mediation to resolve clinical, bioethical, and medical malpractice disputes.

Science.gov (United States)

Lee, Danny W H; Lai, Paul B S

2015-12-01

Mediation is a voluntary process whereby a neutral and impartial third party-t-he mediator--is present to facilitate communication and negotiation between the disputing parties so that amicable settlements can be agreed. Being confidential and non-adversarial in nature, the mediation process and skills are particularly applicable in clinical practice to facilitate challenging communications following adverse events, to assist bioethical decision making and to resolve disputes. Mediation is also a more effective and efficient means of dispute resolution in medical malpractice claims when compared with civil litigation. Health care mediation teams should be set up at individual facilities to provide education and consultation services to frontline staff and patients. At a community level, the Government, the mediation community, and the health care professionals should join forces to promote mediation as a means to settle medical malpractice claims outside of the courtroom.

The flaws in state 'apology' and 'disclosure' laws dilute their intended impact on malpractice suits.

Science.gov (United States)

Mastroianni, Anna C; Mello, Michelle M; Sommer, Shannon; Hardy, Mary; Gallagher, Thomas H

2010-09-01

Apologies are rare in the medical world, where health care providers fear that admissions of guilt or expressions of regret could be used by plaintiffs in malpractice lawsuits. Nevertheless, some states are moving toward giving health care providers legal protection so that they feel free to apologize to patients for a medical mistake. Advocates believe that these laws are beneficial for patients and providers. However, our analysis of "apology" and "disclosure" laws in thirty-four states and the District of Columbia finds that most of the laws have major shortcomings. These may actually discourage comprehensive disclosures and apologies and weaken the laws' impact on malpractice suits. Many could be resolved by improved statutory design and communication of new legal requirements and protections.

A guide to medico-legal photography for personal injury claims.

Science.gov (United States)

Bryson, D

1994-01-01

Clinical photographs are in essence medico-legal records but when instructions are given to take photographs for litigation the requirement is for a more specialized approach than when producing a clinical record for the notes. There are special considerations when providing a medico-legal photographic service, from clients' instructions, preparations before photography, and the photography itself to presenting the photographs and handling the administration. As photographs are taken in support of claims for compensation for personal injury many of them can have far greater impact, financially and psychologically, on the client than clinical photographs. Inadequate coverage could be construed as professional negligence.

Controlling Legal Risk for Effective Hospital Management

Directory of Open Access Journals (Sweden)

Hyun Jun Park

2016-04-01

Full Text Available Purpose: To analyze the types of medical malpractice, medical errors, and medical disputes in a university hospital for the proposal of countermeasures that maximize the efficiency of hospital management, medical departments, and healthcare providers. Materials and Methods: This study retrospectively reviewed and analyzed 55 closed civil lawsuits among 64 medical lawsuit cases carried out in Pusan National University Hospital from January 2000 to April 2013 using medical records, petitions, briefs, and data from the Medical Dispute Mediation Committee. Results: Of 55 civil lawsuits, men were the main plaintiffs in 31 cases (56.4%. The average period from medical malpractice to malpractice proceeding was 16.5 months (range, 1 month to 6.4 years, and the average period from malpractice proceeding to the disposition of a lawsuit was 21.7 months (range, 1 month to 4 years and 11 months. Conclusions: Hospitals can effectively manage their legal risks by implementing a systematic medical system, eliminating risk factors in administrative service, educating all hospital employees on preventative strategies, and improving customer service. Furthermore, efforts should be made to establish standard coping strategies to manage medical disputes and malpractice lawsuits, operate alternative dispute resolution methods including the Medical Dispute Mediation Committee, create a compliance support center, deploy a specialized workforce including improved legal services for employees, and specialize the management-level tasks of the hospital.

Refractive Surgery: Malpractice Litigation Outcomes.

Science.gov (United States)

Custer, Benjamin L; Ballard, Steven R; Carroll, Robert B; Barnes, Scott D; Justin, Grant A

2017-10-01

To review data on malpractice claims related to refractive surgery to identify common allegations and injuries and financial outcomes. The WestlawNext database was reviewed for all malpractice lawsuits/settlements related to refractive eye surgery. Data evaluated included patient demographics, type of operation performed, plaintiff allegation, nature of injury, and litigation outcomes. A total of 167 cases met the inclusion criteria, of which 108 cases (64.7%) were found to be favorable and 59 cases (35.3%) unfavorable to the defendant. A total of 141 cases were tried by a jury with 108 cases (76.4%) favorable and 33 cases (23.6%) unfavorable to the defendant. Laser in situ keratomileusis was performed in 127 cases (76%). The most common allegations were negligence in treatment or surgery in 127 cases (76%) and lack of informed consent in 83 cases (49.7%). For all cases, the need for future surgery (P = 0.0001) and surgery resulting in keratoconus (P = 0.05) were more likely to favor the plaintiff. In jury verdict decisions, cases in which failure to diagnose a preoperative condition was alleged favored the defendant (P = 0.03), whereas machine malfunction (P = 0.05) favored the plaintiff. After adjustment for inflation, the overall mean award was $1,287,872. Jury verdicts and settlements led to mean awards of $1,604,801 and $826,883, respectively. Malpractice litigation in refractive surgery tends to favor the defendant. However, large awards and settlements were given in cases that were favorable to the plaintiff. The need for future surgery and surgery leading to keratoconus increased the chance of an unfavorable outcome.

Educational Malpractice: A Contemporary View with an Eye Towards the Future.

Science.gov (United States)

Harris, J. John, III

This paper examines the developing concept of educational malpractice since the mid-1970s. It discusses the aftermath of Peter Doe v. San Francisco Unified School District, a case in which the court found against the student's claim that his school had failed to provide him with an adequate education. Two approaches are now being taken to define…

Delays in medical malpractice litigation in civil law jurisdictions: some evidence from the Italian Court of Cassation.

Science.gov (United States)

Grembi, Veronica; Garoupa, Nuno

2013-10-01

Medical malpractice law and tort reform are contentious issues. In this paper, we focus on Italy as an example of a civil law jurisdiction. Italian medical malpractice law is essentially judge-made law. However, its effectiveness is likely to be curtailed by excessive delays in litigation. Several reforms have been enacted since the late 1980s to correct this situation. By making use of the decisions of the Italian Court of Cassation (which have shaped medical malpractice law) from 1970 to 2009, we show that these reforms had no general statistically significant impact on delays. Recent reduction of delays does not seem to be related to legal reforms but rather explained by other factors.

The Role of Documentation Quality in Anesthesia-Related Closed Claims: A Descriptive Qualitative Study.

Science.gov (United States)

Wilbanks, Bryan A; Geisz-Everson, Marjorie; Boust, Rebecca R

2016-09-01

Clinical documentation is a critical tool in supporting care provided to patients. Sound documentation provides a picture of clinical events that can be used to improve patient care. However, many other uses for clinical documentation are equally important. Such documentation informs clinical decision support tools, creates a legal record of patient care, assists in financial reimbursement of services, and serves as a repository for secondary data analysis. Conversely, poor documentation can impair patient safety and increase malpractice risk exposure by reflecting poor or inaccurate information that ultimately may guide patient care decisions.Through an examination of anesthesia-related closed claims, a descriptive qualitative study emerged, which explored the antecedents and consequences of documentation quality in the claims reviewed. A secondary data analysis utilized a database generated by the American Association of Nurse Anesthetists Foundation closed claim review team. Four major themes emerged from the analysis. Themes 1, 2, and 4 primarily describe how poor documentation quality can have negative consequences for clinicians. The third theme primarily describes how poor documentation quality that can negatively affect patient safety.

["Is there a doctor on board?" - legal aspects of medical care in emergency situations during spare time].

Science.gov (United States)

Lindner, Christina; Lindner, Gregor; Exadaktylos, Aristomenis K

2013-12-11

Medical emergencies on international flights are not uncommon. In these situations the question often arises whether physicians are obliged to render first aid and whether omission leads to legal consequences. The general obligation to aid those in need applies to everyone, not only to physicians. Evading this duty makes liable to prosecution for omittance of defence of a third person in line with Art. 128 of the Swiss Penal Code, punishable by custodial sentence up to three years or an equivalent punitive fine. Vocational and professional law extend the duty to aid for physicians to urgent cases. Although resulting from the performance of a legal obligation, malpractice occurred in the course of first aid can lead to claims for compensation - even from foreign patients, and that according to their own domestic law.

78 FR 58202 - Federal Tort Claims Act (FTCA) Medical Malpractice Program Regulations: Clarification of FTCA...

Science.gov (United States)

2013-09-23

...) Medical Malpractice Program Regulations: Clarification of FTCA Coverage for Services Provided to Non... not limit coverage to childhood vaccinations; and (3) To add the following new example as subsection 6... that have substantial direct effects on the states, the relationship between the national government...

ANTI-DISCRIMINATION LAW AND COURT PRACTICE IN CROATIA-INDIVIDUAL AND ASSOCIATIONAL ANTI-DISCRIMINATION CLAIM AS (INEFFICIENT MECHANISMS FOR LEGAL PROTECTION

Directory of Open Access Journals (Sweden)

Paula Poretti

2015-01-01

Full Text Available In the paper basic legal sources of European and Croatian anti-discrimination law are presented. Special attention is given to Anti-discrimination Act from 2009 which was enacted with the aim to provide anti-discrimination legal framework as a guarantee of a high level of legal protection from different forms of discrimination in Croatian legal system. Individual and associational anti—discrimination claim as legal mechanisms for efficient legal protection are questioned. Also, along with the numeric indicators which are provided in order to illustrate practice of the courts, an overview of available inidividual and associational anti-discrimination claims through which proceedings in front of courts and other competent authorities were initiated in last few years is presented. Deficiencies in anti-discrimination law and problems of court practice in Croatia are detected. Defects which need to be eliminated in order to create preconditions for efficient legal protection from discrimination in Croatian legal system are highlighted.

The malpractice crisis in obstetrics and gynecology: is there a solution?

Science.gov (United States)

Barber, H. R.

1991-01-01

The malpractice ripoff began when the no-fault automobile accident law was passed. Many lawyers were in a panic at this time and turned to medical malpractice litigation to make a living. It became the conduit to quick wealth. The patient was the loser, the lawyer the winner, and the physician often devastated by the patient's ingratitude. For a patient-plaintiff to maintain a successful lawsuit for medical negligence against a physician, four elements must be alleged and proved in a court of law: duty, breach of duty, causation, and damages. Each must be proved by a patient to prevail against a physician. Since this is very difficult to do, the lawyers have subtly brought in a new approach called maloccurrence. This is defined as a bad outcome unrelated to the quality of care provided. The lawyers need not prove the four elements to win a malpractice case; many are won on deceit and in violation of the law by introducing the concept of maloccurrence. Not only are tort reforms needed but out of court alternatives must be mandated by law or our health care delivery system will be destroyed. Government interference and the malpractice ripoff has had a devastating effect on the talent attracted to medical school, and the number of applicants is falling rapidly. The medical malpractice crisis could soon be translated into a health delivery service crisis. Concerned citizens must join together with the medical profession and leaders of the legal profession to halt this monstrous injustice. The litigation milieu has not only paralyzed the health care industry but it has had a devastating effect across the board on the way Americans live and do business. It must be solved now for justice delayed is justice denied. PMID:2049569

Pathology and medical malpractice. Academic and trainee empirical review of cases by State of Texas physicians.

Science.gov (United States)

Allen, Timothy Craig; Stafford, Mehary; Liang, Bryan A

2014-04-01

This study examines whether the assumptions that pathologists understand the medical malpractice negligence rule and have a clear single standard of care are reasonable. Two hundred eighty-one Texas academic pathologists and trainees were presented 10 actual pathology malpractice cases from publicly available sources, representing the tort system's signal. Of the respondents, 55.52% were trainees, and 44.48% were pathology faculty. Only in two cases did more than 50% of respondents correctly identify the behavior of pathologists as defined by legal outcomes. In only half of the cases did more than 50% of pathologists concur with the jury verdict. This study provides further evidence that physicians do not understand the legal rule of negligence. Pathologists have a poor understanding of negligence and cannot accurately predict a jury verdict. There is significant divergence from the single standard of care assumption. Alternative methods to provide appropriate compensation and to establish physician accountability should be explored. Additional education about medical negligence is needed.

Medical malpractice in the management of small bowel obstruction: A 33-year review of case law.

Science.gov (United States)

Choudhry, Asad J; Haddad, Nadeem N; Rivera, Mariela; Morris, David S; Zietlow, Scott P; Schiller, Henry J; Jenkins, Donald H; Chowdhury, Naadia M; Zielinski, Martin D

2016-10-01

Annually, 15% of practicing general surgeons face a malpractice claim. Small bowel obstruction accounts for 12-16% of all surgical admissions. Our objective was to analyze malpractice related to small bowel obstruction. Using the search terms "medical malpractice" and "small bowel obstruction," we searched through all jury verdicts and settlements for Westlaw. Information was collected on case demographics, alleged reasons for malpractice, and case outcomes. The search criteria yielded 359 initial case briefs; 156 met inclusion criteria. The most common reason for litigation was failure to diagnose and timely manage the small bowel obstruction (69%, n = 107). Overall, 54% (n = 84) of cases were decided in favor of the defendant (physician). Mortality was noted in 61% (n = 96) of cases. Eighty-six percent (42/49) of cases litigated as a result of failing to diagnose and manage the small bowel obstruction in a timely manner, resulting in patient mortality, had a verdict with an award payout for the plaintiff (patient). The median award payout was $1,136,220 (range, $29,575-$12,535,000). A majority of malpractice cases were decided in favor of the defendants; however, cases with an award payout were costly. Timely intervention may prevent a substantial number of medical malpractice lawsuits in small bowel obstruction, arguing in favor of small bowel obstruction management protocols. Copyright © 2016 Elsevier Inc. All rights reserved.

Epidemiology of malpractice claims in the orthopedic and trauma surgery department of a French teaching hospital: A 10-year retrospective study.

Science.gov (United States)

Agout, C; Rosset, P; Druon, J; Brilhault, J; Favard, L

2018-02-01

Orthopedic and trauma surgery is the specialty for which claims for compensation are most often filed. Little data exists on the subject in France, especially in a teaching hospital. We conducted a retrospective study aimed at (1) identifying the epidemiological characteristics of patients filing claims against the orthopedic surgery and traumatology department of a teaching hospital in France, (2) analyzing the surgical procedures involved, the type of legal proceedings, and the financial consequences. The epidemiological profile of proceedings seeking damages in France is consistent with the data from European and American studies. An observational, retrospective, single-center study of all claims for damages between 2007 and 2016 involving the orthopedic and trauma surgery department of a teaching hospital was carried out. Patients' epidemiological data, the surgical procedure, type of legal proceeding, and financial consequences were analyzed. Of the 51,582 surgical procedures performed, 71 claims (0.0014%) were analyzed (i.e., 1/726 procedures). A significant increase in the number of cases (p=0.040) was found over a 10-year period. Of these, 36/71 (53.7%) were submitted to the French regional conciliation and compensation commission (CRCI), 23/71 (32.8%) were filed with the administrative court, and 12/71 (13.4%) were submitted for an amicable settlement. The most common reason for which patients filed claims was hospital-acquired infections, with 36/71 (50.7%) cases. Twenty-nine complaints (40.8%) resulted in monetary damages being awarded to the patient, with an average award of € 28,301 (€ 2,400-299,508). Damage awards were significantly higher (pClaims against orthopedic surgeons have been increasing significantly over the last 10 years. Although rare, they represent a significant cost to society. Hospital-acquired infections are the main reason for disputes in our specialization. IV, retrospective study. Copyright © 2017 Elsevier Masson SAS. All

Pregnancy-associated Death - Clarifying the Cause of Death and Medico-legal Assessments in Accusations of Malpractice.

Science.gov (United States)

Dettmeyer, Reinhard; Lang, Juliane; Amberg, Rainer; Zedler, Barbara; Schulz, Ronald; Birngruber, Christoph

2018-02-01

Pregnancy-associated deaths are extremely rare in Germany. Most deaths are from natural causes, and a range of causes are possible. The deaths of 22 women who died of pregnancy-associated causes and who were autopsied in the Institute of Forensic Medicine of Justus-Liebig University Gießen between 1992 and 2016 were analyzed. The autopsy results and histological examinations for the majority of women who died of pregnancy-associated causes between 1992 and 2016 showed that they had died of natural causes, although complications of pregnancy were a leading cause of death. The death of a pregnant woman should not automatically raise the suspicion of malpractice, although the question does arise in cases of bleeding complications only detected at very late stages. Experts must prove that a real mistake was made during treatment and provide evidence of the causality between malpractice and patient death. Particularly when well-known complications of pregnancy were present, this is only the case if poor monitoring resulted in the complication being detected too late or if treatment was not in accordance with accepted standards of care. The majority of pregnancy-associated deaths are from natural causes and the death of a pregnant woman does not mean that medical malpractice was involved, although this accusation is often levelled in cases where rupture was not immediately diagnosed or in cases of fatal postpartum hemorrhage.

Cross-border issues in the development of medical tourism in Malaysia: legal challenges and opportunities.

Science.gov (United States)

Nemie, Puteri; Kassim, Jahn

2009-08-01

Strategically located at the crossroads of Asia, Malaysia has become one of the key players in the fast-growing and lucrative market for health care services in Asia. Medical travel across international boundaries has been made possible through affordable airfares and the favourable exchange rates of the Malaysian ringgit has contributed to the rise of the "medical tourism phenomenon" where medical travel is combined with visiting popular tourist destinations in Malaysia. Further, competitive medical fees and modern medical facilities have also made Malaysia a popular destination for medical tourists. Nevertheless, the increased number of foreign patients has opened up possibilities of Malaysian health care providers being subjected to malpractice claims and triggering a myriad of cross-border legal issues. Presently, there is no internationally accepted legal framework to regulate medical tourism and issues of legal redress in relation to unsatisfactory provision of treatment across international boundaries. The economic benefits of medical tourism must be based upon a solid legal regulatory framework and strong ethical standards as well as upon high-quality medical and health care services. It is therefore important to assess the existing legal framework affecting the development of medical tourism in Malaysia in order to explore the gaps, deficiencies and possibilities for legal and regulatory reform.

Malpractice litigation following spine surgery.

Science.gov (United States)

Daniels, Alan H; Ruttiman, Roy; Eltorai, Adam E M; DePasse, J Mason; Brea, Bielinsky A; Palumbo, Mark A

2017-10-01

OBJECTIVE Adverse events related to spine surgery sometimes lead to litigation. Few studies have evaluated the association between spine surgical complications and medical malpractice proceedings, outcomes, and awards. The aim of this study was to identify the most frequent causes of alleged malpractice in spine surgery and to gain insight into patient demographic and clinical characteristics associated with medical negligence litigation. METHODS A search for "spine surgery" spanning February 1988 to May 2015 was conducted utilizing the medicolegal research service VerdictSearch (ALM Media Properties, LLC). Demographic data for the plaintiff and defendant in addition to clinical data for the procedure and legal outcomes were examined. Spinal cord injury, anoxic/hypoxic brain injury, and death were classified as catastrophic complications; all other complications were classified as noncatastrophic. Both chi-square and t-tests were used to evaluate the effect of these variables on case outcomes and awards granted. RESULTS A total of 569 legal cases were examined; 335 cases were excluded due to irrelevance or insufficient information. Of the 234 cases included in this investigation, 54.2% (127 cases) resulted in a defendant ruling, 26.1% (61) in a plaintiff ruling, and 19.6% (46) in a settlement. The awards granted for plaintiff rulings ranged from $134,000 to $38,323,196 (mean $4,045,205 ± $6,804,647). Awards for settlements ranged from $125,000 to $9,000,000 (mean $1,930,278 ± $2,113,593), which was significantly less than plaintiff rulings (p = 0.022). Compared with cases without a delay in diagnosis of the complication, the cases with a diagnostic delay were more likely to result in a plaintiff verdict or settlement (42.9% vs 72.7%, p = 0.007) than a defense verdict, and were more likely to settle out of court (17.5% vs 40.9%, p = 0.008). Similarly, compared with cases without a delay in treatment of the complication, those with a therapeutic delay were more

medico-legal perspectives in history

African Journals Online (AJOL)

Various legal codes dealing with medical malpractice existed in Egypt, Mesopotamia, China, Islam, Greece, Rome, Persia and India. The first documented Code of Laws ever used by human civilisation in, for example, Mesopotamia is to be found from the Law Code of Hammurabi – a textual source of evidence concerning ...

Characteristics of claims in the management of septic arthritis in Japan: Retrospective analyses of judicial precedents and closed claims

Directory of Open Access Journals (Sweden)

Yasuhiro Otaki

2018-03-01

Conclusion: It is important to pay particular attention to SA following sepsis in newborns and to monitor for any signs of SA after joint injection to ensure early diagnosis. Analysis of both malpractice claims and accident and incident reports is essential to ensure a full understanding of the situation in Japan.

A clinical analysis of 500 medico-legal claims evaluating the causes and assessing the potential benefit of alternative dispute resolution.

Science.gov (United States)

B-Lynch, C; Coker, A; Dua, J A

1996-12-01

1. To evaluate the common causes of medico-legal dispute in obstetrics and gynaecology. 2. To assess the potential benefit of early alternative dispute resolution. A prospective analysis of over 500 cases submitted from over 100 solicitors between 1984 and 1994 for medical expert opinion on potential medico-legal claims. Five hundred consecutive cases that met the inclusion criteria: 488 from the United Kingdom and 12 from abroad (Hong Kong, Republic of Ireland). The main principles underlining medico-legal disputes and causes of such claims. Analysis of 500 claims show 46% were misguided allegations, 19% incompetent care, 12% error of judgement, 9% lack of expertise, 7% failure of communication, 6% poor supervision and 1% inadequate staffing. Of the misguided allegations 119/225 cases (59%) were obstetric and 111/275 (40%) cases were gynaecological. The most common cause of obstetric dispute was "cerebral palsy' (22%), while the commonest cause of gynaecological dispute was failed sterilisation (19%). Settled claims were under-reported by solicitors. Because of the high percentage (46%) of misguided allegations, an alternative course of dispute resolution must be a realistic way forward. This course of action, combined with improved communication, could result in a major reduction in the costs of potential medical litigation. Early alternative dispute resolution should be considered in an attempt to reduce the escalating quantum of damages and costs. We recommend recruiting independent, experienced and unbiased consultants in active practice within the appropriate specialty to review such cases at the level of hospital complaints management as an in house review procedure, particularly for small and moderate-sized claims, as a means whereby doctors can retain control of medico-legal disputes, in contrast to control by the legal profession.

Analysis of Closed Claims in the Clinical Management of Rheumatoid Arthritis in Japan

Directory of Open Access Journals (Sweden)

Yasuhiro Otaki

2017-01-01

Conclusions: The characteristics of malpractice claims associated with RA management, including the high frequency of medication-related allegations, breakdowns in the assessment process, and high claim numbers among patients older than 60 years, suggest the importance of caution exercised by physicians when administering immunosuppressants for the clinical treatment of RA.

ANTI-DISCRIMINATION LAW AND COURT PRACTICE IN CROATIA-INDIVIDUAL AND ASSOCIATIONAL ANTI-DISCRIMINATION CLAIM AS (IN)EFFICIENT MECHANISMS FOR LEGAL PROTECTION

OpenAIRE

Paula Poretti

2015-01-01

In the paper basic legal sources of European and Croatian anti-discrimination law are presented. Special attention is given to Anti-discrimination Act from 2009 which was enacted with the aim to provide anti-discrimination legal framework as a guarantee of a high level of legal protection from different forms of discrimination in Croatian legal system. Individual and associational anti—discrimination claim as legal mechanisms for efficient legal protection are questioned. Also, along with the...

Legal Considerations in Clinical Decision Making.

Science.gov (United States)

Ursu, Samuel C.

1992-01-01

Discussion of legal issues in dental clinical decision making looks at the nature and elements of applicable law, especially malpractice, locus of responsibility, and standards of care. Greater use of formal decision analysis in clinical dentistry and better research on diagnosis and treatment are recommended, particularly in light of increasing…

Comparison of Emergency Medicine Malpractice Cases Involving Residents to Non-Resident Cases.

Science.gov (United States)

Gurley, Kiersten L; Grossman, Shamai A; Janes, Margaret; Yu-Moe, C Winnie; Song, Ellen; Tibbles, Carrie D; Shapiro, Nathan I; Rosen, Carlo L

2018-04-17

Data are lacking on how emergency medicine (EM) malpractice cases with resident involvement differs from cases that do not name a resident. To compare malpractice case characteristics in cases where a resident is involved (resident case) to cases that do not involve a resident (non-resident case) and to determine factors that contribute to malpractice cases utilizing EM as a model for malpractice claims across other medical specialties. We used data from the Controlled Risk Insurance Company (CRICO) Strategies' division Comparative Benchmarking System (CBS) to analyze open and closed EM cases asserted from 2009-2013. The CBS database is a national repository that contains professional liability data on > 400 hospitals and > 165,000 physicians, representing over 30% of all malpractice cases in the U.S (> 350,000 claims). We compared cases naming residents (either alone or in combination with an attending) to those that did not involve a resident (non-resident cohort). We reported the case statistics, allegation categories, severity scores, procedural data, final diagnoses and contributing factors. Fisher's exact test or t-test was used for comparisons (alpha set at 0.05). Eight hundred and forty-five EM cases were identified of which 732 (87%) did not name a resident (non-resident cases), while 113 (13%) included a resident (resident cases) (Figure 1). There were higher total incurred losses for non-resident cases (Table 1). The most frequent allegation categories in both cohorts were "Failure or Delay in Diagnosis/Misdiagnosis" and "Medical Treatment" (non-surgical procedures or treatment regimens i.e. central line placement). Allegation categories of Safety and Security, Patient Monitoring, Hospital Policy and Procedure and Breach of Confidentiality were found in the non-resident cases. Resident cases incurred lower payments on average ($51,163 vs. $156,212 per case). Sixty six percent (75) of resident vs 57% (415) of non-resident cases were high severity claims

The use of propofol by gastroenterologists: medico-legal issues.

Science.gov (United States)

Axon, Andrew E

2010-01-01

The increasing use of non-anesthesiologist-administered propofol for sedation during gastrointestinal endoscopy has both clinical and legal consequences. As medical practices develop, the law of clinical negligence will be applied in the context of such developments. While the law will recognize the desirability of advanced techniques and methods, in circumstances where an injury or adverse outcome occurs, the facts of a particular case will be scrutinized to determine whether or not the duty of care between patient and clinician has been breached. This paper considers a number of specific matters likely to arise in the context of a clinical negligence/malpractice claim resulting from the use of non-anesthesiologist-administered propofol, in particular the role and standard of care expected of gastroenterologist and/or anesthetic provider, the relevance of FDA labeling, the implementation and use of protocols, the importance of patient selection and informed consent. Copyright 2010 S. Karger AG, Basel.

Randomized Trial of Reducing Ambulatory Malpractice and Safety Risk: Results of the Massachusetts PROMISES Project.

Science.gov (United States)

Schiff, Gordon D; Reyes Nieva, Harry; Griswold, Paula; Leydon, Nicholas; Ling, Judy; Federico, Frank; Keohane, Carol; Ellis, Bonnie R; Foskett, Cathy; Orav, E John; Yoon, Catherine; Goldmann, Don; Weissman, Joel S; Bates, David W; Biondolillo, Madeleine; Singer, Sara J

2017-08-01

Evaluate application of quality improvement approaches to key ambulatory malpractice risk and safety areas. In total, 25 small-to-medium-sized primary care practices (16 intervention; 9 control) in Massachusetts. Controlled trial of a 15-month intervention including exposure to a learning network, webinars, face-to-face meetings, and coaching by improvement advisors targeting "3+1" high-risk domains: test result, referral, and medication management plus culture/communication issues evaluated by survey and chart review tools. Chart reviews conducted at baseline and postintervention for intervention sites. Staff and patient survey data collected at baseline and postintervention for intervention and control sites. Chart reviews demonstrated significant improvements in documentation of abnormal results, patient notification, documentation of an action or treatment plan, and evidence of a completed plan (all Pcoaches, and learning network decreased selected ambulatory safety risks often seen in malpractice claims.

The defendant in a medical malpractice suit: an integral part of the defense team

International Nuclear Information System (INIS)

Petrek, F.R. Jr.; Slovis, M.R.

1998-01-01

This article explains the litigation process of a medical malpractice suit and offers suggestions to help pediatric radiologists cope with the stress of being sued. It provides tangible ways in which the pediatric radiologist can become an important part of the defense team. Our goal is to enable the pediatric radiologist to place the lawsuit in a proper perspective and demonstrate the importance of providing medical insight to aid in forming legal strategy. (orig.)

Orthopedic board certification and physician performance: an analysis of medical malpractice, hospital disciplinary action, and state medical board disciplinary action rates.

Science.gov (United States)

Kocher, Mininder S; Dichtel, Laura; Kasser, James R; Gebhardt, Mark C; Katz, Jeffery N

2008-02-01

Specialty board certification status has become the de facto standard of competency by which the profession and the public recognize physician specialists. However, the relationship between orthopedic board certification and physician performance has not been established. Rates of medical malpractice claims, hospital disciplinary actions, and state medical board disciplinary actions were compared between 1309 board-certified (BC) and 154 non-board-certified (NBC) orthopedic surgeons in 3 states. There was no significant difference between BC and NBC surgeons in medical malpractice claim proportions (BC, 19.1% NBC, 16.9% P = .586) or in hospital disciplinary action proportions (BC, 0.9% NBC, 0.8% P = 1.000). There was a significantly higher proportion of state medical board disciplinary action for NBC surgeons (BC, 7.6% NBC, 13.0% P = .028). An association between board certification status and physician performance is necessary to validate its status as the de facto standard of competency. In this study, BC surgeons had lower rates of state medical board disciplinary action.

Legal Medicine in Medical Schools: A Survey of the State of the Art.

Science.gov (United States)

Grumet, Barbara Ruhe

1979-01-01

Results of a survey of American medical schools indicate that there is considerable interest in legal medicine and that while 40 percent of the schools require students to complete some course work in legal medicine, the curricula vary considerably among the schools. Topics most frequently covered are informed consent and malpractice. (Author/JMD)

Know-how provider’s right to claim damages for non-pecuniary loss in light of the legal nature of know-how

Directory of Open Access Journals (Sweden)

Tuğçe Oral

2017-12-01

Full Text Available The know-how contract is one of the most important means for transferring and developing technology. It is crucial to find out whether the parties of know-how contract have a right to claim damages for non-pecuniary loss in light of the legal nature of knowhow. In this article, I begin by defining the know-how contracts and in particular I will analyze the main obligations of the parties. Secondly, I will deal with the definition and the legal nature of know-how, since considerable uncertainty exists as to the degree or type of protection regarding the legal nature of know-how. There are different opinions put forward, which defines the legal nature of know-how as a property, an intangible asset, a monopoly of fact and a personality right. Finally, and on the basis of the conclusion reached under the previous section, I will discuss whether it is possible for know-how provider to claim damages for non-pecuniary loss.

Legal Services: Claims

Science.gov (United States)

1997-12-31

waive such exemp- tions or privileges and direct release of the protected documents, upon balancing all pertinent factors, including finding that...injury causing death until expiration of decedent’s worklife ex- pectancy. When requested, the previous five years Federal income tax forms must be...knowing at all times how much of the CEA has been obligated, its remaining balance , and assessing each month whether the balance will cover claims

The opinion of Turkish cardiologists on current malpractice system and an alternative patient compensation system proposal: PCS study group.

Science.gov (United States)

Olcay, Ayhan; Emren, Sadık Volkan; Babür Güler, Gamze; Güler, Ekrem; Ertunç, Vedat; Berilgen, Rida; Aslan, Abdullah; Şimşek, Ersin Çağrı; Gölcük, Şükriye Ebru; Yalın, Kıvanç

2017-10-01

Cardiologists participate in the diagnosis and interventional treatment of numerous high-risk patients. The goal of this study was to investigate how the current malpractice system in Turkey influences cardiologists' diagnostic and interventional behavior and to obtain their opinions about an alternative patient compensation system. The present cross-sectional study assessed the practice of defensive medicine among cardiologists who are actively working in various types of workplace within the Turkish healthcare system. A 24-item questionnaire was distributed to cardiology residents, specialists, and academics in Turkey in print format, by electronic mail, or via cell phone message. A total of 253 cardiologists responded to the survey. Among them, 29 (11.6%) had been sued for malpractice claims in the past. Of the cardiologists who had been sued, 2 (6.9%) had been ordered to pay financial compensation, and 1 (3.4%) was given a sentence of imprisonment due to negligence. In all, 132 (52.8%) of the surveyed cardiologists reported that they had changed their practices due to fear of litigation, and 232 (92.8%) reported that they would prefer the new proposed patient compensation system to the current malpractice system. Among the cardiologists surveyed, 78.8% indicated that malpractice fear had affected their decision-making with regard to requesting computed tomography angiography or thallium scintigraphy, 71.6% for coronary angiography, 20% for stent implantation, and 83.2% for avoiding treating high-risk patients. The results of this survey demonstrated that cardiologists may request unnecessary tests and perform unneeded interventions due to the fear of malpractice litigation fear. Many also avoid high-risk patients and interventions. The majority indicated that they would prefer the proposed alternative patient compensation system to the current malpractice system.

Medical Malpractice Implications of Clinical Practice Guidelines.

Science.gov (United States)

Ruhl, Douglas S; Siegal, Gil

2017-08-01

Clinical practice guidelines aim to improve medical care by clarifying and making useful recommendations to providers. Although providers should account for patients' unique characteristics when determining a treatment plan, it is generally perceived as good practice to follow guidelines when applicable. This is of interest in malpractice litigation, where it is essential to establish a standard of care to evaluate the performances of providers. Although the opinions of expert witnesses are used to determine standards of care, guidelines are expected to play a leading role. Guidelines alone should not establish a legal standard but may help inform this discussion in the courtroom. Therefore, it is incumbent that excellent, practical, and timely guidelines are continually created and updated in a transparent way. These guidelines must be very clear and underscore the various strengths of recommendation based on the quality of available evidence.

The importance of distinguishing illegality from guilt in trials for alleged medical malpractice

Directory of Open Access Journals (Sweden)

Manuel Fernando Díaz Brousse

2012-10-01

Full Text Available A proper analysis of the essential elements that comprise a criminal offense that falls under the purview of medical negligence is fundamental in order to rule, in justice, cases of alleged malpractice. It is necessary to properly distinguish between accusations of illegality and those of guilt. Open legal essays and precedents about such illicit acts provide judges with great latitude in determining when acts are consistent or not with standard care. This power mandates that judges should ground their convictions on objective infringements of the law rather than subjective criteria.

Medical Malpractice

DEFF Research Database (Denmark)

Grembi, Veronica

2014-01-01

MM first came to the attention of policy makers primarily in the USA where, from the 1970s, healthcare providers denounced problems in getting insurance for medical liability, pointing out to a crisis in the MM insurance market (Sage WM (2003) Understanding the first malpractice crisis of the 21th...

31 CFR 3.22 - Legal review.

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Legal review. 3.22 Section 3.22 Money and Finance: Treasury Office of the Secretary of the Treasury CLAIMS REGULATIONS AND INDEMNIFICATION OF DEPARTMENT OF TREASURY EMPLOYEES Claims Under the Small Claims Act § 3.22 Legal review. Claims...

Using administrative and claims data in the GNC-study – how to overcome legal restrictions

Directory of Open Access Journals (Sweden)

Janett Powietzka

2017-04-01

Unfortunately, one of the biggest obstacles for the scientific use of administrative and claims data still remains unsolved. The application for data use at the local supervisory authority of the data owner requires the description and limitation of the research question and the period of use of this data. This is in conflict with the modern longitudinal design of GNC because it wants to establish a research structure and data base in order to answer a variety of future and unspecified research questions. Hence, current legal requirements in Germany prevent the full utilization of the potential of administrative and claims data. Therefore, the German Federal Commissioner for Data Protection and Freedom of Information recommended an amendment to the social law.

Epistemic dependence in contemporary science: Practices and malpractices

DEFF Research Database (Denmark)

Andersen, Hanne

2014-01-01

Despite an increased focus on scientific practice in the philosophy of science in recent years, there has been relatively little focus on malpractices such as intentional fraud or gross negligence. This is the more striking since malpractice in research  both in the form of outright misconduct...... 1999; 1994). Most existing philosophical analyses of malpractice in science have centered on intentional deceit and treated the phenomenon primarily as a topic for ethical analyses. However, in this paper I shall go beyond this focus on deceit and discuss intentional, reckless as well as negligent...

40 CFR 307.20 - Who may present claims.

Science.gov (United States)

2010-07-01

... agent, executor, administrator, or other legal representative. A claim presented by an entity or an authorized agent, executor, administrator, or other legal representative must be presented in the name of the claimant. The claim must be signed by the authorized agent, executor, administrator, or other legal...

Informed consent: a socio-legal study.

Science.gov (United States)

Rathor, M Y; Rani, Mohammad Fauzi Abdul; Shah, Azarisman Mohammad; Akter, Sheikh Fariuddin

2011-12-01

Informed consent [IC] is a recognized socio-legal obligation for the medical profession. The doctrine of IC involves the law, which aims to ensure the lawfulness of health assistance and tends to reflect the concept of autonomy of the person requiring and requesting medical and/or surgical treatment. Recent changes in the health care delivery system and the complex sociological settings, in which it is practiced, have resulted in an increase in judicial activity and medical negligence lawsuits for physicians. While IC is a well-established practice, it often fails to meet its stated purpose. In the common law, the standard of medical care to disclose risks has been laid down by the Bolam test- a familiar concept to most physicians, but it has been challenged recently in many jurisdictions. This paper aims to discuss some important judgments in cases of alleged medical negligence so as to familiarize doctors regarding their socio-legal obligations. We also propose to discuss some factors that influence the quality of IC in clinical practice. Literature review. The law of medical consent has been undergoing changes in recent years. Case law appears to be evolving towards a more patient centered standard of disclosure. Patient's expectations are higher and they are aware of the power of exercising their rights. Failure to obtain IC is one of the common allegations in medical malpractice suits. The medical professionals need to change their mindset and avoid claims of negligence by providing information that is "reasonable" in the eyes of the court.

Excusable neglect in malpractice suits against radiologists: a proposed jury instruction to recognize the human condition.

Science.gov (United States)

Caldwell, Charles; Seamone, Evan R

2007-01-01

This article unwraps the nature and source of human errors involved in Radiology, revealing unique elements of the specialty that warrant special consideration in medical malpractice cases. The authors compare these errors to negligent practices in other professions and conclude that a general concept of negligence cannot adequately address the complexities of decision-making in Radiology. After analyzing legal precedent, they develop an innovative jury instruction that recognizes particular situations of error in Radiology that occur in the absence of negligence.

31 CFR 3.3 - Legal review.

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Legal review. 3.3 Section 3.3 Money and Finance: Treasury Office of the Secretary of the Treasury CLAIMS REGULATIONS AND INDEMNIFICATION OF DEPARTMENT OF TREASURY EMPLOYEES Claims Under the Federal Tort Claims Act § 3.3 Legal review. Any...

Limits of negligent responsibility for medical malpractice

Directory of Open Access Journals (Sweden)

Marin Mrčela

2017-01-01

Full Text Available Criminal offence of medical malpractice is one of core medical criminal offences. Protected object is health of patients. Application of inadequate methods in health treatment can have severe consequences for patient’s health, even death. Croatian jurisprudence is familiar with such cases. However, Croatian literature until now did not deal with this sensitive area of criminal law. Scope and limits of responsibility for negligent form of medical malpractice can cause doubts in court’s practice when deciding about criminal liability. This paper is dedicated to this topic. After presentation of main characteristics of this criminal offence, the authors are making an effort to establish criteria for estimation of negligence in case of medical malpractice. They are testing their thesis on one very complicated case from recent Croatian jurisprudence.

Delays in Medical Malpractice Litigation in Civil Law Jurisdictions

DEFF Research Database (Denmark)

Grembi, Veronica; Garoupaa, Nuno

2013-01-01

Medical malpractice law and tort reform are contentious issues. In this paper, we focus on Italy as an example of a civil law jurisdiction. Italian medical malpractice law is essentially judge-made law. However, its effectiveness is likely to be curtailed by excessive delays in litigation. Several...... reforms have been enacted since the late 1980s to correct this situation. By making use of the decisions of the Italian Court of Cassation (which have shaped medical malpractice law) from 1970 to 2009, we show that these reforms had no general statistically significant impact on delays. Recent reduction...

Operating room fires: a closed claims analysis.

Science.gov (United States)

Mehta, Sonya P; Bhananker, Sanjay M; Posner, Karen L; Domino, Karen B

2013-05-01

To assess patterns of injury and liability associated with operating room (OR) fires, closed malpractice claims in the American Society of Anesthesiologists Closed Claims Database since 1985 were reviewed. All claims related to fires in the OR were compared with nonfire-related surgical anesthesia claims. An analysis of fire-related claims was performed to identify causative factors. There were 103 OR fire claims (1.9% of 5,297 surgical claims). Electrocautery was the ignition source in 90% of fire claims. OR fire claims more frequently involved older outpatients compared with other surgical anesthesia claims (P fire claims (P fires (n = 93) increased over time (P fires occurred during head, neck, or upper chest procedures (high-fire-risk procedures). Oxygen served as the oxidizer in 95% of electrocautery-induced OR fires (84% with open delivery system). Most electrocautery-induced fires (n = 75, 81%) occurred during monitored anesthesia care. Oxygen was administered via an open delivery system in all high-risk procedures during monitored anesthesia care. In contrast, alcohol-containing prep solutions and volatile compounds were present in only 15% of OR fires during monitored anesthesia care. Electrocautery-induced fires during monitored anesthesia care were the most common cause of OR fires claims. Recognition of the fire triad (oxidizer, fuel, and ignition source), particularly the critical role of supplemental oxygen by an open delivery system during use of the electrocautery, is crucial to prevent OR fires. Continuing education and communication among OR personnel along with fire prevention protocols in high-fire-risk procedures may reduce the occurrence of OR fires.

Tort law and medical malpractice insurance premiums.

Science.gov (United States)

Kilgore, Meredith L; Morrisey, Michael A; Nelson, Leonard J

2006-01-01

This paper estimated the effects of tort law and insurer investment returns on physician malpractice insurance premiums. Data were collected on tort law from 1991 through 2004, and multivariate regression models, including fixed effects for state and year, were used to estimate the effect of changes in tort law on medical malpractice premiums. The premium consequences of national policy changes were simulated. The analysis found that the introduction of a new damage cap lowered malpractice premiums for internal medicine, general surgery, and obstetrics/gynecology by 17.3%, 20.7%, and 25.5%, respectively. Lowering damage caps by dollar 100,000 reduced premiums by 4%. Statutes of repose also resulted in lower premiums. No other tort law changes had the effect of lowering premiums. Simulation results indicate that a national cap of dollar 250,000 on awards for noneconomic damages in all states would imply premium savings of dollar 16.9 billion. Extending a dollar 250,000 cap to all states that do not currently have them would save dollar 1.4 billion annually, or about 8% of the total. A negative effect on malpractice premiums was found for the Dow Jones industrial average, but not for bond prices; effects of the Nasdaq index were not significant for internal medicine, but were marginally significant for surgery and obstetrics premiums.

The role of the autopsy in medical malpractice cases, I: a review of 99 appeals court decisions.

Science.gov (United States)

Bove, Kevin E; Iery, Clare

2002-09-01

Fear that damaging information from autopsy may be introduced as evidence in lawsuits alleging medical malpractice is often cited as one factor contributing to the decline in autopsy rates. To determine how autopsy information influences the outcome of medical malpractice litigation. We studied state court records in 99 cases of medical malpractice adjudicated from 1970 to the present to assess the role of information from autopsies in the outcomes. The 3 largest groups defined by cause of death at autopsy were acute pulmonary embolism, acute cardiovascular disease, and drug overdose/interaction. Findings for defendant physicians outnumbered medical negligence in the original trial proceedings by a 3:1 margin. The appellate courts affirmed 51 acquittals and 19 findings of negligence, and reversed the original trial court decision in 29 cases for technical reasons. We found no significant relationship between accuracy of clinical diagnosis (using the autopsy standard) and outcome of a suit charging medical negligence. Even when a major discrepancy existed between the autopsy diagnosis and the clinical diagnosis, and the unrecognized condition was deemed treatable, defendant physicians were usually exonerated. Moreover, major diagnostic discrepancies were relatively uncommon in suits in which a physician was found to be negligent. Conversely, in about 20% of cases, autopsy findings were helpful to defendant physicians. Our study confirms that a finding of medical negligence is based on standard-of-care issues rather than accuracy of clinical diagnosis. Autopsy findings may appear to be neutral or favorable to either the plaintiff or the defendant, but are typically not the crux of a successful legal argument for either side in a malpractice action. We conclude that fear of autopsy findings has no rational basis and is an important obstacle to uninhibited outcomes analysis.

Responsabilidad por una práctica médica inadecuada: una perspectiva económica Liability for medical malpractice: an economic approach

Directory of Open Access Journals (Sweden)

M. Carles

2003-12-01

Full Text Available Los cambios en la organización de las instituciones sanitarias y el incremento del número de denuncias por mala praxis de los últimos años han puesto de relieve la necesidad de estudiar el concepto de responsabilidad médica y su repercusión en la provisión de asistencia sanitaria. Hasta el momento, el debate se ha centrado básicamente en los aspectos legales. Sin embargo, falta discutir sus implicaciones económicas. Este trabajo revisa las investigaciones que han realizado un análisis económico del tema. En primer lugar, examinamos las que introducen paulatinamente los conceptos de incertidumbre, aversión al riesgo o riesgo moral. Posteriormente, en el entorno sanitario, prestamos especial atención a los modelos que incluyen nuevos argumentos en la función objetivo de los profesionales o, cuando existe información asimétrica, a los que plantean un problema de negociación. Por último, consideramos el mercado de seguros de responsabilidad sanitaria, y en este apartado vemos cómo la variable reputación, o la posibilidad de ejercer una medicina defensiva, influyen en la provisión de asistencia sanitaria. Nuestro análisis sugiere que, debido a las características del mercado sanitario, deben utilizarse los modelos propuestos por la economía de la información en el análisis económico formal, pero conviene plantear hipótesis alternativas para adaptar dichos modelos a la especificidad de los distintos sistemas sanitarios.In recent years, changes in the organization of healthcare institutions and the increased number of medical malpractice claims have revealed the need to study the concept of medical responsibility and the repercussion of these changes on healthcare provision. To date, discussion has focussed on legal aspects and economic implications have been largely ignored. The present article reviews studies that have performed an economic analysis the subject. Firstly, we examine studies that gradually introduce the

Know-how provider’s right to claim damages for non-pecuniary loss in light of the legal nature of know-how

OpenAIRE

Tuğçe Oral

2017-01-01

The know-how contract is one of the most important means for transferring and developing technology. It is crucial to find out whether the parties of know-how contract have a right to claim damages for non-pecuniary loss in light of the legal nature of knowhow. In this article, I begin by defining the know-how contracts and in particular I will analyze the main obligations of the parties. Secondly, I will deal with the definition and the legal nature of know-how, since considerable uncertaint...

Professional liability insurance in Obstetrics and Gynaecology: estimate of the level of knowledge about malpractice insurance policies and definition of an informative tool for the management of the professional activity

Directory of Open Access Journals (Sweden)

Scurria Serena

2011-12-01

Full Text Available Abstract Background In recent years, due to the increasingly hostile environment in the medical malpractice field and related lawsuits in Italy, physicians began informing themselves regarding their comprehensive medical malpractice coverage. Methods In order to estimate the level of knowledge of medical professionals on liability insurance coverage for healthcare malpractice, a sample of 60 hospital health professionals of the obstetrics and gynaecology area of Messina (Sicily, Italy were recluted. A survey was administered to evaluate their knowledge as to the meaning of professional liability insurance coverage but above all on the most frequent policy forms ("loss occurrence", "claims made" and "I-II risk". Professionals were classified according to age and professional title and descriptive statistics were calculated for all the professional groups and answers. Results Most of the surveyed professionals were unaware or had very bad knowledge of the professional liability insurance coverage negotiated by the general manager, so most of the personnel believed it useful to subscribe individual "private" policies. Several subjects declared they were aware of the possibility of obtaining an extended coverage for gross negligence and substantially all the surveyed had never seen the loss occurrence and claims made form of the policy. Moreover, the sample was practically unaware of the related issues about insurance coverage for damages related to breaches on informed consent. The results revealed the relative lack of knowledge--among the operators in the field of obstetrics and gynaecology--of the effective coverage provided by the policies signed by the hospital managers for damages in medical malpractice. The authors thus proposed a useful information tool to help professionals working in obstetrics and gynaecology regarding aspects of insurance coverage provided on the basis of Italian civil law. Conclusion Italy must introduce a compulsory

Actuarial considerations of medical malpractice evaluations in M&As.

Science.gov (United States)

Frese, Richard C

2014-11-01

To best project an actuarial estimate for medical malpractice exposure for a merger and acquisition, a organization's leaders should consider the following factors, among others: How to support an unbiased actuarial estimation. Experience of the actuary. The full picture of the organization's malpractice coverage. The potential for future loss development. Frequency and severity trends.

32 CFR 842.129 - Settlement of claims against NAFIs.

Science.gov (United States)

2010-07-01

... LITIGATION ADMINISTRATIVE CLAIMS Nonappropriated Fund Claims § 842.129 Settlement of claims against NAFIs. (a) This subpart does not establish legal theories for adjudication of claims. Refer to the appropriate...

The US Public Health Service "treating tobacco use and dependence clinical practice guidelines" as a legal standard of care.

Science.gov (United States)

Torrijos, Randy M; Glantz, Stanton A

2006-12-01

The important factors in evaluating the role of clinical practice guidelines (CPGs) in medical malpractice litigation have been discussed for several years, but have focused on broad policy implications rather than on a concrete example of how an actual guideline might be evaluated. There are four items that need to be considered in negligence torts: legal duty, a breach of that duty, causal relationship between breach and injury, and damages. To identify the arguments related to legal duty. The Treating Tobacco Use and Dependence (revised 2000) CPG, sponsored by the US Public Health Service, recommends effective and inexpensive treatments for nicotine addiction, the largest preventable cause of death in the US, and can be used as an example to focus on important considerations about the appropriateness of CPGs in the judicial system. Furthermore, the failure of many doctors and hospitals to deal with tobacco use and dependence raises the question of whether this failure could be considered malpractice, given the Public Health Service guideline's straightforward recommendations, their efficacy in preventing serious disease and cost-effectiveness. Although each case of medical malpractice depends on a multitude of factors unique to individual cases, a court could have sufficient basis to find that the failure to adequately treat the main cause of preventable disease and death in the US qualifies as a violation of the legal duty that doctors and hospitals owe to patients habituated to tobacco use and dependence.

Dissecting malpractice in pancreaticoduodenectomy cases.

Science.gov (United States)

Anandalwar, Seema P; Scholer, Anthony J; Ninan, Gigio; Oliver, Joseph B; Christian, Derick; Eloy, Jean Anderson; Chokshi, Ravi J

2017-05-15

Medical malpractice is a growing concern for physicians in all fields. Surgical fields have some of the highest malpractice premiums and litigation rates. Pancreaticoduodenectomy (PD) has become a popular procedure; however, it is still associated with significant morbidity and mortality. This study is the first to analyze factors involved in litigation regarding PD cases. The Westlaw database was searched for jury verdicts and settlements using the terms "medical malpractice" and "pancreaticoduodenectomy". Twenty-nine cases from 1991 to 2012 were initially collected. Seven entries not involving PD and three duplicate cases were excluded. Nineteen cases were included for analysis. Of the 19 cases included in the analysis, three (15.8%) reached a settlement, three (15.8%) were ruled in favor of the plaintiff, and 13 (68.4%) were ruled in favor of the physician. The average settlement award was $398,333 (range, $195,000-500,000), and the average plaintiff award was $4,288,869 (range, $1,066,608-10,300,000). The most common factors raised in litigation included PD being allegedly unnecessary (47.4%), followed by postoperative negligence and misdiagnosis (36.8% each). The most common factors present in litigation included the allegation that PD was unnecessarily performed. The cases that are awarded large monetary sums are those that involve continued medical care. Ways to improve patient safety and limit litigation include increasing transparency and communication with a thorough discussion between surgeon and patient of the most common topics of litigation discussed. Published by Elsevier Inc.

Difficult Decision on Tyroid Surgery of Expert Witness: Complication or Malpractice

Directory of Open Access Journals (Sweden)

Ali Rıza Tümer

2017-10-01

Full Text Available Introduction: Recurrent laryngeal nerve (RLN paralysis and hypocalcemia following thyroid surgery have been designated as complication or malpractice. In this study, it was aimed to evaluate surgeons’ opinions towards RLN injury and hypocalcemia after bilateral subtotal thyroidectomy (BST and total thyroidectomy (TT in nodular goiter and thyroid carcinoma.  Materials and Methods: We prepared a questionnaire to determine approaches of surgeons in such cases. We grouped the   the respondents according their thyroid surgery experiments and  asked them to determine whether it is malpractice or complication in cases with unilateral or bilateral RLN paralysis and hypocalcemia after “bilateral subtotal thyroidectomy” and in cases with unilateral or bilateral RLN paralysis after “total thyroidectomy”. Results: In all groups describing bilateral RNL injury was more common. Problems which are defined as "complication" in cancer patiens, were more likely defined as "malpractice" in benign cases. However these differences were generally not  statistically significant.  Conclusions: There is no consensus about malpractice and complication discrimination among physicians. Every physician should evaluate every specific case in its own nature and conditions when asked to determine whether the case should be determined as complication or malpractice.

Public utilities and the public interest - raising and acknowledging this claim in proceedings concerning provisional legal protection

International Nuclear Information System (INIS)

Fischerhof, H.

1976-01-01

The following can be said of appeal proceedings against provisionally granted legal protection as claimed according to section 5 article 80 VwGO, the public utilities attending the proceedings, but not the licensing authority, being in the position to file this appeal: 1) The licensing authority takes part in the appeal proceedings and has the right to be heard. The licensing authority can also continue to act in the public interest in order to maintain the ordinances it issued, ordinances which were ordered to take immediate effect with public interest in mind. 2) The court of appeal has to examine the factual and the legal aspects of the previous instance's decision. 3) The public utility as the complainant can, within the framework of its official duties, combine the public interest with its own interests. (orig./HP) [de

The US Public Health Service “treating tobacco use and dependence clinical practice guidelines” as a legal standard of care

Science.gov (United States)

Torrijos, Randy M; Glantz, Stanton A

2006-01-01

Background The important factors in evaluating the role of clinical practice guidelines (CPGs) in medical malpractice litigation have been discussed for several years, but have focused on broad policy implications rather than on a concrete example of how an actual guideline might be evaluated. There are four items that need to be considered in negligence torts: legal duty, a breach of that duty, causal relationship between breach and injury, and damages. Objective To identify the arguments related to legal duty. Results The Treating Tobacco Use and Dependence (revised 2000) CPG, sponsored by the US Public Health Service, recommends effective and inexpensive treatments for nicotine addiction, the largest preventable cause of death in the US, and can be used as an example to focus on important considerations about the appropriateness of CPGs in the judicial system. Furthermore, the failure of many doctors and hospitals to deal with tobacco use and dependence raises the question of whether this failure could be considered malpractice, given the Public Health Service guideline's straightforward recommendations, their efficacy in preventing serious disease and cost‐effectiveness. Conclusion Although each case of medical malpractice depends on a multitude of factors unique to individual cases, a court could have sufficient basis to find that the failure to adequately treat the main cause of preventable disease and death in the US qualifies as a violation of the legal duty that doctors and hospitals owe to patients habituated to tobacco use and dependence. PMID:17130373

Breakdowns in communication of radiological findings: an ethical and medico-legal conundrum.

Science.gov (United States)

Berlin, Leonard; Murphy, Daniel R; Singh, Hardeep

2014-12-01

Communication problems in diagnostic testing have increased in both number and importance in recent years. The medical and legal impact of failure of communication is dramatic. Over the past decades, the courts have expanded and strengthened the duty imposed on radiologists to timely communicate radiologic abnormalities to referring physicians and perhaps the patients themselves in certain situations. The need to communicate these findings goes beyond strict legal requirements: there is a moral imperative as well. The Code of Medical Ethics of the American Medical Association points out that "Ethical values and legal principles are usually closely related, but ethical obligations typically exceed legal duties." Thus, from the perspective of the law, radiologists are required to communicate important unexpected findings to referring physicians in a timely fashion, or alternatively to the patients themselves. From a moral perspective, radiologists should want to effect such communications. Practice standards, moral values, and ethical statements from professional medical societies call for full disclosure of medical errors to patients affected by them. Surveys of radiologists and non-radiologic physicians reveal that only few would divulge all aspects of the error to the patient. In order to encourage physicians to disclose errors to patients and assist in protecting them in some manner if malpractice litigation follows, more than 35 states have passed laws that do not allow a physician's admission of an error and apologetic statements to be revealed in the courtroom. Whether such disclosure increases or decreases the likelihood of a medical malpractice lawsuit is unclear, but ethical and moral considerations enjoin physicians to disclose errors and offer apologies.

Neonatal euthanasia: A claim for an immoral law.

Science.gov (United States)

Vanden Eijnden, Serge; Martinovici, Dana

2013-06-01

Active ending of the life of a newborn baby is a crime. Yet its clandestine practise is a reality in several European countries. In this paper, we defend the necessity to institute a proper legal frame for what we define as active neonatal euthanasia. The only legal attempt so far, the Dutch Groningen protocol, is not satisfactory. We critically analyse this protocol, as well as several other clinical practises and philosophical stances. Furthermore, we have tried to integrate our opinions as clinicians into a law project, with the purpose of pinpointing several issues, specific of perinatality that should be addressed by such a law. In conclusion, we argue that the legalisation of neonatal euthanasia under exceptional circumstances is the only way to avoid all the "well-intentioned" malpractices associated with ending life at the very dawn of it.

Medical-legal issues in headache: penal and civil Italian legislation, working claims, social security, off-label prescription.

Science.gov (United States)

Aguggia, M; Cavallini, M; Varetto, L

2006-05-01

Primary headaches can be considered simultaneously as symptom and disease itself, while secondary headaches are expressions of a pathological process that can be systemic or locoregional. Because of its subjective features, headache is often difficult to assess and quantify by severity, frequency and invalidity rate, and for these reasons it has often been implicated in legal controversies. Headache has seldom been considered in the criminal law, except when it represents a typical symptom of a disease whose existence can be objectively assessed (i. e. raised intracranial pressure). Therefore, in civil legislation it is not yet coded to start claiming for invalidity compensation. In particular, one of the most debated medical-legal questions is represented by headaches occurring after head injury. Headache is often the principal symptom at the beginning of several toxic chronic syndromes, with many implications, especially in working claims, and, more recently, it may be referred to as one of the most frequent symptoms by victims of mobbing (i. e. psychological harassment in the workplace). The National Institute for Industrial Accident Insurance (INAIL) scales (instituted by the law 38/2000) mention the "Subjective cranial trauma syndrome" and give an invalidity rate evaluation. With reference to other headache forms, no legislation really exists at the present time, and headache is only considered as a symptom of a certain coded disease. Requests for invalidity social pension and the question of off-label prescriptions (drug prescription for a disease, without formal indication for it) are other controversial matters.

Medicolegal aspects of rhinology practice.

Science.gov (United States)

Apaydin, N; Çomoğlu, S; Özer, Y; Avci, H; Eş, H; Orhan, K S

2016-10-01

To investigate rhinology-related malpractice claims with the aim of optimising safe practice. The database of the National Institute of Forensic Medicine was reviewed. In total, 241 otorhinolaryngology malpractice case reports dating from 2005 to 2012 were evaluated, and 83 malpractice cases related to rhinology treatments were separated. There was no significant difference between the number of male (n = 42) and female (n = 41) claimants. The mean patient age was 32.07 ± 10.53 years (range, 10-75 years). Seventy-nine cases involved surgical treatment in rhinology. The most common complaints were: unsatisfactory cosmetic results (n = 30), optic nerve injury (n = 10), septal perforation (n = 9) and intracranial penetration (n = 4). Malpractice was detected in 21 cases (25.3 per cent). No delinquency was found in 62 cases (74.7 per cent). Physicians should be aware of legal consequences related to rhinology practice. Further study is needed on this topic, as well as interdisciplinary collaboration, to ensure best practices and to avoid litigation.

Complementary and alternative medicine in child and adolescent psychiatry: legal considerations.

Science.gov (United States)

Cohen, Michael H; Natbony, Suzanne R; Abbott, Ryan B

2013-07-01

The rising popularity of complementary and alternative medicine (CAM) in child and adolescent psychiatry raises unique ethical and legal concerns for psychiatrists and other conventional health care providers. This article explores these concerns and provides clinical advice for promoting patient health and safety while minimizing the psychiatrist's risk. Although any departure from the conventional standard of care is a potential risk, the risk of malpractice liability for practicing integrative medicine in child and adolescent psychiatry is low. CAM is most safely recommended from a legal standpoint when there is some published evidence of safety and efficacy. Copyright © 2013 Elsevier Inc. All rights reserved.

Can shared decision-making reduce medical malpractice litigation? A systematic review.

Science.gov (United States)

Durand, Marie-Anne; Moulton, Benjamin; Cockle, Elizabeth; Mann, Mala; Elwyn, Glyn

2015-04-18

To explore the likely influence and impact of shared decision-making on medical malpractice litigation and patients' intentions to initiate litigation. We included all observational, interventional and qualitative studies published in all languages, which assessed the effect or likely influence of shared decision-making or shared decision-making interventions on medical malpractice litigation or on patients' intentions to litigate. The following databases were searched from inception until January 2014: CINAHL, Cochrane Register of Controlled Trials, Cochrane Database of Systematic Reviews, EMBASE, HMIC, Lexis library, MEDLINE, NHS Economic Evaluation Database, Open SIGLE, PsycINFO and Web of Knowledge. We also hand searched reference lists of included studies and contacted experts in the field. Downs & Black quality assessment checklist, the Critical Appraisal Skill Programme qualitative tool, and the Critical Appraisal Guidelines for single case study research were used to assess the quality of included studies. 6562 records were screened and 19 articles were retrieved for full-text review. Five studies wee included in the review. Due to the number and heterogeneity of included studies, we conducted a narrative synthesis adapted from the ESRC guidance for narrative synthesis. Four themes emerged. The analysis confirms the absence of empirical data necessary to determine whether or not shared decision-making promoted in the clinical encounter can reduce litigation. Three out of five included studies provide retrospective and simulated data suggesting that ignoring or failing to diagnose patient preferences, particularly when no effort has been made to inform and support understanding of possible harms and benefits, puts clinicians at a higher risk of litigation. Simulated scenarios suggest that documenting the use of decision support interventions in patients' notes could offer some level of medico-legal protection. Our analysis also indicated that a sizeable

Trends in US malpractice payments in dentistry compared to other health professions - dentistry payments increase, others fall.

Science.gov (United States)

Nalliah, R P

2017-01-13

Background Little is known about trends in the number of malpractice payments made against dentists and other health professionals. Knowledge of these trends will inform the work of our professional organisations.Methods The National Practitioner Data Bank (NPDB) in the United States was utilised. Data about malpractice payments against dentists, hygienists, nurses, optometrists, pharmacists, physicians (DO and MD), physicians' assistants, podiatrists, psychologists, therapists and counsellors during 2004-14 were studied. Variables include type of healthcare provider, year malpractice payment was made and range of payment amount.Results In 2004 there were 17,532 malpractice payments against the studied health professions. In 2014 there were 11,650. In 2004, the number of malpractice payments against dentists represented 10.3% of all payments and in 2014 it represented 13.4%. Number of malpractice payments against dentists in 2012-2014 increased from 1,388 to 1,555.Conclusions There is an upward pressure on the number of dental malpractice payments over the last 3 years. Concurrently, there is a downward pressure on the number of combined non-dentist healthcare professional malpractice payments.

The Multiplication Effect of Legal Insurance

NARCIS (Netherlands)

J.P.B. De Mot (Jef); B. Depoorter (Ben); M.G. Faure (Michael)

2016-01-01

textabstractBecause legal insurance policies cover the expenses of plaintiffs in bringing legal claims, such policies increase the risk of negligent or careless acts by tortfeasors. For this reason, potential tortfeasors would prefer to avoid injuring holders of legal insurance policies. Since

A Legal Analysis of the Precedents of Medical Disputes in the Cosmetic Surgery Field

Directory of Open Access Journals (Sweden)

Bo Young Park

2016-05-01

Full Text Available BackgroundDisputes regarding medical malpractice occur between practitioners and patients. As patients have become increasingly aware regarding medical care, an increase in the unexpected side effects of procedures has been observed, thereby leading to an increase in disputes regarding medical malpractice. In this study, we reviewed trends in precedents involving cosmetic surgery-related medical disputes, with the goal of helping to prevent unnecessary disputes in the future.MethodsWe conducted a search of the judgments made in South Korean courts between 2000 and 2013 that were related to the field of plastic surgery. A total of 54 judgments were analyzed, and the selected precedents were reviewed and classified according to the kind of negligence involved.ResultsThe claim amounts ranged from under 8 million KRW (6,991 USD to 750 million KRW (629,995 USD. The most common ratio of the judgment amount to the claim amount was 20%–30%. The judgments were classified according to the following categories: violation of the duty of explanation in 17 cases (29%, violation of the duty of care in 10 cases (17%, violation of both duties in 20 cases (35%, and no violation of duty in six cases (10%.ConclusionsCosmetic surgery-related suits require different approaches than general malpractice suits. The Supreme Court requires plastic surgeons to determine the type, timing, methods, and scope of their treatments when considering possible results. Therefore, practitioners should be educated on their rights and responsibilities to enable them to cope with any possible medical dispute that may arise.

A Legal Analysis of the Precedents of Medical Disputes in the Cosmetic Surgery Field.

Science.gov (United States)

Park, Bo Young; Kim, Min Ji; Kang, So Ra; Hong, Seung Eun

2016-05-01

Disputes regarding medical malpractice occur between practitioners and patients. As patients have become increasingly aware regarding medical care, an increase in the unexpected side effects of procedures has been observed, thereby leading to an increase in disputes regarding medical malpractice. In this study, we reviewed trends in precedents involving cosmetic surgery-related medical disputes, with the goal of helping to prevent unnecessary disputes in the future. We conducted a search of the judgments made in South Korean courts between 2000 and 2013 that were related to the field of plastic surgery. A total of 54 judgments were analyzed, and the selected precedents were reviewed and classified according to the kind of negligence involved. The claim amounts ranged from under 8 million KRW (6,991 USD) to 750 million KRW (629,995 USD). The most common ratio of the judgment amount to the claim amount was 20%-30%. The judgments were classified according to the following categories: violation of the duty of explanation in 17 cases (29%), violation of the duty of care in 10 cases (17%), violation of both duties in 20 cases (35%), and no violation of duty in six cases (10%). Cosmetic surgery-related suits require different approaches than general malpractice suits. The Supreme Court requires plastic surgeons to determine the type, timing, methods, and scope of their treatments when considering possible results. Therefore, practitioners should be educated on their rights and responsibilities to enable them to cope with any possible medical dispute that may arise.

32 CFR 536.111 - Investigation of claims arising under international agreements (for those claims arising in the...

Science.gov (United States)

2010-07-01

... under international agreements (for those claims arising in the United States). Responsibility for... civilian component is attached, including the legal office of another armed force, to carry out the responsibility to investigate. The investigation will comply with the responsible Service's implementing claims...

Medical Malpractice Phenomena: Signals for Changing Medical and Health Care Values

DEFF Research Database (Denmark)

Brødsgaard, I.; Moore, R.

1990-01-01

Excellent discussion of the economic factors such as medical malpractice and corporate medicine that have begun to interfere with the doctor-patient relationship and why this relationship is so essential in order to prevent medical malpractice. Issues of quality assurance are relevant to the doctor-patient...... relationship and the quality of health care....

Medical Malpractice Reform: A Fix for a Problem Long out of Fashion.

Science.gov (United States)

Kirkner, Richard Mark

2017-10-01

State tort reforms have all but relegated the malpractice crisis to the history books. But there's good news for those of you into all things retro: The House of Representatives just voted to fix the malpractice crisis by a 222-197 margin.

Epistemic dependence in contemporary science: Practices and malpractices

DEFF Research Database (Denmark)

Andersen, Hanne

2014-01-01

Despite an increased focus on scientific practice in the philosophy of science in recent years, there has been relatively little focus on malpractices such as intentional fraud or gross negligence. This is the more striking since malpractice in research  both in the form of outright misconduct...... such as fraud and deceit and in the form of the so-called ‘grey zone’ behavior such as sloppiness and incompetence  has been a topic of growing concern both among scientists themselves and among politicians, administrators and in the general population (for an overview of this development, see e.g. Steneck...

Trend of Malpractice Litigation against Neurosurgeons in Japan: An Analysis of Disclosed Database by Courts in Japan from 2001 through 2015.

Science.gov (United States)

Nagashima, Hisashi; Wada, Yoshitaka; Hongo, Kazuhiro

2017-08-15

Following the modern raising of public awareness, the numbers of malpractice litigation are increasing in the health care delivery system in Japan despite the extensive efforts of physicians. Authors reviewed the issues of litigation and the reasons for court decision from the healthcare-related negligence lawsuits in the past 15 years in Japan and investigated the cautionary points for reducing potential litigation. Healthcare-related negligence lawsuits between January 2001 and December 2015 were retrieved and sorted in each clinical field from the database in Courts in Japan and investigated on the proportional factors of the claims and court decisions in the neurosurgical field. During the period, 446 of healthcare-related court decisions including 41 against neurosurgeons (9.2%) were retrieved. Three of 41 decisions retrieved were decisions to retries for lower court decisions. In 38 claims against the neurosurgeons, 26 identified the negligence and 12 dismissed. In 26 decisions in favor of the plaintiffs, identified negligence in diagnosis in 4, clinical judgment in 3, technical skills in 5, clinical management in 7 and process of informed consent in 7. Five out of 18 decisions after 2006 were identified as negligence in an informed consent process, and additional one, who was mainly identified in inadequate technical skills also identified existing an inadequate informed consent process as a fundamental cause of litigation. Neurosurgeons are a higher risk group for malpractice litigation in Japan and adequate informed consent is important to reduce the risk of litigation.

Malpractice by physical therapists: descriptive analysis of reports in the National Practitioner Data Bank public use data file, 1991-2004.

Science.gov (United States)

Sandstrom, Robert

2007-01-01

As physical therapists increase autonomous practice, medical error becomes more important to public safety and public perceptions of the profession. The purpose of this study was to describe malpractice by physical therapists in the United States based on physical therapist malpractice reports in the National Practitioner Data Bank between January 1, 1991, and December 31, 2004. A frequency analysis of data related to physical therapist malpractice reports was performed. The relationship between size of malpractice payment and public policy related to access to physical therapist services and malpractice experience was explored. A total of 664 malpractice reports were found in the study period (mean, 47.73 events annually). California had 114 malpractice events, while Maine and Wyoming had none. The median payment amount for physical therapist malpractice was $10,000 to $15,000. "Treatment-related" events and events related to "improper technique" were the most common reasons for a malpractice report. Incidence of malpractice by physical therapists is low (estimated at 2.5 events/10,000 working therapists/year), and the average malpractice payment is small (public policy related to direct patient access to physical therapy services.

["The severe degree of negligence" and its application in the settle of medical malpractice].

Science.gov (United States)

Wang, You-Min; Zhang, Qin-Chu

2006-04-01

To found the quantifiable index of "The severe degree of negligence" in describing the general severity degree of medical malpractice or medical dispute. "The severe degree of negligence" can be calculated by the way of multiplying the coefficient of medical malpractice's grade by the coefficient of responsibility degree. There are 15 grades of "The severe degree of negligence" through calculation, from the severest degree of 1 to the lightest degree of 20. "The severe degree of negligence" can give an order of severe degree to different grade and different responsibility of medical malpractice. According to this order, the operation of medical malpractice and medical dispute settle will be easier and more rationality.

24 CFR 242.33 - Covenant for malpractice, fire, and other hazard insurance.

Science.gov (United States)

2010-04-01

... for malpractice, fire, and other hazard insurance. The mortgage shall contain a covenant binding the mortgagor to maintain adequate liability, fire, and extended coverage insurance on the property. The... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Covenant for malpractice, fire, and...

Correlates of Examination Malpractice among Secondary School Students in Oyo State, Nigeria

Science.gov (United States)

Animasahun, R. A.; Ogunniran, J. O.

2014-01-01

The purpose of this study is to investigate the correlates of examination malpractice among secondary school students in Oyo State, Nigeria. The instrument used for the study was tagged Predisposing Factors towards Examination Malpractice Questionnaire (PFTEMQ). The instrument was administered to 300 students randomly selected from 20 multi staged…

A Contemporary Medicolegal Analysis of Outpatient Medication Management in Chronic Pain.

Science.gov (United States)

Abrecht, Christopher R; Brovman, Ethan Y; Greenberg, Penny; Song, Ellen; Rathmell, James P; Urman, Richard D

2017-11-01

Opioids are frequently used in chronic pain management but are associated with significant morbidity and mortality in some patient populations. An important avenue for identifying complications-including serious or rare complications-is the study of closed malpractice claims. The present study is intended to complement the existing closed claims literature by drawing on claims from a more recent timeframe through a partnership with a large malpractice carrier, the Controlled Risk Insurance Company (CRICO). The goal of this study was to identify patient medical comorbidities and aberrant drug behaviors, as well as prescriber practices associated with patient injury and malpractice claims. Another objective was to identify claims most likely to result in payments and use this information to propose a strategy for reducing medicolegal risk. The CRICO Strategies Comparative Benchmarking System is a database of claims drawing from >350,000 malpractice claims from Harvard-affiliated institutions and >400 other academic and community institutions across the United States. This database was queried for closed claims from January 1, 2009, to December 31, 2013, and identified 37 cases concerning noninterventional, outpatient chronic pain management. Each file consisted of a narrative summary, including expert witness testimony, as well as coded fields for patient demographics, medical comorbidities, the alleged damaging event, the alleged injurious outcome, the total financial amount incurred, and more. We performed an analysis using these claim files. The mean patient age was 43.5 years, with men representing 59.5% of cases. Payments were made in 27% of cases, with a median payment of $72,500 and a range of $7500-$687,500. The majority of cases related to degenerative joint disease of the spine and failed back surgery syndrome; no patients in this series received treatment of malignant pain. Approximately half (49%) of cases involved a patient death. The use of long

20 CFR 429.103 - Who may file my claim?

Science.gov (United States)

2010-04-01

... authorized agent, or your legal representative may file the claim. (c) Claims based on death. The executor or... behalf as agent, executor, administrator, parent, guardian or other representative. ...

32 CFR 536.93 - Claims not payable under the Non-Scope Claims Act.

Science.gov (United States)

2010-07-01

... agent or employee. The doctrine of comparative negligence does not apply. (b) Is for medical, hospital... recoverable by the claimant under an indemnifying law or indemnity contract. If the claim is in part legally...

A report on 15 years of clinical negligence claims in rhinology.

Science.gov (United States)

Geyton, Thomas; Odutoye, Tunde; Mathew, Rajeev

2014-01-01

This study was designed to determine the characteristics of medical negligence claims in rhinology. In 2010-2011 the National Health Service (NHS) litigation bill surpassed 1 billion Great British Pounds (GBP; 1.52 billion U.S. dollars [US$]). Systematic analysis of malpractice complaints allows for the identification of errors and can thereby improve patient safety and reduce the burden of litigation claims on health services. Claims relating to ear, nose, and throat between 1995 and 2010 were obtained from the NHS Litigation Authority and were analyzed. The series contains 65 closed claims that resulted in payment totaling 3.1 million GBP (US$4.7 million). Fifty claims were related to surgical complications. Functional endoscopic sinus surgery and septoplasty were the procedures most commonly associated with successful claims. There were 11 cases of orbital injury including 6 cases of visual loss and 5 cases of diplopia. The most common cause of a claim was failure to recognize the complication or manage it appropriately. Lack of informed consent was claimed in eight cases. Other claims arose because of errors in outpatient procedures (two), diagnosis (six), delayed surgery (one), and errors in medical management (three). This is the first study to report the outcomes of negligence claims in rhinology in the United Kingdom. Claims in rhinology are associated with a high success rate. Steps that can be taken to reduce litigation include careful patient workup and ensuring adequate informed consent. Where there is a suspicion of orbital damage early recognition and intervention is needed to reduce long-term injury to the patient.

Assessment of risk in radiology using malpractice RVU

International Nuclear Information System (INIS)

Cristofaro, Massimo; Bellandi, Giuseppe; Squarcione, Salvatore; Petecchia, Antonella; Mammarella, Assunta; Bibbolino, Corrado

2007-01-01

Introduction: Analysis on the causes and remedies needed to reduce the incidence of malpractice has been under continual studies, although limited data is available regarding quantitative evaluation of the risk. Objectives: To determine radiological risk in a preventive and quantitative manner and verify if the malpractice relative value units (MP-RVU) are a good indicator of associated risk factors. Materials and methods: Radiological examinations executed by our Radiology Department in 2000-2004 have been codified according to nomenclature HCPCS (Healthcare Common Procedure Coding System) used by United States of America Centers for Medicare and Medicaid Services (CMS). For every examination was calculated the annual weight of malpractice. The data has been groupped in macroaggregates by methodology. The ratio MP-RVU/no. examinations has been considered as an index of insurance risk (MP index) Results: A total of 133,005 examinations were performed, which produced 25,252 MP-RVU points, the total mp index was 0.193. Traditional radiology represents 38% of the examinations, accounting for 8% of MP-RVU with a MP index = 0.039. Ultrasound represents 35% of the examinations, accounting for 23% of MP-RVU with a MP index = 0.125. CT represents 13% of the examinations, accounting for 28% of MP-RVU with a MP index = 0.434. MR represents 11% of the examinations, accounting for 39% of MP-RVU with a MP index = 0.667. Conclusions: Malpractice relative value units (MP-RVU) are indicative of the risk considered globally and when subgrouped. MP index correlates this risk with number of exams carried out divided by methodology. This model providing quantitative data for projects concerning risk management and in allowing the correlation between data obtained in different departments

Assessment of risk in radiology using malpractice RVU

Energy Technology Data Exchange (ETDEWEB)

Cristofaro, Massimo [U.O. di Diagnostica per Immagini, Istituto Nazionale per le Malattie Infettive IRCCS, L. Spallanzani Via Portuense, 292, 00149 Rome (Italy)]. E-mail: mcristofar@srm.org; Bellandi, Giuseppe [Servizio di Radiologia ASL 3 Ospedale di Pescia, Via Battisti 2, 51017 Pescia (PT) (Italy)]. E-mail: g.bellandi@mail.vdn.usl3.toscana.it; Squarcione, Salvatore [Direzione Sanitaria Istituto Istituto Nazionale per le Malattie Infettive IRCCS, L. Spallanzani, Via Portuense 292, 00149 Rome (Italy)]. E-mail: squarcione@inmi.it; Petecchia, Antonella [Direzione Sanitaria Istituto Istituto Nazionale per le Malattie Infettive IRCCS, L. Spallanzani, Via Portuense 292, 00149 Rome (Italy)]. E-mail: petecchia@inmi.it; Mammarella, Assunta [Direzione Sanitaria Istituto Istituto Nazionale per le Malattie Infettive IRCCS, L. Spallanzani, Via Portuense 292, 00149 Rome (Italy)]. E-mail: mammarella@inmi.it; Bibbolino, Corrado [U.O. di Diagnostica per Immagini, Istituto Nazionale per le Malattie Infettive IRCCS, L. Spallanzani Via Portuense, 292, 00149 Rome (Italy)]. E-mail: bibbolino@inmi.it

2007-02-15

Introduction: Analysis on the causes and remedies needed to reduce the incidence of malpractice has been under continual studies, although limited data is available regarding quantitative evaluation of the risk. Objectives: To determine radiological risk in a preventive and quantitative manner and verify if the malpractice relative value units (MP-RVU) are a good indicator of associated risk factors. Materials and methods: Radiological examinations executed by our Radiology Department in 2000-2004 have been codified according to nomenclature HCPCS (Healthcare Common Procedure Coding System) used by United States of America Centers for Medicare and Medicaid Services (CMS). For every examination was calculated the annual weight of malpractice. The data has been groupped in macroaggregates by methodology. The ratio MP-RVU/no. examinations has been considered as an index of insurance risk (MP index) Results: A total of 133,005 examinations were performed, which produced 25,252 MP-RVU points, the total mp index was 0.193. Traditional radiology represents 38% of the examinations, accounting for 8% of MP-RVU with a MP index = 0.039. Ultrasound represents 35% of the examinations, accounting for 23% of MP-RVU with a MP index = 0.125. CT represents 13% of the examinations, accounting for 28% of MP-RVU with a MP index = 0.434. MR represents 11% of the examinations, accounting for 39% of MP-RVU with a MP index = 0.667. Conclusions: Malpractice relative value units (MP-RVU) are indicative of the risk considered globally and when subgrouped. MP index correlates this risk with number of exams carried out divided by methodology. This model providing quantitative data for projects concerning risk management and in allowing the correlation between data obtained in different departments.

Predictors of examination malpractice among secondary school ...

African Journals Online (AJOL)

African Journal for the Psychological Study of Social Issues ... Validated scales were used to collect data and SPSS was used to carry out a t-test and stepwise ... Keywords: Examination, Malpractice, Text Anxiety, Secondary School Students.

32 CFR 842.46 - Who may file a claim.

Science.gov (United States)

2010-07-01

... authorized agents may file claims for personal injury. (c) Duly appointed guardians of minor children or any other persons legally entitled to do so under applicable local law may file claims for minors' personal... action surviving an individual's death. (e) Insurers with subrogation rights may file claims for losses...

[Malpractice in laparoscopic cholecystectomy. Results of cases recently considered by the Expert Commission].

Science.gov (United States)

Kienzle, H F

1999-01-01

The Expert Commission for medical malpractice which is part of the Medical Chamber of Nordrhein received about 60 applications in connection with laparoscopic cholecystectomy; as of August 1998 5 complaints were let off and 11 of them are still being considered. So far 44 complaints have been considered and in 25 of them medical malpractice has been established. The medical malpractice detected laparoscopic cholecystectomy cases were mainly bile duct injuries of which 13 required a biliodigestive anastomosis for reconstruction, four cases required and end-to-end anastomosis and in one case a T-tube drainage was needed. The youngest one of these patients was 21 years old, the oldest one was 61 years old. Four times the bile duct injury was not considered as malpractice, because it could be intraoperatively made out and immediately treated. Trocar injuries were twice a cause for malpractice and once it was not. Each of the following cases was also recognized as a malpractice. One lost gallstone one dislocated Roedersnare, one electric injury, one delayed reintervention and one insufficient information. The following cases were decided as non-malpractice: in two cases a slipped clip, in five cases subhepatical hematoma/abscess, in three cases a secondary bleeding, once a lesion of the splenic capsule and finally a running sore with subsequent incisional hernia. Three courses of treatment with consequence of death also contained mistakes: one electric injury of the bowel, one bile duct lesion and one information rebuke. The bile duct injury is the most considerable risk for laparoscopic cholecystectomy and implies also a high risk for the future health. The experienced surgeon distinguishes himself by the fact that he is right about the situation and converts sooner that later to conventional cholecystectomy if there's any doubt. In open surgery the principle is applied that structures may be only divided when they are clearly identified. The same goes even on a wider

Legal and regulatory education and training needs in the healthcare industry.

Science.gov (United States)

Henson, Steve W; Burke, Debra; Crow, Stephen M; Hartman, Sandra J

2005-01-01

As in any other industry, laws and regulations significantly impact the functioning of the healthcare industry. Some laws, such as those relating to malpractice and social insurance systems, affect the manner in which the industry operates. Other laws, such as those regulating antitrust and employment practices, affect the organization and the environment in which the industry operates. It is increasingly important that practitioners and managers be cognizant of this complex and dynamic legal minefield. This study examined healthcare managers and executives' knowledge of 9 key issues in the legal and regulatory environment of the healthcare industry. Specifically, the study focused on knowledge concerning tort and contract liability, insurance law, labor and employment regulation, criminal and ethical responsibility, antitrust regulation, the law governing business associations and recent developments. Findings suggest that the levels of knowledge required to manage legal and regulatory issues are much greater than the existing levels of knowledge.

Analysis of 11 years of clinical negligence claims in esophagogastric cancer in England.

Science.gov (United States)

Ratnasingham, K; Stroud, L; Knight, J; Preston, S R; Sultan, J

2017-04-01

In the National Health Service (NHS), clinical negligence claims and associated compensations are constantly rising. The aim of this study is to identify the size, trends, and causes of litigations claims in relation to esophagogastric (EG) cancer in the NHS. Data requests were submitted to the NHS Litigation Authority (NHSLA) for the period of January 2003 to December 2013. Data were reviewed, categorized clinically, and analyzed in terms of causes and costs behind claims. In this time period, there were 163 claims identified from the NHSLA database. Ninety-five (58.3%) claims were successful with a pay out of £6.25 million. An increasing overall claim frequency and success rate were found over the last few years. Majority of the claims were from gastric cancer 84 (88.4%). The commonest cause of complaint in successful claims was delay or failure in diagnosis (21.1%) and treatment (17.9%). There were only 10.5% successful intraoperative claims, of which 50% were due to unnecessary or additional procedures. The frequency and success rates of malpractice claims in EG cancer are rising. The failure or delay in diagnosing and treatment in EG malignancy are the common cause for successful litigation claims. The findings further reinforce the need to improve early diagnosis. © The Authors 2017. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Telemental Health for Children and Adolescents: An Overview of Legal, Regulatory, and Risk Management Issues.

Science.gov (United States)

Kramer, Gregory M; Luxton, David D

2016-04-01

The use of technology to provide telemental healthcare continues to increase; however, little has been written about the legal and regulatory issues involved in providing this form of care to children and adolescents. This article reviews existing laws and regulations to summarize the risk management issues relevant to providing telemental healthcare to children and adolescents. There are several legal and regulatory areas in which telemental health clinicians need to have awareness. These areas include: 1) Licensure, 2) malpractice liability, 3) credentialing and privileging, 4) informed consent, 5) security and privacy, and 6) emergency management. Although legal and regulatory challenges remain in providing telemental healthcare to children and adolescents, it is possible to overcome these challenges with knowledge of the issues and appropriate risk management strategies. We provide general knowledge of these key legal and regulatory issues, along with some risk management recommendations.

Leading Causes of Anesthesia-Related Liability Claims in Ambulatory Surgery Centers.

Science.gov (United States)

Ranum, Darrell; Beverly, Anair; Shapiro, Fred E; Urman, Richard D

2017-11-16

We present a contemporary analysis of patient injury, allegations, and contributing factors of anesthesia-related closed claims, which involved cases that specifically occurred in free-standing ambulatory surgery centers (ASCs). We examined ASC-closed claims data between 2007 and 2014 from The Doctors Company, a medical malpractice insurer. Findings were coded using the Comprehensive Risk Intelligence Tool developed by CRICO Strategies. We compared coded data from ASC claims with hospital operating room (HOR) claims, in terms of injury severity category, nature of injury, nature of allegation, contributing factors identified, and contributing comorbidities and claim value. Ambulatory surgery center claims were more likely to be classified as medium severity than HOR claims, more likely to involve dental damage or pain than HOR claims, but less likely to involve death or respiratory or cardiac arrest. Technical performance was the most common contributing factor: 47% of ASCs and 48% of HORs. Only 7% of allegations relating to technical performance were judged to be a direct result of poor technical performance. The most common anesthesia procedures resulting in ASC claims were injection of anesthesia into a peripheral nerve (34%) and intubation (29%). Obesity was the most common contributing comorbidity in both settings. Mean closed claim value was significantly lower for ASC than HOR claims, averaging US $87,888 versus $107,325. Analysis of ASC and HOR claims demonstrates significant differences and several common sources of liability. These include improving strategies for thorough screening, preoperative assessment and risk stratifying of patients, incorporating routine dental and airway assessment and documentation, diagnosing and treating perioperative pain adequately, and improving the efficacy of communication between patients and care providers.

Mandatory presuit mediation: 5-year results of a medical malpractice resolution program.

Science.gov (United States)

Jenkins, Randall C; Smillov, Arlene E; Goodwin, Matthew A

2014-01-01

The Florida Patient Safety and Presuit Mediation Program (FLPSMP) is a mandatory mediation program designed to provide deserving patients with fast, fair compensation while limiting the healthcare provider expenses incurred during traditional litigation. Mediation occurs before litigation begins; therefore, patients with meritorious claims receive compensation often years earlier than they would with extended litigation. This early mediation fosters confidential and candid communication between doctors and patients, which promotes early fact-finding and candid discussion. The program went into effect across the University of Florida (UF) Health system on January 1, 2008. In an article previously published in this journal, we discussed the positive trend observed 2 years after the implementation of the FLPSMP. This article incorporates 5 years of data, which includes new benchmarks with state and national data, to demonstrate that the program can be used successfully as a medical malpractice solution. © 2014 American Society for Healthcare Risk Management of the American Hospital Association.

BLM Colorado Mining Claims Closed

Data.gov (United States)

Department of the Interior — Shapefile Format –This data set consists of closed mining claim records extracted from BLM’s LR2000 database. These records contain case attributes as well as legal...

BLM Colorado Mining Claims Active

Data.gov (United States)

Department of the Interior — Shapefile Format –This data set consists of active mining claim records extracted from BLM’s LR2000 database. These records contain case attributes as well as legal...

Creditors’ claims in bankruptcy proceedings - issues and concerns

Directory of Open Access Journals (Sweden)

Viktor Palić

2013-12-01

Full Text Available A generally accepted rule in the bankruptcy law is that a bankruptcy creditor can file a claim against the debtor only in bankruptcy proceedings. This rule has a legal effect. If the creditor’s claim in the bankruptcy proceeding has not been disputed, the creditor is not able to instigate legal and execution proceedings. Obviously, this applies to financial claims. However, it is not clear whether the above can be applied when the claim is not financial but when it concerns a request for the nullification of a contract. It is of particular interest whether such a request can be made by a counterclaim against the debtor in an ordinary judicial proceeding or only in bankruptcy proceedings. Using a practical example, the authors concluded that it is possible for a creditor to make a request for the nullification of a contract by a counterclaim in a civil lawsuit.

Systematic analysis of ear-nose-throat malpractice complaints may be beneficial for patient safety

DEFF Research Database (Denmark)

Nikoghosyan-Bossen, Gohar; Hauberg, Agnes; Homøe, Preben

2012-01-01

The analysis of malpractice complaints can provide valuable information on patient safety. This study offers a detailed examination of the backgrounds concerning reasons and outcomes of ear, nose and throat (ENT) malpractice complaints handled by the National Board of Patients' Complaints (NBPC),...

Pereira's attack on legalizing euthanasia or assisted suicide: smoke and mirrors.

Science.gov (United States)

Downie, J; Chambaere, K; Bernheim, J L

2012-06-01

To review the empirical claims made in: Pereira J. Legalizing euthanasia or assisted suicide: the illusion of safeguards and controls. Curr Oncol 2011;18:e38-45. We collected all of the empirical claims made by Jose Pereira in "Legalizing euthanasia or assisted suicide: the illusion of safeguards and controls." We then collected all reference sources provided for those claims. We compared the claims with the sources (where sources were provided) and evaluated the level of support, if any, the sources provide for the claims. We also reviewed other available literature to assess the veracity of the empirical claims made in the paper. We then wrote the present paper using examples from the review. Pereira makes a number of factual statements without providing any sources. Pereira also makes a number of factual statements with sources, where the sources do not, in fact, provide support for the statements he made. Pereira also makes a number of false statements about the law and practice in jurisdictions that have legalized euthanasia or assisted suicide. Pereira's conclusions are not supported by the evidence he provided. His paper should not be given any credence in the public policy debate about the legal status of assisted suicide and euthanasia in Canada and around the world.

12 CFR 793.3 - Administrative claim; who may file.

Science.gov (United States)

2010-01-01

... authorized agent, or his legal representative. (c) A claim based on death may be presented by the executor or... accompanied by evidence of his authority to present a claim on behalf of the claimant as agent, executor...

Infidelity and the Possibility of a Liberal Legal Moralism

DEFF Research Database (Denmark)

Thaysen, Jens Damgaard

2017-01-01

This paper argues that according to the influential version of legal moralism presented by Moore infidelity should all-things-considered be criminalized. This is interesting because criminalizing infidelity is bound to be highly controversial and because Moore’s legal moralism is a prime example...... of a self-consciously liberal legal moralism, which aims to yield legislative implications that are quite similar to liberalism, while maintaining that morality as such should be legally enforced. Moore tries to make his theory yield such implications, first by claiming that the scope of our moral...... obligations is much more limited than legal moralists have traditionally claimed, and second by allowing for the possibility that the goodness of legally enforcing morality is often outweighed by the badness of limiting citizens’ morally valuable autonomy and spending scarce resources on enforcement. If Moore...

27 CFR 70.123 - Claims for credit or refund.

Science.gov (United States)

2010-04-01

..., documentary evidence to establish the legal authority of the fiduciary need not accompany the claim, provided... necessary documentary evidence should accompany the claim. A claim may be executed by an agent of the person... Office of Management and Budget under control number 1512-0141) (26 U.S.C. 6402) [T.D. ATF-251, 52 FR...

Root Canal Stripping: Malpractice or Common Procedural Accident-An Ethical Dilemma in Endodontics.

Science.gov (United States)

Ciobanu, Ionela Elisabeta; Rusu, Darian; Stratul, Stefan-Ioan; Didilescu, Andreea Cristina; Cristache, Corina Marilena

2016-01-01

Root canal stripping is defined as an oblong, vertical perforation that appears especially in the middle section of curved root canals during endodontic treatments with nickel-titanium (Ni-Ti) instruments. Its occurrence may drastically affect the outcome of the treatment, transforming a common otherwise efficient endodontic procedure into a complication such as tooth extraction. In order to discuss the ethical and legal consequences, two cases of dental strip perforations are herewith presented. Due to the existence of risk factors for dental strip perforation, experience of the clinician and the use of magnification and modern imagistic methods (CBCT) may avoid or reduce the frequency of this type of accidents. Under correct working circumstances, dental stripping should not be regarded as a malpractice but as a procedural accident. However, the patient must always be informed, before and during the endodontic procedure, about the event and the possible complications that may occur.

Nuclear liability claims handling and costs - Germany and some comparative solutions

International Nuclear Information System (INIS)

Harbruecker, D.

2000-01-01

Comparison of legal status in Central Europe: coverage by insurance and State intervention, coverage of legal expenses and interests on awards technical problems of claims handing after a nuclear incident: guidelines to be prepared by insurer before and not after an incident occurred, demands on provider of financial security claims handling for part guaranteed by State to be transferred to insurer, necessary regulations of such arrangements (author)

Factor Responsible for Examination Malpractices as Expressed by Undergraduates of Osun State University, Nigeria

Science.gov (United States)

Yusuf; Adeoti, Florence; Olufunke, Yinusa Rasheedat; Ruth, Bamgbose Oluwayemisi

2015-01-01

The study investigated perception of undergraduates on factors responsible for examination malpractices. The study is a descriptive study; a sample of two hundred (200) undergraduates formed the participants for the study. A questionnaire titled: "Factor responsible for examination malpractices was used for data collection. Data collected…

45 CFR 60.7 - Reporting medical malpractice payments.

Science.gov (United States)

2010-10-01

... note), (v) Date of birth, (vi) Name of each professional school attended and year of graduation, (vii... malpractice has occurred. (Approved by the Office of Management and Budget under control number 0915-0126) ...

Is South Africa on the verge of a medical malpractice litigation storm ...

African Journals Online (AJOL)

A healthy tension between the medical and legal professions should lead to an overall improvement in quality of health care, but consideration will need to be given to issues such as specialist courts, alternative means of resolution, claim quantum determination and capping. Although these issues will technically not ...

Legal aspects of cruise medicine - can a non-US ship's doctor be sued for malpractice in Florida?

Science.gov (United States)

Dahl, Eilif

2014-01-01

An English ship's doctor treated a non-US female patient for abdominal discomfort on a foreign-flagged cruise ship off the coast of Haiti. In Mexico the patient underwent abdominal surgery, followed by complications, for which her lawyers wanted to take the ship's doctor to court in Florida, USA. A trial court granted their wish, but this decision was reversed on appeal as the factors discussed were insufficient to establish Florida jurisdiction over the ship's doctor. The decision is not about whether malpractice occurred; it is about limiting the possibility of taking the ship's doctor to a court in a location preferred by the plaintiffs' lawyers. The appeal court ruling is important for non-US doctors working as independent contractors on cruise vessels that visit US ports, and it will hopefully prevent some of the more frivolous law suits from being filed in the future.

Analysis of Factors Associated With Rhytidectomy Malpractice Litigation Cases.

Science.gov (United States)

Kandinov, Aron; Mutchnick, Sean; Nangia, Vaibhuv; Svider, Peter F; Zuliani, Giancarlo F; Shkoukani, Mahdi A; Carron, Michael A

2017-07-01

This study investigates the financial burden of medical malpractice litigation associated with rhytidectomies, as well as factors that contribute to litigation and poor defendant outcomes, which can help guide physician practices. To comprehensively evaluate rhytidectomy malpractice litigation. Jury verdict and settlement reports related to rhytidectomy malpractice litigations were obtained using the Westlaw Next database. Use of medical malpractice in conjunction with several terms for rhytidectomy, to account for the various procedure names associated with the procedure, yielded 155 court cases. Duplicate and nonrelevant cases were removed, and 89 cases were included in the analysis and reviewed for outcomes, defendant specialty, payments, and other allegations raised in proceedings. Data were collected from November 21, 2015, to December 25, 2015. Data analysis took place from December 25, 2015, to January 20, 2016. A total of 89 cases met our inclusion criteria. Most plaintiffs were female (81 of 88 with known sex [92%]), and patient age ranged from 40 to 76 years (median age, 56 years). Fifty-three (60%) were resolved in the defendant's favor, while the remaining 36 cases (40%) were resolved with either a settlement or a plaintiff verdict payment. The mean payment was $1.4 million. A greater proportion of cases involving plastic surgeon defendants were resolved with payment compared with cases involving defendants with ear, nose, and throat specialty (15 [36%] vs 4 [24%]). The most common allegations raised in litigation were intraoperative negligence (61 [69%]), poor cosmesis or disfigurement (57 [64%]), inadequate informed consent (30 [34%]), additional procedures required (14 [16%]), postoperative negligence (12 [14%]), and facial nerve injury (10 [11%]). Six cases (7%) involved alleged negligence surrounding a "lifestyle-lift" procedure, which tightens or oversews the superficial muscular aponeurosis system layer. In this study, although most cases of

External Quality Assurance in Higher Education: How Can It Address Corruption and Other Malpractices?

Science.gov (United States)

Martin, Michaela

2016-01-01

Corruption and malpractices in higher education are today a major concern in nearly all higher education systems worldwide. It is a multifaceted phenomenon and has become particularly visible in the academic domain. This paper represents an exploration of the possible role that quality assurance can play in addressing corruption and malpractices.…

Legal pluralism and social justice in economic and political development

NARCIS (Netherlands)

Benda-Beckmann, von F.

2001-01-01

Legal pluralism is an approach which accepts the possibility that within any given polity, there can be more than one 'legal order' and that the state is not the exclusive source of legal regulation. Nevertheless, defining whether a particular claim or social relation is legally sanctioned is a

Parenting styles, gender, religiosity and examination malpractices ...

African Journals Online (AJOL)

This study examined the influence of parenting styles, gender and religiousity on the attitude of students towards examination malpractices. One hundred and ninety –eight participants were used which comprises of 100 males and 98 females of Adekunle Ajasin University, Akungba- Akoko in Ondo state. Parental care scale ...

Factors Influencing Examination Malpractice in Secondary Schools ...

African Journals Online (AJOL)

The main purpose of this study was to investigate factors influencing examination malpractice in some selected secondary schools in Cross River State, Nigeria. A sample of one thousand two hundred (1200) students were selected across the three educational zones of Ogoja, Ikom and Calabar using stratified, random ...

Poor Agreement Among Expert Witnesses in Bile Duct Injury Malpractice Litigation An Expert Panel Survey

NARCIS (Netherlands)

de Reuver, Philip R.; Dijkgraaf, Marcel G. W.; Gevers, Sjef K. M.; Gouma, Dirk J.

2008-01-01

Objective: To determine the inter-rater agreement of expert witness testimonies in bile duct injury malpractice litigation. Background Data: Malpractice litigation is an increasing concern in modem surgical practice. As most of the lawyers are not educated in medicine, expert witnesses are asked to

Poor agreement among expert witnesses in bile duct injury malpractice litigation: an expert panel survey.

NARCIS (Netherlands)

Reuver, P.R. de; Dijkgraaf, M.G.; Gevers, S.K.; Gouma, D.J.; Bleichrodt, R.P.; Cuesta, M.A.; Erp, W.F. van; Gerritsen, J.; Hesselink, E.J.; Laarhoven, C.J.H.M. van; Lange, J. de; Obertop, H.; Stassen, L.P.; Terpstra, O.T.; Tilanus, H.W.; Vroonhoven, T.J.; Wit, L. de

2008-01-01

OBJECTIVE: To determine the inter-rater agreement of expert witness testimonies in bile duct injury malpractice litigation. BACKGROUND DATA: Malpractice litigation is an increasing concern in modern surgical practice. As most of the lawyers are not educated in medicine, expert witnesses are asked to

Medicine beyond borders: the legal and ethical challenges.

Science.gov (United States)

Kassim, Puteri Nemie J

2009-09-01

The ease and affordability of international travel has contributed to the rapid growth of the healthcare industry where people from all around the world are traveling to other countries to obtain medical, dental, and surgical care while at the same time touring, vacationing and fully experiencing the attractions of the countries that they are visiting. A combination of many factors has led to the recent increase in popularity of medical tourism such as exorbitant costs of healthcare in industrialized nations, favorable currency exchange rates in the global economy, rapidly improving technology in many countries of the world and most importantly proven safety of healthcare in selected foreign nations. Nevertheless, the development of medical tourism has certainly awakened many ethical and legal issues, which must be addressed. Issues pertaining to malpractice, consumer protection, organ trafficking, alternative medicine and telemedicine need comprehensive legal regulatory framework to govern them. Ethical issues are also been raised by the promotion of medical tourism in particular those pertaining to doctor and patient relationship. A future, where medical law is subsumed into various legal and ethical dimensions, poses serious challenges for the practice and ethics of medicine.

Clinical psychopharmacology and medical malpractice: the four Ds.

Science.gov (United States)

Preskorn, Sheldon H

2014-09-01

The four Ds of medical malpractice are duty, dereliction (negligence or deviation from the standard of care), damages, and direct cause. Each of these four elements must be proved to have been present, based on a preponderance of the evidence, for malpractice to be found. The principles of psychopharmacology and the information in the package insert for a drug often play a central role in deciding whether dereliction and direct cause for damages were or were not applicable in a particular case. The author uses data from two cases in which patients were inadvertently fatally poisoned by medication to illustrate two ways in which such information can affect the outcome. In one case, the clinician should have known that he was giving a toxic dose to the patient, whereas that was not true in the other case.

Examination Management and Examination Malpractice: The Nexus

Science.gov (United States)

Ogunji, James A.

2011-01-01

Examination malpractice or cheating has become a global phenomenon. In different countries of the world today, developed and developing, academic dishonesty especially cheating in examinations has heightened and taken frightening dimension. In many countries of the world this phenomenon has become a serious matter of concern that has left many…

Professional liability in orthopaedics and traumatology in Italy.

Science.gov (United States)

Tarantino, Umberto; Giai Via, Alessio; Macrì, Ernesto; Eramo, Alessandro; Marino, Valeria; Marsella, Luigi Tonino

2013-10-01

Interest in medical errors has increased during the last few years owing to the number of medical malpractice claims. Reasons for the increasing number of claims may be related to patients' higher expectations, iatrogenic injury, and the growth of the legal services industry. Claims analysis provides helpful information in specialties in which a higher number of errors occur, highlighting areas where orthopaedic care might be improved. We determined: (1) the number of claims involving orthopaedics and traumatology in Rome; (2) the risk of litigation in elective and trauma surgery; (3) the most common surgical procedures involved in claims and indemnity payments; (4) the time between the adverse medical event and the judgment date; and (5) issues related to informed consent. We analyzed 1925 malpractice judgments decided in the Civil Court of Rome between 2004 and 2010. In total, 243 orthopaedics claims were filed, and in 75% of these cases surgeons were found liable; 149 (61%) of these resulted from elective surgery. Surgical teams were sued in 30 claims and found liable in 22. The total indemnity payment ordered was more than €12,350,000 (USD 16,190,000). THA and spinal surgery were the most common surgical procedures involved. Inadequate informed consent was reported in 5.3% of cases. Our study shows that careful medical examination, accurate documentation in medical records, and adequate informed consent might reduce the number of claims. We suggest monitoring of court judgments would be useful to develop prevention strategies to reduce claims.

Vrednotenje tveganja za nastanek zapleta in sprožitev spora v gastrointestinalni endoskopiji

Directory of Open Access Journals (Sweden)

Davorin Dajčman

2005-07-01

Full Text Available Background: Discussion of risk management may seem trivial to physician in the day-to-day activities of practice. Most physicians recognize the benefits of being proactive in trying to minimize the risks of malpractice litigation through careful documentation, informed consent and adhering to accepting many other areas of risk. The standard of care is a legal concept within professional guidelines describing the duty that physician endoscopists fulfill in their care of a patient. The endoscopist’s legal duty is to practice within the reasonable standard of care. A failure to practice within the standard constitutes a »breach of duty«, which is one of the elements of proof that a plaintiff must satisfy to win a malpractice claim. Practicing within the standard is the endoscopist’s ultimate legal defense. Unrequested interaction between practitioners of the legal and medical fields is not usually the one anticipated with great pleasure by people at all.Conclusions: This article considers endoscopists’ practice from the legal point of view concepts and provide a better understanding how the standards and guidelines in gastrointestinal endoscopy reflect clinical practice. It is also meant for endoscopists and any other physicians who are interested in reviewing their practices for potentially litigious situations and in discussion how to optimize their protection against a successful judgment.

Errors and malpractice lawsuits in radiology: what the radiologist needs to know.

Science.gov (United States)

Busardò, Francesco Paolo; Frati, Paola; Santurro, Alessandro; Zaami, Simona; Fineschi, Vittorio

2015-09-01

All medical specialties dealing with patients include an intrinsic risk in exposing them to issues resulting from human errors. Radiology is not spared from this risk since it includes "decision-making under conditions of uncertainty." In medical imaging, the line between the word "error" and misdiagnosis or discrepancy is very difficult to demarcate, mainly because the diagnostic process is not a binary relation and it is not always possible to establish if a pathological condition is present or not. The error in radiology is strongly related to the diagnostic process; hence, it can be defined as a "diagnostic error" which represents the most common cause of medical malpractice suits against radiologists. In this paper, the authors described the features of errors occurring in radiology, trying to establish their impact and prevalence. Secondly, some data coming from different countries were compared in order to highlight the most frequent causes leading to malpractice lawsuits in radiology and how the phenomenon of malpractice in this field is represented worldwide.

Physicians and strikes: can a walkout over the malpractice crisis be ethically justified?

Science.gov (United States)

Fiester, Autumn

2004-01-01

Malpractice insurance rates have created a crisis in American medicine. Rates are rising and reimbursements are not keeping pace. In response, physicians in the states hardest hit by this crisis are feeling compelled to take political action, and the current action of choice seems to be physician strikes. While the malpractice insurance crisis is acknowledged to be severe, does it justify the extreme action of a physician walkout? Should physicians engage in this type of collective action, and what are the costs to patients and the profession when such action is taken? I will offer three related arguments against physician strikes that constitute a prima facie prohibition against such action: first, strikes are intended to cause harm to patients; second, strikes are an affront to the physician-patient relationship; and, third, strikes risk decreasing the public's respect for the medical profession. As with any prima facie obligation, there are justifying conditions that may override the moral prohibition, but I will argue that the current malpractice crisis does not rise to the level of such a justifying condition. While the malpractice crisis demands and justifies a political response on the part of the nation's physicians, strikes and slow-downs are not an ethically justified means to the legitimate end of controlling insurance costs.

Radiation injury claims: an overview and update

International Nuclear Information System (INIS)

Schaffer, W.G.

1984-01-01

The author reviews the radiation injury claims problem and summarizes the legal framework in which the claims are presently brought. Two cases are reviewed in which the decisions are troubling. The implications of these decisions are discussed in the overall radiation injury claims problem. The author notes that in the largest radiation injury case tried in the United States, the court was unable to resolve the claims within the confines of the existing law. The disregard for established norms of adjudication and the resultant decline in predictability of outcome portends grave consequences, not only for the nuclear industry but for other industries involved with potentially toxic substances

LEGAL PROTECTION VERSUS LEGAL CONSCIOUSNESS (The changing Perspective in Law and Society Research

Directory of Open Access Journals (Sweden)

Muhammad Helmy Hakim

2016-05-01

Full Text Available Considering the important role of historical, cultural, social, and attitudinal aspects in the study of law, there has been a shift from instrumental law to constitutive law. While instrumental law considers law beyond the social and cultural spheres, constitutive law integrally embraces law, politics, ideology, and action. Legal consciousness is an important asset for marginalised people who are at high risk of discriminative treatments in occupational and social life. Not only will they are legally aware of their rights and obligations at works, they will have adequate knowledge of where and how to name, blame, and claim in case mistreatment do occur. Legally proficient will allow them build legal protection which is not adequately provided by the authorized bodies.

38 CFR 10.43 - Claim by guardian of child of veteran.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Claim by guardian of... AFFAIRS ADJUSTED COMPENSATION Adjusted Compensation; General § 10.43 Claim by guardian of child of veteran. A claim made by a legal guardian on behalf of his or her ward, a child of a veteran, shall be...

Complications and patient-injury after ankle fracture surgery. -A closed claim analysis with data from the Patient Compensation Association in Denmark

DEFF Research Database (Denmark)

Bjørslev, Naja; Ebskov, Lars Bo; Mersø, Camilla

2018-01-01

BACKGROUND: The Patient Compensation Association (PCA) receives claims for financial compensation from patients who believe they have sustained damage from their treatment in the Danish health care system. In this study, we have analysed closed claims in which patients suffered injuries due...... to the surgical treatment of their ankle fracture. We identified causalities contributing to these injuries and malpractices, as well as the economic consequences of these damages. METHODS: Fifty-one approved closed claims from the PCA database from the years 2004-2009 were analysed in a retrospective systematic...... of damages. General recommendations regarding ORIF were not followed in 21/49 of the perioperative damages. The pronation fracture was the most common. The patients received a total average compensation of 17.561 USD each. CONCLUSION: Managing the complex ankle fracture, requires considerable experience...

Examination Malpractice in Nigeria: Rank-ordering the Types ...

African Journals Online (AJOL)

Although 'giraffing' and carrying of prepared materials into the examination hall were the most common forms of examination malpractice, bribery (ranked 4.5) was the anchor. Students, peer group and parents were the worst malpractitioners in a decreasing order of culpability. Overvaluing of certificates and teachers' ...

Claims of Need in Property Law and Politics

DEFF Research Database (Denmark)

Cockburn, Patrick Joseph

2016-01-01

between the claims of the needy and the rights of property owners. Against this backdrop this article compares three theoretical accounts of how the fact of human need should impact upon our thinking about property rights: the rights-based arguments of Jeremy Waldron, the radical democratic theory...... of Lawrence Hamilton, and the anarchist commentary of Colin Ward. While ‘theories’ of need have paid much attention to the nature of need ‘itself’, the paper argues that this comparison reveals another issue that is just as important: where and how should claims of need be registered in legal and political......Both courts of law and political theorists have grappled with the problem of giving the concept of ‘need’ a place in our reasoning about the rights and wrongs of property regimes. But in the UK, legal changes in the last 15 years have eroded the legal possibilities for striking some compromise...

Liability versus innovation: the legal case for regenerative medicine.

Science.gov (United States)

Keren-Paz, Tsachi; El Haj, Alicia J

2014-10-01

Medical innovation occupies a position somewhere between standard practice and clinical research, but innovation is primarily intended to benefit an individual patient where standard treatment fails. Medical innovations in the area of regenerative medicine have the potential to completely transform medical practice, but rely upon some major revision to the nature of treatments beyond drug-based therapies. There is considerable investment in scientific and clinical research, but further attention could be paid to legal barriers to medical innovation imposed by the threat of medical malpractice. We survey in this article the legal framework for making determinations of medical malpractice in general, and highlight the issues specific to innovative treatments. In essence, liability could be imposed for failing to adequately inform the patient about the innovative nature of the suggested therapy or based on the fact that the risks outweighed the benefits. As for the latter, we examine whether liability is likely to be based merely on deviating from existing practice or on an examination on the merits of the treatments' risks and benefits. The facts that some risks are unforeseeable and some benefits are external to the patient complicate negligence determinations. The first fact relates to the problem of judging adverse events in hindsight; the second, to the obligation to make decisions based on the patient's best interest and avoid conflict of interests. In addition, we evaluate the relationship between the obligations to secure the patient's informed consent and to avoid clinical negligence. We identify the need for further research to examine the significance of the putative anti-innovation bias that current liability regimen has, and to examine whether a move to strict liability might avoid such bias, while being fair to patients who contribute for the advancement of medical knowledge by participating in innovative therapies.

Burnout, job satisfaction, and medical malpractice among physicians.

Science.gov (United States)

Chen, Kuan-Yu; Yang, Che-Ming; Lien, Che-Hui; Chiou, Hung-Yi; Lin, Mau-Roung; Chang, Hui-Ru; Chiu, Wen-Ta

2013-01-01

Our objective was to estimate the incidence of recent burnout in a large sample of Taiwanese physicians and analyze associations with job related satisfaction and medical malpractice experience. We performed a cross-sectional survey. Physicians were asked to fill out a questionnaire that included demographic information, practice characteristics, burnout, medical malpractice experience, job satisfaction, and medical error experience. There are about 2% of total physicians. Physicians who were members of the Taiwan Society of Emergency Medicine, Taiwan Surgical Association, Taiwan Association of Obstetrics and Gynecology, The Taiwan Pediatric Association, and Taiwan Stroke Association, and physicians of two medical centers, three metropolitan hospitals, and two local community hospitals were recruited. There is high incidence of burnout among Taiwan physicians. In our research, Visiting staff (VS) and residents were more likely to have higher level of burnout of the emotional exhaustion (EE) and depersonalization (DP), and personal accomplishment (PA). There was no difference in burnout types in gender. Married had higher-level burnout in EE. Physicians who were 20~30 years old had higher burnout levels in EE, those 31~40 years old had higher burnout levels in DP, and PA. Physicians who worked in medical centers had a higher rate in EE, DP, and who worked in metropolitan had higher burnout in PA. With specialty-in-training, physicians had higher-level burnout in EE and DP, but lower burnout in PA. Physicians who worked 13-17hr continuously had higher-level burnout in EE. Those with ≥41 times/week of being on call had higher-level burnout in EE and DP. Physicians who had medical malpractice experience had higher-level burnout in EE, DP, and PA. Physicians who were not satisfied with physician-patient relationships had higher-level burnout than those who were satisfied. Physicians in Taiwan face both burnout and a high risk in medical malpractice. There is high

An improved accrual: reducing medical malpractice year-end adjustments.

Science.gov (United States)

Frese, Richard C

2012-08-01

Healthcare organizations can improve their year-end malpractice insurance accruals by taking the following steps: Maintain productive communication. Match accrual and accounting policies. Adjust amount of credit to own historical loss experience. Request more frequent analysis. Obtain a second opinion.

An insight into medical malpractice and litigation | Aimakhu ...

African Journals Online (AJOL)

Medical malpractice otherwise known as a breach of professional obligation and negligence of duty by medical practitioners has been identified as the major cause of emerging medical litigation in Nigeria. Medical personnel must be aware in their practice that patients are becoming more aware of their rights. The public ...

19 CFR 24.72 - Claims; set-off.

Science.gov (United States)

2010-04-01

... CUSTOMS FINANCIAL AND ACCOUNTING PROCEDURE § 24.72 Claims; set-off. When an importer of record or other... indebted to the United States, either as principal or surety, for an amount which is legally fixed and...

Malpractice and radiologists, update 1986: an 11.5-year perspective

International Nuclear Information System (INIS)

Berlin, L.

1986-01-01

All medical malpractice lawsuits filed in Cook County, IL, from January 1, 1980, through June 30, 1986, were reviewed and compared with similar data for the period of January 1, 1975, through December 30, 1979. A total of 11,203 suits were filed during the 11.5-year period; of these, 1391 (12%) were radiology related. The latter were categorized into six groups. The largest was missed radiologic diagnoses, which accounted for 40% of the total. The remaining groups included complications, 19%; failure to order, 17%; radiation therapy, 11%; slip and fall, 5%; and miscellaneous, 8%. Over the 1975-1986 period, the rise in the number of suits alleging radiologic misses outpaced all other groups. Although the most common type of miss continues to involve fractures, the frequency of missed carcinomas has grown at a disproportionately faster rate. Misses specifically involving CT, nuclear medicine, and sonography also are becoming more prevalent. Radiographic misses continue to occur at an average rate of 30%, with little hope of improvement. Methods to combat the rising number of malpractice suits are discussed. It is concluded that although programs to educate radiologists on risk management should continue, the ultimate solution may be a more enlightened public attitude as to what actually constitutes malpractice, and institution of tort reform measures by federal and state legislatures

The Legal Past, Present and Future of Prenatal Genetic Testing: Professional Liability and Other Legal Challenges Affecting Patient Access to Services

Directory of Open Access Journals (Sweden)

Deborah Pergament

2014-12-01

Full Text Available This chapter is an overview of the current status of the law in the United States regarding prenatal genetic testing with an emphasis on issues related to professional liability and other challenges affecting patient access to prenatal genetic testing. The chapter discusses the roles that federal regulations, promulgated by the Centers for Medicare and Medicaid Services (CMS, the Food and Drug Administration (FDA and the Federal Trade Commission (FTC, play in the regulation of prenatal genetic tests. The chapter discusses tort litigation based on allegations of malpractice in the provision of prenatal genetic testing and how courts have analyzed issues related to causation, damages and mitigation of damages. The chapter provides reference information regarding how individual states address causes of action under the tort theories of wrongful birth and wrongful life. The chapter concludes with a discussion of future legal issues that may affect clinical prenatal genetic testing services arising from the continued expansion of prenatal genetic testing, legal restrictions on access to abortion and the potential development of embryonic treatments.

Medico-legal aspects of altered sensation following endodontic treatment: a retrospective case series

DEFF Research Database (Denmark)

Givol, Navot; Rosen, Eyal; Bjørndal, Lars

2011-01-01

The objective of this study was to analyze cases of liability claims related to persistent altered sensation following endodontic treatments so as to characterize the medico-legal aspects of this complication.......The objective of this study was to analyze cases of liability claims related to persistent altered sensation following endodontic treatments so as to characterize the medico-legal aspects of this complication....

Election malpractice in students union government of Nnamdi ...

African Journals Online (AJOL)

Results also showed the preventive measures of election malpractices to include amongst others that votes should not be bought with money or gift items; the electoral body should be well trained and continued to be trained and materials for elections must be adequate and distributed on time. The implications of the study ...

Hospital exclusion clauses limiting liability for medical malpractice ...

African Journals Online (AJOL)

In 2002 the Supreme Court of Appeal ruling in Afrox Healthcare Beperk v. Strydom held that the common law allows hospitals to exclude liability for medical malpractice resulting in death or physical or psychological injury – except in the case of gross negligence. The effect of this judgment has now been superseded by the ...

38 CFR 14.605 - Suits against Department of Veterans Affairs employees arising out of a wrongful act or omission...

Science.gov (United States)

2010-07-01

... MISCELLANEOUS CLAIMS Federal Tort Claims § 14.605 Suits against Department of Veterans Affairs employees arising... damage, personal injury, or death allegedly occurring as a result of malpractice or negligence committed... Health Administration. Accordingly, a malpractice or negligence suit for property damage, personal injury...

Legal transformations of business disputes in post-soviet Ukraine

Directory of Open Access Journals (Sweden)

Tatiana Kyselova

2011-10-01

Full Text Available This paper explores mobilisation of law by Ukrainian business people at the pre-litigation stage of disputes, when litigation has not as yet been commenced but a legal claim has been formalised through the pretenziya - a formal letter to the delinquent party written to a special template. In Soviet times the pretenziya was by law an obligatory prerequisite before filing a claim in a commercial court (arbitrazh, but nowadays it is optional. Having analysed the spectrum of legal and extra-legal functions of pretenziya, this paper concludes that due to its adaptability, pretenziya proved capable of operating both as a token of the public order – the ‘shadow of the law’ - and as part of a private contract enforcement. Pretenziya in a voluntary form has not only survived in market-oriented economy but even opened up new avenues for the creative use of legal forms in post-Soviet business.

13 CFR 114.103 - Who may file a claim?

Science.gov (United States)

2010-01-01

... THE FEDERAL TORT CLAIMS ACT AND REPRESENTATION AND INDEMNIFICATION OF SBA EMPLOYEES Administrative.... Death The executor, administrator, or legal representative of the decedent's estate, or any other person...

32 CFR 536.9 - Responsibilities and operations of area claims offices.

Science.gov (United States)

2010-07-01

... detachment, recruiting company or station, or DOD agency) within the area appoints a claims officer to... their areas of jurisdiction, appropriate legal publications on state or territorial law and precedent... understanding between the affected commands. (3) Normally, claims that cannot be settled by a COE ACO will be...

78 FR 9428 - Agency Information Collection Activities; Proposed Collection; Comments Requested: Claims of U.S...

Science.gov (United States)

2013-02-08

... Collection; Comments Requested: Claims of U.S. Nationals for Compensation for Serious Personal Injuries Against the Government of Iraq and Referred to the Foreign Claims Settlement Commission by the Department of State Legal Adviser ACTION: 30-day notice. The Foreign Claims Settlement Commission (Commission...

The medicolegal landscape of spine surgery: how do surgeons fare?

Science.gov (United States)

Makhni, Melvin C; Park, Paul J; Jimenez, Jesus; Saifi, Comron; Caldwell, Jon-Michael; Ha, Alex; Figueroa-Santana, Bianca; Lehman, Ronald A; Weidenbaum, Mark

2018-02-01

Because of the limited and confidential nature of most legal data, scarce literature is available to physicians about reasons for litigation in spine surgery. To optimally compensate patients while protecting physicians, further understanding of the medicolegal landscape is needed for high-risk procedures such as spine surgery. Based on these, surgeons can explore ways to better protect both their patients and themselves. To characterize the current medicolegal environment of spine surgery by analyzing a recent dataset of malpractice litigation. A retrospective study. All malpractice cases involving spine surgery available to public query between the years of 2010 and 2014. Case outcome for spine surgery malpractice cases between the years of 2010 and 2014. WestlawNext was used to analyze spine surgery malpractice cases at the state and federal level between the years 2010 and 2014. WestlawNext is a subscription-based, legal search engine that contains publicly available federal and state court records. All monetary values were inflation adjusted for 2016. One hundred three malpractice cases were categorized by case descriptors and outcome measures. Claims were categorized as either intraoperative complaints or preoperative complaints. Rulings in favor of the defendant (surgeon) were noted in 75% (77 of 103) of the cases. Lack of informed consent was cited in 34% of cases. For the 26 cases won by the plaintiff, the average amount in settlement was $2,384,775 versus $3,945,456 in cases brought before a jury. Cases involving consent averaged a compensation of $2,029,884, whereas cases involving only intraoperative complaints averaged a compensation of $3,667,530. A significant correlation was seen between increased compensation for plaintiffs and cases involving orthopedic surgeons (p=.020) or nerve injury (p=.005). Wrong-level surgery may be associated with lower plaintiff compensation (p=.055). The length of cases resulting in defense verdicts averaged 5.51 years

Associations with legal representation in a compensation setting 12 months after injury.

Science.gov (United States)

Casey, Petrina P; Feyer, Anne Marie; Cameron, Ian D

2015-05-01

Many people with Whiplash Associated Disorder (WAD) seek treatment though a compensation system where factors such as legal involvement have been reported as having a negative impact on recovery outcomes. To compare those with and without legal involvement in their compensation claim, and identify associations with legal involvement at 12 months post injury; and longer term disability. Inception cohort study. 246 people with WAD compensation claim. Legal involvement and Functional Rating Index at 12 months post injury. Participants were recruited from an insurance database. Baseline health (Functional Rating Index, Pain Catastrophising Scale and SF-36), socio-economic, work capacity, and claims data were collected within three months of injury and 12 months. Logistic regression models were used to identify associations with legal involvement at 12 months; and disability (FRI) at 12 months. At baseline 246 participants were enrolled into the study in a median 72 days post injury. At 12 months post injury 52 (25%) had engaged a lawyer. The significant independent associations with legal involvement at 12 months were higher levels of initial disability, work disability, speaking a language other than English at home and lower levels of mental health. Specifically, the odds of lawyer involvement at 12 months post injury was 4.9 times greater for those with work disability; 2.3 times greater for those who spoke a language other than English at home. In terms of health, they had poorer mental health and for every 10 unit increase in the baseline FRI score the odds of having lawyer involvement increased by 38%. DISABILITY: at 12 months (FRI) was significantly independently associated with, PCS-helplessness (pdisadvantage, have had a prior claim and a worse baseline health profile compared to those without a lawyer. Understanding this profile could allow for improved claims processes and targeted interventions to assist this group through any perceived complexities in the

Mediation in Medical Malpractice - Realities and Prospects

Directory of Open Access Journals (Sweden)

Alexandru Boroi

2015-05-01

Full Text Available Medical professional liability is the result of specific breaches of the medical profession, which are contained in Law 95/2006 on health reform. Beyond the motivation of blaming medical personnel activity, there are many other aspects that may give rise to controversy in terms of medical ethics, from the informed consent of the patient and to the need for reaching criminal responsibility and compensation in cases of medical malpractice.

Users' perception of library use malpractices: case study of ...

African Journals Online (AJOL)

This study investigated library users perception of library use malpractices in academic libraries; using University of Calabar as a case study. Simple random sampling technique was use to draw a sample of 500 users from a population of 1804 registered users of the library. Questionnaire was use for data collection.

32 CFR 750.43 - Claims payable.

Science.gov (United States)

2010-07-01

... in nature, having little parallel in civilian pursuits, and in which the U.S. Government has... agreement are payable under the MCA, even though legally enforceable against the U.S. Government as contract.... Claims filed under this paragraph may, if in the best interest of the U.S. Government, be referred to and...

78 FR 13094 - Remedies for Small Copyright Claims: Third Request for Comments

Science.gov (United States)

2013-02-26

... comments regarding how a small copyright claims system might be structured and function, including from... sides--especially in cases with a degree of legal complexity--and the system should be designed to... claims system, including how the voluntary or mandatory nature of such a system might affect the analysis...

The Impact of State Medical Malpractice Reform on Individual-Level Health Care Expenditures.

Science.gov (United States)

Yu, Hao; Greenberg, Michael; Haviland, Amelia

2017-12-01

Past studies of the impact of state-level medical malpractice reforms on health spending produced mixed findings. Particularly salient is the evidence gap concerning the effect of different types of malpractice reform. This study aims to fill the gap. It extends the literature by examining the general population, not a subgroup or a specific health condition, and controlling for individual-level sociodemographic and health status. We merged the Database of State Tort Law Reforms with the Medical Expenditure Panel Survey between 1996 and 2012. We took a difference-in-differences approach to specify a two-part model for analyzing individual-level health spending. We applied the recycled prediction method and the bootstrapping technique to examining the difference in health spending growth between states with and without a reform. All expenditures were converted to 2010 U.S. dollars. Only two of the 10 major state-level malpractice reforms had significant impacts on the growth of individual-level health expenditures. The average annual expenditures in states with caps on attorney contingency fees increased less than that in states without the reform (p negligence rule, the average annual expenditures increased more in both states with a pure comparative fault reform (p < .05) and states with a comparative fault reform that barred recovery if the plaintiff's fault was equal to or greater than the defendant's (p < .05). A few state-level malpractice reforms had significantly affected the growth of individual-level health spending, and the direction and magnitude of the effects differed by type of reform. © Health Research and Educational Trust.

Litigation in paediatrics

LENUS (Irish Health Repository)

Murphu, JFA

2011-03-01

on the issue. This is understandable. Most individuals are healthy during their childhood and have less need of and less interaction with medical services when compared with adults. However, Paediatric litigation does happen and furthermore it is likely to increase in parallel with other specialties. Carroll and Buddenbaum1 have described the pattern of Paediatric litigation in the US. The annual incidence of malpractice claims has been quoted to be as high as 6.6 claims per 100 Paediatricians per year. Almost 30% of Paediatricians have been sued with many being sued on more than one occasion. Of these cases 36% were settled out of court, 33% were dropped by the plaintiff with the remainder going before the judiciary. The authors point out that in the US medical malpractice is a hotly debated issue. Litigation has a questionable impact on health care quality, cost, and access to services. The AMA believes that rising premiums are resulting in the curtailment of medical care particularly in states with high medico-legal rates. The Physician Insurers Association of America (PIAA) is a trade organisation which insures 60% of all private practicing physicians and surgeons has been a useful source of data. In the 20 year period 1985-2005 among a total of 214,226 claims there were 6363 (2.9%) Paediatric claims which ranked it 10th among the 28 specialties covered. The claims arose in equal numbers from the hospital and Paediatrician’s office settings. Common reasons for Paediatric litigation were errors in diagnosis (32%), incorrect performance of a medical or surgical procedure (13%), failure to monitor or manage a case effectively (10%) and medication error (5%). The top five medico-legal conditions were meningitis, routine infant or child checks, newborn respiratory problems, appendicitis and brain-damaged infants as a co-defendant with Obstetrics. Good quality information about litigation is important because the discussion among doctors is frequently confused by

[Clinical safety and professional liability claims in Orthopaedic Surgery and Traumatology].

Science.gov (United States)

Bori, G; Gómez-Durán, E L; Combalia, A; Trilla, A; Prat, A; Bruguera, M; Arimany-Manso, J

2016-01-01

The specialist in orthopaedic and traumatological surgery, like any other doctor, is subject to the current legal provisions while exercising their profession. Mandatory training in the medical-legal aspects of health care is essential. Claims against doctors are a reality, and orthopaedic and traumatological surgery holds first place in terms of frequency of claims according to the data from the General Council of Official Colleges of Doctors of Catalonia. Professionals must be aware of the fundamental aspects of medical professional liability, as well as specific aspects, such as defensive medicine and clinical safety. The understanding of these medical-legal aspects in the routine clinical practice can help to pave the way towards a satisfactory and safe professional career. The aim of this review is to contribute to this training, for the benefit of professionals and patients. Copyright © 2015 SECOT. Published by Elsevier Espana. All rights reserved.

Abstract legal effect of juridical acts in European and Serbian law

Directory of Open Access Journals (Sweden)

Dudaš Atila

2012-01-01

Full Text Available In this paper the author gives an overview of the development from abstract to causal juridical acts and explains the abstract legal effect of juridical acts in present-day European civil law (in the law of Germany, Austria, Switzerland and France. He concludes that in contemporary law juridical acts cannot have full abstract legal effect, as in archaic legal orders, because modern legal orders do not allow the creation of claims and debts in a way that entirely excludes the possibility to scrutinize whether a juridical act is null and void for the infringement of public order by its aim. In relation to the law of Serbia, the author refers to the difference between juridical acts that create obligations, that is claims and debts, and acts by which the parties merely dispose of the claims and debts already imposed. This division of juridical acts has its origins in the German legal culture, but it is fairly applicable to the Serbian law, as well. The author points out that the requirement of the Law on obligations, that all juridical acts must have a valid cause, applies without exception to juridical acts imposing an obligation (the so-called Verpflichtungsgeschäfte, regardless of whether they are concluded in the form of an abstract of causal act, i.e. whether the purpose of the transaction is determinable from their content. In this context he refers to the standpoint adopted in the doctrine that the cause of juridical acts gains relevance by three means: by the agreement of the parties, objection of the respondent and when the court determines ex officio whether the contract is contrary to public order. The author supports the point of view that in Serbian law juridical acts aimed merely to disposing of claims and debts already imposed (the so-called Verfügungsgeschäfte may have a legal effect, which is independent from their cause. For these reasons, the author is of the opinion that in present-day legal orders, hence in Serbian law too

[Pitfalls in informed consent: a statistical analysis of malpractice law suits].

Science.gov (United States)

Echigo, Junko

2014-05-01

In medical malpractice law suits, the notion of informed consent is often relevant in assessing whether negligence can be attributed to the medical practitioner who has caused injury to a patient. Furthermore, it is not rare that courts award damages for a lack of appropriate informed consent alone. In this study, two results were arrived at from a statistical analysis of medical malpractice law suits. One, unexpectedly, was that the severity of a patient's illness made no significant difference to whether damages were awarded. The other was that cases of typical medical treatment that national medical insurance does not cover were involved significantly more often than insured treatment cases. In cases where damages were awarded, the courts required more disclosure and written documents of information by medical practitioners, especially about complications and adverse effects that the patient might suffer.

Clinical safety and professional liability claims in Ophthalmology.

Science.gov (United States)

Dolz-Güerri, F; Gómez-Durán, E L; Martínez-Palmer, A; Castilla Céspedes, M; Arimany-Manso, J

2017-11-01

Patient safety is an international public health priority. Ophthalmology scientific societies and organisations have intensified their efforts in this field. As a tool to learn from errors, these efforts have been linked to the management of medical professional liability insurance through the analysis of claims. A review is performed on the improvements in patient safety, as well as professional liability issues in Ophthalmology. There is a high frequency of claims and risk of economic reparation of damage in the event of a claim in Ophthalmology. Special complaints, such as wrong surgery or lack of information, have a high risk of financial compensation and need strong efforts to prevent these potentially avoidable events. Studies focused on pathologies or specific procedures provide information of special interest to sub-specialists. The specialist in Ophthalmology, like any other doctor, is subject to the current legal provisions and appropriate mandatory training in the medical-legal aspects of health care is essential. Professionals must be aware of the fundamental aspects of medical professional liability, as well as specific aspects, such as defensive medicine and clinical safety. The understanding of these medical-legal aspects in the routine clinical practice can help to pave the way towards a satisfactory and safe professional career, and help in increasing patient safety. The aim of this review is to contribute to this training, for the benefit of professionals and patients. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

Increased number of ear-nose-throat malpractice complaints in Denmark

DEFF Research Database (Denmark)

Nikoghosyan-Bossen, Gohar; Hauberg, Agnes; Homøe, Preben

2012-01-01

Danish ear, nose and throat (ENT) physicians have little knowledge of the type of decisions made at the Danish National Board of Patients' Complaints (NBPC). The aim of this study was to analyze and describe the epidemiology of ENT malpractice complaints by showing their distribution and volume i...

Gender-Based Pay Disparities in Intercollegiate Coaching: The Legal Issues.

Science.gov (United States)

Gaal, John; Glazier, Michael S.; Evans, Thomas S.

2002-01-01

Explores the legal issues surrounding pay disparities between men and women in intercollegiate coaching, including how courts have treated disparate wage claims under the Equal Pay Act, Title VII of the Civil Rights Act of 1964, and Title IX, and the defenses used by institutions. Offers suggestions for defending claims and a detailed review of…

Social media in the health-care setting: benefits but also a minefield of compliance and other legal issues.

Science.gov (United States)

Moses, Richard E; McNeese, Libra G; Feld, Lauren D; Feld, Andrew D

2014-08-01

Throughout the past 20 years, the rising use of social media has revolutionized health care as well as other businesses. It allows large groups of people to create and share information, ideas, and experiences through online communications, and develop social and professional contacts easily and inexpensively. Our Gastroenterology organizations, among others, have embraced this technology. Although the health-care benefits may be many, social media must be viewed through a legal lens, recognizing the accompanying burdens of compliance, ethical, and litigation issues. Theories of liability and risk continue to evolve as does the technology. Social media usage within the medical community is fraught with potential legal issues, requiring remedial responses to meet patients' needs and comply with current laws, while not exposing physicians to medical malpractice and other tort risks.

Action against 2nd partial construction permit for Muelheim-Kaerlich reactor dismissed on grounds of the community having no claim to legal action

International Nuclear Information System (INIS)

Anon.

1985-01-01

Key sentences: (non-official) 1. A community is not authorized to plead its citizens' rights and interests. 2. A community is not entitled to plead environmental and nature-protection aspects. 3. Fear of community-owned land being adversely affected constitutes no cause of action. 4. By transferring self-administration tasks to an independent company the community gives up the possibility to plead on its own behalf the legal claims deriving from the self-administration. Koblenz Court of Administration. Ruling of December 13, 1984 - 10 K 3/82 - (non-final). From the reasons given for the ruling: Nonsuit on grounds of the action being inadmissible. (orig./HP) [de

Legalization of drugs of abuse and the pediatrician.

Science.gov (United States)

Schwartz, R H

1991-10-01

Growing numbers of individuals are proposing that drugs be legalized in the United States, with claims that federal, state, and local efforts to prohibit the use of illicit drugs are irrational and unenforceable. "Drug reform" advocates include persons of all political persuasions. Ironically, the call for drug reform comes at a time when trends in drug abuse, as reflected in national and state surveys, show a promising decline. It also is contradictory to at least one recent public opinion poll, in which respondents opposed the legalization of marijuana by a five-to-one margin. While their position is by no means unanimous, proponents of drug reform generally base their arguments on several key premises, such as elimination of or reductions in drug trafficking, enforcement, and interdiction expenditures; increased tax revenues from the legal sale of drugs; and reductions in health-care expenses associated with drug treatment. Reform advocates further claim that legalization would not be followed by an increase in drug use. The validity of each of these arguments is highly questionable. Legalization is a simplistic, short-sighted solution to a complex issue with public health, economic, criminal justice, and societal ramifications. Legalization would, moreover, abrogate the position taken in 1961 by the United States and 114 other nations in ratifying the United Nations Single Convention on Narcotic Drugs. The impact of drug reform merits an unbiased study by an independent agency. Until that time, pediatricians should inform themselves of the arguments for and against drug reform and be prepared to educate patients and their families about the issue.

Sex work and the claim for grassroots legislation.

Science.gov (United States)

Fassi, Marisa N

2015-01-01

The aim of this paper is to contribute to understanding of legal models that aim to control sex work, and the policy implications of these, by discussing the experience of developing a grassroots legislation bill proposal by organised sex workers in Córdoba, Argentina. The term 'grassroots legislation' here refers to a legal response that derives from the active involvement of local social movements and thus incorporates the experiential knowledge and claims of these particular social groupings in the proposal. The experience described in this paper excludes approaches that render sex workers as passive victims or as deviant perpetrators; instead, it conceives of sex workers in terms of their political subjectivity and of political subjectivity in its capacity to speak, to decide, to act and to propose. This means challenging current patterns of knowledge/power that give superiority to 'expert knowledge' above and beyond the claims, experiences, knowledge and needs of sex workers themselves as meaningful sources for law making.

Large-scale computer networks and the future of legal knowledge-based systems

NARCIS (Netherlands)

Leenes, R.E.; Svensson, Jorgen S.; Hage, J.C.; Bench-Capon, T.J.M.; Cohen, M.J.; van den Herik, H.J.

1995-01-01

In this paper we investigate the relation between legal knowledge-based systems and large-scale computer networks such as the Internet. On the one hand, researchers of legal knowledge-based systems have claimed huge possibilities, but despite the efforts over the last twenty years, the number of

The Symbolic Meaning of Legal Subjectivity

NARCIS (Netherlands)

Pessers, D.; van Klink, B.; van Beers, B.; Poort, L.

2016-01-01

The legitimacy of the law is not to be found, as is often claimed, in procedural justice, but in the core function of the law: the symbolic insertion of every new generation into the community of legal subjects. This symbolic function is most ambitiously expressed in the Universal Declaration of

A Contemporary Analysis of Medicolegal Issues in Obstetric Anesthesia Between 2005 and 2015.

Science.gov (United States)

Kovacheva, Vesela P; Brovman, Ethan Y; Greenberg, Penny; Song, Ellen; Palanisamy, Arvind; Urman, Richard D

2018-05-10

Detailed reviews of closed malpractice claims have provided insights into the most common events resulting in litigation and helped improve anesthesia care. In the past 10 years, there have been multiple safety advancements in the practice of obstetric anesthesia. We investigated the relationship among contributing factors, patient injuries, and legal outcome by analyzing a contemporary cohort of closed malpractice claims where obstetric anesthesiology was the principal defendant. The Controlled Risk Insurance Company (CRICO) is the captive medical liability insurer of the Harvard Medical Institutions that, in collaboration with other insurance companies and health care entities, contributes to the Comparative Benchmark System database for research purposes. We reviewed all (N = 106) closed malpractice cases related to obstetric anesthesia between 2005 and 2015 and compared the following classes of injury: maternal death and brain injury, neonatal death and brain injury, maternal nerve injury, and maternal major and minor injury. In addition, settled claims were compared to the cases that did not receive payment. χ, analysis of variance, Student t test, and Kruskal-Wallis tests were used for comparison between the different classes of injury. The largest number of claims, 54.7%, involved maternal nerve injury; 77.6% of these claims did not receive any indemnity payment. Cases involving maternal death or brain injury comprised 15.1% of all cases and were more likely to receive payment, especially in the high range (P = .02). The most common causes of maternal death or brain injury were high neuraxial blocks, embolic events, and failed intubation. Claims for maternal major and minor injury were least likely to receive payment (P = .02) and were most commonly (34.8%) associated with only emotional injury. Compared to the dropped/denied/dismissed claims, settled claims more frequently involved general anesthesia (P = .03), were associated with delays in care (P = .005

Legal and institutional problems facing geothermal development in Hawaii

Energy Technology Data Exchange (ETDEWEB)

1978-10-01

The problems discussed confronting future geothermal development in Hawaii include: a seemingly insoluble mismatch of resource and market; the burgeoning land claims of the Native Hawaiian community; a potential legal challenge to the State's claim to hegemony over all of Hawaii's geothermal resources, regardless of surface ownership; resistance to any sudden, large scale influx of Mainland industry, and questionable economics for the largest potential industrial users. (MHR)

A critique of cannabis legalization proposals in Canada.

Science.gov (United States)

Kalant, Harold

2016-08-01

An editorial in this issue describes a cannabis policy framework document issued by a major Canadian research centre, calling for legalization of non-medical use under strict controls to prevent increase in use, especially by adolescents and young adults who are most vulnerable to adverse effects of cannabis. It claims that such a system would eliminate the severe personal, social and monetary costs of prohibition, diminish the illicit market, and provide more humane management of cannabis use disorders. It claims that experience with regulation of alcohol and tobacco will enable a system based on public health principles to control access of youth to cannabis without the harm caused by prohibition. The present critique argues that the claims made against decriminalization and for legalization are unsupported, or even contradicted, by solid evidence. Early experience in other jurisdictions suggests that legalization increases use by adolescents and its attendant harms. Regulation of alcohol use does not provide a good model for cannabis controls because there is widespread alcohol use and harm among adolescents and young adults. Government monopolies of alcohol sale have been used primarily as sources of revenue rather than for guarding public health, and no reason has been offered to believe they would act differently with respect to cannabis. Good policy decisions require extensive unbiased information about the individual and social benefits and costs of both drug use and proposed control measures, and value judgments about the benefit/harm balance of each option. Important parts of the necessary knowledge about cannabis are not yet available, so that the value judgments are not yet possible. Therefore, a better case can be made for eliminating some of the harms of prohibition by decriminalization of cannabis possession and deferring decision about legalization until the necessary knowledge has been acquired. Copyright © 2016 Elsevier B.V. All rights reserved.

The legal ensurance of underground ultimate storage of radioactive wastes without risk

International Nuclear Information System (INIS)

Prasse, R.

1974-01-01

1. The legal position towards the property owner: a) with a view to the freedom of property claim, b) in the light of the influence of the property owner. 2. The legal position towards the neighbouring property owners: a) resistance rights of the body corporate responsible for the ultimate storage, b) resistance rights of the neighbouring property owner. 3. The legal position towards those authorized to mine: a) mining free minerals, b) mining minerals reserved for the state. 4. The legal position towards prospectors. (orig./HP) [de

Claiming damages where dividends remain unpaid: A contribution ...

African Journals Online (AJOL)

Besides a contractual right, this article also investigates the Oxford Legal Group case in establishing at least an implied right (based on the doctrine of proper purpose) to claim an undeclared dividend or unauthorised dividend that is contrary to the board of directors discretion not to authorise any dividends. Both these cases ...

Collective Settlement of Mass Claims in The Netherlands

NARCIS (Netherlands)

W.H. van Boom (Willem)

2009-01-01

textabstractAs far as collective mass claim settlement is concerned, it has been said that ‘the European landscape is a mixed bag of differing collective redress mechanisms’. One of the legal sys-tems in this ‘mixed bag’ is the small jurisdiction of the Kingdom of The Netherlands. With the enactment

A panacea to the asymptotic effect of examination malpractice in a ...

African Journals Online (AJOL)

We prove that in a dense population of candidates seeking admission in an environment saddled with examination malpractice, educational institutions can maintain the enrolment structure at a certain level n * if a specific quota is fixed by the Ministry of Education or its regulating agency for new entrants into the system.

Laboratory specimens and genetic privacy: evolution of legal theory.

Science.gov (United States)

Lewis, Michelle Huckaby

2013-03-01

Although laboratory specimens are an important resource for biomedical research, controversy has arisen when research has been conducted without the knowledge or consent of the individuals who were the source of the specimens. This paper summarizes the most important litigation regarding the research use of laboratory specimens and traces the evolution of legal theory from property claims to claims related to genetic privacy interests. © 2013 American Society of Law, Medicine & Ethics, Inc.

[Surgical assessment of complications after thyroid gland operations].

Science.gov (United States)

Dralle, H

2015-01-01

The extent, magnitude and technical equipment used for thyroid surgery has changed considerably in Germany during the last decade. The number of thyroidectomies due to benign goiter have decreased while the extent of thyroidectomy, nowadays preferentially total thyroidectomy, has increased. Due to an increased awareness of surgical complications the number of malpractice claims is increasing. In contrast to surgical databases the frequency of complications in malpractice claims reflects the individual impact of complications on the quality of life. In contrast to surgical databases unilateral and bilateral vocal fold palsy are therefore at the forefront of malpractice claims. As guidelines are often not applicable for the individual surgical expert review, the question arises which are the relevant criteria for the professional expert witness assessing the severity of the individual complication. While in surgical databases major complications after thyroidectomy, such as vocal fold palsy, hypoparathyroidism, hemorrhage and infections are equally frequent (1-3 %), in malpractice claims vocal fold palsy is significantly more frequent (50 %) compared to hypoparathyroidism (15 %), hemorrhage and infections (about 5 % each). To avoid bilateral nerve palsy intraoperative nerve monitoring has become of utmost importance for surgical strategy and malpractice suits alike. For surgical expert review documentation of individual risk-oriented indications, the surgical approach and postoperative management are highly important. Guidelines only define the treatment corridors of good clinical practice. Surgical expert reviews in malpractice suits concerning quality of care and causality between surgical management, complications and sequelae of complications are therefore highly dependent on the grounds and documentation of risk-oriented indications for thyroidectomy, intraoperative and postoperative surgical management.

[Medical errors from positions of mutual relations of patient-lawyer-doctor].

Science.gov (United States)

Radysh, Ia F; Tsema, Ie V; Mehed', V P

2013-01-01

The basic theoretical and practical aspects of problem of malpractice in the system of health protection Ukraine are presented in the article. On specific examples the essence of the term "malpractice" is expounded. It was considered types of malpractice, conditions of beginning and kinds of responsibility to assumption of malpractice. The special attention to the legal and mental and ethical questions of problem from positions of protection of rights for a patient and medical worker is spared. The necessity of qualification malpractices on intentional and unintentional, possible and impermissible is grounded.

Sovereignty Frames and Sovereignty Claims

OpenAIRE

Walker, Neil

2013-01-01

This essay argues that much of the contemporary confusion and controversy over the meaning and continuing utility of the concept of sovereignty stems from a failure to distinguish between sovereignty as a deep framing device for making sense of the modern legal and political word on the one hand, and the particular claims which are made on behalf of particular institutions, agencies, rules or other entities to possess sovereign authority on the other. The essay begins by providing a basic acc...

Partnering With a Medical Malpractice Insurer to Improve Patient Safety and Decrease Risk.

Science.gov (United States)

Keohane, Carol A; Dwyer, Kathy; Boulanger, Jason; Zigmont, Katherine; Babayan, Astrid; Cushing, Elizabeth; Walsh, Brian

Implementing evolving science into clinical practice remains challenging. Assimilating new scientific evidence into clinical protocols and best practice recommendations, in a timely manner, can be difficult. In this article, we examine the value of partnering with a captive medical malpractice insurance company and its Patient Safety Organization to use data and convening opportunities to build upon the principles of implementation science and foster efficient and widespread adoption of the most current evidence-based interventions. Analyses of medical malpractice and root-cause analysis data set the context for this partnership and acted as a catalyst for creating best practice guidelines for adopting therapeutic hypothermia in the treatment of neonatal encephalopathy. What follows is a powerful example of successfully leveraging the collective wisdom of healthcare providers across specialties and institutional lines to move patient safety forward while managing risk.

Contrasting Medical and Legal Standards of Evidence: A Precision Medicine Case Study.

Science.gov (United States)

Marchant, Gary E; Scheckel, Kathryn; Campos-Outcalt, Doug

2016-03-01

As the health care system transitions to a precision medicine approach that tailors clinical care to the genetic profile of the individual patient, there is a potential tension between the clinical uptake of new technologies by providers and the legal system's expectation of the standard of care in applying such technologies. We examine this tension by comparing the type of evidence that physicians and courts are likely to rely on in determining a duty to recommend pharmacogenetic testing of patients prescribed the oral anti-coagulant drug warfarin. There is a large body of inconsistent evidence and factors for and against such testing, but physicians and courts are likely to weigh this evidence differently. The potential implications for medical malpractice risk are evaluated and discussed. © 2016 American Society of Law, Medicine & Ethics.

Ampliando la protección a segundas indicaciones en Europa: swiss-type claim y european-type claim

Directory of Open Access Journals (Sweden)

Carlos Augusto Conde-Gutiérrez

2015-06-01

Full Text Available La Oficina de Patentes Europea (EPO protege las segundas indicaciones o usos sobre composiciones o sustancias ya existentes en el estado de la técnica con el ánimo de incentivar a la industria farmacéutica en Europa. Este artículo explora los aspectos legales y técnicos mediante los cuales la EPO ha otorgado patentes no solo a segundas indicaciones, sino también a terceras o sucesivas indicaciones. En particular, se analiza el alcance del Swiss-type Claim y el European-type Claim. De igual manera, se realiza un análisis comparativo entre el Convenio sobre Patentes Europeo y decisiones de la EPO, y la Decisión 486 de 2000 de la Comunidad Andina (Régimen Común sobre Propiedad Industrial sobre segundas indicaciones.

Constitutionality of enforcement of claims by private enforcement agents

Directory of Open Access Journals (Sweden)

Bodiroga Nikola

2014-01-01

Full Text Available The main focus of this paper is legal status of private enforcement agents in Serbia. The 2011 Serbian Law on Enforcement and Security has introduced private enforcement agents as legal professionals in charge mainly for carrying out of the enforcement. Special enforcement procedure for collection of utilities and similar claims has become exclusive competence of private enforcement agents. Since enforcement procedure has always been regarded as a set of coercive measures against enforcement debtor, it became questionable whether this coercion could be exercised by private enforcement agents. It has been argued by legal scholars that enforcement of civil judgments and other enforcement deeds belongs only to the state authority. The author tackles this issue from the standpoint of decisions of constitutional courts and jurisprudence of European Court of Human Rights.

Medical Malpractice Litigation Following Arthroscopic Surgery.

Science.gov (United States)

Shah, Kalpit N; Eltorai, Adam E M; Perera, Sudheesha; Durand, Wesley M; Shantharam, Govind; Owens, Brett D; Daniels, Alan H

2018-04-10

Our study aims to analyze a variety of factors involving malpractice lawsuits following arthroscopy, focusing on reasons for lawsuit and establishing predictors for the outcome of the lawsuit. Two legal databases, VerdictSearch and Westlaw, were queried for arthroscopic cases in adult patients. For all included cases, clinical and demographic data were recorded. The effects of plaintiff demographics, joint involved, lawsuit allegation, case ruling, and size of indemnity payments were assessed. Of the 240 included cases, 62 (26%) resulted in plaintiff verdict, 160 (67%) resulted in defense verdict, and 18 (8%) were settled without trial. Plaintiff demographics (age and sex) had no effect on the case ruling. There was no statistical difference between indemnity awards for plaintiff verdicts ($1,013,494) and settled cases ($848,331; P = .13). Patient death was noted in 20 cases (8.3%); a significantly higher proportion of these cases were settled versus went to trial (P = .0022), including 19 patients (95%) who had knee arthroscopy and 16 deaths (80%) resulting from a pulmonary embolus. Plaintiff verdict or settlement were seen significantly more frequently for vascular complications and wrong-sided surgery. Alternatively, defense verdicts followed lawsuits alleging surgeon technical error. Wrong-sided surgery, retained instruments, deep venous thrombosis, and postoperative infections were seen at a significantly higher proportion after knee arthroscopy than after arthroscopy of other joints. Similarly, neurological injury was significantly associated with elbow and hip arthroscopy, while allegations of technical error by the surgeon and block-related complications were associated with shoulder arthroscopy. Plaintiff verdict or settlement were seen for vascular complications and wrong-sided surgery, while defense verdicts followed lawsuits alleging surgeon technical error and block-related complications. We also identified types of allegations that were associated

How nuclear liability practices have been implemented in US. US nuclear claims experience

International Nuclear Information System (INIS)

Bardes, C.R.

2000-01-01

Three Mile Island has been only major nuclear incident in US involving a power plant that resulted in payments to public. In addition to Three Mile Island, there have been only 3 lawsuits by members of the public against nuclear power plant operators; these alleged bodily injury and property damage resulting from normal operations. Of 202 claims handled by ANI, 161 involved individual nuclear facilities workers. Costs of the worker claims (through 1998) was US $1.5 million for indemnity (losses) and US$35.9 million for legal defense costs. By far, 1979 TMI accident produced largest number of third-party claims. ANI's emergency claims handling procedure for large nuclear accident tested and proved itself at Three Mile Island

Legalization of abortion doubtful in Italy.

Science.gov (United States)

1973-09-03

A proposal to legalize abortion has been presented to the Italian parliament by Representative Loris Fortuna. Thus far, the bill has the whole-hearted support of only the Radical Party. The Vatican has already voiced its strong opposition to this legislation. "The proposal to legalize abortion, even in certain circumstances, must inevitably be met with resistance and refusal," said Father Concetti, the Vatican representative. Professor Emanuele Lauricella, secretary of the Italian Obstetrics and Gynecology Society, on the other hand, claimed that abortion should be permitted, not only when an immediate danger to the mother's life exists, but also when there are other, simpler health risks. The passage of the bill in the near future, however, is very doubtful.

Shareholder Protection and Stock Market Development: An Empirical Test of the Legal Origins Hypothesis

OpenAIRE

John Armour; Simon Deakin; Prabirjit Sarkar; Mathias Siems; Ajit Singh

2008-01-01

We test the ‘law matters’ and ‘legal origin’claims using a newly created panel dataset measuring legal change over time in a sample of developed and developing countries. Our dataset improves on previous ones by avoiding country-specific variables in favour of functional and generic descriptors, by taking into account a wider range of legal data, and by considering the effects of weighting variables in different ways, thereby ensuring greater consistency of coding....

Inbound medical tourism to Barbados: a qualitative examination of local lawyers' prospective legal and regulatory concerns.

Science.gov (United States)

Crooks, Valorie A; Cohen, I Glenn; Adams, Krystyna; Whitmore, Rebecca; Morgan, Jeffrey

2015-07-28

Enabled by globalizing processes such as trade liberalization, medical tourism is a practice that involves patients' intentional travel to privately obtain medical care in another country. Empirical legal research on this issue is limited and seldom based on the perspectives of destination countries receiving medical tourists. We consulted with diverse lawyers from across Barbados to explore their views on the prospective legal and regulatory implications of the developing medical tourism industry in the country. We held a focus group in February 2014 in Barbados with lawyers from across the country. Nine lawyers with diverse legal backgrounds participated. Focus group moderators summarized the study objective and engaged participants in identifying the local implications of medical tourism and the anticipated legal and regulatory concerns. The focus group was transcribed verbatim and analyzed thematically. Five dominant legal and regulatory themes were identified through analysis: (1) liability; (2) immigration law; (3) physician licensing; (4) corporate ownership; and (5) reputational protection. Two predominant legal and ethical concerns associated with medical tourism in Barbados were raised by participants and are reflected in the literature: the ability of medical tourists to recover medical malpractice for adverse events; and the effects of medical tourism on access to health care in the destination country. However, the participants also identified several topics that have received much less attention in the legal and ethical literature. Overall this analysis reveals that lawyers, at least in Barbados, have an important role to play in the medical tourism sector beyond litigation - particularly in transactional and gatekeeper capacities. It remains to be seen whether these findings are specific to the ecology of Barbados or can be extrapolated to the legal climate of other medical tourism destination countries.

Criminal law as a response to medical malpractice: pluses and minuses--comparing Italian and U.S. experiences.

Science.gov (United States)

Di Landro, Andrea R

2012-06-01

The paper is divided into three parts. The first part sets out the comparative differences between the tort of malpractice in common law and the criminal negligence in civil law: while the common law takes for mens rea only the "gross" negligence, and rarely medical negligence, other law systems instead (and particularly Italian law) criminalize also ordinary negligence, frequently in medical malpractice cases. The second part of the paper addresses the pluses of using criminal law as response to medical malpractice: inadequate medical self-policing and "repeat offenders" problems are analysed, in the perspective of the patient, of the doctor, of the insurance company, and of the community. The third part addresses the minuses of the criminal law as response: medical "shame and blame" mentality, criminal stigma and culture of fear are disincentives to incident reporting and to system analysis (the most important means of prevention); "defensive medicine" and "courts-abiding medicine" are managed not yet in the patient's exclusive interest, but in the egoistic/utilitarian aim to avoid denunciations; finally, the uncertainty of the medicine, the accusatory system and the proof "beyond a reasonable doubt" seem hardly compatible with each other.

我國地方法院刑事醫療糾紛判決的實證分析：2000年至2010年 An Empirical Study of Medical Malpractice Judgments from District Criminal Courts in Taiwan: 2000-2010

Directory of Open Access Journals (Sweden)

劉邦揚 Pang-Yang Liu

2011-12-01

Full Text Available 本文以法學實證研究方法進行撰寫，並全面性地蒐集我國自 2000 年1月1 日起至2010 年6 月30 日止，所有地方法院作成的刑事醫療糾紛判決書，並且擷取判決書中之客觀可辨的資訊進行建檔，利用統計軟體SPSS 17.0版進行描述性統計分析與推論性統計，期待真實呈現地方法院刑事醫療糾紛的訴訟現況。本研究共蒐集到277 個刑事判決，計380 名具醫師身分之被告，並發現此類訴訟有著「低定罪率」與「高自訴比率」等特徵，足供醫療糾紛研究者加以關注。 Recently, the debate on decriminalization of medical malpractice has received mounting attentions in both medical and law communities. An increasing number of studies try to analyze different aspects of the issue for future criminal law revision. However, the existing literature focuses mainly on theoretical discussion. Of the limited legal empirical studies, they are mostly limited in study scope and number of cases analyzed. Due to the limitations in study scope and size, previous findings may not reflect the true picture of medical malpractice lawsuits in Taiwan over time. Therefore, we aimed to conduct a population-based study to analyze characteristics, process, and court decisions of medical malpractice lawsuits in Taiwan. The “Law Bank” database was used to search all the district criminal court’s medical malpractice judgments from 21 district courts in Taiwan during the period of January 1st, 2000 to June 30th, 2010. Exclusion criteria were applied. A total of 277 eligible cases and 380 physician-defendants were included. Contents of each court judgment were analyzed and description statistical methods were applied. Factors affecting judgment was revealed by chi-square test and logistic regression analysis. In general, medical malpractice lawsuits had a low conviction rate, the punishment tended to be trivial, and when patient hurt from medical

Malpractice in Counseling Neuropsychology.

Science.gov (United States)

Woody, Robert Henley

1992-01-01

Responds to earlier four articles on integration of counseling psychology and neuropsychology by noting that neuropsychology occurs in settings with high risk of legal complaints. Contends that aspiration to press counseling psychology toward clinical neuropsychology should be filtered through consideration for legal risk. Explores legal…

The Prevalence of Traditional Malpractice during Pregnancy, Child Birth, and Postnatal Period among Women of Childbearing Age in Meshenti Town, 2016

Directory of Open Access Journals (Sweden)

Haileyesus Gedamu

2018-01-01

Full Text Available Background. Cultural practices, beliefs, and taboos are often implicated in determining the care received by mothers during pregnancy and child birth which is an important determinant of maternal mortality. Objective. To assess prevalence of cultural malpractice during pregnancy, child birth, and postnatal period among women of childbearing age in Meshenti town, Amhara region, northwest Ethiopia, in 2016. Methods. Community based cross-sectional study was conducted among women of reproductive age group interviewed during the study period from May 10 to June 17, 2016. Total sample size was 318 women of reproductive age group. Systematic sampling technique was conducted. Result. Overall, 50.9% of the respondents had cultural malpractices during their pregnancy. Out of 318 women, 62 (19.5% practiced nutrition taboo, 78 (24.5% practiced abdominal massage, 87 (29.7% delivered their babies at home, 96 (32.8% avoided colostrums, 132 (45.2% washed their baby before 24 hr after delivery, and 6 (6.9% cut the cord by unclean blade. Conclusion and Recommendation. The findings of this study show that different traditional malpractice during perinatal period is still persisting in spite of modern developments in the world. Health education and promoting formal female education are important to decrease or avoid these cultural malpractices.

Implications of marijuana legalization for adolescent substance use.

Science.gov (United States)

Hopfer, Christian

2014-01-01

Marijuana that is legally available for adults has multiple implications for adolescent substance use. One potential effect that legalization may have is an increase in adolescent use to due increased availability, greater social acceptance, and possibly lower prices. Legalization may also facilitate the introduction of new formulations of marijuana (edible, vaporized) and with potentially higher potencies. It is unknown what adolescent consumption patterns will be if marijuana is widely available and marketed in different forms, or what effects different patterns of adolescent use will have on cognition, the development of marijuana use disorders, school performance, and the development of psychotic illnesses. Also unclear is whether adolescent users will be experiencing higher levels of tetrahydrocannabinol (THC) compared with previous generations of users due to higher potencies. Although previous studies of the effects of adolescent marijuana use provide some guidance for current policy and public health recommendations, many new studies will be needed that answer questions in the context of use within a legal adult environment. Claims that marijuana has medicinal benefits create additional challenges for adolescent prevention efforts, as they contrast with messages of its harmfulness. Prevention and treatment approaches will need to address perceptions of the safety of marijuana, claims of its medicinal use, and consider family-wide effects as older siblings and parents may increasingly openly consume and advocate for marijuana use. Guidance for primary care physicians will be needed regarded screening and counseling. Widespread legalization and acceptance of marijuana implies that as law enforcement approaches for marijuana control decline, public health, medical, and scientific efforts to understand and reduce negative consequences of adolescent marijuana use need to be substantially increased to levels commensurate with those efforts for tobacco and alcohol.

Understanding the legal duty of care in the course of negligence.

Science.gov (United States)

Tingle, John

The first article in this series gave an introduction to clinical negligence (Vol 11(15): 1033-1035). This article begins with a discussion of the law of negligence within the context of the law generally. What must be established in order to bring a legal claim for compensation in negligence is also discussed along with the important concept of owing a legal duty of care. The duty of care concept is illustrated through two cases.

Development of an electronic claim system based on an integrated electronic health record platform to guarantee interoperability.

Science.gov (United States)

Kim, Hwa Sun; Cho, Hune; Lee, In Keun

2011-06-01

We design and develop an electronic claim system based on an integrated electronic health record (EHR) platform. This system is designed to be used for ambulatory care by office-based physicians in the United States. This is achieved by integrating various medical standard technologies for interoperability between heterogeneous information systems. The developed system serves as a simple clinical data repository, it automatically fills out the Centers for Medicare and Medicaid Services (CMS)-1500 form based on information regarding the patients and physicians' clinical activities. It supports electronic insurance claims by creating reimbursement charges. It also contains an HL7 interface engine to exchange clinical messages between heterogeneous devices. The system partially prevents physician malpractice by suggesting proper treatments according to patient diagnoses and supports physicians by easily preparing documents for reimbursement and submitting claim documents to insurance organizations electronically, without additional effort by the user. To show the usability of the developed system, we performed an experiment that compares the time spent filling out the CMS-1500 form directly and time required create electronic claim data using the developed system. From the experimental results, we conclude that the system could save considerable time for physicians in making claim documents. The developed system might be particularly useful for those who need a reimbursement-specialized EHR system, even though the proposed system does not completely satisfy all criteria requested by the CMS and Office of the National Coordinator for Health Information Technology (ONC). This is because the criteria are not sufficient but necessary condition for the implementation of EHR systems. The system will be upgraded continuously to implement the criteria and to offer more stable and transparent transmission of electronic claim data.

Defensive Medicine in U.S. Spine Neurosurgery.

Science.gov (United States)

Din, Ryan S; Yan, Sandra C; Cote, David J; Acosta, Michael A; Smith, Timothy R

2017-02-01

Observational cross-sectional survey. To compare defensive practices of U.S. spine and nonspine neurosurgeons in the context of state medical liability risk. Defensive medicine is a commonly reported and costly phenomenon in neurosurgery. Although state liability risk is thought to contribute greatly to defensive practice, variation within neurosurgical specialties has not been well explored. A validated, online survey was sent via email to 3344 members of the American Board of Neurological Surgeons. The instrument contained eight question domains: surgeon characteristics, patient characteristics, practice type, insurance type, surgeon liability profile, basic surgeon reimbursement, surgeon perceptions of medical legal environment, and the practice of defensive medicine. The overall response rate was 30.6% (n = 1026), including 499 neurosurgeons performing mainly spine procedures (48.6%). Spine neurosurgeons had a similar average practice duration as nonspine neurosurgeons (16.6 vs 16.9 years, P = 0.64) and comparable lifetime case volume (4767 vs 4,703, P = 0.71). The average annual malpractice premium for spine neurosurgeons was similar to nonspine neurosurgeons ($104,480.52 vs $101,721.76, P = 0.60). On average, spine neurosurgeons had a significantly higher rate of ordering labs, medications, referrals, procedures, and imaging solely for liability concerns compared with nonspine neurosurgeons (89.2% vs 84.6%, P = 0.031). Multivariate analysis revealed that spine neurosurgeons were roughly 3 times more likely to practice defensively compared with nonspine neurosurgeons (odds ratio, OR = 2.9, P = 0.001) when controlling for high-risk procedures (OR = 7.8, P < 0.001), annual malpractice premium (OR = 3.3, P = 0.01), percentage of patients publicly insured (OR = 1.1, P = 0.80), malpractice claims in the last 3 years (OR = 1.13, P = 0.71), and state medical-legal environment (OR = 1.3, P = 0

Stress related workers' compensation claims: recommendations involving records release.

Science.gov (United States)

Martin, K J

1992-08-01

1. The cost of stress claims is predicted to cripple the workers' compensation system, where stress claims are burgeoning and the average payout is twice that of a typical injury. The major reason to release medical records in a stress claim is to determine the validity of the claim arising from the job. 2. Occupational health nurses are frequently asked by the courts to reveal personal client information and may not be protected by the "nurse-client relationship" or "privileged communication." Politically, very little interest has been shown in restricting disclosure of private information. 3. Both ANA and AAOHN have adopted strong positions about safeguarding privacy. Legally, the ultimate responsibility for wrongful acts committed by the nurse falls on the individual nurse. 4. The most important reason to guard confidential health information is the basic tenet of the nurse-client relationship in which personal matters are held in confidence. To break this trust is to jeopardize the ability to provide optimal client care, which is the essence of nursing.

Litigation in Obstetrics: a Lesson Learnt and a Lesson to Share

Directory of Open Access Journals (Sweden)

Min Min Chou

2006-03-01

Full Text Available A perfect baby is the expectation of all parents, and a perfect outcome is the mission of obstetrics. Every obstetrician dreads to hear that there is an unexpected maternal mortality and/or severe fetal injury at the hospital. The role of a perceived public expectation of perfection in obstetric medicine reflects a belief that bad outcomes in obstetrics should not be tolerated and that every maternal-fetal injury merits financial compensation and punishment. What has brought these troubling times to obstetric medicine? The drivers behind malpractice crises are the four leading interest groups in the medical-legal debate: pregnant patients and their environment (husband, parents, relatives, friends, legislators, and the media, health-care providers, insurance companies, and trial attorneys. Litigation in obstetrics is the result of a complex of events when malpractice (presumed or real impacts on the attitude of pregnant women and their environment. In such complexity, information is mandatory but may often be misinterpreted. If messages are not tailored to the receiver's capacity, communicating well with the pregnant patient becomes crucial. Therefore, to reduce medical-legal issues in obstetrics, increasing attention and an applicable standard of obstetric care to avoid negligence and medical errors should go along with better communication with pregnant women. Communication should be clear, targeted, effective, flexible, and empathic to share a common language and decisions. This review briefly presents and discusses some of the most frequently encountered medical-legal claim cases in obstetric practice. In-depth review of pregnancy-related deaths and major morbidities can help determine strategies needed to continue making pregnancy safer.

Efficacy of a physician's words of empathy: an overview of state apology laws.

Science.gov (United States)

Saitta, Nicole; Hodge, Samuel D

2012-05-01

Apology laws are gaining traction in the United States, prompting health care professionals to offer words of condolence for adverse medical outcomes without the fear of being sued for malpractice. Although these laws vary by jurisdiction, they have been shown to reduce the financial consequences of a medical malpractice lawsuit. The authors provide an overview of the laws regarding this issue and discuss apologies as a means to reduce medical malpractice claims.

Reformers, Batting Averages, and Malpractice: The Case for Caution in Value-Added Use

Science.gov (United States)

Gleason, Daniel

2014-01-01

The essay considers two analogies that help to reveal the limitations of value-added modeling: the first, a comparison with batting averages, shows that the model's reliability is quite limited even though year-to-year correlation figures may seem impressive; the second, a comparison between medical malpractice and so-called educational…

Consumers’ Health-Related Motive Orientations and Reactions to Claims about Dietary Calcium

Directory of Open Access Journals (Sweden)

Christine Hoefkens

2013-01-01

Full Text Available Health claims may contribute to better informed and healthier food choices and to improved industrial competitiveness by marketing foods that support healthier lifestyles in line with consumer preferences. With the more stringent European Union regulation of nutrition and health claims, insights into consumers’ health-related goal patterns and their reactions towards such claims are needed to influence the content of lawful claims. This study investigated how consumers’ explicit and implicit health-related motive orientations (HRMOs together with the type of calcium-claim (nutrition claim, health claim and reduction of disease risk claim influence perceived credibility and purchasing intention of calcium-enriched fruit juice. Data were collected in April 2006 through a consumer survey with 341 Belgian adults. The findings indicate that stronger implicit HRMOs (i.e., indirect benefits of calcium for personal health are associated with higher perceived credibility, which is not (yet translated into a higher purchasing intention. Consumers’ explicit HRMOs, which refer to direct benefits or physiological functions of calcium in the body — as legally permitted in current calcium-claims in the EU — do not associate with reactions to the claims. Independently of consumers’ HRMOs, the claim type significantly affects the perceived credibility and purchasing intention of the product. Implications for nutrition policy makers and food industries are discussed.

[Professional responsibility in surgery and informed consent. Reflections of a clinical surgeon.

Science.gov (United States)

Picardi, Nicola

2012-09-05

The medico-legal conflict especially against the surgical profession is reaching ever higher levels, such as to make consider threatened the choice for surgery of the future generations. Surgery is an Art characterized by enthusiasm and entrepreneurship chosen on the basis of a genuine vocation, but nowadays becomes increasingly prey to indirect interests, with profound negative influence on the serenity of its operators. The current legislation, for civil controversies exposes the surgeons to a presumptive judgment of guilt unless the demonstration with proofs of wrong claims, and even from television screens come daily suggestions and incitements to carry out claims also if related to the last ten years of treatments received, if someone suspects or considers to have been object of "malpractice", and particularly without payment for promoters of the shares for lawyers and medico-legal specialists. We try to analyze the situation as objectively as possible, highlighting the inconsistencies and illusions for the rules alleged to protect both the patient and the surgeon, emphasizing instead the responsibilities of different professional groups, while not denying the need for full commitment of surgeons to operate with prudence, diligence and competence.

Exploring the secret history of the legal service of the European Executives, 1952-1967

DEFF Research Database (Denmark)

Rasmussen, Morten

key private archives, consequently constitutes the first attempt to write a history of the legal service of the European executives from 1952 to 1967. With the functions and actions of the legal service being very far from the public spotlight, the story presented here has until now been completely...... to finally be able to affirm, reject or nuance Stein’s classic claim....

Untested assumptions: psychological research and credibility assessment in legal decision-making

Directory of Open Access Journals (Sweden)

Jane Herlihy

2015-05-01

Full Text Available Background: Trauma survivors often have to negotiate legal systems such as refugee status determination or the criminal justice system. Methods & results: We outline and discuss the contribution which research on trauma and related psychological processes can make to two particular areas of law where complex and difficult legal decisions must be made: in claims for refugee and humanitarian protection, and in reporting and prosecuting sexual assault in the criminal justice system. Conclusion: There is a breadth of psychological knowledge that, if correctly applied, would limit the inappropriate reliance on assumptions and myth in legal decision-making in these settings. Specific recommendations are made for further study.

Researcher liability for negligence in human subject research: informed consent and researcher malpractice actions.

Science.gov (United States)

Jansson, Roger L

2003-02-01

Two sets of federal regulations, the "Common Rule" and Food and Drug Administration (FDA) regulations, govern human subject research that is either federally-funded or involves FDA regulated products. These regulations require, inter alia, that: (1) researchers obtain informed consent from human subjects, and (2) that an Institutional Review Board (IRB) independently review and approve the research protocol. Although the federal regulations do not provide an express cause of action against researchers, research subjects should be able to bring informed consent and malpractice actions against researchers by establishing a duty of care and standard of care. Researchers owe human subjects a duty of care analogous to the special relationship between physicians and patients. The federal regulations should provide the minimum standard of care for informed consent in human subject research, and complying with them should be a partial defense. In contrast, expert testimony should establish the standard of care for researcher malpractice, and IRB approval should be a partial defense.

Personal professional indemnity and contractual issues for trainees in obstetrics and gynaecology.

Science.gov (United States)

Chatterjee, J; Datta, S; Butt, S; Harpwood, V

2013-02-01

Over the last few decades, more healthcare professionals have faced investigation into complaints about medical care and healthcare outcomes (Department of Health 2003). With increasing medical negligence cases being brought against doctors, it is time to carefully consider the implications of such actions to ensure appropriate safeguards (Ferner and McDowell 2006). At a time when the culture of 'no win, no fee' is rampant, the jobbing frontline doctor is on the back-foot trying to untangle the legalities of a malpractice claim (Ferner and McDowell 2006). Reassuringly, the numbers of doctors referred to the GMC or having to face legal procedures or claims for compensation are still very small (National Audit Office 2001). An essential issue for all doctors is having appropriate indemnity cover in the event that their practice is challenged. The opt-out for the European Working Time Regulations (EWTR) has caused further confusion as to what is covered for junior doctors by individual indemnity policies and the employer's liability scheme. Recently, the RCOG Trainees committee and the BMA Junior Doctors Association issued a joint advice regarding this issue (RCOG 2010). In this paper, we consider the differences in cover provided by the employer's liability scheme, individual professional indemnity schemes and the role of professional bodies. We also seek to clarify the understanding of these surrounding EWTR and the voluntary opt-out clause and provide up-to-date information on medico-legal issues and protection schemes regarding legal liabilities.

Attitudes toward the dubious compensation claim.

Science.gov (United States)

LEGGO, C

1951-07-01

Laws providing for compensation of workmen for occupational injury are a powerful socio-economic force. In settlement of compensation claims the goal, difficult to achieve, is fairness to employee, employer and insurance carrier. Often, medical, legal, economic and social considerations conflict with one another. A "fact" in one field may not be considered so in another. Since medical data and testimony often guide the ultimate decision of a compensation claim, the physician's attitude is a large factor not only immediately and directly in determination of the case at hand but, perhaps more important, in the ultimate direction of the socio-economic forces which spring from the sum of all such determinations. To perpetuate the good in workmen's compensation laws, the next generation of physicians-and of lawyers and business administrators as well, for they, too, are involved-ought to have basic training in the social sciences in order that they may have a broad rather than a segmental view of the problems with which they deal.

[THE SIGNIFICANCE OF THE LEGAL PERSPECTIVE - THE LEGAL WORLD'S CONTRIBUTION TO THE MEDICAL WORLD].

Science.gov (United States)

Sigler-Harcavi, Alona; Cohen Ashkenazi, Limor

2018-04-01

Working with medical and paramedical teams has taught us that the medical staff does not fully utilize the potential of judicial decisions and precedents as a source for learning, drawing conclusions and motivating progress. Judicial ruling is an essential part of the toolbox used by medical administrators in general, and healthcare risk managers in particular. Knowing the relevant legal rulings, before you embark on any given path, is the equivalent of looking before you leap. This is not necessarily an issue of "holy scripture", but should mainly be considered as a source for expanding your perspective. Knowledge of the relevant rulings has many advantages that stem from the unique characteristics of the legal system. While the medical world has a clear and unequivocal advantage regarding knowledge and experience with respect to medicine, the legal world has various other advantages: a different and wider perspective with respect to economic and/or political considerations; universal fundamental principles, such as autonomy, equality, distributive justice, human dignity, the state's obligations to its citizens; complex systems of checks and balances, such as: desirable vs. available, the benefit of few vs. the good of the many, etc. These tools, typical of the legal world, are especially relevant to medicolegal issues, usually associated with medical administration, such as: the obligation of consultation, obligation of follow-up, treatment continuity, priorities, resource distribution, patient rights, etc. The contribution of the legal world to these issues is both unique and essential. Those who question the ability of judges to understand the medical world and to materially contribute to medical thinking and practice, claiming that they lack medical training and experience, should recognize the diverse contribution of the legal world to the medical world.

The Changing Nature of Law’s Natural Person: The Impact of Emerging Technologies on the Legal Concept of the Person

NARCIS (Netherlands)

van Beers, B.C.

This article discusses the legal concept of the person against the background of technological developments. Emerging technologies are offering radical ways to transform the biological and physical aspects of life. Several legal scholars claim that the technological artificialization of human life

Advanced radiographic practice - the legal aspects

International Nuclear Information System (INIS)

Alderson, C.J.; Hogg, P.

2003-01-01

Allied health and nursing professionals are continuing to expand their responsibilities into clinical areas outside their traditional spheres of interest; typically, many of these new responsibilities are found within the medical (doctor) domain. Such responsibilities are often at an advanced clinical level and consequently higher demands are placed upon the professionals, not least in terms of clinical updating, competence to practice and also legal liability. This article explores the legal implications of practising at an advanced clinical level with particular reference to legal claims. The first part of the article commences with an outline of pertinent law in England and Wales. The latter part of the article explores actual cases from which allied health professionals (eg radiographers) can gain valuable information. Throughout the article suggestions for good practice are indicated. Examples of good practice include: the need to base your practice on evidence and peer practice; the need to keep detailed records (protocols) of such practice; the need to know when you are at the limit of your ability; and as such when to ask for advice from a medical practitioner/radiologist

The doctor in claims for work injuries and ill health--legal pitfalls.

Science.gov (United States)

Lee, See-Muah; Sng, Judy; Koh, David

2009-08-01

Occupational health work is currently undertaken by the specialist and the non-specialist physician alike. The work scope can vary from medical assessments of individual workers to health risk assessment at the workplace. The scope of the latter will include evaluation of exposures, hazards, risks and its management to control these risks. Much of the case law governing legal disputes over industrial safety and health have involved the employers. Over the years, the actions brought forth by workers have resulted in a formidable volume of case law based on statutes and on the common law of negligence in tort. Disputes over the assessment of workers' health or workplace health risks to the extent that it is a failure to discharge a reasonable standard of care, may result in the doctor being a defendant. Measures to prevent these legal pitfalls include communication with employers about the causative link of the illness suffered to workplace factors and the clarity of contractual obligations undertaken with regard to workplace health risk assessment.

Insurance: Profitability of the Medical Malpractice and General Liability Lines. Report to Congressional Requesters.

Science.gov (United States)

General Accounting Office, Washington, DC.

This report on the profitability of the property/casualty insurance industry and in particular of the medical malpractice insurance line was prepared at the request of Representatives Henry A. Waxman and James J. Florio and Senators Paul Simon, Daniel K. Inouye, Albert Gore, Jr., and Jay D. Rockefeller. Four different estimates of medical…

Rational suicide, assisted suicide, and indirect legal paternalism.

Science.gov (United States)

Schramme, Thomas

2013-01-01

This article argues in favour of three related claims: First, suicide is not an immoral act. If people autonomously choose to kill themselves, this ought to be respected. Second, we can deem the desire to die comprehensible, and even rational, when the person contemplating suicide does not see a meaning in her life. This assessment is not based on a metaphysically dubious comparison between the actual life of a person and the supposed state of being dead. Third, from the first two theses it does not automatically follow that we should allow other people to help someone who autonomously and rationally chooses to die to pursue this plan. To argue against indirect legal paternalism, the practice of legally preventing someone else to assist a person to perform a suicide or to be killed on request, needs additional reasons. It is argued that assisted suicide and voluntary active euthanasia can indeed be justified by establishing a claim of persons who want to die but are not able to kill themselves. This mainly means that being really free to die should be interpreted as involving the means to fulfil one's desire to die. Copyright © 2013 Elsevier Ltd. All rights reserved.

42 CFR 424.506 - National Provider Identifier (NPI) on all enrollment applications and claims.

Science.gov (United States)

2010-10-01

... SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM CONDITIONS FOR MEDICARE PAYMENT Requirements for Establishing and Maintaining Medicare Billing Privileges § 424.506 National...) A Medicare beneficiary who submits a claim for service to Medicare— (i) Must include the legal name...

How to manage a claim for medical and technical error

International Nuclear Information System (INIS)

Nguyen, T.D.

2012-01-01

Purpose. - The fast modifications in French medical legislation, the increasing number of litigations and the professional consequences for the practitioner warrant the necessity to recall the 'how to manage' a claim for medical error. Patients and methods. - Four cases of legal action against oncologists are presented. Results and discussion. - The importance of quality and traceability of the given information, the essential pieces of the medical file, the description of the different process steps and of the contradictory meeting are presented and discussed. Conclusion. - Beyond the control of medical and technical risks, the practitioners in general and the radiation oncologist in particular should learn on the daily management of the risk related to medical claim. (authors)

Health claims in the labelling and marketing of food products:

Science.gov (United States)

Asp, Nils-Georg; Bryngelsson, Susanne

2007-01-01

Since 1990 certain health claims in the labelling and marketing of food products have been allowed in Sweden within the food sector's Code of Practice. The rules were developed in close dialogue with the authorities. The legal basis was a decision by the authorities not to apply the medicinal products’ legislation to “foods normally found on the dinner table” provided the rules defined in the Code were followed. The Code of Practice lists nine well-established diet–health relationships eligible for generic disease risk reduction claims in two steps and general rules regarding nutrient function claims. Since 2001, there has also been the possibility for using “product-specific physiological claims (PFP)”, subject to premarketing evaluation of the scientific dossier supporting the claim. The scientific documentation has been approved for 10 products with PFP, and another 15 products have been found to fulfil the Code's criteria for “low glycaemic index”. In the third edition of the Code, active since 2004, conditions in terms of nutritional composition were set, i.e. “nutrient profiles”, with a general reference to the Swedish National Food Administration's regulation on the use of a particular symbol, i.e. the keyhole symbol. Applying the Swedish Code of practice has provided experience useful in the implementation of the European Regulation on nutrition and health claims made on foods, effective from 2007.

Conscience claims, metaphysics, and avoiding an LGBT eugenic.

Science.gov (United States)

Brummett, Abram

2018-06-01

Novel assisted reproductive technologies (ART) are poised to present our society with strange new ethical questions, such as whether lesbian, gay, bisexual, and transgender (LGBT) couples should be allowed to produce children biologically related to both parents, or whether trans-women who want to experience childbirth should be allowed to receive uterine transplants. Clinicians opposed to offering such technologies to LGBT couples on moral grounds are likely to seek legal shelter through the conscience clauses enshrined in U.S. law. This paper begins by briefly discussing some novel ART on the horizon and noting that it is unclear whether current conscience clauses will permit fertility clinics to deny such services to LGBT individuals. A compromise approach to conscience is any view that sees the value of respecting conscience claims within limits. I describe and critique the constraints proposed in the recent work of Wicclair, NeJaime and Siegel as ultimately begging the question. My purpose is to strengthen their arguments by suggesting that in the controversial situations that elicit claims of conscience, bioethicists should engage with the metaphysical claims in play. I argue that conscience claims against LGBT individuals ought to be constrained because the underlying metaphysic-that God has decreed the LGBT lifestyle to be sinful-is highly implausible from the perspective of a naturalized metaphysic, which ought to be the lens through which we evaluate conscience claims. © 2018 John Wiley & Sons Ltd.

Collective legal protection: The European approach

Directory of Open Access Journals (Sweden)

Petrušić Nevena

2014-01-01

Full Text Available One of the basic goals of the EU justice policy is to ensure an efficient and effective legal protection, particularly in cross-border disputes and cases concerning the violation of rights guaranteed under the EU legislation. In order to accomplish this goal, the EU embarked on a horizontal harmonization of civil procedure in some sectors and reinforced the institutional cooperation of Member States in the field of civil justice. Concurrently, there were some legal interventions in the field of civil procedure, which contributed to establishing a number of European procedural mechanisms, such as: the European Small Claims Procedure (2007, the European Payment Order Procedure (2006, etc. Many studies and analyses show that procedural mechanisms of collective legal protection are essential for ensuring an efficient and effective legal protection of rights guaranteed by the EU law. The idea of introducing the collective legal protection instruments into the EU law has been present for more than two decades. It has been endorsed by the European Economic and Social Committee, which has played the key role in its promotion. In June 2013, after extensive consultations, the European Commission adopted the Recommendation on common principles for injunctive and compensatory collective redress mechanisms in the Members States concerning violations of rights guaranteed under the EU law. This document has provided a coherent horizontal framework for the collective legal protection at the EU level by establishing the common European principles for collective redress mechanisms which the Member States should incorporate into their national systems. Analysis of the common principles governing the collective legal protection shows that the European approach to shaping the collective redress claims is significantly different from the American class action model, which is considered to be incompatible with the European legal tradition and deemed to provide a wide

Through the Eyes of Higher Education Attorneys: How Department Chairs Are Navigating the Waters of Legal Issues and Risk Management

Science.gov (United States)

Hustoles, Carol L. J.

2012-01-01

Legal and risk management issues substantially impact the operations of colleges and universities, which face escalating compliance requirements in an increasingly litigious environment. Failing to assess legal liability issues and to constructively address them with risk management processes create vulnerability to claims and litigation,…

Courts, Scheduled Damages, and Medical Malpractice Insurance

DEFF Research Database (Denmark)

Bertoli, Paola; Grembi, Veronica

We assess the impact of the introduction of schedules of non-economic damages (i.e. tiered caps systems) on the behavior of insurers operating in the medical liability market for hospitals while controlling the performance of the judicial system, measured as court backlog. Using a difference......-in-differences strategy on Italian data, we find that the introduction of schedules increases the presence of insurers (i.e. medical liability market attractiveness) only in inefficient judicial districts. In the same way, court inefficiency is attractive to insurers for average values of schedules penetration...... of the market, with an increasing positive impact of inefficiency as the territorial coverage of schedules increases. Finally, no significant impact is registered on paid premiums. Our analysis sheds light on a complex set of elements affecting the decisions of insurers in malpractice markets. The analysis...

Contested Property Claims

DEFF Research Database (Denmark)

Property relations are such a common feature of social life that we can sometimes forget the immense complexity of the web of laws, practices, and ideas that allow a property regime to function smoothly. But we are quickly reminded of this complexity when social conflict over property erupts. When...... social actors confront a property regime – for example by squatting – they enact what can be called ‘contested property claims’. These confrontations raise crucial issues of social justice and show the ways in which property conflicts often reflect wider social conflicts. Through a series of case studies...... from across the globe, this multidisciplinary anthology exploring contested property claims brings together works from anthropologists, legal scholars, and geographers, who show how disagreements give us a privileged window onto how property regimes function and illustrates the many ways...

Contested Property Claims

DEFF Research Database (Denmark)

Property relations are such a common feature of social life that the complexity of the web of laws, practices, and ideas that allow a property regime to function smoothly are often forgotten. But we are quickly reminded of this complexity when conflict over property erupts. When social actors...... confront a property regime – for example by squatting – they enact what can be called ‘contested property claims’. As this book demonstrates, these confrontations raise crucial issues of social justice and show the ways in which property conflicts often reflect wider social conflicts. Through a series...... of case studies from across the globe, this multidisciplinary anthology brings together works from anthropologists, legal scholars, and geographers, who show how exploring contested property claims offers a privileged window onto how property regimes function, as well as an illustration of the many ways...

Investigation on legal problems encountered by emergency medicine physicians in Turkey.

Directory of Open Access Journals (Sweden)

Afsin Emre Kayipmaz

Full Text Available Medicine is a profession that carries certain risks. One risky area of practice is the emergency department. Emergency physicians diagnose and treat a high volume of patients, and are also responsible for preparing reports for forensic cases. In this study, we aim to investigate emergency physicians' legal-administrative problems and reveal their level of understanding on forensic cases.An electronic questionnaire form was prepared after the approval of an ethical committee. This form was sent to the residents, specialists and academicians of emergency medicine by e-mail. The physicians were asked to fill out the form online. All the gathered data was analyzed. Descriptive statistics were presented as frequency percentages with mean and standard deviation. Chi-square tests were used to compare the groups. Correlation between number of complaint cases and age, sex, career, institution, and duration of service in emergency department were investigated. p<0.05 was considered statistically significant.294 physicians participated in the questionnaire. According to the questionnaire, 170 of the physicians were reported to the patient communication units due to medical malpractice. Mean number of compliant reports was 3.20±3.5. 29 of the physicians received administrative penalties. 42 of the physicians were judged in the court for medical malpractice. 1 physician was fined 5000 Turkish Liras as a result of these judgments.We found that the number of complaint reports is negatively correlated with duration of service in emergency medicine and age. There was a significant difference between number of complaint reports and career (p<0.05. The physicians' level of awareness on forensic cases was found to be insufficient. Lack of legislation knowledge may be an important cause of complaint reports concerning emergency physicians, who have a high load of patients. Thus, we think that increasing the frequency of post-graduate education sessions and

Brain imaging tests for chronic pain: medical, legal and ethical issues and recommendations.

Science.gov (United States)

Davis, Karen D; Flor, Herta; Greely, Henry T; Iannetti, Gian Domenico; Mackey, Sean; Ploner, Markus; Pustilnik, Amanda; Tracey, Irene; Treede, Rolf-Detlef; Wager, Tor D

2017-10-01

Chronic pain is the greatest source of disability globally and claims related to chronic pain feature in many insurance and medico-legal cases. Brain imaging (for example, functional MRI, PET, EEG and magnetoencephalography) is widely considered to have potential for diagnosis, prognostication, and prediction of treatment outcome in patients with chronic pain. In this Consensus Statement, a presidential task force of the International Association for the Study of Pain examines the capabilities of brain imaging in the diagnosis of chronic pain, and the ethical and legal implications of its use in this way. The task force emphasizes that the use of brain imaging in this context is in a discovery phase, but has the potential to increase our understanding of the neural underpinnings of chronic pain, inform the development of therapeutic agents, and predict treatment outcomes for use in personalized pain management. The task force proposes standards of evidence that must be satisfied before any brain imaging measure can be considered suitable for clinical or legal purposes. The admissibility of such evidence in legal cases also strongly depends on laws that vary between jurisdictions. For these reasons, the task force concludes that the use of brain imaging findings to support or dispute a claim of chronic pain - effectively as a pain lie detector - is not warranted, but that imaging should be used to further our understanding of the mechanisms underlying pain.

Tipping the scales.

Science.gov (United States)

1998-12-01

In the US, the October 1998 murder of a physician who performed abortions was an outward manifestation of the insidious battle against legal abortion being waged by radical Christian social conservatives seeking to transform the US democracy into a theocracy. This movement has been documented in a publication entitled, "Tipping the Scales: The Christian Right's Legal Crusade Against Choice" produced as a result of a 4-year investigation conducted by The Center for Reproductive Law and Policy. This publication describes how these fundamentalists have used sophisticated legal, lobbying, and communication strategies to further their goals of challenging the separation of church and state, opposing family planning and sexuality education that is not based solely on abstinence, promoting school prayer, and restricting homosexual rights. The movement has resulted in the introduction of more than 300 anti-abortion bills in states, 50 of which have passed in 23 states. Most Christian fundamentalist groups provide free legal representation to abortion clinic terrorists, and some groups solicit women to bring specious malpractice claims against providers. Sophisticated legal tactics are used by these groups to remove the taint of extremism and mask the danger posed to US constitutional principles being posed by "a well-financed and zealous brand of radical lawyers and their supporters."

The Rio Orinoco and the haven - two major cases from a legal point of view

International Nuclear Information System (INIS)

Jacobsson, M.

1993-01-01

The International Oil Pollution Compensation Fund (IOPC Fund), an inter-governmental organization with 49 member states, has recently been involved in two major oil spills of great interest from both a legal and a technical point of view. The Rio Orinoco incident occurred in Canada and the Haven incident took place in Italy. The Rio Orinoco was carrying asphalt when it grounded in the Gulf of St Lawrence. The grounding led to extensive salvage and cleanup operations carried out on behalf of the Canadian authorities. The claims for compensation, totalling 15 million Canadian dollars (12.5 million US dollars), were settled out of court. This paper discusses the main legal problems that arose, for example, the reasonableness of certain operations and the relationship between pollution prevention and salvage. The Haven exploded off Genoa with 144,000 metric tons of crude oil on board. A large quantity of oil escaped, necessitating extensive cleanup operations in Italy, France, and Monaco. Over 1,300 claims for compensation have been submitted totalling US$1.4 billion. This paper deals with some of the main legal problems that have arisen as a result of this incident, for example, the admissibility of claims relating to non-economic damage to the marine environment and the method to be applied for the conversion of the maximum amount payable by the IOPC Fund into Italian lire

Educational Malpractice: Breach of Statutory Duty and Affirmative Acts of Negligence by a School District.

Science.gov (United States)

Beckham, Joseph

1979-01-01

A cause of action for educational malpractice may well receive initial judicial recognition through successfully harmonizing allegations of breach of a statutory duty of care and acts of negligence of a type and magnitude that would distinguish a student-plaintiff's injuries from others for whose benefit the statutory duty was created. (Author)

Preventing medico-legal issues in clinical practice

Directory of Open Access Journals (Sweden)

Bevinahalli N Raveesh

2016-01-01

Full Text Available The medical profession is considered to be one of the noblest professions in the world. The practice of medicine is capable of rendering noble service to humanity provided due care, sincerity, efficiency, and professional skill is observed by the doctors. However, today, the patient–doctor relationship has almost diminished its fiduciary character and has become more formal and structured. Doctors are no longer regarded as infallible and beyond questioning. Corporatization of health care has made it like any other business, and the medical profession is increasingly being guided by the profit motive rather than that of service. On the other hand, a well-publicized malpractice case can ruin the doctor's career and practice. The law, like medicine, is an inexact science. One cannot predict with certainty an outcome of cases many a time. It depends on the particular facts and circumstances of the case, and also the personal notions of the judge concerned who is hearing the case. The axiom “you learn from your mistakes” is too little honored in healthcare. The best way to handle medico-legal issues is by preventing them, and this article tries to enumerate the preventive measures in safeguarding the doctor against negligence suit.

Restitutionary Road: Reflecting on Good Governance and the Role of the Land Claims Court

Directory of Open Access Journals (Sweden)

JM Pienaar

2011-06-01

Full Text Available Although 95% of all claims that had been submitted by 1998 have indeed been processed, a mere 49% of the land that was restored since 1994 housed successful enterprises by the end of 2010. Accordingly, sixteen years into the restitution process the statistics are rather disappointing. Restitution of land as a land reform mechanism is a unique temporal process that involves various role players. This contribution focuses on the role that the Land Claims Court has to play within the context of “good governance”. In this regard the legislative and policy frameworks within which restitution and the Land Claims Court operate, are first set out after which the unique characteristics of the restitution programme are highlighted. Although the main function of the Land Claims Court is to grapple with and adjudicate on legal issues, it also has a role to play in effecting good governance. This may be done by its involvement in the legal process leading up to the finalization of claims by issuing directives, acting as a review forum and by removing land from the restitution process under section 34 of the Restitution Act. However, a more pro-active role may be played by the Court by its involvement in deciding the exact form of restitution or restoration in a particular case. In this regard the Court can find that restitution has to be conditional and that certain requirements have to be met in order for the process to be effective and successful. With reference to Baphiring Community v Uys and Others (Case number LCC 64/1998 it is clear that a pro-active approach would require the Court to engage in difficult, often conflicting, issues and to embark on in-depth investigations and analyses where necessary.

Legalities of the radiograph

International Nuclear Information System (INIS)

Bundy, A.L.

1988-01-01

The radiograph itself plays a major role in medical malpractice cases. Also, many questions arise concerning the rights to and storage of x-ray films. These issues are addressed in this chapter. To keep the terminology simple, the word radiograph represents all imaging documentation on hard copy film (x-rays, nuclear medicine, computer-assisted studies, ultrasound, and magnetic resonance imaging)

Further Evidence that Legalized Abortion Lowered Crime: A Reply to Joyce

Science.gov (United States)

Donohue, John J., III; Levitt, Steven D.

2004-01-01

Joyce's failure to uncover a negative relationship between crime and abortion was because of his decision to concentrate on a non-representative six-year period. Evidence supporting the claims that the crack-cocaine epidemic hit the high-abortion early-legalizing states earlier and more severely than other states of the U.S in 1970 is presented.

32 CFR 536.120 - Claims payable as maritime claims.

Science.gov (United States)

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Claims payable as maritime claims. 536.120... ACCOUNTS CLAIMS AGAINST THE UNITED STATES Maritime Claims § 536.120 Claims payable as maritime claims. A claim is cognizable under this subpart if it arises in or on a maritime location, involves some...

Rights as entitlements and rights as claims

Directory of Open Access Journals (Sweden)

Azevedo, Marco Antônio Oliveira de

2010-01-01

Full Text Available Há pelo menos dois registros diferentes sobre o significado de “direitos”. Segundo um deles, os direitos são relações entre dois termos: uma pessoa e um bem; para o outro, os direitos são relações entre três termos: um indivíduo, uma pessoa e uma ação ou algo. Os registros são diferentes, mas não são totalmente incompatíveis. De acordo com a interpretação de direitos como entitlements, trata-se de direitos morais ou legais, ou seja, as relações de ordem moral ou jurídica das pessoas com bens (de benefícios concedidos a pessoas por uma lei humana, moral ou legal. Como uma espécie de direitos, os direitos humanos são vistos como direitos (entitlements das pessoas ou dos indivíduos a bens essenciais, dos quais podem-se inferir reivindicações (claims contra outras pessoas ou contra governos e representantes. Falamos sobre direitos humanos geralmente desta forma. Mas de acordo com o outro registro, os direitos em sentido próprio têm que ser interpretados como claims. Neste artigo, pretendo apresentar alguns argumentos em favor da vantagem de expor todos os enunciados significativos dos direitos como entitlements em termos explícitos de claims

The Development of the Interface between Law, Medicine and Psychiatry: Medico-Legal Perspectives in History

Directory of Open Access Journals (Sweden)

M Swanepoel

2009-12-01

Full Text Available Medicine and law were related from early times. This relation resulted as a necessity of protecting communities from the irresponsible acts of impostors. Various legal codes dealing with medical malpractice existed in Egypt, Mesopotamia, China, Islam, Greece, Rome, Persia and India. Over the course of the past 30 years, interest in the history of psychiatry has boomed. Much of this proliferation of interest has taken place under the broad influence of postmodernism and has resulted in multiple and diverse histories that no longer seek to provide a linear narrative of constant evolutionary progress. Rather, these new histories explore and disrupt taken for granted assumptions about the past and provide a starting point for discussion and debate about the some of the very foundations of mental health care in South Africa. As a matter of practical importance knowledge of how knowledge accrues and knowledge of the mistakes of the past is of prime importance in preventing similar mistakes in present and future work. An important reason for specifically understanding historical psychiatry is the fact that many of the uncertainties experienced in the present are a direct result of decisions made in the past. The key issue is that while it is tempting to experience current psychiatric and legal approaches towards the mentally disordered as natural and permanent, an understanding of the past helps mental health and legal practitioners to see things in a different perspective. Psychiatric and legal approaches towards the mentally disordered have changed over time and can undoubtedly also be changed in future. Therefore, the research conducted in this article focuses on the history and development of law and psychiatry including prehistoric times, the Arabian countries, the Nile Valley as well as Greece and Rome.

A settlement Forum for Stock Quoted Companies and Shareholders Claiming Damage

DEFF Research Database (Denmark)

Werlauff, Erik

2013-01-01

This article analyses the Dutch group settlement model from a company law and capital market law perspective. The author considers the WCAM procedure primarily as a forum and an instrument for companies in Europe and shareholders claiming damage caused by the company’s insufficient information to...... to the market. The article focuses on important questions for the Dutch settlement model, i.e. questions of jurisdiction, notification, and legal effect of the settlement. The author develops some important perspectives for European procedural and company law.......This article analyses the Dutch group settlement model from a company law and capital market law perspective. The author considers the WCAM procedure primarily as a forum and an instrument for companies in Europe and shareholders claiming damage caused by the company’s insufficient information...

The Legal Risks of Social Responsibility.

Science.gov (United States)

Drechsel, Robert E.

By scrutinizing the extensive and growing literature on media ethics and media codes, as well as the current history of litigation in libel cases, this paper analyzes the risks presented by journalistic social responsibility in the context of expanding tort liability for what might loosely be called journalistic malpractice. Following a review of…

The legalization of small scale mining in Colombia

Directory of Open Access Journals (Sweden)

Alexandra Urán

2013-11-01

Full Text Available The following article presents conceptual and analytical elements that allow us to broaden the debate about the legalization of the mining in Colombia. Looking for items to be able to propose alternatives in order to consolidate a new mining process socially and environmentally sustainable, claiming the value of the ancestral practices and forms of the redistributive production. To this end, it is necessary to start with the discussion of the concepts of formalization and legality, so that we can generate a theoretical framework that will allow us to explore such delicate matter, we will continue to make the framework socio-political, in which it is based that strategy. Then there is a brief context of thereformulation of legal mining, focusing our attention particularly standards which involves or has effects on artisanal mining and/or small-scale mining. There we will find ourselves with a debate on the typology of the mining and the current difficulties to define schemasof legalization or formalization of small-scale mining in Colombia. To conclude with a proposal to formalize as a mechanism of transition to an administrative system - legislativethat will connect more effectively with the realities and skills of the ethnic communities that practice small-scale mining.

A Legal Analysis and Contrarian View of the Syllabus-as-Contract Perspective

Science.gov (United States)

Kaufmann, Kent D.

2015-01-01

Despite the claim made in the scholarship of teaching and learning (SoTL) literature for over two decades that a syllabus is a contract, the courts have uniformly ruled that it is not. While there is no harm in thinking one's syllabus is a contract, there may be legal risk in proclaiming it so. The author provides an analysis of the…

32 CFR 536.121 - Claims not payable as maritime claims.

Science.gov (United States)

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Claims not payable as maritime claims. 536.121... ACCOUNTS CLAIMS AGAINST THE UNITED STATES Maritime Claims § 536.121 Claims not payable as maritime claims... (except at (e) and (k)), and 536.46; (b) Are not maritime in nature; (c) Are not in the best interests of...

RESPONSIBILITY OF PHYSICAL EDUCATION TEACHER: CONSEQUENCES OF THE LEGAL CLAIMS IN ACCIDENTS

Directory of Open Access Journals (Sweden)

Roberto Silva Piñeiro

2015-12-01

Full Text Available Being physical education an area that collects some case law, and that the professionalization required studies specifically, a review of appeals and complaints concerning accidents in school physical education, including sessions inside and outside. It was studied the sense of judicial and administrative resolutions about school accidents in physical education in Spain between 1988-2012, and its effects on physical education professionals. Most opinions and judgments studied the claims were rejected for various reasons, among them the casuality and risk taking, although there are outstanding judgments, blaming the teacher for not being present in class and for not preventing situations. The administration usually paid, although in some cases the teacher also participates.

The anatomy of a malpractice suit

International Nuclear Information System (INIS)

Reuter, S.R.; Bundy, A.L.; Gunn, W.G.; Johnson, G.C.

1987-01-01

The Medical-Legal Committee of the RSNA presents an overview of medical negligence in the radiologic context and discusses the procedural aspects of the legal process that a radiologist who has been sued might expect to face during discovery and a trial. Special aspects of radiologic negligence, such as misdiagnosis and complications of special procedures, are discussed. The defendant radiologist's role during discovery and the role of the radiologist as a witness completes the program

The (Mal)Practice of Dowry in Contemporary India. A Challenge to Marriage and Family Ministry

OpenAIRE

Jainus Xavier, Nixen Raj; Jainus Xavier, Nixen Raj; Knieps-Port le Roi, Thomas

2012-01-01

The author explores the (mal)practice of dowry in contemporary India and the challenge it presents to marriage and family ministry. He explains how originally harmless and well-intended dowry customs changed under the influence of historical circumstances that turned them into a business-like family strategy aimed at rising families’ social status, wealth and power. This evolution had dramatic consequences for Indian marriage and family life and especially for women. Dowry-related violence an...

The legal status of the fetus: an international review.

Science.gov (United States)

Seymour, John

2002-08-01

The article examines the way that courts and legislatures in the United Kingdom, the United States of America, Canada and Australia have answered questions regarding the legal status of a fetus. These questions have arisen in a variety of legal situations: the article deals with succession, criminal, child protection and negligence law. The conclusion offered is that a fetus has a value and an existence that the law should recognise. This does not mean, however, that in all circumstances the law should protect the interests of the fetus. Law-makers will respond differently to claims made on behalf of a fetus, depending on the context. The fetus does not have a uniform value or character in the eyes of the law. The law makes choices as to the situations in which it will take account of actual or threatened antenatal harm.

32 CFR 536.129 - Claims cognizable as UCMJ claims.

Science.gov (United States)

2010-07-01

... Personnel Claims Act and chapter 11 of AR 27-20, which provides compensation only for tangible personal... 32 National Defense 3 2010-07-01 2010-07-01 true Claims cognizable as UCMJ claims. 536.129 Section 536.129 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS...

Negligence and the legal standard of care: what is 'reasonable' conduct?

Science.gov (United States)

Miola, José

Medical negligence has become a big issue for medical practitioners. Fear of the law, and of litigation, has led to claims of defensive medical practice among doctors and nurses. At the heart of this lies the legal definition of the standard of care, where the law seeks to determine when conduct is 'reasonable' (and thus not negligent), or 'unreasonable' (and thus a breach of the legal duty of care and potentially negligent). In this article the author clarifies what the law means by 'reasonableness' with respect to nurses, drawing on both the law and the NMC Code. Furthermore, the article shall demonstrate that the law is not something to be fearful of but, rather, demands a standard no higher than that of the NMC.

Forensic Odontology: A Boon to Community in Medico-legal Affairs

Directory of Open Access Journals (Sweden)

Ramasamy Chidambaram

2016-03-01

Full Text Available Forensic odontology is a sub-discipline of dental science which involves the relationship between dentistry and the law. The specialty of forensic odontology is applied in radiographic investigation, human bite marks analysis, anthropologic examination and during mass disasters. Besides the fact that radiographs require pretentious laboratory, it is still claimed to be a facile, rapid, non-invasive method of age identification in the deceased. The budding DNA technology has conquered the traditional procedures and currently being contemplated as chief investigating tool in revealing the hidden mysteries of victims and suspects, especially in hopeless circumstances. Forensic odontology has played a chief role in solving cold cases and proved to be strong evidence in the court of law. Systematic collection of dental records and preservation of the same would marshal the legal officials in identification of the deceased. To serve the forensic operation and legal authorities, dental professionals need to be familiar with the basics of forensic odontology, which would create a consciousness to preserve the dental data. The aim of this paper is to emphasize the vital applications of forensic odontology in medico-legal issues. Conjointly the recent advancements applied in forensic human identification have been updated. Keywords: bite marks; dental records; forensic identification; mass disaster; medico-legal issues. | PubMed

Legal regulators of strengthening altruism in ukrainian society

Directory of Open Access Journals (Sweden)

O. B. Feldman

2015-01-01

Full Text Available In the article the legal mechanisms of strengthening altruism in Ukrainian society are analysed. Altruism constantly develops, acquires new forms under act of public relations. In modern Ukrainian society altruism must take the special place in institutionalization of human dignity and rights and freedoms of man, become the norm of social activity. In the article there is a necessity of perfection of normatively­legal base on the basis of principle of altruism, harmonization of relations between the state and civil society in the field of the altruism directed practices. Sharp social contradictions, estrangement of man, can be overcame only through claim of initial social values on principles of idea of dignity and human rights. There must be valuable partnership of the state and eleemosynary organizations in democratic society, creating favourable terms for opening public potential and directing of altruism activity of population. The special attention must be spared to providing of rights for invalids and defencing of them from discrimination.

Indexation of Consumer and Mortgage Credit in Iceland in 2014: A Critical Battle between Legality, Fairness and Legitimacy

Directory of Open Access Journals (Sweden)

Maria Elvira Mendez Pinedo

2014-11-01

Full Text Available Six years after the financial crisis that led to the collapse of the banking system in 2008, the over-indebtedness of households is one of the most important problems in Iceland. This study aims to cast light on a specific feature of the Icelandic credit system in connection with the problem of over-indebtedness. The main research question is whether the end of indexation of credit is close or not. The author argues, in the first place, that indexation of credit ex-post to the consumer price index (CPI in negative amortization schemes is responsible for over-indebtedness. In the second place, the author describes the challenges ahead in the field of consumer and mortgage credit in Iceland in the light of European law (European Union EU and European Economic Area EEA. The incorporation of Directive 2008/48 on credit agreement for consumers to the Icelandic domestic order through the EEA Agreement allowed a preliminary legal review of the practice in light of EU/EEA consumer credit law, both at national and European level without a final conclusion. It has nevertheless led to the judicial review on the legality of some indexation alleged malpractices before national courts and to the EFTA Court for interpretation (mostly on Directives 93/13/EEC on unfair terms 87/102/EEC on consumer credit. A ruling from the Supreme Court is expected on several cases. A critical battle between the legality, the fairness and the legitimacy of indexation of credit is taking place in Iceland under the influence of European law.

Some malpractices in application of computed radiography

International Nuclear Information System (INIS)

Liu Ruihong; Jia Shaotian; Wang Yusheng; Li Baohua; Chen Lin; Wang Zhenguang; Liu Jianxin; Gong Jingyue; Liu Daoyong; Xie Xuesong

2007-01-01

Objective: To improve the CR image quality and to promote the digital image standard constitution by analyzing the common problems and malpractices in application of computed radiography. Methods: Phenomenon and reasons of 107 CR junk-films from nine three-'A'-hospitals were analyzed, discussed, recorded, and statistised by 20 radiologists, radiographers and engineers. Results: Among 107 junk films, there are 36 cases (33.64%) of incorrect operations, 29 cases (27.10%) of artifacts in reading and transferring the data of IP, 15 cases (14.02%) of artifacts in IP system, and 13 cases (12.15%) of selection of inappropriate radiographic parameters, and 9 cases (8.41%) of printer-failures, and 5 cases (4.67%) of inappropriate post-processing techniques. By analyzing the reasons of 107 junk films we found that 60.74% were due to less responsibilities and incorrect operations, and 35.51% were due to new problems in CR techniques, and other were due to inappropriate post-processing techniques. Conclusion: Responsibilities, operation regulations, digital image quality standards, studying of new techniques and appropriate use of the post-processing techniques are the key points for improving the CR image quality and the diagnosis level. (authors)

Competitive Legal Professionals’ use of Technology in Legal Practice and Legal Research

Directory of Open Access Journals (Sweden)

T du Plessis

2008-12-01

Full Text Available Advances in the information and communication technologies have led to the availability of a range of primary and secondary legal research publications online via the Internet, rather than on other storing devices such as compact discs or publications in the print media. Not only has information and communication technology (ICT impacted on the availability of legal information resources, but its effects are also noticed in various law-related areas such as legal practice management, legal education, corporate governance and the law per se. The question addressed by this article is whether the application of ICTs has an effect on the practice of law, and specifically whether information and knowledge management affects the processes of legal research in modern legal practice. Various issues are considered in this regard, including what the concept of knowledge management (KM entails in a law firm and what the current KM trends in South African law firms are. The article investigates global trends in the application of ICTs for legal research purposes, what the specific applications of KM in support of legal research may be, how information technology applications and KM systems and strategies can support the legal research process, and what the benefits of KM are to legal research. It finally discusses the impact technology has had on the skills required of competitive legal professionals.

"Legal Highs"--An Emerging Epidemic of Novel Psychoactive Substances.

Science.gov (United States)

Zawilska, Jolanta B

2015-01-01

During the last decade, there has been an increase in the availability and use of novel psychoactive substances (NPS), also known as "legal highs," across the world. They include a wide range of products, from natural plant-originated substances to synthetic compounds, that can be purchased both online and from high street retailers. "Legal highs" mimic psychoactive effects of illicit drugs of abuse. However, they are claimed to consist of compounds that are legal to sell, possess, and use, often labeled as "not for human consumption" to circumvent drug abuse legislation. Based on the spectrum of their actions on cognitive processes, mood, and behavior, "legal highs" can be classified into four basis categories: amphetamine- and ecstasy-like stimulants, synthetic cannabinoids (SCs), hallucinogenic/dissociative, and opioid-like compounds. NPS may, however, exhibit a combination of these actions due to their designed chemical structure. Although the prevalence and pattern of NPS use differ between various countries, the most popular groups are SCs and psychostimulants, described in this chapter. Currently, there is limited information available on the potential acute toxicity (harms) associated with the use of these substances. However, the number of intoxicated people presenting with emergencies is constantly increasing, providing evidence that negative health and social consequences may indeed seriously affect recreational and chronic users. © 2015 Elsevier Inc. All rights reserved.

Possible gasoline-induced chronic liver injury due to occupational malpractice in a motor mechanic: a case report.

Science.gov (United States)

Gunathilaka, Mahesh Lakmal; Niriella, Madunil Anuk; Luke, Nathasha Vihangi; Piyarathna, Chathura Lakmal; Siriwardena, Rohan Chaminda; De Silva, Arjuna Priyadarshin; de Silva, Hithanadura Janaka

2017-07-03

Hydrocarbon-induced occupational liver injury is a well-known clinical entity among petroleum industry workers. There are many types of hydrocarbon exposure, with inhalation being the most common. Hydrocarbon-induced occupational liver injury is a rarely suspected and commonly missed etiological agent for liver injury. We report a case of a non-petroleum industry worker with chronic liver disease secondary to hydrocarbon-induced occupational liver injury caused by chronic low-grade hydrocarbon ingestion due to occupational malpractice. A 23-year-old Sri Lankan man who was a motor mechanic presented to our hospital with decompensated cirrhosis. He had been chronically exposed to gasoline via inadvertent ingestion due to occupational malpractice. He used to remove gasoline from carburetors by sucking and failed to practice mouth washing thereafter. On evaluation, he had histologically proven established cirrhosis. A comprehensive history and workup ruled out other nonoccupational etiologies for cirrhosis. The patient's long-term occupational gasoline exposure and clinical course led us to a diagnosis of hydrocarbon-induced occupational liver injury leading to decompensated cirrhosis. Hydrocarbon-induced occupational liver injury should be considered as a cause when evaluating a patient with liver injury with possible exposure in relevant occupations.

Medical Litigation Across Specialties

LENUS (Irish Health Repository)

Murphy, JFA

2013-07-01

Medical negligence is a major cause of fear and anxiety for doctors. The threat of malpractice consists of 3 factors, the risk of a claim, the probability of a claim leading to a payment, and the size of the payment. The Clinical Indemnity Scheme (CIS) insures against indemnity payments but it cannot protect the doctor against the indirect consequences of litigation including stress, the long hours mounting a defence against the allegation, and the damage to one’s reputation. The adversarial tort system focuses on punishment, blame and compensation. The emotional anguish and potential damage to the doctor’s reputation can be considerable. Doctors subjected to malpractice suits regardless of the outcome may experience depression, anger, frustration and excessive use of alcohol

CIVIL PROTECTION MECHANISM OF THE ASSIGNEE RIGHTS BASED ON THE PATENT CLAIM

Directory of Open Access Journals (Sweden)

N. V. Marchenko

2014-04-01

Full Text Available Purpose. Statistical analysis of inventive activity in Ukraine shows that the largest number of applications is submitted by employees of universities and research institutions – almost 60% of all inventions. Practice of inventions execution proves that for researchers, especially for students, the most difficult part of the application and author documents is the claim. The purpose of research is a synthesis and supplying the general principles of quality drafting the patent claim, providing further legal protection of the patent. Methodology. Monitoring and analysis of the world documentary informational flow through the civil protection mechanism of the assignee rights on the basis of the patent claim allows us to compare the world systems of formulas development and summarize some key moments concerning the point in question. The example analysis of the correct patent claim drafting and its interpretation in court cases on intellectual property was made. Findings. The specific properties of the patent claim were described. They are conciseness, latitude, completeness and certainty, compliance with unity requirements and novelty of the invention. On the basis of the research it is established that there is a great difference between Ukrainian and American patent claims. A number of common mistakes and shortcomings during the claim drafting were identified. The need to restore the various forms of the invention training in universities of Ukraine was emphasized, since on this basis one should train a number of specialists who are able to carry out the commercialization of intellectual property results into productive findings. Originality. A number of issues and techniques was investigated and summarized. They can be applied by the courts in interpreting of the patent claim in the processing of intellectual property cases. Especially it concerns determining the correct drafting of the patent claim. Practical value. This work may be used

Accommodating the medical use of marijuana: surveying the differing legal approaches in Australia, the United States and Canada.

Science.gov (United States)

Bogdanoski, Tony

2010-02-01

While the scientific and medical communities continue to be divided on the therapeutic benefits and risks of cannabis use, anecdotal evidence from medical users themselves suggests that using cannabis is indeed improving their quality of life by alleviating their pain and discomfort. Notwithstanding the benefits anecdotally claimed by these medical users and the existence of some scientific studies confirming their claims, criminal drug laws in all Australian and most United States jurisdictions continue to prohibit the possession, cultivation and supply of cannabis even for medical purposes. However, in contrast to Australia and most parts of the United States, the medical use of cannabis has been legal in Canada for about a decade. This article reviews these differing legal and regulatory approaches to accommodating the medical use of cannabis (namely, marijuana) as well as some of the challenges involved in legalising it for medical purposes.

What makes health public?: a critical evaluation of moral, legal, and political claims in public health

National Research Council Canada - National Science Library

Coggon, John

2012-01-01

.... Covering important works from legal, moral, and political theory, public health, public health law and ethics, and bioethics, this is a foundational text for scholars, practitioners and policy bodies interested in freedoms, rights and responsibilities relating to health"--

ClaimAssociationService

Data.gov (United States)

Department of Veterans Affairs — Retrieves and updates a veteranÆs claim status and claim-rating association (claim association for current rating) from the Corporate database for a claim selected...

Auditing Litigation and Claims: Conflicts and the Compromise of Privilege

Directory of Open Access Journals (Sweden)

Harleen Kaur

2013-12-01

Full Text Available Auditing standards require an auditor to make various enquiries about liabilities in general this may entail consideration of potential litigations and claims that the audited entity may be facing. To perform this part of audit, the auditors will generally seek representation letters from lawyers of the company detailing an estimate prepared by management, confirmed by their lawyers through a representation letter, and then sent directly to the auditors. This paper reviews the implications for the auditing profession of a case that involved auditors seeking such representation letters. The case involves litigation between theWestpac Banking Corporation and 789TEN Pty Ltd. While theWestpac case confirmed the legal position of the auditor in their task of collecting evidence in order to form an opinion in Australia, it highlights a significant anomaly under the law and should place the issue of solicitor’s representation letters as audit evidence firmly on the agenda of policymakers. This issue of the compromise of legal privilege during the conduct of an audit is also not confined to Australia: other common law jurisdictions, such as the UK and the US, have also sought to clarify the position of auditors when issues of the integrity of legal privacy privilege arise.

Medical reports on persons claiming compensation for personal injury.

Science.gov (United States)

Cornes, P; Aitken, R C

1992-06-01

An audit of one insurance company's files on all employer's liability and third party motor claims settled over two years for 5000 pounds or more presented an opportunity to review the medical reports on the patients involved. A stratified random sample of files on 203 patients contained 602 reports prepared by 400 consultants. Content analysis was undertaken to evaluate compliance with published guidance on reports prepared for medico-legal purposes and to ascertain how well reports met recipients' requirements. While clinical topics were well covered, generally to a high standard, other functional, psychosocial and occupational topics, reflecting the wider clinical and non-clinical frame of reference within which lawyers and insurers normally seek information and advice, were covered less frequently, extensively and comprehensively--leaving considerable scope to improve these aspects of assessment and reporting. Further review of this aspect of professional practice should include attention to the appropriateness of existing guidance, postgraduate training requirements and the involvement of other agencies or professions in some aspects of assessment for medico-legal purposes.

False Testimony and Oath: Reopening a Legal Case in Iranian Courts

Directory of Open Access Journals (Sweden)

Iman Zeajeldi

2017-02-01

Full Text Available In Iranian legal laws, hearing a case ends by issuing the final judgment. However, the law has provided conditions where the individuals can apply for retrial so that their rights will be protected and losses will be prevented. This means that court will rehear a case for which it has issued a final judgment. Now, each of the parties to the claim who has applied for reopening must prove the conditions of reopening. One of the conditions is proving the falsehood in the claim. Yet, the question is ‘under which conditions the falsehood brings about the annulment of the judgment issued’. The present research aims to study the effects of falsehood cases in the possibility of applying for reopening and annulling the judgment issued.

Defining hip fracture with claims data: outpatient and provider claims matter.

Science.gov (United States)

Berry, S D; Zullo, A R; McConeghy, K; Lee, Y; Daiello, L; Kiel, D P

2017-07-01

Medicare claims are commonly used to identify hip fractures, but there is no universally accepted definition. We found that a definition using inpatient claims identified fewer fractures than a definition including outpatient and provider claims. Few additional fractures were identified by including inconsistent diagnostic and procedural codes at contiguous sites. Medicare claims data is commonly used in research studies to identify hip fractures, but there is no universally accepted definition of fracture. Our purpose was to describe potential misclassification when hip fractures are defined using Medicare Part A (inpatient) claims without considering Part B (outpatient and provider) claims and when inconsistent diagnostic and procedural codes occur at contiguous fracture sites (e.g., femoral shaft or pelvic). Participants included all long-stay nursing home residents enrolled in Medicare Parts A and B fee-for-service between 1/1/2008 and 12/31/2009 with follow-up through 12/31/2011. We compared the number of hip fractures identified using only Part A claims to (1) Part A plus Part B claims and (2) Part A and Part B claims plus discordant codes at contiguous fracture sites. Among 1,257,279 long-stay residents, 40,932 (3.2%) met the definition of hip fracture using Part A claims, and 41,687 residents (3.3%) met the definition using Part B claims. 4566 hip fractures identified using Part B claims would not have been captured using Part A claims. An additional 227 hip fractures were identified after considering contiguous fracture sites. When ascertaining hip fractures, a definition using outpatient and provider claims identified 11% more fractures than a definition with only inpatient claims. Future studies should publish their definition of fracture and specify if diagnostic codes from contiguous fracture sites were used.

Avoiding malpractice suits through the use of informed consent.

Science.gov (United States)

Annas, G J

1976-03-01

The doctrine of informed consent is based on a long tradition of promoting self-autonomy and rational decision-making. The amount of information required to be disclosed by the doctor to the patient is that which permits the patient to decide for himself whether or not to undergo the recommended treatment. It includes information about risks of death or serious bodily harm, probability of success, problems of recuperation, and alternative modes of treatment. Disclosing such information contributes to the doctor-patient relationship and therefore makes recourse to malpractice litigation in the face of an unsatisfactory or untoward result less likely. Attempts to abolish the doctrine are potentially counterproductive and could lead to widespread mistrust of the medical profession on the part of a society that increasingly demands more information in all areas. Physicians will best serve both themselves and their patients by fully disclosing all relevant information before asking patients to consent to specific therapies.

Forensic bitemark identification: weak foundations, exaggerated claims

Science.gov (United States)

Saks, Michael J.; Albright, Thomas; Bohan, Thomas L.; Bierer, Barbara E.; Bowers, C. Michael; Bush, Mary A.; Bush, Peter J.; Casadevall, Arturo; Cole, Simon A.; Denton, M. Bonner; Diamond, Shari Seidman; Dioso-Villa, Rachel; Epstein, Jules; Faigman, David; Faigman, Lisa; Fienberg, Stephen E.; Garrett, Brandon L.; Giannelli, Paul C.; Greely, Henry T.; Imwinkelried, Edward; Jamieson, Allan; Kafadar, Karen; Kassirer, Jerome P.; Koehler, Jonathan ‘Jay’; Korn, David; Mnookin, Jennifer; Morrison, Alan B.; Murphy, Erin; Peerwani, Nizam; Peterson, Joseph L.; Risinger, D. Michael; Sensabaugh, George F.; Spiegelman, Clifford; Stern, Hal; Thompson, William C.; Wayman, James L.; Zabell, Sandy; Zumwalt, Ross E.

2016-01-01

Abstract Several forensic sciences, especially of the pattern-matching kind, are increasingly seen to lack the scientific foundation needed to justify continuing admission as trial evidence. Indeed, several have been abolished in the recent past. A likely next candidate for elimination is bitemark identification. A number of DNA exonerations have occurred in recent years for individuals convicted based on erroneous bitemark identifications. Intense scientific and legal scrutiny has resulted. An important National Academies review found little scientific support for the field. The Texas Forensic Science Commission recently recommended a moratorium on the admission of bitemark expert testimony. The California Supreme Court has a case before it that could start a national dismantling of forensic odontology. This article describes the (legal) basis for the rise of bitemark identification and the (scientific) basis for its impending fall. The article explains the general logic of forensic identification, the claims of bitemark identification, and reviews relevant empirical research on bitemark identification—highlighting both the lack of research and the lack of support provided by what research does exist. The rise and possible fall of bitemark identification evidence has broader implications—highlighting the weak scientific culture of forensic science and the law's difficulty in evaluating and responding to unreliable and unscientific evidence. PMID:28852538

Excess in Self-Defense and its Consequences to the Assesment of the Victim's Legal Crime Precipitation

Directory of Open Access Journals (Sweden)

Diego José Dias Mendes

2016-10-01

Full Text Available This article explores the ongoing debate concerning excessive self-defense and its possible consequences to the assessment of victim legal precipitation of crimes. While part one introduces excess in its most accepted structure, part two describes theories that pursue the best reasons why the excess may, in certain cases, not be punished, focusing the ones who claim that those reasons relate to agressor’s self-responsibility, then applying their arguments to the evaluation of legal crime precipitation. It concludes that these theories can only hold by discriminating moral value of guilty and innocent victims, which is unacceptable.

Medication errors as malpractice-a qualitative content analysis of 585 medication errors by nurses in Sweden.

Science.gov (United States)

Björkstén, Karin Sparring; Bergqvist, Monica; Andersén-Karlsson, Eva; Benson, Lina; Ulfvarson, Johanna

2016-08-24

Many studies address the prevalence of medication errors but few address medication errors serious enough to be regarded as malpractice. Other studies have analyzed the individual and system contributory factor leading to a medication error. Nurses have a key role in medication administration, and there are contradictory reports on the nurses' work experience in relation to the risk and type for medication errors. All medication errors where a nurse was held responsible for malpractice (n = 585) during 11 years in Sweden were included. A qualitative content analysis and classification according to the type and the individual and system contributory factors was made. In order to test for possible differences between nurses' work experience and associations within and between the errors and contributory factors, Fisher's exact test was used, and Cohen's kappa (k) was performed to estimate the magnitude and direction of the associations. There were a total of 613 medication errors in the 585 cases, the most common being "Wrong dose" (41 %), "Wrong patient" (13 %) and "Omission of drug" (12 %). In 95 % of the cases, an average of 1.4 individual contributory factors was found; the most common being "Negligence, forgetfulness or lack of attentiveness" (68 %), "Proper protocol not followed" (25 %), "Lack of knowledge" (13 %) and "Practice beyond scope" (12 %). In 78 % of the cases, an average of 1.7 system contributory factors was found; the most common being "Role overload" (36 %), "Unclear communication or orders" (30 %) and "Lack of adequate access to guidelines or unclear organisational routines" (30 %). The errors "Wrong patient due to mix-up of patients" and "Wrong route" and the contributory factors "Lack of knowledge" and "Negligence, forgetfulness or lack of attentiveness" were more common in less experienced nurses. The experienced nurses were more prone to "Practice beyond scope of practice" and to make errors in spite of "Lack of adequate

CIVIL LIABILITY OF DOCTORS AND THEIR INSURANCE (MALPRACTICE

Directory of Open Access Journals (Sweden)

Gârbo Viorica Irina

2013-07-01

Full Text Available Malpractice insurance of medical staff is probably the oldest professional liability insurance underwritten in the insurance market in Romania. The aim of our research is to theoretically examine in a qualitative inquiry the usefulness of insurance completion by the practitioners from the Romanian health system at both state and private, in order to improve a best practice medical insurance. The medical profession is practiced in Romania under the Code of Medical Ethics 30 March 2012 prepared in code that complies with international standards contained in the Geneva Declaration of 1948, as amended by the World Medical Association and the International Code of Medical Ethics. The forms of medical liability are: disciplinary, administrative, civil and criminal and only the civil liability can be taken into insurance because only it meets the conditions of insurability. Once we explain in general and the insurance liability in particular we show articles of the Romanian Civil Code which establishes the obligation the one that caused an injury to a third person for the repair or indemnify and conditions provided by the Civil Code as an act to be considered liability. Then we refer to situations where the patient may be damaged through the fault of the doctor or the doctor unit operates. The object of malpractice insurance is loss of money that the insured would have to pay a patient whom he caused injury as a result of acts or deeds of negligence committed to, during and in relation to professional activity. Risks taken in the insurance are personal injury, illness or death of the patient and / or moral damages. Regarding the excluded risks we have presented an overview of the more common contracts underwritten by Romanian insurance companies. We show the way of underwriting, the insured sums of the standard insurance and the additional one which subscribes moral damages, to companies in Romania agreed by bodies which organize and supervise the

Legal protection of private persons in the case of acts of foreign states contrary to international law - with special reference to international environmental law

Energy Technology Data Exchange (ETDEWEB)

Schwarze, J

1986-01-01

The author describes the basis for claims following to international law for a case like Chernobyl. He examines possibilities of enforcement of private claims, regarding legal protection in courts of the state where the incident occurred, and of the state where the damage was suffered, of the International Court of Justice, and by way of diplomatic protection. Individual guarantees of procedure still can be improved at present.

Case Study: The Myanmar and Bangladesh Maritime Boundary Dispute in the Bay of Bengal and Its Implications for South China Sea Claims

Directory of Open Access Journals (Sweden)

Ravi A. Balaram

2012-01-01

Full Text Available This paper seeks to review the pertinent Myanmar and Bangladesh history in overlapping maritime territorial claims leading up to the September 2011 International Tribunal for the Law of the Sea (ITLOS case: Dispute Concerning Delimitation of the Maritime Boundary Between Bangladesh and Myanmar in the Bay of Bengal. It will dissect the legal proceedings as primary source documents and apply the relevant judgement findings to analyse the implications for the respective countries and for South China Sea maritime boundary disputes. While the judgements of this case set certain legal precedents that may be more easily applied to bilateral disputes, the implications, nevertheless, impinge on multilateral claims as well. To the extent that the Bangladesh-Myanmar ITLOS judgement provides a pathway to third-party, independent, and peaceful resolution to the potentially explosive and escalating tensions in the South China Sea, this paper argues that findings are relevant, but limited.

The non-appearance of the selection procedure and possibilities of legal protection of the unsuccessful bidder; Das Ausbleiben des Auswahlverfahrens und Rechtsschutzmoeglichkeiten des unterlegenen Bieters

Energy Technology Data Exchange (ETDEWEB)

Meyer-Hetling, Astrid; Templin, Wolf [Kanzlei Becker Buettner Held, Berlin (Germany)

2012-02-15

A violation of the municipality against the relevant guidelines for awarding concessions may have legal consequences, in particular in terms of a already completed selection process. The authors of the contribution under consideration focus on the complete absence of an concession legal selection process. First of all, the energy legal, competition legal and European legal requirements and bids are presented against which the franchising community violated. Subsequently, the authors examine the question of whether this violation immediately results in the nullity of the concession contract, as well as the question of the claims of the company not taken into account against the municipality. Furthermore, the procedural and antitrust tools are presented for the non-considered companies.

A Formidable Task: Reflections on obtaining legal empirical evidence on human trafficking in Canada

Directory of Open Access Journals (Sweden)

Hayli Millar

2017-04-01

Full Text Available This article explores the experiences, challenges and findings of two empirical research studies examining Canada’s legal efforts to combat human trafficking. The authors outline the methodologies of their respective studies and reflect on some of the difficulties they faced in obtaining empirical data on human trafficking court cases and legal proceedings. Ultimately, the authors found that Canadian trafficking case law developments are in their early stages with very few convictions, despite a growing number of police-reported charges. The authors assert it is difficult to assess the efficacy and effects of Canadian anti-trafficking laws and policies due to the institutional and political limitations to collecting legal data in this highly politicised subject area. They conclude with five recommendations to increase the transparency of Canada’s public claims about its anti-trafficking enforcement efforts and call for more empirically-based law reform.

Formal and Legal Aspects of Buying and Commissioning Flats

Science.gov (United States)

Dubas, Sebastian; Nowotarski, Piotr; Milwicz, Roman

2017-10-01

Formal and legal aspects of buying flats and their reception is very current topic and touches wide group of buyers. Annually in Poland great amount of flats is being sold and put to use. However, the case of housing purchase requires knowledge of both the construction and the legal aspects each buyer has to encounter. The paper faces the subject of formal and legal aspects, and analyses accompanying procedure of purchase and reception of housing in Poland. The article presents principles associated with the acquisition of a dwelling, process of works reception, removal of detected faults, fault-free reception, transfer of ownership, warranties, guarantees and possibilities of their enforcement. Contracting parties of the developer agreement were revealed. In addition, the entities present in the course of works such as general contractor were mentioned, due to the fact of his direct influence on the results of a contract terms between developer and buyer. Logical connection between three parties (buyer-developer-general contractor) were shown and direct and indirect dependencies were revealed. Existing laws and regulations that govern the relationship between the developer and the buyer of a dwelling were determined showing basic rights and responsibilities of each. The article also presents problems resulting from delaying the completion of works by developer’s fault and indicates possible legal paths to follow in order claim their rights. Due to the fact, that many of discussed formal and legal aspects in this subject have their origin connected to construction works and design issues, author suggests increased quality control and efficient work organization in order to solve problems before appearance.

“Health Courts” and Accountability for Patient Safety

Science.gov (United States)

Mello, Michelle M; Studdert, David M; Kachalia, Allen B; Brennan, Troyen A

2006-01-01

Proposals that medical malpractice claims be removed from the tort system and processed in an alternative system, known as administrative compensation or ‘health courts,’ attract considerable policy interest during malpractice ‘crises,’ including the current one. This article describes current proposals for the design of a health court system and the system's advantages for improving patient safety. Among these advantages are the cultivation of a culture of transparency regarding medical errors and the creation of mechanisms to gather and analyze data on medical injuries. The article discusses the experiences of foreign countries with administrative compensation systems for medical injury, including their use of claims data for research on patient safety; choices regarding the compensation system's relationship to physician disciplinary processes; and the proposed system's possible limitations. PMID:16953807

Discrimination of legal entities: Phenomenological characteristics and legal protection

Directory of Open Access Journals (Sweden)

Petrušić Nevena

2017-01-01

Full Text Available Their social nature encourages people to associate and jointly achieve the goals that they would not be able to achieve individually. Legal entities are created as one of the legal modalities of that association, as separate entities that have their own legal personality independent of the subjectivity of their members. Legal entities are holders of some human rights, depending on the nature of the right, including the right to non-discrimination. All mechanisms envisaged for legal protection against discrimination in the national legislation are available to legal persons. On the other hand, the situation is quite different in terms of access to international forums competent to deal with cases of discrimination. Legal entities do not have access to some international forums, while they may have access to others under the same conditions prescribed for natural persons. Legal entities may be exposed to various forms of direct and indirect discrimination both in the private and in the public sphere of social relations. Phenomenological characteristics of discrimination against legal persons are not substantially different from discrimination against individuals. There are no significant differences regarding the application of discrimination test in cases of discrimination of legal entities as compared to the use of this test in cases involving discrimination of natural persons or groups of persons. Legal entities may be discriminated against on the basis of characteristics of their legal personality, such as those which are objective elements of the legal entity and part of its legal identity. Discrimination of legal entities may be based on personal characteristics of its members (i.e. people who make a personal essence of a legal entity because their characteristics can be 'transferred' to the legal entity and become part of its identity. Legal entities should also be protected from this special form of transferred (associative discrimination.

The assessment of performance and self-report validity in persons claiming pain-related disability.

Science.gov (United States)

Greve, Kevin W; Bianchini, Kevin J; Brewer, Steve T

2013-01-01

One third of all people will experience spinal pain in their lifetime and half of these will experience chronic pain. Pain often occurs in the context of a legally compensable event with back pain being the most common reason for filing a Workers Compensation claim in the United States. When financial incentives to appear disabled exist, malingered pain-related disability is a potential problem. Malingering may take the form of exaggerated physical, emotional, or cognitive symptoms and/or under-performance on measures of cognitive and physical capacity. Essential to the accurate detection of Malingered Pain-related Disability is the understanding that malingering is an act of will, the goal of which is to increase the appearance of disability beyond that which would naturally arise from the injury in question. This paper will review a number of Symptom Validity Tests (SVTs) that have been developed to detect malingering in patients claiming pain-related disability and will conclude with a review of studies showing the diagnostic benefit of combining SVT findings from a comprehensive malingering assessment. The utilization of a variety of tools sensitive to the multiple manifestations of malingering increases the odds of detecting invalid claims while reducing the risk of rejecting a valid claim.

Legal protection of private persons in the case of acts of foreign states contrary to international law - with special reference to international environmental law

International Nuclear Information System (INIS)

Schwarze, J.

1986-01-01

The author describes the basis for claims following to international law for a case like Chernobyl. He examines possibilities of enforcement of private claims, regarding legal protection in courts of the state where the incident occurred, and of the state where the damage was suffered, of the International Court of Justice, and by way of diplomatic protection. Individual guarantees of procedure still can be improved at present. (CW) [de

Kirit C. Shah, M.D. v. Stan Harris and Nancy Harris. "Construction of Legal Arguments, Statutes of Limitations, and Medical Malpractice." Lesson Plans for Secondary Teachers on How Lawyers Prepare Their Arguments. Courts in the Classroom: Curriculum Concepts and Other Information on Indiana's Courts for the K-12 Educator.

Science.gov (United States)

Osborn, Elizabeth

Stan and Nancy Harris filed a complaint against Kirit C. Shah, M.D., for misdiagnosing Mr. Harris's illness, charging Dr. Shah with negligence and asking for damages. A medical malpractice action in Indiana is governed by a two year statute of limitations. Because the Harrises failed to bring their action against Dr. Shah within this two year…

Spectrum of diagnostic errors in radiology.

Science.gov (United States)

Pinto, Antonio; Brunese, Luca

2010-10-28

Diagnostic errors are important in all branches of medicine because they are an indication of poor patient care. Since the early 1970s, physicians have been subjected to an increasing number of medical malpractice claims. Radiology is one of the specialties most liable to claims of medical negligence. Most often, a plaintiff's complaint against a radiologist will focus on a failure to diagnose. The etiology of radiological error is multi-factorial. Errors fall into recurrent patterns. Errors arise from poor technique, failures of perception, lack of knowledge and misjudgments. The work of diagnostic radiology consists of the complete detection of all abnormalities in an imaging examination and their accurate diagnosis. Every radiologist should understand the sources of error in diagnostic radiology as well as the elements of negligence that form the basis of malpractice litigation. Error traps need to be uncovered and highlighted, in order to prevent repetition of the same mistakes. This article focuses on the spectrum of diagnostic errors in radiology, including a classification of the errors, and stresses the malpractice issues in mammography, chest radiology and obstetric sonography. Missed fractures in emergency and communication issues between radiologists and physicians are also discussed.

Issues with monitoring the safety of psychoactive products under a legal regulated market for new psychoactive substances ('legal highs') in New Zealand.

Science.gov (United States)

Rychert, Marta; Wilkins, Chris; Witten, Karen

2017-09-01

New Zealand's Psychoactive Substances Act (2013) established the world's first regulated market for 'low risk' psychoactive products ('legal highs'). Under an interim PSA regime, 47 existing products were permitted to be continued to be sold. To explore issues with the implementation of regulatory systems to monitor the safety of products on the legal market under the interim Psychoactive Substances Act regime. Semi-structured interviews with 30 key stakeholders, including industry, government agency, health and drug service professionals were conducted, transcribed and analysed thematically. In retrospect stakeholders questioned the decision to approve strong synthetic cannabinoid smoking products, noting their health risks because of product formulation, inconsistent manufacturing practices and smoking as the means of administration. Industry actors claimed the decision to approve synthetic cannabinoid smokeable products prevented potentially safer products from gaining market share. The system for withdrawing approved products which were subsequently found to be harmful was criticised for the poor quality of data available, limited engagement with health professionals and the slowness of product withdrawal. Many of the problems with the regime were attributed to the urgency under which the legal market under the interim Psychoactive Substances Act was established and implemented. The selection of 'safer' products, implementation of the product monitoring system, and engagement with health professionals may have benefited from more time and resources. An incremental approach to establishing the new market may have made the regulatory management of the new regime more workable. [Rychert M, Wilkins C, Witten K. Issues with monitoring the safety of psychoactive products under a legal regulated market for new psychoactive substances ('legal highs') in New Zealand. Drug Alcohol Rev 2017;00:000-000]. © 2017 Australasian Professional Society on Alcohol and other Drugs.

Illicit drug policy in Spain: the opinion of health and legal professionals.

Science.gov (United States)

Rossi, Paola; Blay, Ester; Costela, Víctor; Torrens, Marta

2018-01-01

The high frequency of criminal behaviour and related legal problems associated with substance addiction generates a field of interaction between legal and healthcare systems. This study was developed as a multicentre project to investigate the opinions of professionals from legal and healthcare systems about policies on illegal drugs and their implementation in practice. A multiple choice questionnaire designed ad hoc was administered to a sample of 230 professionals from legal and healthcare fields working in the cities of Barcelona, Granada and Bilbao. The questionnaire included sociodemographic and work-related data, and assessed interviewees' information about the response to drug-related crime and opinion on drug policy issues. This article presents the results from Spain. The main results showed that both groups of professionals value alternative measures to imprisonment (AMI) as useful tools to prevent offenses related to drug use and claim a broader application of AMI. They also evaluated positively the regulations on cannabis use in effect. Though the attitude of healthcare professionals towards the application of AMI is more permissive, both groups favour restricting these sanctions in cases of recidivism. Both groups show mild satisfaction with the current addiction healthcare system and express dissatisfaction with actual drug policies in Spain.

Medical malpractice reform and employer-sponsored health insurance premiums.

Science.gov (United States)

Morrisey, Michael A; Kilgore, Meredith L; Nelson, Leonard Jack

2008-12-01

Tort reform may affect health insurance premiums both by reducing medical malpractice premiums and by reducing the extent of defensive medicine. The objective of this study is to estimate the effects of noneconomic damage caps on the premiums for employer-sponsored health insurance. Employer premium data and plan/establishment characteristics were obtained from the 1999 through 2004 Kaiser/HRET Employer Health Insurance Surveys. Damage caps were obtained and dated based on state annotated codes, statutes, and judicial decisions. Fixed effects regression models were run to estimate the effects of the size of inflation-adjusted damage caps on the weighted average single premiums. State tort reform laws were identified using Westlaw, LEXIS, and statutory compilations. Legislative repeal and amendment of statutes and court decisions resulting in the overturning or repealing state statutes were also identified using LEXIS. Using a variety of empirical specifications, there was no statistically significant evidence that noneconomic damage caps exerted any meaningful influence on the cost of employer-sponsored health insurance. The findings suggest that tort reforms have not translated into insurance savings.

Counting the cost of negligence in neurosurgery: Lessons to be learned from 10 years of claims in the NHS.

Science.gov (United States)

Hamdan, Alhafidz; Strachan, Roger D; Nath, Fredrick; Coulter, Ian C

2015-04-01

Despite substantial progress in modernising neurosurgery, the specialty still tops the list of medico-legal claims. Understanding the factors associated with negligence claims is vital if we are to identify areas of underperformance and subsequently improve patient safety. Here we provide data on trends in neurosurgical negligence claims over a 10-year period in England. We used data provided by the National Health Service Litigation Authority to analyse negligence claims related to neurosurgery from the financial years 2002/2003 to 2011/2012. Using the abstracts provided, we extracted information pertaining to the underlying pathology, injury severity, nature of misadventure and claim value. Over the 10-year period, the annual number of claims increased significantly. In total, there were 794 negligence claims (range 50-117/year); of the 613 closed cases, 405 (66.1%) were successful. The total cost related to claims during the 10 years was £65.7 million, with a mean claim per successful case of £0.16 million (total damages, defence and claimant costs of £45.1, £6.36 and £14.3 million, respectively). Claims related to emergency cases were more costly compared to those of elective cases (£209,327 vs. £112,627; P=0.002). Spinal cases represented the most frequently litigated procedures (350; 44.1% of total), inadequate surgical performance the most common misadventure (231; 29.1%) and fatality the commonest injury implicated in claims (102; 12.8%). Negligence claims related to wrong-site surgery and cauda equina syndrome were frequently successful (26/26; 100% and 14/16; 87.5% of closed cases, respectively). In England, the number of neurosurgical negligence claims is increasing, the financial cost substantial, and the burden significant. Lessons to be learned from the study are of paramount importance to reduce future cases of negligence and improve patient care.

Lack of Definition of Compensation in International Investment Disputes for Non-Expropriation Claims: Is There an Appropriate Mechanism to Determine it?

Directory of Open Access Journals (Sweden)

Ligia Catherine Arias Barrera

2011-12-01

The structure followed is as follows: Firstly, the principle of full compensation applicable to international state responsibility and the key aspects of State liability in three main legal systems. Secondly, the analysis of some relevant awards based on non-expropriation claims including NAFTA, ICSID and Energy Chapter Treaty cases. The aim is to determine whether the principle of full compensation has been applied by arbitrators. Finally, to propose some general parameters to determine compensation in non-expropriation claims and to avoid entry into conflict with the three main liability systems studied, i.e French, German and English.

Surgery of the hallux valgus in an ambulatory setting: a liability risk?

Science.gov (United States)

Galois, L; Serwier, J-M; Arashvand, A D

2017-05-01

The primary objective of the study is to make an inventory of malpractice in hallux valgus surgery in an ambulatory setting and to identify the patient characteristics for a higher risk of malpractice. The secondary objective is creating a methodology for analyzing the medicolegal aspects of a surgery in day case comparing with hospitalization. The database of the Branchet insurance company was used. A total of 11,000 claims for a period of 11 years (2002-2013) have been investigated. The files of the patients with hallux valgus surgery were isolated from the insurer's database using CCAM codes. The medical director, a medical officer, the legal expert and finally the judge had already analyzed all these cases. The authors reviewed the various documents with a specific questionnaire. We identified 14 cases of claims in relation with hallux valgus 1-day surgery among a total of 138 claims for hallux valgus including all techniques (10%). All patients were female. The mean age was 42.6 years (19-64) in ambulatory patients (AG group) in comparison with 49.5 years (19-73) in hospitalized patients (HG group). Percutaneous techniques were significantly more represented in the AG group (p = 0.002) and scarfs osteotomies in the HG group (p = 0.004). The use of tourniquet seemed to be lower in the AG group, but it was a not significant trend (p = 0.085). In term of anesthesia procedures, no significant differences were seen between the two groups. The comparison of the complications common to both groups showed no significant difference except for insufficient results which were more frequent in the AG group (p = 0.026). The rate of insufficient informed consent seemed to be higher in the AG group, but it was a not significant trend (p = 0.084). No specific data regarding claims in relation with hallux valgus 1-day surgery are available to our knowledge in the literature. We did not identify in our study specific complications related to ambulatory procedures

Perioperative Complications in Obstructive Sleep Apnea Patients Undergoing Surgery: A Review of the Legal Literature.

Science.gov (United States)

Fouladpour, Nick; Jesudoss, Rajinish; Bolden, Norman; Shaman, Ziad; Auckley, Dennis

2016-01-01

38% and 58% of cases, respectively. Verdicts favored the plaintiffs in 58% of cases and the defendants in 42%. In cases favoring the plaintiff, the average financial penalty was $2.5 million (±$2.3 million; range, $650,000--$7.7 million). Perioperative complications related to OSA are increasingly being reported as the central contention of malpractice suits. These cases can be associated with severe financial penalties. These data likely underestimate the actual medicolegal burden, given that most such cases are settled out of court and are not accounted for in the legal literature.

Homicide committed by psychiatric patients: Psychiatrists' liability in Italian law cases.

Science.gov (United States)

Terranova, Claudio; Rocca, Gabriele

2016-01-01

Interest in psychiatrists' professional liability in Italy has increased in recent years because of the number of medical malpractice claims. Professional liability for failure to prevent violent behaviour by psychiatric patients is particularly debated. This study describes three Italian cases in which health professionals - physicians and nurses - were found guilty of manslaughter for murders committed by psychiatric patients. Examination of the cases focuses on claims of malpractice, patients' characteristics, the circumstances of the homicide and the reasons for the court's judgment. In particular, the predictability of violent behaviour and the concept of causal links are examined in detail. The cases provide an opportunity for a study of comparative jurisprudence. The topics discussed are relevant not only to practicing psychiatrists but also to experts assessing medical liability in cases of criminal acts committed by psychiatric patients. © The Author(s) 2015.

Adoption of Sustainable Practices And Certification ISO 14001: A Case Study in a Law and Legal Advice Firm

Directory of Open Access Journals (Sweden)

Letícia Eugênia Arenhart

2013-12-01

Full Text Available This article seeks to analyze how the company X Advocacy and Legal Consultancy can implant sustainable and quality practices to obtain the environmental certification ISO 14001. To achieve the objective, a qualitative and quantitative approach study was conducted. Regarding procedures, it consisted in a case study with a descriptive focus. From observation of the reality of X Advocacy and Legal Consultancy and its claims in relation to obtaining ISO 14001 certification, it is possible to propose as solution the implementation of a number of initiatives and sustainability actions in three pillars – social, environmental and economic. Suggestions were also developed about the dimensions of quality in order to formulate the basis for X Advocacy and Legal Consultancy environmental policy and possible implementation of ISO 14,001. 

BenefitClaimWebServiceBean/BenefitClaimWebService

Data.gov (United States)

Department of Veterans Affairs — A formal or informal request for a type of monetary or non-monetary benefit. This service provides benefit claims and benefit claim special issues data, allows the...

Is The Late Mandibular Fracture From Third Molar Extraction a Risk Towards Malpractice? Case Report with the Analysis of Ethical and Legal Aspects

Directory of Open Access Journals (Sweden)

Weuler dos Santos Silva

2017-06-01

Full Text Available Objectives: The present study reports a case of late mandibular fracture due to third molar extraction and highlights the inherent clinical, ethical and legal aspects related to this surgical complication. Material and Methods: A female patient underwent surgical procedure for the extraction of the mandibular right third molar. Two days after the surgery the patient reported pain and altered occlusion in the right side of the mandible. After clinical and radiographic re-examination, the diagnosis of late mandibular fracture was established. A second surgery, under general anaesthesia, was performed for the fixation of the mandibular bone. Results: The fractured parts were reduced and fixed with locking plate systems and 2 mm screws following load-sharing principles. The masticatory function showed optimal performance within 7 and 21 days after the surgery. Complete bone healing was observed within 1 year of follow-up. Conclusions: For satisfactory surgical outcomes, adequate surgical planning and techniques must be performed. Signed informed consents explaining the risks and benefits of the treatment must be used to avoid ethical and legal disputes in dentistry.

[Criminal claims about medical professional liability in the Instituto de Medicina Legal of Lima, Peru].

Science.gov (United States)

Navarro-Sandoval, Cleyber; Arones-Guevara, Shermany; Carrera-Palao, Rosa; Casana-Jara, Kelly; Colque-Jaliri, Tomasa

2013-07-01

To determine the characteristics of the criminal complaints claining medical professional liability, based on the expert reports issued by the Forensic Examination Division of Lima, Peru. A cross-sectional study was carried out, which included all the expert reports issued between 2005 and 2010 at the Forensic Examination Division of Lima, Peru. A descriptive analysis of each of the variables was performed. 60.3% (495/821) of the criminal complaints for medical professional liability were valued as being in accordance with the lex artis while 16.8% (138/821) were not in accordance with the lex artis. In 13% (107/821) of the cases, conclusions could not be drawn;in 9.9% (81/821) of the cases, the conclusions in the expert report did not include an valuations of the medical act.The cases in which the injury was attributed to the process of the disease itself accounted for 80.9% (502/620), and those in which in the injury was considered a result of the health care received were 19.0% (118/620). The distribution of the cause of the injury based on accordance with the lex artis showed significant differences. In our country, the number of claims for claimed medical liability is increasing, predominantly in relation to surgical specialties, where a medical act is more likely to be considered not in accordance with the lex artis. In addition, in a significant percentage of cases, no conclusions are drawn about the medical act.

Plastic Surgery Overseas: How Much Should a Physician Risk in the Pursuit of Higher-Quality Continuity of Care?

Science.gov (United States)

Schweikart, Scott

2018-04-01

In this article I discuss medical tourism, whereby patients go overseas for plastic surgery treatment in order to save money. However, if malpractice occurs abroad, there are several barriers that make it difficult for patients to recover damages. I explain these legal barriers and then discuss the possible causes of action patients can have over their "domestic physician" (their personal physician who might have referred surgery abroad or who gives postoperative follow-up care) and how these causes of action can create avenues of legal recovery not otherwise available. The possible liability of the domestic physician in the context of surgical malpractice abroad creates an ethical tension in the pursuit of higher-quality continuity of care, as the more involved the physician becomes in the process, the more likely he or she will assume liability. © 2018 American Medical Association. All Rights Reserved.

Everything's Bigger in Texas: Except the Medmal Settlements

NARCIS (Netherlands)

T. Baker (Tom); E. Helland (Eric); J.M. Klick (Jonathan)

2016-01-01

textabstractRecent work using Texas closed claim data finds that physicians are rarely required to use personal assets in medical malpractice settlements even when plaintiffs secure judgments above the physician's insurance limits. In equilibrium, this should lead physicians to purchase less

Attitudes towards evaluation of psychiatric disability claims: a survey of Swiss stakeholders.

Science.gov (United States)

Schandelmaier, Stefan; Leibold, Andrea; Fischer, Katrin; Mager, Ralph; Hoffmann-Richter, Ulrike; Bachmann, Monica Susanne; Kedzia, Sarah; Busse, Jason Walter; Guyatt, Gordon Henry; Jeger, Joerg; Marelli, Renato; De Boer, Wout Ernst Lodewijk; Kunz, Regina

2015-01-01

In Switzerland, evaluation of work capacity in individuals with mental disorders has come under criticism. We surveyed stakeholders about their concerns and expectations of the current claim process. We conducted a nationwide online survey among five stakeholder groups. We asked 37 questions addressing the claim process and the evaluation of work capacity, the maximum acceptable disagreement in judgments on work capacity, and its documentation. Response rate among 704 stakeholders (95 plaintiff lawyers, 285 treating psychiatrists, 129 expert psychiatrists evaluating work capacity, 64 social judges, 131 insurers) varied between 71% and 29%. Of the lawyers, 92% were dissatisfied with the current claim process, as were psychiatrists (73%) and experts (64%), whereas the majority of judges (72%) and insurers (81%) were satisfied. Stakeholders agreed in their concerns, such as the lack of a transparent relationship between the experts' findings and their conclusions regarding work capacity, medical evaluations inappropriately addressing legal issues, and the experts' delay in finalising the report. Findings mirror the characteristics that stakeholders consider important for an optimal work capacity evaluation. For a scenario where two experts evaluate the same claimant, stakeholders considered an inter-rater difference of 10%‒20% in work capacity at maximum acceptable. Plaintiff lawyers, treating psychiatrists and experts perceive major problems in work capacity evaluation of psychiatric claims whereas judges and insurers see the process more positively. Efforts to improve the process should include clarifying the basis on which judgments are made, restricting judgments to areas of expertise, and ensuring prompt submission of evaluations.

Erro médico em cirurgia do aparelho digestivo: contribuição para o estudo das provas técnicas, periciais e documentais e suas implicações jurídicas Medical malpractice in digestive system surgeries: a contribution to the study of technical, expertise and documentary evidence and its legal implications

Directory of Open Access Journals (Sweden)

João Batista Opitz Jr.

2007-03-01

1996 to 2002 related solely to digestive system surgery. The practical importance of the subject for the medical-social evolution has been addressed in the first place. The points looked for in this research were: physician/patient relationship (even during the claim; the information about medical procedures and limitations to the patient and family; the technical/legal documentation attached to the case; the professional's education and specialization. The analysis was based exclusively on the documents attached to the case record, trying to find the breach of the physician/patient relationship and the existence of informed consent. An examination of the documentation attached to the defense by the parties or court request, was also done. RESULTS: In 93,34% of the cases rupture in the physician/patient relationship occurred. Informed consent was found in only 10%. In 85% no or incomplete medical records were found. In 79%, absence of physical examination, and the same in 59% in clinical evolution, was noted. In 80% the writing was illegible. No medical identification was found in 61%. Information about previous allergies were not asked in 89% of the patients. Surgical descriptions were illegible in 80% and too brief in 47%, and all of them had no citation of the defense arguments to the malpractice accusation. Regarding medical post-graduation status, 7% had medical residency, 13% were in course of residency program, 67% had specialization certificates and 13% had a master or phD degree. CONCLUSION: Among the preventive ways to avoid a civil action for damages due to medical malpractice, the main points are: good relationship between doctors and patients; the formulation of complete patient records, being legible, stamped, and signed and an informed consent. The professional's technical experience and background do not constitute a mitigating circumstance for fullfiling the action.

"Legal highs" on the net-Evaluation of UK-based Websites, products and product information.

Science.gov (United States)

Schmidt, Martin M; Sharma, Akhilesh; Schifano, Fabrizio; Feinmann, Charlotte

2011-03-20

A vast array of substances are marketed as "legal highs" in the UK. These products are mainly marketed online and are packaged and produced to mimic illicit drugs. Little is known about the full range of products available at present and no studies have evaluated the product information provided to consumers. AIMS & HYPOTHESIS: To describe the available legal high products marketed by UK-based Internet retailers and evaluate the product information provided to consumers. Websites were identified using the terms "buy legal highs+UK" and two search engines. The first 100 hits and a random sample of 5% of the remaining results were screened. Websites based in the UK were included and all products were entered on a database. Information on product name, list price, claimed effects, side effects, contraindications and interactions was extracted. A descriptive analysis was conducted using SPSS v14. 115 Websites met the inclusion criteria but due to duplicate listings this was reduced to 39 unique Websites. 1308 products were found and evaluated. The average product price was 9.69 British pounds. Products took the form of pills (46.6%), smoking material (29.7%) and single plant material/extract (18.1%). Most products claimed to be stimulants (41.7%), sedatives (32.3%), or hallucinogens (12.9%). 40.1% of products failed to list ingredients, 91.9% failed to list side effects, 81.9% failed to list contraindications and 86.3% failed to list drug interactions. Top 5 products (with active ingredients in brackets) by frequency were Salvia divinorum (Salivinorin A), Kratom (Mitragynine), Hawaiian Baby Woodrose Seeds (Lysergic Acid Amide), Fly Agaric (Ibotenic Acid, Muscimol) and Genie (JWH018, CP47497). Products marketed as "legal highs" are easily available from UK-based Internet retailers and are reasonably affordable. Safety information provided to consumers is poor. Uninformed users risk serious adverse effects. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

THE RELEVANCE OF SOCIO-LEGAL STUDIES IN LEGAL SCIENCE

Directory of Open Access Journals (Sweden)

Victor Imanuel W. Nalle

2015-02-01

Full Text Available Some law schools in Indonesia reject socio-legal studies with epistemological arguments that puts jurisprudence as sui generis. Rejection is based argument that jurisprudence is a normative science. In fact socio-legal studies in the development of jurisprudence outside Indonesia has long existed and contributed to the legal reform. Socio-legal studies also significant for legal reform. It is caused by the existence of non doctrinal aspect in law making and implementation of the law. Therefore the position and relevance of socio-legal research is not related to the benefits that provided for the development of national law or jurisprudence. Beberapa fakultas hukum di Indonesia menolak penelitian sosio-legal dengan argumentasi epistemologis yang menempatkan ilmu hukum sebagai sui generis. Penolakan tersebut didasarkan argumentasi bahwa ilmu hukum adalah ilmu yang bersifat normatif. Kenyataannya studi sosio-legal dalam perkembangan ilmu hukum di luar Indonesia telah lama eksis dan berperan dalam pembaharuan hukum. Selain itu, studi sosiolegal juga berperan dalam pembaharuan hukum. Hal ini disebabkan adanya aspek-aspek nondoktrinal yang berperan dalam pembentukan hukum dan implementasi hukum di masyarakat. Oleh karena itu kedudukan dan relevansi penelitian sosio-legal pada ada tidaknya manfaat yang diberikan bagi perkembangan hukum nasional ataupun ilmu hukum.

THE RELEVANCE OF SOCIO-LEGAL STUDIES IN LEGAL SCIENCE

Directory of Open Access Journals (Sweden)

Victor Imanuel W. Nalle

2015-02-01

Full Text Available Some law schools in Indonesia reject socio-legal studies with epistemological arguments that puts jurisprudence as sui generis. Rejection is based argument that jurisprudence is a normative science. In fact socio-legal studies in the development of jurisprudence outside Indonesia has long existed and contributed to the legal reform. Socio-legal studies also significant for legal reform. It is caused by the existence of non doctrinal aspect in law making and implementation of the law. Therefore the position and relevance of socio-legal research is not related to the benefits that provided for the development of national law or jurisprudence.   Beberapa fakultas hukum di Indonesia menolak penelitian sosio-legal dengan argumentasi epistemologis yang menempatkan ilmu hukum sebagai sui generis. Penolakan tersebut didasarkan argumentasi bahwa ilmu hukum adalah ilmu yang bersifat normatif. Kenyataannya studi sosio-legal dalam perkembangan ilmu hukum di luar Indonesia telah lama eksis dan berperan dalam pembaharuan hukum. Selain itu, studi sosiolegal juga berperan dalam pembaharuan hukum. Hal ini disebabkan adanya aspek-aspek nondoktrinal yang berperan dalam pembentukan hukum dan implementasi hukum di masyarakat. Oleh karena itu kedudukan dan relevansi penelitian sosio-legal pada ada tidaknya manfaat yang diberikan bagi perkembangan hukum nasional ataupun ilmu hukum.

Should the District Courts Have Jurisdiction Over Pre-Award Contract Claims? A Claim for the Claims Court

National Research Council Canada - National Science Library

Short, John J

1987-01-01

This thesis briefly examines the jurisdiction of the federal district courts and the United States Court of Claims over pre-award contract claims before the Federal Courts Improvement Act of October 1...

Assisted Suicide in Switzerland: Clarifying Liberties and Claims.

Science.gov (United States)

Hurst, Samia A; Mauron, Alex

2017-03-01

Assisting suicide is legal in Switzerland if it is offered without selfish motive to a person with decision-making capacity. Although the 'Swiss model' for suicide assistance has been extensively described in the literature, the formally and informally protected liberties and claims of assistors and recipients of suicide assistance in Switzerland are incompletely captured in the literature. In this article, we describe the package of rights involved in the 'Swiss model' using the framework of Hohfeldian rights as modified by Wenar. After outlining this framework, we dissect the rights involved in suicide assistance in Switzerland, and compare it with the situation in England and Germany. Based on this approach, we conclude that in Switzerland, claim rights exist for those requesting suicide assistance, and for those who are considering providing such assistance, even though no entitlements exist toward suicide assistance. We then describe the implementation of the 'Swiss model' and difficulties arising within it. Clarifying these issues is important to understand the Swiss situation, to evaluate what features of it may or may not be worth correcting or emulating, and to understand how it can impact requests for suicide assistance in other countries due to 'suicide tourism'. It is also important to understand exactly what sets Switzerland apart from other countries with different legislations regarding suicide assistance. © 2016 John Wiley & Sons Ltd.

Radiology and the law

International Nuclear Information System (INIS)

Bundy, A.L.

1988-01-01

This book contains 12 chapters. Some of the chapter titles are: The Law of Medical Malpractice: An Overview; The Radiologist as Defendant; The Radiologist as an Expert Witness; The Missed Diagnosis; Legalities of the Radiograph; and Angiography and Interventional Radiology

Discounting medical malpractice claim reserves for self-insured hospitals.

Science.gov (United States)

Frese, Richard; Kitchen, Patrick

2011-01-01

The hospital CFO often works with the hospital's actuary and external auditor to calculate the reserves recorded in financial statements. Hospital management, usually the CFO, needs to decide the discount rate that is most appropriate. A formal policy addressing the rationale for discounting and the rationale for selecting the discount rate can be helpful to the CFO, actuary, and external auditor.

Scrutinizing Immutability: Research on Sexual Orientation and U.S. Legal Advocacy for Sexual Minorities.

Science.gov (United States)

Diamond, Lisa M; Rosky, Clifford J

2016-01-01

We review scientific research and legal authorities to argue that the immutability of sexual orientation should no longer be invoked as a foundation for the rights of individuals with same-sex attractions and relationships (i.e., sexual minorities). On the basis of scientific research as well as U.S. legal rulings regarding lesbian, gay, and bisexual (LGB) rights, we make three claims: First, arguments based on the immutability of sexual orientation are unscientific, given what we now know from longitudinal, population-based studies of naturally occurring changes in the same-sex attractions of some individuals over time. Second, arguments based on the immutability of sexual orientation are unnecessary, in light of U.S. legal decisions in which courts have used grounds other than immutability to protect the rights of sexual minorities. Third, arguments about the immutability of sexual orientation are unjust, because they imply that same-sex attractions are inferior to other-sex attractions, and because they privilege sexual minorities who experience their sexuality as fixed over those who experience their sexuality as fluid. We conclude that the legal rights of individuals with same-sex attractions and relationships should not be framed as if they depend on a certain pattern of scientific findings regarding sexual orientation.

[The essentials of workplace analysis for examining occupational disability claims].

Science.gov (United States)

Wachholz, St

2015-12-01

The insurance branch that covers the risk of occupational disability ranks among the most important private entities for offering security as far as the limitation or loss of one's ability to work is concerned. The financial risk of the insurer, the existential concerns and expectations of the claimant, as well as the legal framework and the need for a careful interdisciplinary evaluation, necessitate a professional review and assessment of the facts conducted with a sense of both responsibility and sensitivity. Carefully deliberated and sustainable decisions benefit both insurers and the insured. In order to achieve this, an opinion is required in many--and especially the more complex--cases from an external medical expert, which in turn can only be plausible and conclusive when based on a comprehensive review of the claimant's working environment and its particular (and often unique) requirements. This article is intended to increase the reader's understanding of the coherencies of workplace analysis and medical assessments, as required by insurance law and legislation. In addition, the article delivers valuable clues and guidance, both for medical experts and claims managers at insurance companies. Primarily, the claimant's occupation, as conceived in the terms and conditions of the insurance companies, is explained. The reader is then introduced to the various criteria to be considered when a claimant has several jobs at the same time, is self-employed, could be transferred to another job, is simply unable to commute to the workplace, or is prevented from working due to legal restrictions related to an illness. The article goes on to address the crucial aspect of how the degree of disability is to be measured under different circumstances, namely using the quantitative and the qualitative approach. As a reliable method for obtaining the essential data regarding the claimant's specific working conditions, which are required by both the medical expert and the

Malodorous consequences: what comprises negligence in anosmia litigation?

Science.gov (United States)

Svider, Peter F; Mauro, Andrew C; Eloy, Jean Anderson; Setzen, Michael; Carron, Michael A; Folbe, Adam J

2014-03-01

Our objectives were to evaluate factors raised in malpractice litigation in which plaintiffs alleged that physician negligence led to olfactory dysfunction. We analyzed publically available federal and court records using Westlaw, a widely used computerized legal database. Pertinent jury verdicts and settlements were comprehensively examined for alleged causes of malpractice (including procedures for iatrogenic causes), defendant specialty, patient demographics, and other factors raised in legal proceedings. Of 25 malpractice proceedings meeting inclusion criteria, 60.0% were resolved for the defendant, 12.0% were settled, and 28.0% had jury-awarded damages. Median payments were significant ($300,000 and $412,500 for settlements and awards, respectively). Otolaryngologists were the most frequently named defendants (68.0%), with the majority of iatrogenic cases (55.0%) related to rhinologic procedures. Associated medical events accompanying anosmia included dysgeusia, cerebrospinal fluid leaks, and meningitis. Other alleged factors included requiring additional surgery (80.0%), unnecessary procedures (47.4% of iatrogenic procedural cases), untimely diagnosis leading to anosmia (44.0%), inadequate informed consent (35.0%), dysgeusia (56.0%), and psychological sequelae (24.0%). Olfactory dysfunction can adversely affect quality of life and thus is a potential area for malpractice litigation. This is particularly true for iatrogenic causes of anosmia, especially following rhinologic procedures. Settlements and damages awarded were considerable, making an understanding of factors detailed in this analysis of paramount importance for the practicing otolaryngologist. This analysis reinforces the importance of explicitly including anosmia in a comprehensive informed consent process for any rhinologic procedure. © 2013 ARS-AAOA, LLC.

Ethical decision-making in forensic psychology

Directory of Open Access Journals (Sweden)

M. Swanepoel

2010-07-01

Full Text Available The purpose of this article is to develop a comprehensive process for identifying and addressing primarily ethical issues related to the psychology profession in South Africa. In fulfilling this purpose, research was conducted of relevant ethical and to a lesser extent, legal aspects pertaining to the psychology profession. In an attempt to prevent unprofessional conduct claims against psychologists from succeeding and to alert psychologists to the concurrent ethical problems that may lead to malpractice suits, this article offers material on some important issues – in the context of forensic psychology – such as ethical decision-making and principles, professional ethics, the regulation of psychology as a profession, the Ethical Code of Professional Conduct to which a psychologist should adhere, ethical aspects and issues pertaining to forensic psychology in general, some ethical issues pertaining to child forensic psychology, summary guidelines for ethical decision-making and some steps to follow to ensure sound ethical decisionmaking.

Defining Legal Moralism

DEFF Research Database (Denmark)

Thaysen, Jens Damgaard

2015-01-01

This paper discusses how legal moralism should be defined. It is argued that legal moralism should be defined as the position that “For any X, it is always a pro tanto reason for justifiably imposing legal regulation on X that X is morally wrong (where “morally wrong” is not conceptually equivalent...... to “harmful”)”. Furthermore, a distinction between six types of legal moralism is made. The six types are grouped according to whether they are concerned with the enforcement of positive or critical morality, and whether they are concerned with criminalising, legally restricting, or refraining from legally...... protecting morally wrong behaviour. This is interesting because not all types of legal moralism are equally vulnerable to the different critiques of legal moralism that have been put forth. Indeed, I show that some interesting types of legal moralism have not been criticised at all....

Abortion, metaphysics and morality: a review of Francis Beckwith's defending life: a moral and legal case against abortion choice.

Science.gov (United States)

Nobis, Nathan

2011-06-01

In Defending Life: A Moral and Legal Case Against Abortion Choice (2007) and an earlier article in this journal, "Defending Abortion Philosophically"(2006), Francis Beckwith argues that fetuses are, from conception, prima facie wrong to kill. His arguments are based on what he calls a "metaphysics of the human person" known as "The Substance View." I argue that Beckwith's metaphysics does not support his abortion ethic: Moral, not metaphysical, claims that are part of this Substance View are the foundation of the argument, and Beckwith inadequately defends these moral claims. Thus, Beckwith's arguments do not provide strong support for what he calls the "pro-life" view of abortion.

Why medical professionals have no moral claim to conscientious objection accommodation in liberal democracies.

Science.gov (United States)

Schuklenk, Udo; Smalling, Ricardo

2017-04-01

We describe a number of conscientious objection cases in a liberal Western democracy. These cases strongly suggest that the typical conscientious objector does not object to unreasonable, controversial professional services-involving torture, for instance-but to the provision of professional services that are both uncontroversially legal and that patients are entitled to receive. We analyse the conflict between these patients' access rights and the conscientious objection accommodation demanded by monopoly providers of such healthcare services. It is implausible that professionals who voluntarily join a profession should be endowed with a legal claim not to provide services that are within the scope of the profession's practice and that society expects them to provide. We discuss common counterarguments to this view and reject all of them. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

[Fatal course of neonatal citrobacter infection and its legal evaluation].

Science.gov (United States)

Kokrdová, Z; Janouch, J

2011-02-01

The article describes fatal course of citrobacter central nervous system infection in the neonates and the subsequent legal responsibility of the medical facility. Case report with the review of a lawyer specialized in medical law. Department of Obstetrics and Gynecology, Faculty of Health Studies, University of Pardubice, Pardubice, Faculty of Military Health Science, University of Defence, Hradec Králové. The court granted plaintiff's claim has been fully paid by the insurance company, since it did not show the fault of the medical facility. Health injury was caused by operational activities and the right to compensation is in accordance with Section 420a of the Civil Code.

PRACTICAL ASPECTS REGARDING THE CLAIM FOR THE ANNULMENT OF THE RESOLUTIONS OF THE GENERAL MEETING OF SHAREHOLDERS, FROM A SUBSTANTIAL AND PROCEDURAL PERSPECTIVE

Directory of Open Access Journals (Sweden)

Roxana - Mihaela CATEA

2017-05-01

Full Text Available The purpose of this paper is to provide a brief analysis of the legal framework regarding the procedural and substantial dispositions governing the claim for the annulment of the resolutions of the general meeting of shareholders. The main objective is to render a practical tool both to stakeholders and third parties who are interested in the legal means available for blocking the implementation of any measures which are contrary to the company’s interest. Further to the amendments brought through the New Civil Procedural Code, the claim for annulment of the resolutions of the general assembly must be analyzed from a procedural point of view, as well as from a substantial standpoint. The shareholders must be aware of the grounds for challenging a general assembly's resolution to properly safeguard their rights. One common issue which is invoked as grounds for annulment is the abuse of majority of the majority shareholder. However, the difficulty of alleging such a reason is left to practitioners. Therefore, its application, although not wide, is highly imaginative.

Framing and Claiming: How Information-Framing Affects Expected Social Security Claiming Behavior.

Science.gov (United States)

Brown, Jeffrey R; Kapteyn, Arie; Mitchell, Olivia S

2016-03-01

This paper provides evidence that Social Security benefit claiming decisions are strongly affected by framing and are thus inconsistent with expected utility theory. Using a randomized experiment that controls for both observable and unobservable differences across individuals, we find that the use of a "breakeven analysis" encourages early claiming. Respondents are more likely to delay when later claiming is framed as a gain, and the claiming age is anchored at older ages. Additionally, the financially less literate, individuals with credit card debt, and those with lower earnings are more influenced by framing than others.

SyncClaimService

Data.gov (United States)

Department of Veterans Affairs — Provides various methods to sync Claim related data for NWQ processing. It includes web operations to get Claims, get Unique Contention Classifications, get Unique...

THE LIABILITY FORMS OF THE MEDICAL PERSONNEL.

Science.gov (United States)

Bărcan, Cristian

2015-01-01

Current legislation, namely Law no. 95/2006 on healthcare reform in the medical malpractice domain stipulates that medical staff can be held accountable in the following forms: disciplinary liability, administrative liability, civil liability and criminal liability. Each form of legal liability presents its features, aspects that are found mainly in the procedural rules. However, the differences between the various legal forms of liability are not met only in the procedural rules but also in their effects and consequences. It is necessary to know what the procedure for disciplinary responsibility, administrative liability, civil liability, or criminal liability is. In addition to the differentiation determined by the consequences that may arise from the different forms of legal liability, it is important to know the competent authorities to investigate a case further and the solutions which various public institutions can take regarding the medical staff. Depending on the type of legal liability, authorities have a specialized authority. If the Disciplinary Committee is encountered at the College of Physicians, it may not intervene in cases before the monitoring and competence for malpractice cases Committee. The latter two committees cannot intervene directly in the legal assessment of civil or criminal cases, as no criminal investigation authorities cannot intervene in strictly civilian cases. Therefore, the importance of knowing the competent institutions is imperative.

What is legal medicine--are legal and forensic medicine the same?

Science.gov (United States)

Beran, Roy G

2010-04-01

Some consider the terms "forensic" and "legal" medicine to be synonymous but this is counter to the title of the Faculty of Forensic and Legal Medicine or the dual strands for progression to fellowship of the Australian College of Legal Medicine. The paper examines a very brief historical background to legal medicine and develops a definition of the strands thereof, namely legal and forensic medicine. It demonstrates that the two are different components of the application of medical knowledge upon the legal system. Legal medicine has greater relevance to civil and tort law, impacting upon patient care, whereas forensic medicine relates to criminal law and damage to, or by, patients.

Organizational liability for adverse reactions to the contrast media

International Nuclear Information System (INIS)

Lim, Chang Seon

2007-01-01

Contrast medium is a very useful tool for X-ray examinations. But contrast medium has some unavoidable adverse reactions. For those patients who have never received contrast medium before, it is impossible to predict whether they will suffer from certain kinds of adverse reactions. Thus, radiologists should use strategies to minimize adverse events and be prepared to promptly recognize and manage any reactions to the contrast media. If a radiologist commits medical malpractice, he will face civil responsibility. Medical malpractice means a tort or breach of contrast that occurs in a medical setting. Medical malpractices happen, despite the efforts of hospital staff. Many courts have applied the traditional doctrine of respondeat superior in actions against organizations for injuries caused by their employees. It is a legal doctrine, which states that an employer is responsible for employee actions performed within the course of the employment. A hospital is an organization for health purposes. An organization may be convicted of an offense committed by an employee of the organization acting in its behalf and within the scope of this office or employment. Organizational liability involves a wide variety of legal issues, including tort liability, wrongful employment practices, personal injury, breach of fiduciary duty, and so on. Many executive directors of organizations are aware of their personal and organizational risks of exposure to legal liabilities. The employer must have the right to control the physical conduct of the employee and must consent to receive the employee's services, while expecting some benefits from the services offered. Therefore, legal liability can be imposed for improper selection, assignment, training, and supervision of employees. In conclusion, the hospital itself has organizational liability for adverse reactions to the contrast medium

Framing and Claiming: How Information-Framing Affects Expected Social Security Claiming Behavior

Science.gov (United States)

Brown, Jeffrey R.; Kapteyn, Arie; Mitchell, Olivia S.

2017-01-01

This paper provides evidence that Social Security benefit claiming decisions are strongly affected by framing and are thus inconsistent with expected utility theory. Using a randomized experiment that controls for both observable and unobservable differences across individuals, we find that the use of a “breakeven analysis” encourages early claiming. Respondents are more likely to delay when later claiming is framed as a gain, and the claiming age is anchored at older ages. Additionally, the financially less literate, individuals with credit card debt, and those with lower earnings are more influenced by framing than others. PMID:28579641

On Legal Pluralism and Ghosts in the Sachsenspiegel and in Gaya

Directory of Open Access Journals (Sweden)

Bernd Kannowski

2016-01-01

Full Text Available This paper reflects on legal pluralism. How did medieval societies incorporate both unwritten customs and written law at the same time? How did they constitute the process of finding justice? What is the essense of legal pluralism, and will it help us understand the situation of Taiwan’s indigenous population? We aim to solve these problems by taking a closer look at medieval Saxony: for around 400 years, both laws given by the authorities and traditional customs in Saxony worked fine in parallel. The latter were put into writing by the legal practitioner Eike von Repgow around 1230 for reasons unknown. We refer to his collection of laws and customs of the Saxons as the Sachsenspiegel (»Mirror of Saxons«. While Saxons certainly differed from Taiwan’s indigenous population for many reasons, such as the supposedly weaker egalitarianism among the Saxons than among at least some indigenous groups, the two show some remarkable similarities nonetheless. Just like the Taiwanese Gaya, the Sachsenspiegel’s spiritual origin raises the claim to validity. Furthermore, comparing the handling of a person’s sale of inherited property, the legal situations in the Sachsenspiegel and Taiwan’s unwritten customs resemble each other. The heir can transfer only property he acquired personally. Furthermore, the author discusses the different character of courts and procedure under oral law in contrast to written modern law. Finally, the paper concludes with some remarks about a learned commentary on the Sachsenspiegel written around 1325, combined with an outlook on the possible future of Taiwanese customs.

Carbon capture and storage (CCS) in a civil legal point of view; CO{sub 2}-Abscheidung und -Ablagerung (Carbon Capture and Storage - CCS) in zivilrechtlicher Sicht

Energy Technology Data Exchange (ETDEWEB)

Gast, Ina Carolin

2012-11-01

The author of the book under consideration reports on the possibilities of the German environmental private law in order to address the risks of carbon capture and storage. The focus of this book is concerned with the examination of defense claims, compensation claims and claims for damages of the persons concerned, if activities or plants for carbon capture and storage cause damages at the legal assets. In addition to the civil defense claims and compensation claims from paragraph 1004 sect. 1 of the German civil code (BGB) and paragraph 906 sect. 2 sentence 2 BGB also claims under public law concerning the respective interests of neighbours from paragraph 75 sect. 2 sentence 2 to 4 VwVfG (Law on Administrative Procedure) also shall be included. In addition to this, the author reports on the claims for compensation of tort law and various situations of the strict liability. In particular, the new paragraph 29 of the draft of the carbon dioxide storage law is considered which creates a special strict liability for this novel technology.

Radiological malpractice

International Nuclear Information System (INIS)

Bauer, G.

1987-01-01

As medico-legal statistics show, compared with other branches of medicine, cases of liability of the radiologist or his assistants are relatively rare. The duty to exercise due care as set out in Paragraph 6 of the Austrian penal code or Paragraph 276 of the German civil code, respectively, provide a basic rule of law also for radiology. Due to the risk inherent in the investigation method, incidents in angiography cannot be totally excluded. Therefore, it is of utmost importance that all steps be taken with regard to staff, equipment and drugs to be able to deal with any complications and incidents that may arise. The courts of law require the employer to produce strongest exonerating evidence to prove that the duty to exercise due care in the selection and supervision of the assistants has been duly fulfilled. For the practical execution of radiological investigations of the digestive tract, also the RTA is responsible; her liability when performing an irrigoscopy is particularly great, as perforation of the intestine is often lethal. The introduction of the rectal tube into the vagina by mistake, with resultant injury or death of the patient, will regularly lead to conviction under penal law. (orig.) [de

Legal Hybrids

DEFF Research Database (Denmark)

Herrmann, Janne Rothmar

2009-01-01

in which embryos and foetuses are placed are much more complex. These categories are identified using Danish legislation as an example and on that basis the article extracts and identifies the different parameters that play a part in the legal categorisation of the human conceptus.......The article discusses the inadequacy of traditional theory on legal personhood in relation to embryos and foetuses. To challenge the somewhat binary view of legal personhood according to which the ‘born alive' criterion is paramount the article demonstrates that the number of legal categories...

Reducing legal fees in medical group practices. The role of health care alternative dispute resolution.

Science.gov (United States)

Joseph, D M

1995-01-01

Conflict is a growth industry, particularly in an increasingly complex health care system. Litigation is the most common, and most costly, method of settling health care disputes. Highly adversarial, the process of litigation often generates as much, if not more, hostility than the original dispute. In addition, satisfaction with the outcome is very low. The challenge that has arisen is to manage the conflicts so that the underlying needs and interests of all the parties can best be met. Often the techniques and processes of alternative dispute resolution (ADR) can be successfully used in resolving these sorts of conflicts quickly, cheaply and with greater satisfaction for all parties. Various applications of ADR are currently being used or tested in a variety of health care disputes in the United States and Canada. Tremendous success has been achieved in mediating medical malpractice claims, medical staff disputes, economic credentialing conflicts, insurer relations issues and denial of coverage disputes. Professional relations and departmental staff disputes, partnership and employee conflicts, and organizational disputes within clinics, HMOs and large group practices have all been found particularly amenable to ADR. These are all situations in which everyone benefits from quick, non-hostile resolutions and on-going relationships can continue.

Regional Legal Assistance

Directory of Open Access Journals (Sweden)

Abdul Fatah

2015-06-01

Full Text Available Legal aid policy in the area carried out on several considerations including: Implementation of the authority given to the legal aid act, granting the guarantee and protection of access to justice and equality before the law in the area, equitable distribution of justice and increase public awareness and understanding of the law, and legal implications that accompanied the emergence of the right to legal counsel without pay and the right to choose the legal settlement. How To Cite Fatah, A. (2015. Regional Legal Assistance. Rechtsidee, 2(1, 1-10. doi:http://dx.doi.org/10.21070/jihr.v2i1.7

Formalizing Probabilistic Safety Claims

Science.gov (United States)

Herencia-Zapana, Heber; Hagen, George E.; Narkawicz, Anthony J.

2011-01-01

A safety claim for a system is a statement that the system, which is subject to hazardous conditions, satisfies a given set of properties. Following work by John Rushby and Bev Littlewood, this paper presents a mathematical framework that can be used to state and formally prove probabilistic safety claims. It also enables hazardous conditions, their uncertainties, and their interactions to be integrated into the safety claim. This framework provides a formal description of the probabilistic composition of an arbitrary number of hazardous conditions and their effects on system behavior. An example is given of a probabilistic safety claim for a conflict detection algorithm for aircraft in a 2D airspace. The motivation for developing this mathematical framework is that it can be used in an automated theorem prover to formally verify safety claims.

32 CFR 536.77 - Applicable law for claims under the Military Claims Act.

Science.gov (United States)

2010-07-01

... contributory negligence be interpreted and applied according to the law of the place of the occurrence... 32 National Defense 3 2010-07-01 2010-07-01 true Applicable law for claims under the Military... Act § 536.77 Applicable law for claims under the Military Claims Act. (a) General principles—(1) Tort...

Spectrum of diagnostic errors in radiology

OpenAIRE

Pinto, Antonio; Brunese, Luca

2010-01-01

Diagnostic errors are important in all branches of medicine because they are an indication of poor patient care. Since the early 1970s, physicians have been subjected to an increasing number of medical malpractice claims. Radiology is one of the specialties most liable to claims of medical negligence. Most often, a plaintiff’s complaint against a radiologist will focus on a failure to diagnose. The etiology of radiological error is multi-factorial. Errors fall into recurrent patterns. Errors ...

Emerging Communication Technology and Examination Malpractices in Nigerian Educational Sector

Directory of Open Access Journals (Sweden)

Olufemi Sunday Adeoye

2010-12-01

Full Text Available The breakthrough in communication technology, especially that of GSM phones, in Nigeria is one of the best things that has happened to the nation in terms of its technological advancement. In Nigeria, GSM means Telecom Explosion. The GSM revolution began in August 2001 and changed the face of Information and Communications Technology in Nigeria. It is much easier to reach anybody that you have his / her number, whether they are in the village or in their closet unless in a place where there is no network of the service provider. As revolutionary as GSM may seem to be, its negative effect on our educational sector is of great concern. The ongoing war against examination malpractice is yet to take its toll on perpetrators as they have devised a new method to continue their game through the cell phone technology. Described as e-cheating, the cell phone technology is providing students a smart way to beat the best effort of stakeholders to stamp out the menace. This paper examines GSM technology, the various ways in which cell phones are employed to cheat and suggestions on how to stop e-cheating through cell phones.

Legal gaps relating to labour safety and health in the maritime transport sector in Spain.

Science.gov (United States)

Rodríguez, Julio Louro; Portela, Rosa Mary de la Campa; Carrera, Paula Vazquez

2011-01-01

Nowadays the labour sector is experiencing an important increase in the application of risk prevention policies. Although these policies are very significant due to their repercussions in the health of workers, we noticed important legal gaps in maritime sector regulations. Frequently sea workers are legally abandoned, by exclusion or omission, at the moment of claiming for the improvement of their working environment and the reduction of the negative consequences derived from this negligence over their safety and health. In the present paper we try to shed some light on this topic by analysing and examining minutely the Spanish applicable risk prevention legislation for this sector. Moreover, the recommendations of the International Maritime Organization are compared with the current application of the law. At the same time, we present some possible solutions to such problems from an objective point of view.

School Psychological Services and Program Evaluation

Science.gov (United States)

MacGregor, Mary Jo, Ed.

1972-01-01

A variety of court decisions and laws relevant to malpractice and liability of school psychologists are presented. Terms are defined and examples of faulty psychological testing, defamation, withholding information, and inferred imcompetence are provided. Suggestions regarding litigation and legal defenses are made and issues related to…

Establishing a legal service for major trauma patients at a major trauma centre in the UK.

Science.gov (United States)

Seligman, William H; Thompson, Julian; Thould, Hannah E; Tan, Charlotte; Dinsmore, Andrew; Lockey, David J

2017-09-01

Major trauma causes unanticipated critical illness and patients have often made few arrangements for what are sudden and life-changing circumstances. This can lead to financial, housing, insurance, legal and employment issues for patients and their families.A UK law firm worked with the major trauma services to develop a free and comprehensive legal service for major trauma patients and their families at a major trauma centre (MTC) in the UK. In 2013, a legal service was established at North Bristol NHS Trust. Referrals are made by trauma nurse practitioners and it operates within a strict ethical framework. A retrospective analysis of the activity of this legal service between September 2013 and October 2015 was undertaken. 66 major trauma patients were seen by the legal teams at the MTC. 535 hours of free legal advice were provided on non-compensation issues-an average of 8 hours per patient. This initiative confirms a demand for the early availability of legal advice for major trauma patients to address a range of non-compensation issues as well as for identification of potential compensation claims. The availability of advice at the MTC is convenient for relatives who may be spending the majority of their time with injured relatives in hospital. More data are needed to establish the rehabilitation and health effects of receiving non-compensation advice after major injury; however, the utilisation of this service suggests that it should be considered at the UK MTCs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Accidental aspiration/ingestion of foreign bodies in dentistry: A clinical and legal perspective

Science.gov (United States)

Yadav, Rakesh Kumar; Yadav, Hemant Kumar; Chandra, Anil; Yadav, Simith; Verma, Promila; Shakya, Vijay Kumar

2015-01-01

The potential of foreign body aspiration or ingestion is a worldwide health problem in dentistry. The general dental practitioners should be extremely attentive in handling of minor instruments during any intervention related to the oral cavity, especially in the supine or semi-recumbent position of the patient. Aspiration cases are usually more critical and less common than ingestion. We report a case of iatrogenic aspiration of an endodontic broach, which gets disclosed during the recording of past dental history of the patient. The patient was asymptomatic during that time. A quick posterior-anterior chest radiograph was taken which revealed the presence of broach in the lower lobe of the left lung. The patient was immediately referred to the pulmonary medicine department where the fiberoptic bronchoscope retrieval was planned, and the same was carried out successfully under local anesthesia. Although such accidents have rare occurrence, the associated risks and morbidity are too high to be overlooked, especially from the viewpoint of special care, resources, and the associated financial cost required for their management. Moreover, practitioners are also liable for malpractice litigation given the fact that such cases are avoidable. This article also discusses relevant review literature, risk factors, symptoms, and management of such iatrogenic accidents along with drawing attention to the significance of preventive measures and their role in avoiding meritorious legal and ethical issues. PMID:27390487

The Prevalence and Special Educational Requirements of Dyscompetent Physicians

Science.gov (United States)

Williams, Betsy W.

2006-01-01

Underperformance among physicians is not well studied or defined; yet, the identification and remediation of physicians who are not performing up to acceptable standards is central to quality care and patient safety. Methods for estimating the prevalence of dyscompetence include evaluating available data on medical errors, malpractice claims,…

Ethical Issues in Expert Opinions and Testimony.

Science.gov (United States)

Weed, Roger O.

2000-01-01

This article provides an overview of ethical issues in private for-profit practice, with particular focus on expert testimony, using examples from a sample of claims filed with the National Association of Rehabilitation Professionals in the Private Sector and malpractice insurance companies. Complaints most frequently involve issues related to…

Ultra-processed family foods in Australia: nutrition claims, health claims and marketing techniques.

Science.gov (United States)

Pulker, Claire Elizabeth; Scott, Jane Anne; Pollard, Christina Mary

2018-01-01

To objectively evaluate voluntary nutrition and health claims and marketing techniques present on packaging of high-market-share ultra-processed foods (UPF) in Australia for their potential impact on public health. Cross-sectional. Packaging information from five high-market-share food manufacturers and one retailer were obtained from supermarket and manufacturers' websites. Ingredients lists for 215 UPF were examined for presence of added sugar. Packaging information was categorised using a taxonomy of nutrition and health information which included nutrition and health claims and five common food marketing techniques. Compliance of statements and claims with the Australia New Zealand Food Standards Code and with Health Star Ratings (HSR) were assessed for all products. Almost all UPF (95 %) contained added sugars described in thirty-four different ways; 55 % of UPF displayed a HSR; 56 % had nutrition claims (18 % were compliant with regulations); 25 % had health claims (79 % were compliant); and 97 % employed common food marketing techniques. Packaging of 47 % of UPF was designed to appeal to children. UPF carried a mean of 1·5 health and nutrition claims (range 0-10) and 2·6 marketing techniques (range 0-5), and 45 % had HSR≤3·0/5·0. Most UPF packaging featured nutrition and health statements or claims despite the high prevalence of added sugars and moderate HSR. The degree of inappropriate or inaccurate statements and claims present is concerning, particularly on packaging designed to appeal to children. Public policies to assist parents to select healthy family foods should address the quality and accuracy of information provided on UPF packaging.

Claims-based definition of death in Japanese claims database: validity and implications.

Science.gov (United States)

Ooba, Nobuhiro; Setoguchi, Soko; Ando, Takashi; Sato, Tsugumichi; Yamaguchi, Takuhiro; Mochizuki, Mayumi; Kubota, Kiyoshi

2013-01-01

For the pending National Claims Database in Japan, researchers will not have access to death information in the enrollment files. We developed and evaluated a claims-based definition of death. We used healthcare claims and enrollment data between January 2005 and August 2009 for 195,193 beneficiaries aged 20 to 74 in 3 private health insurance unions. We developed claims-based definitions of death using discharge or disease status and Charlson comorbidity index (CCI). We calculated sensitivity, specificity and positive predictive values (PPVs) using the enrollment data as a gold standard in the overall population and subgroups divided by demographic and other factors. We also assessed bias and precision in two example studies where an outcome was death. The definition based on the combination of discharge/disease status and CCI provided moderate sensitivity (around 60%) and high specificity (99.99%) and high PPVs (94.8%). In most subgroups, sensitivity of the preferred definition was also around 60% but varied from 28 to 91%. In an example study comparing death rates between two anticancer drug classes, the claims-based definition provided valid and precise hazard ratios (HRs). In another example study comparing two classes of anti-depressants, the HR with the claims-based definition was biased and had lower precision than that with the gold standard definition. The claims-based definitions of death developed in this study had high specificity and PPVs while sensitivity was around 60%. The definitions will be useful in future studies when used with attention to the possible fluctuation of sensitivity in some subpopulations.

Claiming health in food products

DEFF Research Database (Denmark)

Lähteenmäki, Liisa

2013-01-01

Health-related information is increasingly used on food products to convey their benefits. Health claims as a subcategory of these messages link the beneficial component, functions or health outcomes with specific products. For consumers, health claims seem to carry the message of increased...... healthiness, but not necessarily making the product more appealing. The wording of the claim seems to have little impact on claim perception, yet the health image of carrier products is important. From consumer-related factors the relevance and attitudes towards functional foods play a role, whereas socio......-demographic factors have only minor impact and the impact seems to be case-dependent. Familiarity with claims and functional foods increase perceived healthiness and acceptance of these products. Apparently consumers make rather rational interpretations of claims and their benefits when forced to assess...

Preimplantation and prenatal diagnosis, wrongful birth and wrongful life: a global view of bioethical and legal controversies.

Science.gov (United States)

Frati, Paola; Fineschi, Vittorio; Di Sanzo, Mariantonia; La Russa, Raffaele; Scopetti, Matteo; Severi, Filiberto M; Turillazzi, Emanuela

2017-05-01

Prenatal diagnosis based on different technologies is increasingly used in developed countries and has become a common strategy in obstetric practice. The tests are crucial in enabling mothers to make informed decisions about the possibility of terminating pregnancy. They have generated numerous bioethical and legal controversies in the field of 'wrongful life' claims (action brought by or on behalf of a child against the mother or other people, claiming that he or she has to endure a not-worth-living existence) and 'wrongful birth' claims (action brought by the mother or parents against the physician for being burdened with an unwanted, often disabled child, which could have been avoided). The possibility which exists nowadays to intervene actively by programming and deciding the phases linked to procreation and birth has raised several questions worldwide. The mother's right to self-determination could be an end but whether or not this right is absolute is debatable. Freedom could, with time, act as a barrier that obstructs intrusion into other people's lives and their personal choices. Therapeutic choices may be manageable in a liberal sense, and the sanctity of life can be inflected in a secular sense. These sensitive issues and the various points of view to be considered have motivated this review. Literature searches were conducted on relevant demographic, social science and medical science databases (SocINDEX, Econlit, PopLine, Medline, Embase and Current Contents) and via other sources. Searches focused on subjects related to bioethical and legal controversies in the field of preimplantation and prenatal diagnosis, wrongful birth and wrongful life. A review of the international state of law was carried out, focusing attention on the peculiar issue of wrongful life and investigating the different jurisdictional solutions of wrongful life claims in a comparative survey. Courts around the world are generally reluctant to acknowledge wrongful life claims due to

[Marketability of food supplements - criteria for the legal assessment].

Science.gov (United States)

Breitweg-Lehmann, Evelyn

2017-03-01

To be placed on the market legally, food supplements have to meet national and European food law regulations. This is true for all substances used as well as for the labeling on the packaging of and the advertising for food supplements. The food business operator is responsible for its compliance with all regulations. Therefore, in this article, a concise step-by-step assessment is presented, covering all necessary legal requirements to market food supplements. Additionally, all steps are visualized in a flow chart. All vitamins, minerals and other substances used have to meet the legal conditions. Food business operators have to make sure that their products do not contain medicinal ingredients based on their pharmacologic effect. It is prohibited to place medicinal products as food supplements on the market. Furthermore, food business operators have to make sure that their products are not non-authorized novel foods according to the novel food regulation (EC) no. 258/97. Also, food supplements have to meet the requirements of article 14 of Regulation (EC) No. 178/2002 concerning the safety of foodstuff. Food shall not be placed on the market if it is unsafe. For food supplements that fail the German food-related legal standards but are legally manufactured in another EU member state or are legally put into circulation, the importer requires the so-called general disposition, which must be applied for at the BVL according to § 54 of the German Food and Feed Act. Another possibility for food which fails to meet German food law is to apply for a certificate of exemption according to § 68 of the Food and Feed Act. The food business operator has to meet the harmonized regulations concerning maximum and minimum levels of additives, flavors and enzymes. The packaging has to meet the compulsory labeling as well the voluntary labeling, like health claims. The BVL is also the relevant authority for other tasks concerning food supplements. A figure shows all

Warranty claim analysis considering human factors

International Nuclear Information System (INIS)

Wu Shaomin

2011-01-01

Warranty claims are not always due to product failures. They can also be caused by two types of human factors. On the one hand, consumers might claim warranty due to misuse and/or failures caused by various human factors. Such claims might account for more than 10% of all reported claims. On the other hand, consumers might not be bothered to claim warranty for failed items that are still under warranty, or they may claim warranty after they have experienced several intermittent failures. These two types of human factors can affect warranty claim costs. However, research in this area has received rather little attention. In this paper, we propose three models to estimate the expected warranty cost when the two types of human factors are included. We consider two types of failures: intermittent and fatal failures, which might result in different claim patterns. Consumers might report claims after a fatal failure has occurred, and upon intermittent failures they might report claims after a number of failures have occurred. Numerical examples are given to validate the results derived.

Claims-Based Definition of Death in Japanese Claims Database: Validity and Implications

Science.gov (United States)

Ooba, Nobuhiro; Setoguchi, Soko; Ando, Takashi; Sato, Tsugumichi; Yamaguchi, Takuhiro; Mochizuki, Mayumi; Kubota, Kiyoshi

2013-01-01

Background For the pending National Claims Database in Japan, researchers will not have access to death information in the enrollment files. We developed and evaluated a claims-based definition of death. Methodology/Principal Findings We used healthcare claims and enrollment data between January 2005 and August 2009 for 195,193 beneficiaries aged 20 to 74 in 3 private health insurance unions. We developed claims-based definitions of death using discharge or disease status and Charlson comorbidity index (CCI). We calculated sensitivity, specificity and positive predictive values (PPVs) using the enrollment data as a gold standard in the overall population and subgroups divided by demographic and other factors. We also assessed bias and precision in two example studies where an outcome was death. The definition based on the combination of discharge/disease status and CCI provided moderate sensitivity (around 60%) and high specificity (99.99%) and high PPVs (94.8%). In most subgroups, sensitivity of the preferred definition was also around 60% but varied from 28 to 91%. In an example study comparing death rates between two anticancer drug classes, the claims-based definition provided valid and precise hazard ratios (HRs). In another example study comparing two classes of anti-depressants, the HR with the claims-based definition was biased and had lower precision than that with the gold standard definition. Conclusions/Significance The claims-based definitions of death developed in this study had high specificity and PPVs while sensitivity was around 60%. The definitions will be useful in future studies when used with attention to the possible fluctuation of sensitivity in some subpopulations. PMID:23741526

Legal method in danish law

DEFF Research Database (Denmark)

Blume, Peter Erik

and furthermore a brief account of Danish legal history is provided. The following chapters concern: • Legal institutions, • Statute and Statutory Law • Legal Decisions • Legal Literature and Legal Knowledge • Other National Legal Sources • External Influences on Danish Law......This book describes how legal method is used within the Danish legal system. Its target group is foreign lawyers and law students who have an interest in knowing how Danish law commonly is determined and applied. In the first chapters legal method and legal sources in general are defined...

LEGAL AND ECONOMIC PERSPECTIVES ON THE LEGAL PENALTY INTEREST

Directory of Open Access Journals (Sweden)

Rodica Diana APAN

2014-06-01

Full Text Available The legal evaluation of the penalty interest, meaning the ex lege determination of its level is applicable only in the case of non-fulfillment of a monetary payment obligation. The applicability of the system of legal evaluation of the interest is generally determined by the absence of a document that ascertains the agreement of the parties, such as a contract, through which the parties, following this agreement, evaluate the prejudice caused by the non-fulfillment of a monetary payment obligation, before the prejudice has occurred. The legal evaluation of the penalty interest, as a component of the regulation in the field of legal interest has the purpose to ensure creditor’s protection. Regardless of the prejudice caused to the creditor, the legal penalty interest shall be determined by relating it to a variable benchmark that is the level of the reference interest rate of the National Bank of Romania, which is the monetary policy interest rate of the National Bank of Romania.

[Factors forming opnion on marijuana legalization in Poland among group of students from medical and technical college faculty].

Science.gov (United States)

Suwała, Małgorzata; Gerstenkorn, Andrzej; Szewczyk, Anna

2015-01-01

Marijuana is the most popular illegal drug in the world. In 2010 17.6% of polish adult population (age 15-64) and 37.3% of youth (age 17-18) declared use of marijuana at least once in their lifetime. Recent years in Poland brought back public discussion regarding decriminalization and legalization of marijuana. The main goal of the study was to reveal the opinion about legalization of marijuana in Poland among students of medical and technical faculty in correlation with chosen socio-demographic factors, college major, attitude to tobacco smoking, use of drugs and religious practice. Study included 230 students (110 from Medical University of Lodz and 120 from Technical University of Lodz). Women consisted on 56.1% of surveyed and men on 43.9%. Study used audit survey as a research method. Results. 40.4% of students considered marijuana as "soft" drug and in majority (65.7%) are convinced that it is not addictive. The main part of studied group (83%) claimed that marijuana is easily accessible in Poland. The majority of the group (38.75%) was against marijuana legalization, a little bit less (35.2%) approved its legalization in Poland and 26.1% had no opinion. Type of college faculty had not been detected as a factor influencing support for legalization. Important factors influencing positive opinion on legalization was: living in the city, tobacco smoking, socializing with legalization supporters, lack of regular religious practice, drug use. CONCLUSION. Young people's diversified opinion regarding legalization of marijuana in Poland should encourage further discussion. Educational and preventive activities within different social groups are necessary to form a conscious opinion on legalization of marijuana in Poland based on the knowledge of actual scientific facts.

Torts.

Science.gov (United States)

Thurston, Paul W.

Chapter 5 of a book on school law, this chapter reports the cases decided during 1979 involving tort claims in the schools. The cases are organized according to headings including negligence (with an emphasis on student injuries), educational malpractice, negligence defenses (especially common law and statutory immunity), liability insurance,…

Corporations and the Uses of Law: International Investment Arbitration as a “Multilateral Legal Order

Directory of Open Access Journals (Sweden)

Peter Muchlinski

2011-05-01

Full Text Available This paper seeks to examine the claim, made by certain legal scholars, that international investment law, though based mainly on Bilateral Investment Treaties (BITs is in fact a multilateral order that introduces principles of an emergent “global administrative law” into the regulation of state conduct in relation to foreign investors and their investments. Such scholars argue that this order develops through the decisions of investor-State arbitral tribunals which are creating a harmonised understanding of the meaning of BIT provisions and an institutional system of adjudication that furthers the development of global administrative principles. Through a critical examination of this approach the paper argues that this field is not a multilateral order but an unstructured process of privatised legal entrepreneurship which seeks to further a professional interest in developing an extensive, investor friendly, regime of BITs. Furthermore, that process fails as a means of providing effective or legitimate legal review of administrative action.  The argument is made both on a theoretical level and by a review of a specific issue in international investment law, namely, the development of  wider types of claims and the rise of so-called “treaty shopping” by means of corporate group structuring.  In particular the multi-jurisdictional location of various affiliates in a multinational enterprise creates a network of potential claimants in investor state disputes, giving rise to the risk of multiple claims, while the possibility of setting up affiliates in various jurisdictions creates opportunities for “treaty shopping”. “Treaty shopping” involves the enterprise locating an affiliate in a jurisdiction that has signed an investment protection treaty with the host country, allowing various affiliates and/or the parent in a group enterprise to benefit from treaty protection even though they possess the nationality of a state that has no

Claims in civil engineering contracts

CERN Document Server

Speirs, N A

1999-01-01

This paper considers claims arising during civil engineering construction contracts. The meaning of the word 'claim' is considered and its possible implications for additional cost and time to completion. The conditions of the construction contract selected will influence the risk apportionment between contractor and client and the price offered by the contractor for the work. Competitive bidding constraints and profit margins in the construction industry, however, may also influence the price offered. This in turn can influence the likelihood of claims arising. The client from his point of view is concerned to complete the work within an agreed time and budget. The circumstances under which claims may arise are reviewed in relation to typical conditions of contract. These circumstances are then related to the CERN LHC civil works. Ways of avoiding claims, where this is possible, are considered. Finally, the means of evaluation of claims and their settlement are considered.

THE MEDICO-SCIENTIFIC MARGINALISATION OF HOMEOPATHY: INTERNATIONAL LEGAL AND REGULATORY DEVELOPMENTS.

Science.gov (United States)

Freckelton, Ian

2015-09-01

The 2010 report of the United Kingdom Science and Technology Committee of the House of Commons and the 2015 report of the Australian National Health and Medical Research Council have overtaken in significance the uncritical Swiss report of 2012 and have gone a long way to changing the environment of tolerance toward proselytising claims of efficacy in respect of homeopathy. The inquiry being undertaken in the United States by the Food and Drug Administration during 2015 may accelerate this trend. An outcome of the reports and inquiries has been a series of decisions from advertising regulators and by courts rejecting medically unjustifiable claims in respect of the efficacy of homeopathy. Class actions have also been initiated in North America against manufacturers of homeopathic products. The changing legal and regulatory environment is generating an increasingly scientifically marginalised existence for homeopathy. That new environment is starting to provide effective inhibition of assertions on behalf of homeopathy and other health modalities whose claims to therapeutic efficacy cannot be justified by reference to the principles of evidence-based health care. This has the potential to reduce the financial support that is provided by insurers and governments toward homeopathy and to result in serious liability exposure for practitioners, manufacturers and those who purvey homeopathic products, potentially including pharmacists. In addition, it may give a fillip to a form of regulation of homeopaths if law reform to regulate unregistered health practitioners gathers momentum, as is taking place in Australia.

Communication-related allegations against physicians caring for premature infants.

Science.gov (United States)

Nguyen, J; Muniraman, H; Cascione, M; Ramanathan, R

2017-10-01

Maternal-fetal medicine physicians (MFMp) and neonatal-perinatal medicine physicians (NPMp) caring for premature infants and their families are exposed to significant risk for malpractice actions. Effective communication practices have been implicated to decrease litigious intentions but the extent of miscommunication as a cause of legal action is essentially unknown in this population. Analysis of communication-related allegations (CRAs) may help toward improving patient care and physician-patient relationships as well as decrease litigation risks. We retrospectively reviewed the Westlaw database, a primary online legal research resource used by United States lawyers and legal professionals, for malpractice cases against physicians involving premature infants. Inclusion criteria were: 22 to 36 weeks gestational age, cases related to peripartum events through infant discharge and follow-up, and legal records with detailed factual narratives. The search yielded 736 legal records, of which 167 met full inclusion criteria. A CRA was identified in 29% (49/167) of included cases. MFMp and/or NPMp were named in 104 and 54 cases, respectively. CRAs were identified in 26% (27/104) and 35% (19/54) of MFMp- and NPMp-named cases, respectively, with a majority involving physician-family for both specialties (81% and 74%, respectively). Physician-family CRAs for MFMp and NPMp most often regarded lack of informed consent (50% and 57%, respectively), lack of full disclosure (41% and 29%, respectively) and lack of anticipatory guidance (36% and 21%, respectively). This study of a major legal database identifies CRAs as significant causes of legal action against MFMp and NPMp involved in the care of high-risk women and infants delivered preterm. Physicians should be especially vigilant with obtaining genuine informed consent and maintaining open communication with families.

Second WCB claims: who is at risk?

Science.gov (United States)

Cherry, Nicola M; Sithole, Fortune; Beach, Jeremy R; Burstyn, Igor

2010-01-01

Many workers with one Workers' Compensation Board (WCB) claim make further claims. If the characteristics of the job, initial injury or worker were predictive of an early second claim, interventions at the time of return to work after the first claim might be effective in reducing the burden of work-related injury. This report explores the characteristic of those who make a second claim. Records of all Alberta WCB claims from January 1, 1995, to December 31, 2004, for individuals 18 to claim, sex and age of claimant, type of injury, type of accident, occupation, industry, an indicator of company size, and industry claim rate were extracted, as well as the date of any second claim. The likelihood of second claim and mean time to second claim were estimated. Multivariate analyses were performed using Cox regression. 1,047,828 claims were identified from 490,230 individuals. Of these, 49.2% had at least two claims. In the multivariate model a reduced time to second claim was associated with male sex, younger age and some types of injury and accident. Machining trades were at highest risk of early second claim (hazard ratio [HR] 2.54 compared with administration), and of the industry sectors manufacturing was at highest risk (HR 1.37 compared with business, personal and professional services). Some caution is needed in interpreting these data as they may be affected by under-reporting and job changes between claims. Nonetheless, they suggest that there remains room for interventions to reduce the considerable differences in risk of a second claim among workers, jobs and industries.

Crew resource management: using aviation techniques to improve operating room safety.

Science.gov (United States)

Ricci, Michael A; Brumsted, John R

2012-04-01

Since the publication of the Institute of Medicine report estimating nearly 100,000 deaths per year from medical errors, hospitals and physicians have a renewed focus upon error reduction. We implemented a surgical crew resource management (CRM) program for all operating room (OR) personnel. In our academic medical center, 19,000 procedures per year are performed in 27 operating rooms. Mandatory CRM training was implemented for all peri-operative personnel. Aviation techniques introduced included a pre-operative checklist and brief, post-operative debrief, read and initial files, and various other aviation-based techniques. Compliance with conduct of the brief/debrief was monitored as well as wrong-site surgeries and retained foreign body events. The malpractice insurance database for claims was also queried for the period prior to and after training. Initial training was accomplished for 517 people, including all anesthesiologists, surgeons, nurses, technicians, and OR assistants. Pre-operative briefing increased from 6.7 to 99% within 4 mo. Wrong site surgeries and retained foreign bodies decreased from a high of seven in 2007 to none in 2008, but, after 14 mo without additional training, these rose to five in 2009. Malpractice expenses (payouts and legal fees) totaled $793,000 (2003-2007), but have been zero since 2008. CRM training and implementation had an impact on reducing the incidence of wrong site surgery and retained foreign bodies in our operating rooms. However, constant reinforcement and refresher training is necessary for sustained results. Though no one technique can prevent all errors, CRM can effect culture change, producing a safer environment.

Zasada podwójnego skutku i zasada moralnej symetrii a kwestia legalizacji eutanazji [Principles of Double Effect and Moral Symmetry and Legalization of Euthanasia

Directory of Open Access Journals (Sweden)

Wacław Janikowski

2013-06-01

Full Text Available In this essay I scrutinize importance of Principles of Double Effect and MoralSymmetry in regard to the question of moral acceptance of euthanasia legalization.My conclusion is that although there is no substantially moral difference betweenpassive and active euthanasia, the problem of morally justifiable legalization ofeuthanasia is still not resolved. That is because some reasons suggest the possibilityof special discrepancy between moral acceptability of euthanasia in certain cases andmoral demand to preserve legal prohibition of euthanasia in general. In the paperI criticize the popular opinion that utilitarianism cannot account of why we giveweight to the question of moral permissibility of intentions. I claim that contraryto this false platitude utilitarianism can even accommodate practical relevance ofPrinciple of Double Effect, but not as a valid per se principle.

Workers Compensation Claim Data -

Data.gov (United States)

Department of Transportation — This data set contains DOT employee workers compensation claim data for current and past DOT employees. Types of data include claim data consisting of PII data (SSN,...

32 CFR 842.110 - Claims not payable.

Science.gov (United States)

2010-07-01

...) Claims for a maritime occurrence covered under U.S. admiralty laws. (o) Claims for: (1) Any tax or... International Agreements Claims Act. (4) The Air Force Admiralty Claims Act and the Admiralty Extensions Act. (5...) Claims from the combat activities of the armed forces during war or armed conflict. (c) Claims for...

The Legal Case

NARCIS (Netherlands)

Sartor, Giovanni; Contissa, Giuseppe; Schebesta, H.; Laukyte, Migle; Lanzi, Paola; Marti, Patrizia; Paola, Tomasello

2013-01-01

This paper presents the first release of the Legal Case, recently developed by the ALIAS Project and still under refinement. The Legal Case is a methodological tool intended to address liability issues of automated ATM systems: it provides for a legal risk management process that can be applied

They'll Be Suing You.

Science.gov (United States)

Weeks, Kent M.

1980-01-01

Few claims for negligence or misrepresentation against higher education have been sustained, but several important cases in lower education have provided a framework for future litigation. It is noted that the students ultimately lost, but educators should not be lulled. The development of a new tort such as educational malpractice takes years.…

IBO Claim Taking Project

Data.gov (United States)

Social Security Administration — IBO manually tracks all Canadian Claims and DSU claims via this report. It also provides a summary for each region and office of origin that the DSU works with. This...

Epilepsy-related automobile accidents in Japan: legal changes about a precedent and penal regulations.

Science.gov (United States)

Imataka, G; Arisue, K

2016-01-01

In Japan, having epilepsy was defined as an absolute disqualification for driving license in the Road Traffic Act enacted in 1960. In view of subsequent changes in domestic road traffic conditions and advances in epilepsy treatment and owing to efforts by interested parties, the 2002 revision of the Road Traffic Act conditionally permitted epileptic patients to obtain a driver's license. However, as fatal traffic accidents associated with driving by epileptic patients continued thereafter, their legal responsibility for driving a car was extensively discussed in newspapers and other media as well as in the Diet. In June 2013, the Road Traffic Act was again revised to incorporate punitive clauses applicable to those with difficulty in driving (not limited to epilepsy only but including various diseases and conditions) who falsely claimed that they had no driving difficulty in the procedure for obtaining or renewing their driver's license. With this revision marking a turning point, the Act on Punishment for Acts That Cause Death or Injury to Others by Driving a Car was enforced as a new statute in May 2014. This paper presents five cases of traffic accidents involved with epileptic patients to explain the impact of these accidents on the 2013 legal revision and a subsequent trend of toughening of legal penalties.

Medicaid Drug Claims Statistics

Data.gov (United States)

U.S. Department of Health & Human Services — The Medicaid Drug Claims Statistics CD is a useful tool that conveniently breaks up Medicaid claim counts and separates them by quarter and includes an annual count.

An Individual Claims History Simulation Machine

Directory of Open Access Journals (Sweden)

Andrea Gabrielli

2018-03-01

Full Text Available The aim of this project is to develop a stochastic simulation machine that generates individual claims histories of non-life insurance claims. This simulation machine is based on neural networks to incorporate individual claims feature information. We provide a fully calibrated stochastic scenario generator that is based on real non-life insurance data. This stochastic simulation machine allows everyone to simulate their own synthetic insurance portfolio of individual claims histories and back-test thier preferred claims reserving method.

Dementia and legal competency.

Science.gov (United States)

Filaković, Pavo; Erić, Anamarija Petek; Mihanović, Mate; Glavina, Trpimir; Molnar, Sven

2011-06-01

The legal competency or capability to exercise rights is level of judgment and decision-making ability needed to manage one's own affairs and to sign official documents. With some exceptions, the person entitles this right in age of majority. It is acquired without legal procedures, however the annulment of legal capacity requires a juristic process. This resolution may not be final and could be revoked thorough the procedure of reverting legal capacity - fully or partially. Given the increasing number of persons with dementia, they are often subjects of legal expertise concerning their legal capacity. On the other part, emphasis on the civil rights of mentally ill also demands their maximal protection. Therefore such distinctive issue is approached with particular attention. The approach in determination of legal competency is more focused on gradation of it's particular aspects instead of existing dual concept: legally capable - legally incapable. The main assumption represents how person with dementia is legally capable and should enjoy all the rights, privileges and obligations as other citizens do. The aspects of legal competency for which person with dementia is going to be deprived, due to protection of one's rights and interests, are determined in legal procedure and then passed over to the guardian decided by court. Partial annulment of legal competency is measure applied when there is even one existing aspect of preserved legal capability (pension disposition, salary or pension disposition, ability of concluding contract, making testament, concluding marriage, divorce, choosing whereabouts, independent living, right to vote, right to decide course of treatment ect.). This measure is most often in favour of the patient and rarely for protection of other persons and their interests. Physicians are expected to precisely describe early dementia symptoms which may influence assessment of specific aspects involved in legal capacity (memory loss, impaired task

Legal Philosophy - Five Questions

DEFF Research Database (Denmark)

This collection gathers together a host of the most eminent contemporary legal philosophers, who writes about their take on legal philosophy, its fundamental questions and potential.......This collection gathers together a host of the most eminent contemporary legal philosophers, who writes about their take on legal philosophy, its fundamental questions and potential....

[Scientometric and publication malpractices. The appearance of globalization in biomedical publishing].

Science.gov (United States)

Fazekas, T; Varró, V

2001-09-16

Attention is drawn to publication and scientometric malpractices utilized by biomedical authors who do not adhere to the accepted ethical norms. The difference between duplicate/redundant and bilingual publications is defined. In the course of discussion of the manipulations that may be observed in the field of scientometry, it is pointed out that abstract of congress lectures/posters can not be taken into consideration for scientometric purposes even if such abstracts are published in journals with impact factors. A further behavioral form is likewise regarded as unacceptable from the aspect of publication ethics: when a physician who has participated in a multicentre, randomized clinical trial receives recognition (in an appendix or in an acknowledgement of an article) as having contributed data, but assesses this appreciation as co-authorship and thereby attempts to augment the value of his or her publication activity. The effects of globalization on biomedical publication activity are considered, and evidence is provided that the rapidly spreading electronic publication for a give rise to new types of ethical dilemmas. It is recommended that, in the current age of Anglo-American globalization, greater emphasis should be placed on the development of medical publication in the mother tongue (Hungarian).

Interrelation of the concepts «legal influence» and «administrative-legal influence»

OpenAIRE

Голуб, Віктор Олександрович

2014-01-01

The author analyzes the concept of «legal influence» and «administrative-legal influence» and examines their interrelation. Also the scientific positions related to understanding the essence of these concepts are analyzed. The author gives characteristic of the features, structural elements and forms of the administrative-legal influence. English abstract V. Golub Interrelation of the concepts «legal influence» and «administrative-legal influence» The author analyzes the concept of «legal inf...

Business structures and sustainable regional legal practice: the use of incorporated legal practices by regional, rural and remote legal practitioners

OpenAIRE

Caroline Lydia Hart

2012-01-01

Since 2007 the Legal Profession Act 2007 (Qld) has offered legal practitioners a wider choice of business structure other than sole practitioner or partnership, to include incorporated legal practice ('ILP') or multidisciplinary partnership. In particular the use of ILPs offers legal practitioners a range of benefits in terms of operating a law firm consistent with business management practices. The status of ILP however comes at a cost of putting in place 'appropriate management systems'. ...

37 CFR 360.25 - Copies of claims.

Science.gov (United States)

2010-07-01

... Section 360.25 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS SUBMISSION OF ROYALTY CLAIMS FILING OF CLAIMS TO ROYALTY FEES COLLECTED UNDER COMPULSORY LICENSE Digital Audio Recording Devices and Media Royalty Claims § 360.25 Copies of claims. A claimant shall, for each claim...

32 CFR 842.94 - Assertable claims.

Science.gov (United States)

2010-07-01

..., against a tort-feasor when: (a) Damage results from negligence and the claim is for: (1) More than $100... ADMINISTRATIVE CLAIMS Property Damage Tort Claims in Favor of the United States (31 U.S.C. 3701, 3711-3719) § 842.... (The two claims should be consolidated and processed under subpart N). (d) The Tort-feasor or his...

Age and recovery from brain injury: legal opinions, clinical beliefs and experimental evidence.

Science.gov (United States)

Johnson, David A; Rose, F D; Brooks, B M; Eyers, S

2003-01-01

Despite considerable scientific evidence to the contrary, many medical practitioners maintain that children recover from brain injury better than adults. This belief, which is commonly referred to as the "Kennard Principle", has important ramifications for personal injury compensation claims in which the amount of financial damages claimed is partly based on medical experts' prognoses for recovery and long-term outcome. The present study investigated whether legal practitioners' beliefs are consistent with those of medical practitioners. Lawyers were asked to estimate their confidence in consultant neurologists' estimates of recovery in four clinically-based but fictitious case studies which differed only in the reported age of the patient. The lawyers showed more confidence in estimates which coincided with the Kennard Principle than those which did not. These results support previous findings in showing widespread belief that "younger is better" in recovery from brain injury. In consequence, it is likely that financial compensation for children with brain injury is currently being underestimated in litigation, thereby prejudicing the long-term outcome of the child.

Analysis - what is legal medicine?

Science.gov (United States)

Beran, Roy G

2008-04-01

Legal medicine addresses the interface between medicine and law in health care. The Australian College of Legal Medicine (ACLM) established itself as the peak body in legal and forensic medicine in Australia. It helped establish the Expert Witness Institute of Australia (EWIA), the legal medicine programme at Griffith University and contributes to government enquiries. Public health, disability assessment, competing priorities of privacy verses notification and determination of fitness for a host of pursuits are aspects of legal medicine. Complementing the EWIA, the ACLM runs training programmes emphasising legal medicine skills additional to clinical practice, advocating clinical relevance. Assessment of athletes' fitness and ensuring that prohibited substances are not inadvertently prescribed represent a growing area of legal medicine. Ethical consideration of health care should respect legal medicine principles rather than armchair commentary. International conventions must be respected by legal medicine and dictate physicians' obligations. The NSW courts imposed a duty to provide emergency medical care. Migration and communicable diseases are aspects of legal medicine. Police surgeons provide a face to legal medicine (which incorporates forensic medicine) underpinning its public perception of specialty recognition. Legal medicine deserves its place as a medical specialty in its own right.

Limitation of liability for maritime claims: Chronological critical review (international instruments and Croatian solutions

Directory of Open Access Journals (Sweden)

Vasilj Aleksandra V.

2016-01-01

Full Text Available Limitation of liability of shipowner can based on property or can be personal - shipowner responds to certain part of the property (for example ship or his entire assets to a certain amount. In the first case it is a real, and in the other the personal limitation of liability. On these principles all international instruments in this legal field have been developed. One of the well-known 'universal' principle of civil law says that the injurer must pay for a damage in full, in full extent and amount. However, when we are applying provisions of maritime law (as well as transport law in general on the liability for damages and its compensation, the situation is quite opposite. Though, that the amount of suffered damages is coming closer to said universal principle of civil law has been confirmed by Amendments to the Protocol to the Convention on Limitation of Liability for Maritime Claims 1996 (LLMC 1996. These Amendments increased amount of general (global limitation of liability for maritime claims by 51% compared to the amounts in LLMC. Increased amounts are applicable from 8th June 2015. Regarding these amendments, a number of issues can be placed: justification for introducing the institute of limitation of liability in general; reasons why the injurer is privileged in maritime (and broader in transport, in the context of the amount of the obligation of compensation for damage; and whether the application of the institute undermine the principle that is enshrined in the legal system of every modern country, according to which the injured party has the right to just compensation. On the other hand, justice can be taken as well as an argument just to implement the limitation of liability system.

A matter of accuracy. Nanobiochips in diagnostics and in research: ethical issues as value trade-offs.

Science.gov (United States)

Le Roux, Ronan

2015-04-01

The paper deals with the introduction of nanotechnology in biochips. Based on interviews and theoretical reflections, it explores blind spots left by technology assessment and ethical investigations. These have focused on possible consequences of increased diffusability of a diagnostic device, neglecting both the context of research as well as increased accuracy, despite it being a more essential feature of nanobiochip projects. Also, rather than one of many parallel aspects (technical, legal and social) in innovation processes, ethics is considered here as a ubiquitous system of choices between sometimes antagonistic values. Thus, the paper investigates what is at stake when accuracy is balanced with other practical values in different contexts. Dramatic nanotechnological increase of accuracy in biochips can raise ethical issues, since it is at odds with other values such as diffusability and reliability. But those issues will not be as revolutionary as is often claimed: neither in diagnostics, because accuracy of measurements is not accuracy of diagnostics; nor in research, because a boost in measurement accuracy is not sufficient to overcome significance-chasing malpractices. The conclusion extends to methodological recommendations.

Medico legal issues.

Science.gov (United States)

Mackenzie, Geraldine; Carter, Hugh

2010-01-01

This chapter gives an educational overview of: * An awareness of the legal issues involved in health informatics * The need for the privacy and security of the patient record * The legal consequences of a breach of the security of the patient record * The concept of privacy law and what precautions ought to be taken to minimize legal liability for a breach of privacy and/or confidentiality.

Harmonization of domestic legislation in the field of civil law with the European Union law: Securing of claims by means of fiduciary agreements

Directory of Open Access Journals (Sweden)

Pajtić Bojan

2012-01-01

Full Text Available This paper analyses fiduciary agreements, which, as a form of contract, that is the means of securing obligation and legal claims, are regulated by provisions of specific laws and codifications in some of the European Union countries. Even the Montenegrin legislator enacted a special law governing these legal matters, however in the Serbian law fiduciary agreements fall into the category of innominate contracts. Fiducia originates in the Roman Law and constitutes the first common form of the pledge law. The Latin term fiducia means 'trust', since these legal matters were, first of all, based on the trust between contractual parties. This paper addresses the institution of 'trust' as it is the Anglo-Saxon counterpart of the fiduciary agreement. Etymologically, 'trust' has the same meaning as the term fiducia - trust. Due to their advantages, fiduciary agreements are not even uncommon in the domestic legal practice, while there are certain, as we have already announced, theoretical, but also practical concerns arguing admissibility of this legal matter. These arguments mainly come down to the thesis (mentioned above that entering into the fiduciary agreement results in violation of the ban on performance of contract lex commissoria in the pledge law. Nevertheless, I provided explanation that differences between contracts of pledge and fiduciary agreements clearly point to the conclusion that fiduciary agreements may not be treated as a pledge, hence they are admissible, that is, they are concluded on the principle of contractual freedom as an imperative norm of the Law on Obligations. Fiduciary agreements (in relation to the realistic means of security offer to the creditor a higher level of security, reduce the period of payment of his claims, also providing practical benefits for the debtor himself. The paper presents the reasons supporting the view that it would be advantageous for the Serbian legislator, in the process of harmonization of the

Consumer attitudes and understanding of cholesterol-lowering claims on food: randomize mock-package experiments with plant sterol and oat fibre claims.

Science.gov (United States)

Wong, C L; Mendoza, J; Henson, S J; Qi, Y; Lou, W; L'Abbé, M R

2014-08-01

Few studies have examined consumer acceptability or comprehension of cholesterol-lowering claims on food labels. Our objective was to assess consumer attitudes and understanding of cholesterol-lowering claims regarding plant sterols (PS) and oat fibre (OF). We conducted two studies on: (1) PS claims and (2) OF claims. Both studies involved a randomized mock-packaged experiment within an online survey administered to Canadian consumers. In the PS study (n=721), we tested three PS-related claims (disease risk reduction claim, function claim and nutrient content claim) and a 'tastes great' claim (control) on identical margarine containers. Similarly, in the OF study (n=710), we tested three claims related to OF and a 'taste great' claim on identical cereal boxes. In both studies, participants answered the same set of questions on attitudes and understanding of claims after seeing each mock package. All claims that mentioned either PS or OF resulted in more positive attitudes than the taste control claim (Pprofile. How consumers responded to the nutrition claims between the two studies was influenced by contextual factors such as familiarity with the functional food/component and the food product that carried the claim. Permitted nutrition claims are approved based on physiological evidence and are allowed on any food product as long as it meets the associated nutrient criteria. However, it is difficult to generalize attitudes and understanding of claims when they are so highly dependent on contextual factors.

Determinants of consumer understanding of health claims

DEFF Research Database (Denmark)

Grunert, Klaus G; Scholderer, Joachim; Rogeaux, Michel

2011-01-01

as safe, risky or other. In addition to the open questions on claim understanding, respondents rated a number of statements on claim interpretation for agreement and completed scales on interest in healthy eating, attitude to functional foods, and subjective knowledge on food and health. Results showed......The new EU regulation on nutrition and health claims states that claims can be permitted only if they can be expected to be understood by consumers. Investigating determinants of consumer understanding of health claims has therefore become an important topic. Understanding of a health claim...... on a yoghurt product was investigated with a sample of 720 category users in Germany. Health claim understanding was measured using open answers, which were subsequently content analysed and classified by comparison with the scientific dossier of the health claim. Based on this respondents were classified...

32 CFR 537.15 - Statutory authority for maritime claims and claims involving civil works of a maritime nature.

Science.gov (United States)

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Statutory authority for maritime claims and claims involving civil works of a maritime nature. 537.15 Section 537.15 National Defense Department of....15 Statutory authority for maritime claims and claims involving civil works of a maritime nature. (a...

Fundamentals of legal argumentation : A survey of theories on the justification of legal decisions

NARCIS (Netherlands)

Feteris, E.T.

2017-01-01

This book is an updated and revised edition of Fundamentals of Legal Argumentation published in 1999. It discusses new developments that have taken place in the past 15 years in research of legal argumentation, legal justification and legal interpretation, as well as the implications of these new

Liability of College Faculty and Administrators

Science.gov (United States)

Wall, Patricia S.; Sarver, Lee

2014-01-01

According to a "Wall Street Journal"/NBC News poll, 59 percent of all adults consider education essential to getting ahead in life. At the same time, an increasing number of adults have begun to blame educators for their failure in life, claiming educational malpractice. Historically, education has been more of an issue at the state and…

Malpractice and the Communication Consultant: A Proactive Approach.

Science.gov (United States)

Montgomery, Daniel J.; And Others

1995-01-01

Provides communication practitioners with an overview of legal and ethical issues facing individuals who market themselves as professional communication consultants. Discusses the tort of negligence. Outlines court-supported practices that professional consultants might use to help protect clients and themselves. Argues that an understanding of…

32 CFR 536.19 - Disaster claims planning.

Science.gov (United States)

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Disaster claims planning. 536.19 Section 536.19... AGAINST THE UNITED STATES The Army Claims System § 536.19 Disaster claims planning. All ACOs will prepare... requirements related to disaster claims planning. ...

THE LEGAL INDEBTEDNESS CAPACITY OF ROMANIAN LOCAL GOVERNMENTS - THEORETICAL AND EMPIRICAL EVIDENCES

Directory of Open Access Journals (Sweden)

Bilan Irina

2011-12-01

Full Text Available The factual, not only formal capacity of local governments to appeal to borrowed resources is, considering the current conditions, a prerequisite for ensuring economic and social development of local communities. In this paper we intend to position the main theoretical and empirical evidences on local governments indebtedness capacity, mainly focusing on its sizing according to Romanian regulatory framework. With respect to previous research, the issue approached is one of great interest as it has not been, in the Romanian literature on local public finances, subject to a separate analysis of proportions. The undertaken analysis comprises a quantitative dimension, based on processed data from the consolidated general budget of Romanian local governments for 2007-2009, in permanent conjunction with monitoring and analysis of the involved qualitative aspects. To ensure the relevance of the research results, the analysis undertaken refers to the legal framework in function throughout the considered period of time, without involving the legislative changes operated in mid-2010. The main conclusions drawn from our analysis indicate that, considering the current Romanian socio-economic environment, under the impact of specific factors of different nature, the legal indebtedness capacity is far from being well valued, thus bringing its benefits to local communities development. This conclusion is valid from a global perspective as well as for different types of local communities. This appears to be inconsistent with the permanently claimed need to fund important local public investments, mainly in infrastructure, indicating, despite the high legal indebtedness capacity, the lack of factual access to borrowed resources. We suggest, therefore, to introduce the concept of effective indebtedness capacity, the result of a particularized correlation for different local governments between legal indebtedness capacity and the manifestation of several factors

Medico-legal problems in radiology

International Nuclear Information System (INIS)

Becker, W.

1979-01-01

The obligation of the pysician to inform the patient - which he has to prove in case of a suit - is based on the patient's right of selfdetermination. This self-dicision information was subject of the panel discussion. Not discussed in detail were the information concerning diagnosis and prognosis, and the instruction of the patient regarding his conduct postoperatively and during medical treatment. Not considered was the so-called malpractice and negligence respectively. Medical liability suits are increasing for various reasons and are frequently directed at a failure to inform the patient because the patient is often unable to prove a negligence of the physician ('surrogate liability'). The dimension of the duty of disclosure (complete information - no information at all) is discussed in general and with special regard to the radiological field. (orig.) [de

38 CFR 3.160 - Status of claims.

Science.gov (United States)

2010-07-01

..., Compensation, and Dependency and Indemnity Compensation Claims § 3.160 Status of claims. The following definitions are applicable to claims for pension, compensation, and dependency and indemnity compensation. (a... for a benefit received after final disallowance of an earlier claim, or any application based on...

Health Claims Data Warehouse (HCDW)

Data.gov (United States)

Office of Personnel Management — The Health Claims Data Warehouse (HCDW) will receive and analyze health claims data to support management and administrative purposes. The Federal Employee Health...

Legal socialization of personality as a phenomenon of legal psychology

Directory of Open Access Journals (Sweden)

Borisova S.E.

2017-01-01

Full Text Available The relevance of the topic to the continuing importance of legal regulation of human behavior, the necessity of foreseeing the adverse consequences of social disorders and urgency of the prevention of deconditioning and deviant behavioral manifestations. In this regard, it is important to examine the phenomenon of legal socialization, causing interest among the representatives of the human Sciences and specialists in different branches of psychological knowledge. Taking into account the multidimensional nature of this phenomenon, it is an essential consideration of the trajectories of its occurrence in correlation with different interacting with other determinants. Such determinants include age psychological characteristics, experience crises of mental development, socially conditioned factors, and the influence of the professional environment. In article are characterized by individual patterns of legal socialization of a personality, revealing its essence, on the basis of summarizing opinions of scientists based on their own point of view. On the basis of the theoretical analysis made assumptions about the peculiarities of legal socialization of the individual occurring in different age periods of life; formulated likely areas for further study the phenomenon under research legal psychology.

Dementia and Legal Competency

OpenAIRE

Filaković, Pavo; Petek Erić, Anamarija; Mihanović, Mate; Glavina, Trpimir; Molnar, Sven

2011-01-01

The legal competency or capability to exercise rights is level of judgment and decision-making ability needed to manage one's own affairs and to sign official documents. With some exceptions, the person entitles this right in age of majority. It is acquired without legal procedures, however the annulment of legal capacity requires a juristic process. This resolution may not be final and could be revoked thorough the procedure of reverting legal capacity – fully or partially. Given ...

37 CFR 360.5 - Copies of claims.

Science.gov (United States)

2010-07-01

... Section 360.5 Patents, Trademarks, and Copyrights COPYRIGHT ROYALTY BOARD, LIBRARY OF CONGRESS SUBMISSION OF ROYALTY CLAIMS FILING OF CLAIMS TO ROYALTY FEES COLLECTED UNDER COMPULSORY LICENSE Cable Claims... hand delivery or by mail, file an original and one copy of the claim to cable royalty fees. ...