Sample records for alleged medical negligence

  1. Medical negligence liability under the consumer protection act: A review of judicial perspective.

    PubMed

    Joga Rao, S V

    2009-07-01

    It is important to know what constitutes medical negligence. A doctor owes certain duties to the patient who consults him for illness. A deficiency in this duty results in negligence. A basic knowledge of how medical negligence is adjudicated in the various judicial courts of India will help a doctor to practice his profession without undue worry about facing litigation for alleged medical negligence.

  2. Medical negligence liability under the consumer protection act: A review of judicial perspective

    PubMed Central

    Joga Rao, S. V.

    2009-01-01

    It is important to know what constitutes medical negligence. A doctor owes certain duties to the patient who consults him for illness. A deficiency in this duty results in negligence. A basic knowledge of how medical negligence is adjudicated in the various judicial courts of India will help a doctor to practice his profession without undue worry about facing litigation for alleged medical negligence. PMID:19881133

  3. Medical records and issues in negligence

    PubMed Central

    Thomas, Joseph

    2009-01-01

    It is very important for the treating doctor to properly document the management of a patient under his care. Medical record keeping has evolved into a science of itself. This will be the only way for the doctor to prove that the treatment was carried out properly. Moreover, it will also be of immense help in the scientific evaluation and review of patient management issues. Medical records form an important part of the management of a patient. It is important for the doctors and medical establishments to properly maintain the records of patients for two important reasons. The first one is that it will help them in the scientific evaluation of their patient profile, helping in analyzing the treatment results, and to plan treatment protocols. It also helps in planning governmental strategies for future medical care. But of equal importance in the present setting is in the issue of alleged medical negligence. The legal system relies mainly on documentary evidence in a situation where medical negligence is alleged by the patient or the relatives. In an accusation of negligence, this is very often the most important evidence deciding on the sentencing or acquittal of the doctor. With the increasing use of medical insurance for treatment, the insurance companies also require proper record keeping to prove the patient's demand for medical expenses. Improper record keeping can result in declining medical claims. It is disheartening to note that inspite of knowing the importance of proper record keeping it is still in a nascent stage in India. It is wise to remember that “Poor records mean poor defense, no records mean no defense”. Medical records include a variety of documentation of patient's history, clinical findings, diagnostic test results, preoperative care, operation notes, post operative care, and daily notes of a patient's progress and medications. A properly obtained consent will go a long way in proving that the procedures were conducted with the

  4. Craniofacial Surgery and Adverse Outcomes: An Inquiry Into Medical Negligence.

    PubMed

    Svider, Peter F; Eloy, Jean Anderson; Folbe, Adam J; Carron, Michael A; Zuliani, Giancarlo F; Shkoukani, Mahdi A

    2015-07-01

    This study aimed to evaluate factors contributing to medical negligence relevant to craniofacial surgery. Retrospective analysis of verdict and settlement reports on the Westlaw legal database for outcome, awards, physician defendants, and other specific factors raised in malpractice litigation. Of 42 verdicts and settlement reports included, 52.4% were resolved with either an out-of-court settlement or plaintiff verdict, with aggregate payments totaling $50.1M (in 2013 dollars). Median settlements and jury-awarded damages were $988,000 and $555,000, respectively. Payments in pediatric cases ($1.2M) were significantly higher. Plastic surgeons, oral surgeons, and otolaryngologists were the most commonly named defendants. The most common alleged factors included intraoperative negligence (69.0%), permanent deficits (54.8%), requiring additional surgery (52.4%), missed/delayed diagnosis of a complication (42.9%), disfigurement/scarring (28.6%), postoperative negligence (28.6%), and inadequate informed consent (20.6% of surgical cases). Failure to diagnose a fracture (19.0%) and cleft-reparative procedures (14.3%) were the most frequently litigated entities. Medical negligence related to craniofacial surgery involves plaintiffs in a wide age range as well as physician defendants in numerous specialties, and proceedings resolved with settlement and plaintiff verdict involve substantial payments. Cases with death, allegedly permanent injuries, and pediatric plaintiffs had significantly higher payments. © The Author(s) 2015.

  5. [Medical negligence].

    PubMed

    Zipper, St G

    2016-06-01

    Medical negligence is a matter of growing public interest. This review outlines various aspects of medical negligence: epidemiology, taxonomy, and the risks, causes, psychology, management and prevention of errors.

  6. When informed consent goes poorly: a descriptive study of medical negligence claims and patient complaints.

    PubMed

    Gogos, Andrew J; Clark, Richard B; Bismark, Marie M; Gruen, Russell L; Studdert, David M

    2011-09-19

    To describe the frequency, characteristics, and outcomes of medicolegal disputes over informed consent. Retrospective review and analysis of negligence claims against doctors insured by Avant Mutual Group Limited and complaints lodged with the Office of the Health Services Commissioner of Victoria that alleged failures in the informed consent process and were adjudicated between 1 January 2002 and 31 December 2008. Case frequency (by medical specialty), type of allegation, type of treatment. A total of 481 cases alleged deficiencies in the informed consent process (218 of 1898 conciliated complaints [11.5%]; 263 of 7846 negligence claims [3.4%]). 57% of these cases were against surgeons. Plastic surgeons experienced dispute rates that were more than twice those of any other specialty or subspecialty group. 92% of cases (442/481) involved surgical procedures and 16% (77/481) involved cosmetic procedures. The primary allegation in 71% of cases was that the clinician failed to mention or properly explain risks of complications. Five treatment types - procedures on reproductive organs (12% of cases), procedures on facial features excluding eyes (12%), prescription medications (8%), eye surgery (7%) and breast surgery (7%) - accounted for 46% of all cases. The typical dispute over informed consent involves an operation, often cosmetic, and allegations that a particular complication was not properly disclosed. With Australian courts now looking to patient preferences in setting legal standards of care for risk disclosure, medicolegal disputes provide valuable insights for targeting both quality improvement efforts and risk management activities.

  7. [Analysis of final judgements in cases of medical negligence occurred in Ukraine].

    PubMed

    Franchuk, Valentyn V; Trach Rosolovska, Svitlana V; Selskyy, Petro R; Mykolenko, Anna Z; Bodnar, Petro Ya

    2018-01-01

    Introduction: The peculiarities of the disadvantages of providing medical care in Ukraine are not well-known abroad. The aim: To study the peculiarities of court decisions in cases of unfavorable consequences of medical activity. Materials and methods: The article analyzes the official data of the General Prosecutor's Office of Ukraine and the website of court decisions regarding criminal cases against medical practitioners. Review: Approximately 600 cases of alleged medical malpractice cases are registered annually in Ukraine. Only less than one percent of them are brought to the court. The guilt of medical practitioners was proven in majority (80,8%) of court decisions. Acquittals of defendants were pronounced in 5,9% of court verdicts. Obstetrics and gynecology, surgery, internal medicine and anesthesiology are in the top of high-risk medical specialties. Conclusions: Majority of medical malpractice litigations are sued in Ukraine baselessly. In cases of medical negligence majority of defendants are acquitted as usual.

  8. Progress in Medicine: Compensation and medical negligence in India: Does the system need a quick fix or an overhaul?

    PubMed Central

    Chandra, Meghana S.; Math, Suresh Bada

    2016-01-01

    In a recent judgment on medical negligence, the Supreme Court awarded compensation amounting to Rs. 11 crore to a victim, which was to be paid by the doctors and the private hospital deemed responsible for the wrongful death of a patient. This landmark decision was by far the largest compensation award in the history of Indian medical negligence litigation. Hence, the process of calculating compensation for medical negligence has received great attention and debate, largely due to the impact that it is going to have on the practice of medicine within the country, in the near future. However, the method of calculation of compensation is unpredictable as it varies hugely across different cases, courts and tribunals resulting, in a loss of faith in the system, protracted litigation, and frequent appeals. With over 80% of India's healthcare being provided by the private sector, predictability and uniformity in the regulation of compensation in medical negligence would benefit the victims and the doctors concerned. A basic knowledge of how medical negligence compensation is calculated and adjudicated in the judicial courts of India will aid a doctor in planning his/her professional indemnity insurance, as well as in practicing his/her profession without undue worry about facing litigation for alleged medical negligence. This article addresses the merits and demerits of large compensation awards, and also discusses whether the system is broken, needs a quick fix, or a massive overhaul. PMID:27891021

  9. Progress in Medicine: Compensation and medical negligence in India: Does the system need a quick fix or an overhaul?

    PubMed

    Chandra, Meghana S; Math, Suresh Bada

    2016-10-01

    In a recent judgment on medical negligence, the Supreme Court awarded compensation amounting to Rs. 11 crore to a victim, which was to be paid by the doctors and the private hospital deemed responsible for the wrongful death of a patient. This landmark decision was by far the largest compensation award in the history of Indian medical negligence litigation. Hence, the process of calculating compensation for medical negligence has received great attention and debate, largely due to the impact that it is going to have on the practice of medicine within the country, in the near future. However, the method of calculation of compensation is unpredictable as it varies hugely across different cases, courts and tribunals resulting, in a loss of faith in the system, protracted litigation, and frequent appeals. With over 80% of India's healthcare being provided by the private sector, predictability and uniformity in the regulation of compensation in medical negligence would benefit the victims and the doctors concerned. A basic knowledge of how medical negligence compensation is calculated and adjudicated in the judicial courts of India will aid a doctor in planning his/her professional indemnity insurance, as well as in practicing his/her profession without undue worry about facing litigation for alleged medical negligence. This article addresses the merits and demerits of large compensation awards, and also discusses whether the system is broken, needs a quick fix, or a massive overhaul.

  10. Medical negligence and the law.

    PubMed

    Murthy, K K S R

    2007-01-01

    After the Consumer Protection Act, 1986, came into effect, a number of patients have filed cases against doctors. This article presents a summary of legal decisions related to medical negligence: what constitutes negligence in civil and criminal law, and what is required to prove it.

  11. [Medical negligence in surgery: 112 cases retrospective analysis].

    PubMed

    Xiang, Jian; Chang, Lin; Wang, Xu; Zhang, Feng-Qin

    2013-06-01

    To explore the general characteristics of medical negligence in surgery in order to provide the reference for forensic practices. One hundred and twelve cases of medical negligence in surgical department were retrospectively analyzed in Fada Institute of Forensic Medicine and Science from 2008 to 2010. The common types of medical negligence cases in the surgery were improper operation procedure (28.57%), failure of consent (26.79%), and inadequate monitoring (22.32%). The results of complications included disability or functional impairment (61.61%), death (31.25%) and transient impairment with no obvious adverse reactions (7.14%). The most common roles played by the medical negligence cases were minor role (26.79%), equal role (19.64%), and slight role (14.29%). Significant attention should be paid to the operation procedure, consent, and monitoring. It should be cautious to not make assessment on involvement degree of medical negligence.

  12. Medical negligence--prevention and management.

    PubMed

    Chao, T C

    1987-04-01

    The rising spate of malpractice cases against doctors appearing in the press and annual reports of medical insurance companies causes concern. Are our doctors more careless or is the public more conscious of litigation? A well publicized malpractice case can ruin the doctor's career and practice. It is well worth a doctor's while to know the pitfalls and learn how to prevent them, and if a mistake happens, how to manage it. Not all mistakes amount to negligence. How will the court view these cases? Some local cases are cited to illustrate the difference between misadventure and negligence. They will serve as guidelines for good medical practice.

  13. The High Court's lost chance in medical negligence: Tabet v Gett (2010) 240 CLR 537.

    PubMed

    Faunce, Thomas; McEwan, Alexandra

    2010-12-01

    In 2010 the High Court of Australia in Tabet v Gett (2010) 240 CLR 537 determined an appeal in a medical negligence case concerning a six-year-old girl who had presented to a major paediatric hospital with symptoms over several weeks of headaches and vomiting after a recent history of chicken pox. The differential diagnosis was varicella, meningitis or encephalitis and two days later, after she deteriorated neurologically, she received a lumbar puncture. Three days later she suffered a seizure and irreversible brain damage. A CT scan performed at that point showed a brain tumour. As Australia does not have a no-fault system providing compensation to cover the long-term care required for such a condition, the girl (through her parents and lawyers) sued her treating physician. She alleged that, because a cerebral CT scan was not performed when clinically indicated after the diagnosis of meningitis or encephalitis and before the lumbar puncture, she had "lost the chance" to have her brain tumour treated before she sustained permanent brain damage. She succeeded at first instance, but lost on appeal. The High Court also rejected her claim, holding unanimously that there were no policy reasons to allow recovery of damages based on possible (less than 50%) "loss of a chance" of a better medical outcome. The court held that the law of torts in Australia required "all or nothing" proof that physical injury was caused or contributed to by a negligent party. The High Court, however, did not exclude loss of chance as forming the substance of a probable (greater than 50%) claim in medical negligence in some future case. In the meantime, patients injured in Australia as a result of possible medical negligence (particularly in the intractable difficult instances of late diagnosis) must face the injustice of the significant day-to-day care needs of victims being carried by family members and the taxpayer-funded public hospital system. The High Court in Tabet v Gett again provides

  14. Medical homicide and extreme negligence.

    PubMed

    Duncanson, Emily; Richards, Virginia; Luce, Kasey M; Gill, James R

    2009-03-01

    Deaths that occur during medical care for the treatment of a disease are rarely certified as homicides. Some "medical" deaths, however, have been criminally prosecuted for manslaughter, reckless endangerment, or reckless homicide. We describe 5 deaths due to medical complications that underwent criminal prosecution. Three of the deaths were certified as homicides. Deaths certified as homicides due to the actions (or inactions) of a caregiver occur in 3 circumstances. The first is when the medical caregiver intentionally causes the death of the patient. The second is a death due to treatment by an unlicensed fraud or quack. The final circumstance is due to extreme medical negligence that involves a gross and wanton disregard for the well-being of the patient and is the most controversial in the medical community. The law defines reckless endangerment as the conscious disregard of a known substantial likelihood of injury to the patient. Criminal neglect typically is defined as the failure to provide timely, safe, adequate, and appropriate services, treatment, and/or care to a patient. In instances of extreme medical negligence, a homicide manner of death is appropriate because the fatality is due to the criminal acts (or inactions) of another. It also furthers one of the major goals of the medicolegal death investigation system, which is to safeguard the public health.

  15. Modern negligence law: Contribution of the medical cases.

    PubMed

    Hodgson, John

    The law on medical negligence is part of the law of negligence generally. It has played a significant part in developing two key aspects of the law. There are special rules to determine the standard of care expected of experts when advising and solving problems, and medical cases have largely shaped the law. Although cases on causation may arise in any area, several of the key cases happen to be medical ones. They are particularly likely to assist where there are alternative causes, as it is often difficult to distinguish the effects of disease from those of inappropriate treatment.

  16. Medical negligence: Indian legal perspective.

    PubMed

    Agrawal, Amit

    2016-10-01

    A basic knowledge of how judicial forums deal with the cases relating to medical negligence is of absolute necessity for doctors. The need for such knowledge is more now than before in light of higher premium being placed by the Indian forums on the value of human life and suffering, and perhaps rightly so. Judicial forums, while seeking to identify delinquents and delinquency in the cases of medical negligence, actually aim at striking a careful balance between the autonomy of a doctor to make judgments and the rights of a patient to be dealt with fairly. In the process of adjudication, the judicial forums tend to give sufficient leeway to doctors and expressly recognize the complexity of the human body, inexactness of medical science, the inherent subjectivity of the process, genuine scope for error of judgment, and the importance of the autonomy of the doctors. The law does not prescribe the limits of high standards that can be adopted but only the minimum standard below which the patients cannot be dealt with. Judicial forums have also signaled an increased need of the doctors to engage with the patients during treatment, especially when the line of treatment is contested, has serious side effects and alternative treatments exist.

  17. Medical negligence- meaning and scope in India.

    PubMed

    Kumar, L; Bastia, B K

    2011-01-01

    It is a principle recognized by our as well as by other legal systems that ignorance of the law is no excuse for violating it. The rule is also expressed in the form of a legal presumption that everyone knows the law. It is the duty of every man to know that part of it which concerns him. A doctor, in particular, is conclusively presumed to know the law, and is dealt with as if he did know it, because in general he can and ought to know it. In the matter of professional liability, the medical profession differs from other occupations for the reason that the former operates in spheres where success cannot be achieved in every case and very often success or failure depends upon factors beyond a medical man's control. Due to the increasing awareness of the rights of a patient in present day society, a medical man has become more vulnerable to being sued by a litigation suit of any kind, civil or criminal. The basis of a medical negligence suit is still alien to the majority of the practicing doctors in our country. Hence, the present article aims at discussing the various aspects of negligence, like the meaning and types of negligence, and the concept of duty of care, degree of care, and standard of care, as considered by the law.

  18. Beyond the standard of care: a new model to judge medical negligence.

    PubMed

    Brenner, Lawrence H; Brenner, Alison Tytell; Awerbuch, Eric J; Horwitz, Daniel

    2012-05-01

    The term "standard of care" has been used in law and medicine to determine whether medical care is negligent. However, the precise meaning of this concept is often unclear for both medical and legal professionals. Our purposes are to (1) examine the limitations of using standard of care as a measure of negligence, (2) propose the use of the legal concepts of justification and excuse in developing a new model of examining medical conduct, and (3) outline the framework of this model. We applied the principles of tort liability set forth in the clinical and legal literature to describe the difficulty in applying standard of care in medical negligence cases. Using the concepts of justification and excuse, we propose a judicial model that may promote fair and just jury verdicts in medical negligence cases. Contrary to conventional understanding, medical negligence is not simply nonconformity to norms. Two additional concepts of legal liability, ie, justification and excuse, must also be considered to properly judge medical conduct. Medical conduct is justified when the benefits outweigh the risks; the law sanctions the conduct and encourages future conduct under similar circumstances. Excuse, on the other hand, relieves a doctor of legal liability under specific circumstances even though his/her conduct was not justified. Standard of care is an inaccurate measure of medical negligence because it is premised on the faulty notion of conformity to norms. An alternative judicial model to determine medical negligence would (1) eliminate standard of care in medical malpractice law, (2) reframe the court instruction to jurors, and (3) establish an ongoing consensus committee on orthopaedic principles of negligence.

  19. The decline of judicial deference to medical opinion in medical negligence litigation in Malaysia.

    PubMed

    Kassim, Puteri Nemie J

    2008-06-01

    The decision of the Federal Court of Malaysia in abandoning the Bolam principle in relation to doctor's duty to disclose risks has clearly marked the decline of judicial deference to medical opinion in medical negligence litigation in Malaysia. It is undeniable that the Bolam principle has acted as a gatekeeper to the number of claims against medical practitioners. This has always been seen as necessary to protect the society from unwanted effects of defensive medicine. However, will these changes contribute significantly to the growth of medical negligence cases in Malaysia? This article will trace the development of the Bolam principle in medical negligence litigation in Malaysia since 1965 and analyse the influence of selected Commonwealth cases on the development. The implications of the Federal Court ruling will also be discussed.

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

    PubMed

    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.

  1. Negligent Liability and the Foreseeability Factor: A Critical Issue for School Counselors.

    ERIC Educational Resources Information Center

    Henderson, Donald H.

    1987-01-01

    Notes that negligent liability suits involving school counselors seem to be increasing. Cites cases, most of which involved defendant's alleged negligence emanating from failure to provide reasonable care to individuals who were later injured or killed. Emphasizes role of foreseeability in determining outcome of negligence cases. Indicates areas…

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

    PubMed

    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.

  3. Allegations of Failure to Obtain Informed Consent in Spinal Surgery Medical Malpractice Claims

    PubMed Central

    Grauberger, Jennifer; Kerezoudis, Panagiotis; Choudhry, Asad J.; Alvi, Mohammed Ali; Nassr, Ahmad; Currier, Bradford

    2017-01-01

    Importance Predictive factors associated with increased risk of medical malpractice litigation have been identified, including severity of injury, physician sex, and error in diagnosis. However, there is a paucity of literature investigating informed consent in spinal surgery malpractice. Objective To investigate the failure to obtain informed consent as an allegation in medical malpractice claims for patients undergoing a spinal procedure. Design, Setting, and Participants In this retrospective cohort study, a national medicolegal database was searched for malpractice claim cases related to spinal surgery for all years available (ie, January 1, 1980, through December 31, 2015). Main Outcomes and Measures Failure to obtain informed consent and associated medical malpractice case verdict. Results A total of 233 patients (117 [50.4%] male and 116 [49.8%] female; 80 with no informed consent allegation and 153 who cited lack of informed consent) who underwent spinal surgery and filed a malpractice claim were studied (mean [SD] age, 47.1 [13.1] years in the total group, 45.8 [12.9] years in the control group, and 47.9 [13.3] years in the informed consent group). Median interval between year of surgery and year of verdict was 5.4 years (interquartile range, 4-7 years). The most common informed consent allegations were failure to explain risks and adverse effects of surgery (52 [30.4%]) and failure to explain alternative treatment options (17 [9.9%]). In bivariate analysis, patients in the control group were more likely to require additional surgery (45 [56.3%] vs 53 [34.6%], P = .002) and have more permanent injuries compared with the informed consent group (46 [57.5%] vs 63 [42.0%], P = .03). On multivariable regression analysis, permanent injuries were more often associated with indemnity payment after a plaintiff verdict (odds ratio [OR], 3.12; 95% CI, 1.46-6.65; P = .003) or a settlement (OR, 6.26; 95% CI, 1.06-36.70; P = .04). Informed consent

  4. Allegations of Failure to Obtain Informed Consent in Spinal Surgery Medical Malpractice Claims.

    PubMed

    Grauberger, Jennifer; Kerezoudis, Panagiotis; Choudhry, Asad J; Alvi, Mohammed Ali; Nassr, Ahmad; Currier, Bradford; Bydon, Mohamad

    2017-06-21

    Predictive factors associated with increased risk of medical malpractice litigation have been identified, including severity of injury, physician sex, and error in diagnosis. However, there is a paucity of literature investigating informed consent in spinal surgery malpractice. To investigate the failure to obtain informed consent as an allegation in medical malpractice claims for patients undergoing a spinal procedure. In this retrospective cohort study, a national medicolegal database was searched for malpractice claim cases related to spinal surgery for all years available (ie, January 1, 1980, through December 31, 2015). Failure to obtain informed consent and associated medical malpractice case verdict. A total of 233 patients (117 [50.4%] male and 116 [49.8%] female; 80 with no informed consent allegation and 153 who cited lack of informed consent) who underwent spinal surgery and filed a malpractice claim were studied (mean [SD] age, 47.1 [13.1] years in the total group, 45.8 [12.9] years in the control group, and 47.9 [13.3] years in the informed consent group). Median interval between year of surgery and year of verdict was 5.4 years (interquartile range, 4-7 years). The most common informed consent allegations were failure to explain risks and adverse effects of surgery (52 [30.4%]) and failure to explain alternative treatment options (17 [9.9%]). In bivariate analysis, patients in the control group were more likely to require additional surgery (45 [56.3%] vs 53 [34.6%], P = .002) and have more permanent injuries compared with the informed consent group (46 [57.5%] vs 63 [42.0%], P = .03). On multivariable regression analysis, permanent injuries were more often associated with indemnity payment after a plaintiff verdict (odds ratio [OR], 3.12; 95% CI, 1.46-6.65; P = .003) or a settlement (OR, 6.26; 95% CI, 1.06-36.70; P = .04). Informed consent allegations were significantly associated with less severe (temporary or emotional) injury (OR

  5. The changing face of medical negligence law: from Bolam to Bolitho.

    PubMed

    Sooriakumaran, Prasanna

    2008-06-01

    The Bolam test was the standard by which medical negligence cases were judged. However, recently, the Bolitho case has resulted in a shift away from Bolam, with significant effects for all future negligence suits. Doctors need to have a thorough understanding of these issues in order to practice successfully in the current litiginous climate.

  6. Analysis of clinical negligence claims following tonsillectomy in England 1995 to 2010.

    PubMed

    Mathew, Rajeev; Asimacopoulos, Eleni; Walker, David; Gutierrez, Tatiana; Valentine, Peter; Pitkin, Lisa

    2012-05-01

    We determined the characteristics of medical negligence claims following tonsillectomy. Claims relating to tonsillectomy between 1995 and 2010 were obtained from the National Health Service Litigation Authority database. The number of open and closed claims was determined, and data were analyzed for primary injury claimed, outcome of claim, and associated costs. Over 15 years, there were 40 claims of clinical negligence related to tonsillectomy, representing 7.7% of all claims in otolaryngology. There were 34 closed claims, of which 32 (94%) resulted in payment of damages. Postoperative bleeding was the most common injury, with delayed recognition and treatment of bleeding alleged in most cases. Nasopharyngeal regurgitation as a result of soft palate fistulas or excessive tissue resection was the next-commonest cause of a claim. The other injuries claimed included dentoalveolar injury, bums, tonsillar remnants, and temporomandibular joint dysfunction. Inadequate informed consent was claimed in 5 cases. Clinical negligence claims following tonsillectomy have a high success rate. Although postoperative bleeding is the most common cause of negligence claims, a significant proportion of claims are due to rare complications of surgery. Informed consent should be tailored to the individual patient and should include a discussion of common and serious complications.

  7. Beyond negligence: avoidability and medical injury compensation.

    PubMed

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

    2008-01-01

    Disenchantment with the tort system and negligence standard in the United States is fueling interest in alternate compensation systems for medical injury. One possibility is experimentation with administrative "health courts," through which specialized adjudicators would utilize neutral experts to render compensability determinations. Compensation would be based not on negligence, but rather on a broader avoidable medical injury (avoidability) standard. Although considerable interest in health courts exists, stakeholders frequently express uncertainty about the meaning and operation of an avoidability standard. Three nations-Sweden, Denmark, and New Zealand-have long operated administrative schemes. We conducted interviews with administrators and stakeholders in these systems. Our goal was to garner lessons on how to operate a health court, and specifically, how to develop and apply alternate compensation criteria such as avoidability. This article reports our findings on the origins and operations of the systems, the evolution of their compensation criteria, and how these criteria are actually applied. We found that all three systems had their primary genesis in ensuring compensation for the injured, as opposed to sanctioning providers. All have abandoned the negligence standard. The Nordic systems use an avoidability standard, principally defined as injury that would not occur in the hands of the best practitioner. Their experience demonstrates that this definition is feasible to apply. New Zealand's recent move to a no-fault system sheds light on the benefits and drawbacks of a variety of compensation standards. Key lessons for successfully applying an alternate standard, such as avoidability, include a strict adherence to national precedent, the use of neutral and experienced experts, and a block on routine transfer of information from compensation investigations to disciplinary authorities. Importantly, all three nations are harnessing their systems' power to

  8. Malodorous consequences: what comprises negligence in anosmia litigation?

    PubMed

    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.

  9. Educational Malpractice: California School District Held Not Liable for Negligence in Instruction in Academic Subjects

    ERIC Educational Resources Information Center

    Martinez, Susanne

    1977-01-01

    This article reviews a suit brought by a high school graduate against a public school district alleging negligence and misrepresentation in academic instruction. The complaint alleged that the plaintiff was unable to read or write above fifth grade level because of the school's failure to educate him. The case was dismissed. (Author/GC)

  10. Negligence in securing informed consent and medical malpractice.

    PubMed

    Perry, C

    1988-01-01

    The doctrine of informed consent requires that the patient must act voluntarily and in the light of adequate information in order to give legally valid consent to medical care. Different models have been developed by various courts to determine whether the informational requirement, what the physician must disclose to the patient about the potential risks of the proposed treatment, has been met under the tort theory of negligence. To prevail, the patient plaintiff must show that a particular jurisdiction's disclosure standard has been breached, that harm has resulted, and that the defendant physician's negligent failure to discuss certain risks was causally responsible for the patient's failure to withhold consent. Perry discusses possible problems of redundancy or inconsistency concerning the relationship between different models for disclosure and causality, and notes that these problems may have serious implications for patient autonomy.

  11. Clinical Errors and Medical Negligence

    PubMed Central

    Oyebode, Femi

    2013-01-01

    This paper discusses the definition, nature and origins of clinical errors including their prevention. The relationship between clinical errors and medical negligence is examined as are the characteristics of litigants and events that are the source of litigation. The pattern of malpractice claims in different specialties and settings is examined. Among hospitalized patients worldwide, 3–16s% suffer injury as a result of medical intervention, the most common being the adverse effects of drugs. The frequency of adverse drug effects appears superficially to be higher in intensive care units and emergency departments but once rates have been corrected for volume of patients, comorbidity of conditions and number of drugs prescribed, the difference is not significant. It is concluded that probably no more than 1 in 7 adverse events in medicine result in a malpractice claim and the factors that predict that a patient will resort to litigation include a prior poor relationship with the clinician and the feeling that the patient is not being kept informed. Methods for preventing clinical errors are still in their infancy. The most promising include new technologies such as electronic prescribing systems, diagnostic and clinical decision-making aids and error-resistant systems. PMID:23343656

  12. Clinical errors and medical negligence.

    PubMed

    Oyebode, Femi

    2013-01-01

    This paper discusses the definition, nature and origins of clinical errors including their prevention. The relationship between clinical errors and medical negligence is examined as are the characteristics of litigants and events that are the source of litigation. The pattern of malpractice claims in different specialties and settings is examined. Among hospitalized patients worldwide, 3-16% suffer injury as a result of medical intervention, the most common being the adverse effects of drugs. The frequency of adverse drug effects appears superficially to be higher in intensive care units and emergency departments but once rates have been corrected for volume of patients, comorbidity of conditions and number of drugs prescribed, the difference is not significant. It is concluded that probably no more than 1 in 7 adverse events in medicine result in a malpractice claim and the factors that predict that a patient will resort to litigation include a prior poor relationship with the clinician and the feeling that the patient is not being kept informed. Methods for preventing clinical errors are still in their infancy. The most promising include new technologies such as electronic prescribing systems, diagnostic and clinical decision-making aids and error-resistant systems. Copyright © 2013 S. Karger AG, Basel.

  13. Dental negligence.

    PubMed

    Tay, C S

    2000-02-01

    Medical and dental errors and negligence are again in the spotlight in recent news report. Dead because of doctor's bad handwriting Prescribing drug overdoses Germ-infested soap pumps--infections in hospitals This articles explains dental negligence including dental duty of care and the standard of care expected of dentists in relation to the Bolam principle.

  14. Introduction to the Tort of Negligence as It Pertains to the Medical Office. Medical Law and Economics, Lesson Plan No. 3.

    ERIC Educational Resources Information Center

    Young, Joan

    Designed as part of a 40-hour course in medical law and economics, this lesson plan was developed to enable students to: (1) define and give examples of the tort of negligence in the medical profession; (2) distinguish between and give examples of personal and professional negligence; (3) be able to identify, for a given situation, the three major…

  15. Estimating the cost of compensating victims of medical negligence.

    PubMed Central

    Fenn, P.; Hermans, D.; Dingwall, R.

    1994-01-01

    The current system in Britain for compensating victims of medical injury depends on an assessment of negligence. Despite the sporadic pressure on the government to adopt a "no fault" approach, such as exists in Sweden, the negligence system will probably remain for the immediate future. The cost of this system was estimated to be 52.3m pounds for England 1990-1. The problem for the future, however, is one of forecasting accuracy at provider level: too high a guess and current patient care will suffer; too low a guess and future patient care will suffer. The introduction of a mutual insurance scheme may not resolve these difficulties, as someone will have to set the rates. Moreover, the figures indicate that if a no fault scheme was introduced the cost might be four times that of the current system, depending on the type of scheme adopted. PMID:8081145

  16. Do no more harm: the psychological stress of the medical examination for alleged child sexual abuse.

    PubMed

    Marks, Susan; Lamb, Robyn; Tzioumi, Dimitra

    2009-03-01

    Currently, there is some controversy that the medical examination following allegations of child sexual abuse may further traumatise the child. Access for children to appropriate care may be hindered if decisions about referral are influenced by personal beliefs, rather than by recognition of the potential health and psychological benefits of the assessment. We aimed to study the expectations and emotional responses of children and their parents to the medical examination. We conducted a prospective quantitative and qualitative study at the Children's Hospital at Westmead. Participants completed questionnaires pre-examination and post-examination, including Children's Anxiety and Pain Scales. Clinicians recorded a Genital Examination Distress Scale and a questionnaire about potentially prognostic variables. Parents found the medical examination significantly less stressful than they had anticipated. They highlighted the importance of being involved in the process, the child's reaction, staff attitudes and the doctor's explanations. Although most parents expected that the medical would be stressful for their child, this did not correlate with the children's reports of feeling scared beforehand. Increased parental and child distress were significantly associated with the child being 12 years or older. The type of abuse was not significantly linked to any of the parent or child self-reports. Our findings indicate that the medical examination is not as stressful as expected and support the recommendation that timely medical assessment by appropriately trained professionals should be offered for all children following allegations of sexual abuse.

  17. Hindsight bias and outcome bias in the social construction of medical negligence: a review.

    PubMed

    Hugh, Thomas B; Dekker, Sidney W A

    2009-05-01

    Medical negligence has been the subject of much public debate in recent decades. Although the steep increase in the frequency and size of claims against doctors at the end of the last century appears to have plateaued, in Australia at least, medical indemnity costs and consequences are still a matter of concern for doctors, medical defence organisations and governments in most developed countries. Imprecision in the legal definition of negligence opens the possibility that judgments of this issue at several levels may be subject to hindsight and outcome bias. Hindsight bias relates to the probability of an adverse event perceived by a retrospective observer ("I would have known it was going to happen"), while outcome bias is a largely subconscious cognitive distortion produced by the observer's knowledge of the adverse outcome. This review examines the relevant legal, medical, psychological and sociological literature on the operation of these pervasive and universal biases in the retrospective evaluation of adverse events. A finding of medical negligence is essentially an after-the-event social construction and is invariably affected by hindsight bias and knowledge of the adverse outcome. Such biases obviously pose a threat to the fairness of judgments. A number of debiasing strategies have been suggested but are relatively ineffective because of the universality and strength of these biases and the inherent difficulty of concealing from expert witnesses knowledge of the outcome. Education about the effect of the biases is therefore important for lawyers, medical expert witnesses and the judiciary.

  18. Factual causation in medical negligence.

    PubMed

    Manning, Joanna

    2007-12-01

    The conventional approach to causation in negligence is the "but for" test, decided on the balance of probabilities. Even when supplemented by the "material contribution" principle, satisfying the onus of proof of causation can be an insuperable obstacle for plaintiffs, particularly in medical cases. Yet, having found a breach of duty, a court's sympathies may gravitate toward the plaintiff at this point in the case. Accordingly, courts have sometimes accepted a relaxation of strict causation principles. The judicial devices are described: a special principle of causation in particular duties of care; a shifting burden of proof; "bridging the evidentiary gap" by drawing a robust inference of causation; treating a material increase in risk as sufficient proof of causation; and permitting causation to be established on the basis of the loss of a material chance of achieving a better outcome and discounting damages. In Accident Compensation Corp v Ambros [2007] NZCA 304 the New Zealand Court of Appeal recognised the need for a legal device to ameliorate the injustice sometimes caused by the strict rules of causation, and preferred the "inferential reasoning" approach favoured by the Canadian common law for use in the context of the accident compensation scheme. It is hoped that the New Zealand Supreme Court approves Ambros if the opportunity arises.

  19. Medical negligence. An overview of legal theory and neurosurgical practice: duty of care.

    PubMed

    Todd, Nicholas V

    2014-04-01

    A working knowledge of the legal principles of medical negligence is helpful to neurosurgeons. It helps them to act in a "reasonable, responsible and logical" manner, that is a practice that is consistent with the surgical practice of their peers. This article will review and explain the relevant medical law in relation to duty of care with illustrative neurosurgical cases.

  20. 20 CFR 30.609 - Is a settlement or judgment received as a result of allegations of medical malpractice in...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... result of allegations of medical malpractice in treating an illness covered by EEOICPA a recovery that... PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS...

  1. 20 CFR 30.609 - Is a settlement or judgment received as a result of allegations of medical malpractice in...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... result of allegations of medical malpractice in treating an illness covered by EEOICPA a recovery that... PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS...

  2. 20 CFR 30.609 - Is a settlement or judgment received as a result of allegations of medical malpractice in...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... result of allegations of medical malpractice in treating an illness covered by EEOICPA a recovery that... PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS...

  3. 20 CFR 30.609 - Is a settlement or judgment received as a result of allegations of medical malpractice in...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... result of allegations of medical malpractice in treating an illness covered by EEOICPA a recovery that... PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS...

  4. 20 CFR 30.609 - Is a settlement or judgment received as a result of allegations of medical malpractice in...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... result of allegations of medical malpractice in treating an illness covered by EEOICPA a recovery that... PROGRAMS, DEPARTMENT OF LABOR ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS...

  5. Medical Negligence Determinations, the "Right to Try," and Expanded Access to Innovative Treatments.

    PubMed

    Meyerson, Denise

    2017-09-01

    This article considers the issue of expanded access to innovative treatments in the context of recent legislative initiatives in the United Kingdom and the United States. In the United Kingdom, the supporters of legislative change argued that the common law principles governing medical negligence are a barrier to innovation. In an attempt to remove this perceived impediment, two bills proposed that innovating doctors sued for negligence should be able to rely in their defence on the fact that their decision to innovate was "responsible." A decision to innovate would be regarded as responsible if it followed a specified process. Although these changes to the law of medical negligence were not passed, this article argues that the idea of a process-based approach was sound. In the United States, a number of states have passed "Right to Try" laws that permit doctors to prescribe and companies to provide investigational products without the need for FDA approval. These laws do not purport to and nor are they able to alter the obligations of individuals and companies under federal law. They are consequently unlikely to achieve their stated aim of expanding access to investigational products. This article argues that they nevertheless have a cogent rationale in so far as they highlight the need for rights-based reform to federal regulations governing access.

  6. Abandoning the common law: medical negligence, genetic tests and wrongful life in the Australian High Court.

    PubMed

    Faunce, Thomas; Jefferys, Susannah

    2007-05-01

    The Australian High Court recently found that the common law could allow parents to claim tortious damages when medical negligence was proven to have led to the birth of an unplanned, but healthy, baby (Cattanach v Melchior (2003) 215 CLR 1). In Harriton v Stephens (2006) 80 ALJR 791; [2006] HCA 15 and Waller v James; Waller v Hoolahan (2006) 80 ALJR 846; [2006] HCA 16 the High Court in a six-to-one decision (Kirby J dissenting) decided that no such claim could be made by a child when medical negligence in failing to order an in utero genetic test caused the child severe disability. In an era when almost all pregnancies will soon require patented fetal genetic tests as part of the professional standard of care, the High Court, by barring so-called "wrongful life" (better termed "wrongful suffering") claims, may have created a partial immunity from suit for their corporate manufacturers and the doctors who administer them. What lessons can be learnt from this case about how the Australian High Court is, or should be, approaching medical negligence cases and its role as guardian of the Australian common law?

  7. Medical negligence: Coverage of the profession, duties, ethics, case law, and enlightened defense - A legal perspective.

    PubMed

    Pandit, M S; Pandit, Shobha

    2009-07-01

    A patient approaching a doctor expects medical treatment with all the knowledge and skill that the doctor possesses to bring relief to his medical problem. The relationship takes the shape of a contract retaining the essential elements of tort. A doctor owes certain duties to his patient and a breach of any of these duties gives a cause of action for negligence against the doctor. The doctor has a duty to obtain prior informed consent from the patient before carrying out diagnostic tests and therapeutic management. The services of the doctors are covered under the provisions of the Consumer Protection Act, 1986 and a patient can seek redressal of grievances from the Consumer Courts. Case laws are an important source of law in adjudicating various issues of negligence arising out of medical treatment.

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

    ERIC Educational Resources Information Center

    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)

  9. Telling patients about medical negligence.

    PubMed Central

    Warner, E.

    1983-01-01

    A 7-year-old boy, diagnosed as having croup, develops an upper airway obstruction due to epiglottitis during the therapy, resulting in cerebral anoxia. Pediatricians to whom the boy is referred feel that failure to consider epiglottitis in the original diagnosis constitutes negligence. The parents suspect nothing. What should the pediatricians say or do? Images p367-a p368-a PMID:6871805

  10. Medical negligence based on bad faith, breach of contract, or mental anguish.

    PubMed

    Ficarra, B J

    1980-01-01

    Financial recovery owing to breach of contract is restricted to the pecuniary amount lost because of failure to perform on the stipulated contract. With the acquisition of newer knowledge, attorneys are now utilizing the weapon of contractual failure as applied to medical negligence. The impetus to this new weapon for the plaintiff has accrued because of the favorable verdicts rendered from positive decisions based upon bad faith.

  11. Negligence on the Playing Field: Determining the Scope of Legal Liability. North Dakota Economic Studies, Number 42.

    ERIC Educational Resources Information Center

    Karns, Jack E.

    In recent years the number of lawsuits brought by injured secondary school athletes alleging negligence on the part of coaches, school officials, and referees has risen dramatically. This study analyzes the legal liability implications for administrators and others involved in school sports in North Dakota. An introductory section describes…

  12. Negligence, genuine error, and litigation

    PubMed Central

    Sohn, David H

    2013-01-01

    Not all medical injuries are the result of negligence. In fact, most medical injuries are the result either of the inherent risk in the practice of medicine, or due to system errors, which cannot be prevented simply through fear of disciplinary action. This paper will discuss the differences between adverse events, negligence, and system errors; the current medical malpractice tort system in the United States; and review current and future solutions, including medical malpractice reform, alternative dispute resolution, health courts, and no-fault compensation systems. The current political environment favors investigation of non-cap tort reform remedies; investment into more rational oversight systems, such as health courts or no-fault systems may reap both quantitative and qualitative benefits for a less costly and safer health system. PMID:23426783

  13. When Care is a "Systematic Route of Torture": Conceptualizing the Violence of Medical Negligence in Resource-Poor Settings.

    PubMed

    Heckert, Carina

    2016-12-01

    Descriptions of patient mistreatment fill ethnographic accounts of healthcare in resource-poor settings. Often, anthropologists point to structural factors and the ways that the global political economy produces substandard care. This approach makes it difficult to hold parties accountable when there is blatant disregard for human life on the part of individuals providing care. In this article, I draw on the illness narrative of Magaly Chacón, the first HIV positive individual in Bolivia to file charges of medical negligence after failing to receive care to prevent mother-to-child transmission. Magaly's narrative demonstrates how structural conditions are often used to explain away poor patient outcomes, shifting attention away from and normalizing the symbolic violence that also perpetuates substandard care of marginalized patients. I use Magaly's accusations to interrogate how defining acts of mistreatment as medical negligence can be a productive exercise, even when it is difficult to disentangle structural constraints from blatant acts of negligence. Defining who is negligent in resource-poor settings is not easy, as Magaly's case demonstrates. However, Magaly's case also demonstrates that accusations of negligence themselves can demand accountability and force changes within the local structures that contribute to the systematic mistreatment of marginalized patients.

  14. The Importance of the Medical Record: A Critical Professional Responsibility.

    PubMed

    Ngo, Elizabeth; Patel, Nachiket; Chandrasekaran, Krishnaswamy; Tajik, A Jamil; Paterick, Timothy E

    2016-01-01

    Comprehensive, detailed documentation in the medical record is critical to patient care and to a physician when allegations of negligence arise. Physicians, therefore, would be prudent to have a clear understanding of this documentation. It is important to understand who is responsible for documentation, what is important to document, when to document, and how to document. Additionally, it should be understood who owns the medical record, the significance of the transition to the electronic medical record, problems and pitfalls when using the electronic medical record, and how the Health Information Technology for Economic and Clinical Health Act affects healthcare providers and health information technology.

  15. Outcome-Based Practice: Disclosure Rates of Child Sexual Abuse Comparing Allegation Blind and Allegation Informed Structured Interviews.

    ERIC Educational Resources Information Center

    Cantlon, Julie; And Others

    1996-01-01

    This study evaluated the use of "allegation blind" interviews (in which interviewers did not know the specific allegation involved) with children (n=1535) suspected of being victims of child sexual abuse. The "allegation blind" interview technique yielded a statistically higher disclosure rate than the "allegation informed" interviews. (Author/DB)

  16. Medical teams and the standard of care in negligence.

    PubMed

    Sappideen, Carolyn

    2015-09-01

    Medical teams are essential to the delivery of modern, patient-centred health care in hospitals. A collective model of responsibility envisaged by team care is inconsistent with common law tort liability which focuses on the individual rather than the team. There is no basis upon which a team can be liable as a collective at common law. Nor does the common law'countenance liability for the conduct of other team members absent some form of agency, vicarious liability or non-delegable duty. Despite the barriers to the adoption of a team standard of care in negligence, there is scope for team factors to have a role in determining the standard of care so that being a team player is part and parcel of what it is to be a competent professional. If this is the case, the skill set, and the standard of care expected of the individual professional, includes skills based on team models of communication, cross-monitoring and trust.

  17. A phenomenological study of the effects of clinical negligence litigation on midwives in England: the personal perspective.

    PubMed

    Robertson, Judith H; Thomson, Ann M

    2014-03-01

    to explore how midwives' personal involvement in clinical negligence litigation affects their emotional and psychological well-being. descriptive phenomenological study using semi-structured interviews. in-depth interviews were conducted in participants' homes or at their place of work and focused on participants' experience of litigation. Participants were recruited from various regions of England. 22 National Health Service (NHS) midwives who had been alleged negligent. unfamiliarity with the legal process when writing statements, attending case conferences and being a witness in court provoked significant stress for midwives. This was exacerbated by the prolonged nature of maternity claims. Support ranged from good to inadequate. Participants who no longer worked for the defendant Trust felt unsupported. Stress could manifest as physical and mental ill-health. Some midwives internalised the allegations of negligence believing their whole career had become worthless. Previous knowledge of the legal process ameliorated the experience. Midwives also exhibited anger and resentment when litigation concluded and some took years to heal from the experience. midwives come from a caring and relational paradigm. When interfacing with the adversarial and contentious paradigm of tort law, midwives can abreact and suffer emotional, physical and psychological harm. Support for midwives experiencing litigation must be improved. Understanding the effects of personal involvement in litigation is important in order to improve the quality of support for this group of midwives. It will also aid development of targeted education for undergraduate, post-graduate and in-service midwives. In the longer term it may help policy makers when considering reform of clinical negligence litigation and NHS employers to structure support mechanisms for staff involved. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. 42 CFR 93.201 - Allegation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON RESEARCH MISCONDUCT Definitions § 93.201 Allegation. Allegation means a disclosure of possible research misconduct...

  19. Scrutinising the duty of care and standard of care in English medical negligence.

    PubMed

    Gromek-Broc, Katarzyna

    2012-03-01

    The aim of this article is to discuss the difficulties that claimants encounter in civil law action in English medical negligence cases. It argues that the current legal framework, in particular in relation to the existence of the duty of care and the assessment of standard of care, is haphazard and flawed. It suggests that the law should provide the boundaries that would encompass a moral obligation to rescue and to treat. In conclusion it discusses some timid attempts to reform the law in order to facilitate redress and compensation.

  20. The spectrum of medical errors: when patients sue

    PubMed Central

    Kels, Barry D; Grant-Kels, Jane M

    2012-01-01

    Inarguably medical errors constitute a serious, dangerous, and expensive problem for the twenty-first-century US health care system. This review examines the incidence, nature, and complexity of alleged medical negligence and medical malpractice. The authors hope this will constitute a road map to medical providers so that they can better understand the present climate and hopefully avoid the “Scylla and Charybdis” of medical errors and medical malpractice. Despite some documented success in reducing medical errors, adverse events and medical errors continue to represent an indelible stain upon the practice, reputation, and success of the US health care industry. In that regard, what may be required to successfully attack the unacceptably high severity and volume of medical errors is a locally directed and organized initiative sponsored by individual health care organizations that is coordinated, supported, and guided by state and federal governmental and nongovernmental agencies. PMID:22924008

  1. Alleged biological father incest: a forensic approach.

    PubMed

    Gomes, Vânia; Jardim, Patrícia; Taveira, Francisco; Dinis-Oliveira, Ricardo J; Magalhães, Teresa

    2014-01-01

    Paternal incest is one of the most serious forms of intrafamilial sexual abuse with clinical, social, and legal relevance. A retrospective study was performed, based on forensic reports and judicial decisions of alleged cases of biological paternal incest of victims under 18 years old (n = 215) from 2003 to 2008. Results highlight that in a relevant number of cases: victims were female; the abuse begun at an early age with reiteration; the alleged perpetrator presented a history of sexual crimes against children; sexual practices were physically poorly intrusive, which associated with a forensic medical evaluation performed more than 72 h after the abuse, explain partially the absence of physical injuries or other evidence-these last aspects are different from extrafamilial cases. In conclusion, observations about paternal incest are likely to exacerbate the psychosocial consequences of the abuse and may explain the difficulty and delay in detect and disclose these cases. Few cases were legally prosecuted and convicted. © 2013 American Academy of Forensic Sciences.

  2. Frequency of traumatic lesions alleged by victims of assault during police custody.

    PubMed

    Lorin de la Grandmaison, G; Houssaye, C; Bourokba, N; Durigon, M

    2007-08-01

    A retrospective study was undertaken to determine the frequency of traumatic lesions found in individuals alleging police brutality during official custody in the département of Hauts-de-Seine, located in the west suburbs of Paris. All medical certificates relating to the examination of 11,653 individuals detained during the year 2004 were analysed. From this population, there were 119 cases where victimized individuals alleged police assault and 245 revealed aggressive police manhandling, as indicated by traces of tight handcuffs. Among the individuals alleging police violence, most of them showed recent traumatic lesions (n=91). The majority of lesions were superficial contusions frequently located in the cervico-cephalic area. All traumatic lesions were compatible with the allegations of police assault. Neurological complications secondary to the application of handcuffs were encountered in less than 2% of the cases. Although no death was recorded in police custody during the period of the study, approximately 5% of the population that had encountered some form of police violence was found to require emergency hospitalization.

  3. Clinical negligence in hospitals in France and England.

    PubMed

    Kelly, Michael J; de Bono Q C, John; Métayer, Patrice

    2015-12-01

    This article arose from the back-to-back presentations by Michael Kelly and Patrice Métayer to the Anglo-French Medical Society in 2013 on the French and English legal systems handling a case of alleged clinical negligence as it proceeds from complaint to settlement or judgment in the two jurisdictions. Both systems have a hospital-based first stage with various avenues being available for amicable resolution, the French version being more regulated and prescribed than the English one. In both jurisdictions fewer than 5% cases go down the criminal route. Before the court is involved, in England there is an elaborate lawyer-controlled phase involving negotiations between the two sides and their experts which is expensive but often leads to pre-trial settlement for significant sums of money. Medical experts are central to all of this. In England they are largely unregulated and entirely advisory in an open market, in France they are both regulated and supervised by judges, being placed on official lists. These experts take a major inquisitorial role in a Debate between the two sides, combining the functions of Single Joint Expert (SJE), arbiter and mentor. If agreement is not reached, a second Debate before a different Expert is arranged. In both countries fewer than 5% cases reach a court for a hearing before a judge. In England a trial is an elaborate lengthy, expensive adversarial contest where all of the issues are rehearsed in full with factual and expert evidence, whereas in France in a contested case the judge reviews the reports of the two Debates with the lawyers who were involved (and not the experts, factual witnesses or parties). © The Author(s) 2015.

  4. 10 CFR 733.5 - Allegations received by DOE.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Allegations received by DOE. 733.5 Section 733.5 Energy DEPARTMENT OF ENERGY ALLEGATIONS OF RESEARCH MISCONDUCT § 733.5 Allegations received by DOE. If DOE receives directly a written allegation of research misconduct with regard to research under a DOE contract or...

  5. 10 CFR 733.5 - Allegations received by DOE.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Allegations received by DOE. 733.5 Section 733.5 Energy DEPARTMENT OF ENERGY ALLEGATIONS OF RESEARCH MISCONDUCT § 733.5 Allegations received by DOE. If DOE receives directly a written allegation of research misconduct with regard to research under a DOE contract or...

  6. 10 CFR 733.5 - Allegations received by DOE.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Allegations received by DOE. 733.5 Section 733.5 Energy DEPARTMENT OF ENERGY ALLEGATIONS OF RESEARCH MISCONDUCT § 733.5 Allegations received by DOE. If DOE receives directly a written allegation of research misconduct with regard to research under a DOE contract or...

  7. 10 CFR 733.5 - Allegations received by DOE.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Allegations received by DOE. 733.5 Section 733.5 Energy DEPARTMENT OF ENERGY ALLEGATIONS OF RESEARCH MISCONDUCT § 733.5 Allegations received by DOE. If DOE receives directly a written allegation of research misconduct with regard to research under a DOE contract or...

  8. 10 CFR 733.5 - Allegations received by DOE.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Allegations received by DOE. 733.5 Section 733.5 Energy DEPARTMENT OF ENERGY ALLEGATIONS OF RESEARCH MISCONDUCT § 733.5 Allegations received by DOE. If DOE receives directly a written allegation of research misconduct with regard to research under a DOE contract or...

  9. 42 CFR 93.402 - ORI allegation assessments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... RESEARCH MISCONDUCT Responsibilities of the U.S. Department of Health and Human Services Research Misconduct Issues § 93.402 ORI allegation assessments. (a) When ORI receives an allegation of research misconduct directly or becomes aware of an allegation or apparent instance of research misconduct, it may...

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

    PubMed

    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.

  11. Balancing public health and practitioner accountability in cases of medical manslaughter: reconsidering the tests for criminal negligence-related offences in Australia after R v Patel.

    PubMed

    Tuckett, Nikita

    2011-12-01

    In 2010 Dr Jayant Patel was convicted of several offences on the basis of criminal negligence. Following the Queensland Court of Appeal's 2011 endorsement of the trial judge's decision, the case provides a timely opportunity to review prosecutions for medical negligence criminal offences throughout Australia and to critically examine the tests in assessing whether the balance has been correctly struck. The author argues that the thresholds required for prosecutions for criminal negligence for medical manslaughter are problematic and unduly onerous, and do not adequately strike the balance between the utilitarian value in health care and patient safety, on the one hand, and practitioner accountability and deterrence, on the other. This article considers reforms to remedy the imbalance, including a reformulation of the Criminal Code (Qld) and common law thresholds, proposals for the enactment of a separate offence of criminally negligent manslaughter and the utilisation of corporate prosecutions for manslaughter liability to broaden accountability in health care and promote patient safety on a systemic level.

  12. 37 CFR 2.76 - Amendment to allege use.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2012-07-01 2012-07-01 false Amendment to allege use. 2.76... COMMERCE RULES OF PRACTICE IN TRADEMARK CASES Amendment of Application § 2.76 Amendment to allege use. (a.... If an amendment to allege use is filed outside the time period specified in this paragraph, it will...

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

    PubMed

    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.

  14. Systemic Negligence: Why It Is Morally Important for Developing World Bioethics.

    PubMed

    Chakraborti, Chhanda

    2015-12-01

    In the context of clinical and non-clinical biomedical practices, negligence is usually understood as a lapse of a specific professional duty by a healthcare worker or by a medical facility. This paper tries to delineate systemic negligence as another kind of negligence in the context of health systems, particularly in developing countries, that needs to be recognized and addressed. Systemic negligence is not just a mere collection of stray incidences of medical errors and system failures in a health system, but is proposed in this paper as a more pervasive kind of neglect. Several non-medical factors, such as lack of social and political will, also contribute to it and hence is more difficult to address in a health system. This paper argues that recognizing systemic negligence and including it research agenda have special moral importance for researchers in developing world bioethics, public health ethics and for health activists in the developing world. For, it can be a potent health system barrier, and can seriously impair efforts to ensure patient safety, particularly in the weaker health systems. As it erodes accountability in a health system, addressing it is also important for the twin goals of ensuring patient safety and improving health system performance. Above all, it needs to be addressed because the tolerance of its persistence in a health system seems to undervalue health as a social good. © 2014 John Wiley & Sons Ltd.

  15. Hemidiaphragm Paralysis after Robotic Prostatectomy: Medical Malpractice or Unforeseeable Event?

    PubMed

    Focardi, Martina; Bonelli, Aurelio; Pinchi, Vilma; Vittori, Gianni; De Luca, Federica; Norelli, Gian-Aristide

    2017-01-01

    The authors present a case of suspected malpractice linked to the onset of hemidiaphragm paralysis after robot-assisted radical prostatectomy (RARP). The approach to the case is shown from a medico-legal point of view. It is demonstrated how, after a thorough review of the literature, this was not a case of medical malpractice but an unforeseeable event. This paper aims at contributing to the very few reports dealing with the onset of hemidiaphragm paralysis after RARP, thus fostering clinical knowledge of these rare events and meanwhile providing useful data for the medico-legal handling in case of alleged negligence of surgeons. © 2015 S. Karger AG, Basel.

  16. Loss of chance in medical negligence.

    PubMed

    Leslie, K; Bramley, D; Shulman, M; Kennedy, E

    2014-05-01

    Occasionally accidents and complications occur during anaesthesia and perioperative care that result in injury to the patient. Unfortunately, this is sometimes due to a breach in the anaesthetist's duty of care to the patient. Sometimes, rather than being the cause of immediate damage, the act or omission results in an alteration in the prognosis of the complaint or increased risk of complications related to the complaint. This avenue for a negligence action is known as 'loss of chance of a better outcome' and has been the subject of much legal argument in Australia in recent years. A recent High Court of Australia decision is widely seen as having 'closed the door' to, or at least made it difficult for the patient to succeed in, loss of chance cases. Many anaesthetists may not be familiar with the concept of 'loss of chance'. This review will explore the concept of loss of chance and the manner in which Australian courts have dealt with it before and after Tabet v Gett from the perspective of the anaesthetist.

  17. Inappropriate publication of trial results and potential for allegations of illegal share dealing.

    PubMed

    Freestone, D S; Mitchell, H

    1993-04-24

    There is increasing evidence of fraud in clinical research, and one aspect concerns trading in pharmaceutical company shares by people who may have confidential information about the results of clinical trials. Plainly this has implications for honest investigators, who may find themselves exposed to such allegations. In this paper Dr D S Freestone and Mr H Mitchell, QC, identify three interlinked issues which they think underlie the potential for these allegations. They are pressure for premature or inappropriate communication of research results; trading in pharmaceutical company shares by academic clinical investigators; and the possibility that clinical investigators might succumb to temptation. Dr Freestone and Mr Mitchell suggest that whenever possible results of clinical studies should be published in appropriate medical journals without prior public disclosure. This conflicts with Stock Exchange rules, which require that price sensitive information should be published at the earliest opportunity and preclude priority of publication in medical journals. Freestone and Mitchell believe that rarely rapid public disclosure is acceptable if it is to protect patients' interests but that it must not prejudice publication in the medical or scientific press. When rapid public disclosure is needed, they say, every attempt should be made to inform prescribers before patients. Dr Freestone and Mr Mitchell warn that academic clinical investigators who have access to unpublished price sensitive information about pharmaceutical companies whose shares they trade in will almost certainly be in breach of the Company Securities (Insider Dealing) Act 1985. Furthermore, disclosing such information to third parties, they say, exposes those people also to potential criminal liability. Freestone and Mitchell advise that when potential for allegations of conflict of interest exists clinical investigators should consider declaring their position to ethics committees and any

  18. Inappropriate publication of trial results and potential for allegations of illegal share dealing.

    PubMed Central

    Freestone, D S; Mitchell, H

    1993-01-01

    There is increasing evidence of fraud in clinical research, and one aspect concerns trading in pharmaceutical company shares by people who may have confidential information about the results of clinical trials. Plainly this has implications for honest investigators, who may find themselves exposed to such allegations. In this paper Dr D S Freestone and Mr H Mitchell, QC, identify three interlinked issues which they think underlie the potential for these allegations. They are pressure for premature or inappropriate communication of research results; trading in pharmaceutical company shares by academic clinical investigators; and the possibility that clinical investigators might succumb to temptation. Dr Freestone and Mr Mitchell suggest that whenever possible results of clinical studies should be published in appropriate medical journals without prior public disclosure. This conflicts with Stock Exchange rules, which require that price sensitive information should be published at the earliest opportunity and preclude priority of publication in medical journals. Freestone and Mitchell believe that rarely rapid public disclosure is acceptable if it is to protect patients' interests but that it must not prejudice publication in the medical or scientific press. When rapid public disclosure is needed, they say, every attempt should be made to inform prescribers before patients. Dr Freestone and Mr Mitchell warn that academic clinical investigators who have access to unpublished price sensitive information about pharmaceutical companies whose shares they trade in will almost certainly be in breach of the Company Securities (Insider Dealing) Act 1985. Furthermore, disclosing such information to third parties, they say, exposes those people also to potential criminal liability. Freestone and Mitchell advise that when potential for allegations of conflict of interest exists clinical investigators should consider declaring their position to ethics committees and any

  19. 76 FR 8767 - Agency Information Collection Activities: e-Allegations Submission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-15

    ... Activities: e-Allegations Submission AGENCY: U.S. Customs and Border Protection, Department of Homeland... (OMB) for review and approval in accordance with the Paperwork Reduction Act: e- Allegations Submission.... Title: e-Allegations Submission. OMB Number: 1651-0131. Abstract: In the interest of detecting trade...

  20. False allegations of abuse and Munchausen syndrome by proxy.

    PubMed Central

    Meadow, R

    1993-01-01

    Fourteen children from seven families are reported for whom false allegations of abuse were made by the mother. Twelve children were alleged to have incurred sexual abuse, one both sexual and physical abuse, and one physical abuse alone. Thirteen of the children had incurred, or were currently victims of, factitious illness abuse invented by the mother. The one child with no history of factitious illness abuse had a sibling who had incurred definite factitious illness abuse. The false allegations of abuse did not occur in the context of parental separation, divorce, or custody disputes concerning the children. They occurred in the context of Munchausen syndrome by proxy abuse. The age of the children, 3 to 9 years, was older than the usual age for Munchausen syndrome by proxy abuse. The mother was the source of the false allegations and was the person who encouraged or taught six of the children to substantiate allegations of sexual abuse. PMID:8503664

  1. From Bolam-Bolitho to Modified-Montgomery - A Paradigm Shift in the Legal Standard of Determining Medical Negligence in Singapore.

    PubMed

    Neo, Han Yee

    2017-09-01

    In a recent landmark litigation, the Singapore Court of Appeal introduced a new legal standard for determining medical negligence with regards to information disclosure - the Modified-Montgomery test. This new test fundamentally shifts the legal position concerning the standard of care expected of a doctor when he dispenses medical advice. Previously, a doctor is expected to disclose what a "reasonable physician" would tell his patient. Now, a doctor must disclose "all material risks" that a "reasonable patient" would want to know under his unique circumstances. Patient-centred communication is no longer an aspirational ideal but has become a legal mandate. Manpower, administrative, logistic and medical educational reforms should start now, so as to support the average physician transit from the era of the Bolam-Bolitho, to that of the Modified-Montgomery.

  2. The differential diagnosis of ritual abuse allegations.

    PubMed

    Bernet, W; Chang, D K

    1997-01-01

    Because psychiatrists do not have a consistent way to classify and define the forms of child abuse that may be mistaken for ritual abuse, the objective of this paper is to create a comprehensive differential diagnosis of allegations of ritual abuse. The authors reviewed 60 articles, chapters, and books that contained allegations of ritual abuse or behaviors that might be mistaken for ritual abuse, that were made by patients or caretakers. This paper clarifies the behaviors that represent or may be mistaken for ritual abuse: Cult-based ritual abuse, pseudoritualistic abuse, activities by organized satanic groups, repetitive psychopathological abuse, sexual abuse by pedophiles, child pornography portraying ritual abuse, distorted memory, false memory, false report due to a severe mental disorder, pseudologia phantastica, adolescent behavior simulating ritual abuse, epidemic hysteria, deliberate lying, and hoaxes. The differential diagnosis of allegations of ritual abuse is important in both clinical and forensic psychiatry. In some cases, it will not be possible to tell whether a particular allegation is factual or what the underlying mental processes are. It is important to separate the role of the mental health professional as therapist from the role as an expert witness in court.

  3. 32 CFR 516.18 - Litigation alleging individual liability.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Litigation alleging individual liability. 516.18 Section 516.18 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Reporting Legal Proceedings to HQDA § 516.18 Litigation alleging...

  4. 32 CFR 516.18 - Litigation alleging individual liability.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 3 2011-07-01 2009-07-01 true Litigation alleging individual liability. 516.18 Section 516.18 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS LITIGATION Reporting Legal Proceedings to HQDA § 516.18 Litigation alleging...

  5. 22 CFR 92.27 - Affiant's allegations in affidavit.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Affiant's allegations in affidavit. 92.27... of his knowledge and belief. (3) If the allegations made on information and belief are material, the sources of information and grounds of belief should be set out and a good reason given why a positive...

  6. 22 CFR 92.27 - Affiant's allegations in affidavit.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Affiant's allegations in affidavit. 92.27... of his knowledge and belief. (3) If the allegations made on information and belief are material, the sources of information and grounds of belief should be set out and a good reason given why a positive...

  7. 22 CFR 92.27 - Affiant's allegations in affidavit.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Affiant's allegations in affidavit. 92.27... of his knowledge and belief. (3) If the allegations made on information and belief are material, the sources of information and grounds of belief should be set out and a good reason given why a positive...

  8. 22 CFR 92.27 - Affiant's allegations in affidavit.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Affiant's allegations in affidavit. 92.27... of his knowledge and belief. (3) If the allegations made on information and belief are material, the sources of information and grounds of belief should be set out and a good reason given why a positive...

  9. 22 CFR 92.27 - Affiant's allegations in affidavit.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... allegations: (1) Material facts within the personal knowledge of the affiant should be alleged directly and positively. Facts are not to be inferred where the affiant has it in his power to state them positively and... rather than on facts within his personal knowledge, he should aver that such matters are true to the best...

  10. Resolution of the Korean War biological warfare allegations.

    PubMed

    Leitenberg, M

    1998-01-01

    Recently acquired documents from the former Soviet Union prove that the accusations of United States use of biological weapons during the Korean conflict were fraudulent. The article discusses the history of the allegations of biological weapons use by the United States during the Korean conflict. It also considers the basis for making false allegations of biological weapons utilization.

  11. Allegations of children's involvement in ritual sexual abuse: clinical experience of 20 cases.

    PubMed

    Weir, I K; Wheatcroft, M S

    1995-04-01

    Twenty cases were evaluated in which allegations had been made of children being involved in ritual sexual abuse (RSA). A selection of case histories are presented together with a summary of the salient points in the other cases. Using a standard format developed for assessing the validity of allegations in sexual abuse cases, it was concluded that false allegations of ritual sexual abuse occurred in three-quarters of the cases and true allegations only in one-quarter. This high rate of false allegations is unlike the author's clinical experience in other cases of child sexual abuse where the rate of false allegations is much lower and similar to other published series. Reasons for the high rate of false allegations are discussed.

  12. Beyond Munchausen by proxy: a proposed conceptualization for cases of recurring, unsubstantiated sexual abuse allegations.

    PubMed

    Lindahl, Mary W

    2009-01-01

    In the emerging literature, cases involving recurring, unsubstantiated allegations of child sexual abuse have generally been categorized as Munchausen by proxy. Recent scholars have recommended restricting the label to the original conceptualization, involving purposeful deception motivated by psychological needs for medical attention. This leaves many cases unclassified that do not fit the Munchausen by proxy criteria, involve significant risks to the child, and ultimately fall outside of existing structures for Child Protective Services/legal intervention. This paper presents a reconceptualization of such cases, proposing to label them "recurring sexual abuse allegation" cases. Defining the set of cases more clearly can aid child protection workers in their management and encourage research on prevalence, consequences to children, treatment strategies, and needed legal reforms.

  13. Forensic evaluation in alleged sibling incest against children.

    PubMed

    Falcão, Vera; Jardim, Patrícia; Dinis-Oliveira, Ricardo Jorge; Magalhães, Teresa

    2014-01-01

    Sibling incest is a serious form of intrafamilial sexual abuse with health, social, and legal relevance. A retrospective study was conducted through the analysis of forensic medical reports of the alleged sibling incest of victims under 18 years old (n = 68) from 2004 to 2011 as well as the respective judicial outcomes. Results demonstrated that sibling's sexual abuse is associated with several circumstances that might exacerbate its severity such as vaginal, anal, and/or oral penetration. Moreover, the victim's young age, the proximity between victim and abuser, and the fact that it is committed at the victim's and/or abuser's home and by using physical violence and verbal threats justify a late detection of these cases.

  14. OBLIGING SURGEONS TO ENHANCE: NEGLIGENCE LIABILITY FOR UNCORRECTED FATIGUE AND PROBLEMS WITH PROVING CAUSATION.

    PubMed

    Goold, Imogen; Maslen, Hannah

    2015-01-01

    Increasing interest in the use of cognitive enhancing pharmaceuticals, such as modafinil, has led to considerable ethical debate about issues around authenticity, fairness and even whether there is a moral obligation to enhance. This latter question has raised questions as to whether there might be a legal obligation to enhance. We have argued elsewhere that the law will not oblige a professional to self-enhance. In this article, we explore a second reason why a claim of negligence for a failure to enhance would be unlikely to succeed: the problem of establishing causation. As the science on enhancers and what they are capable of currently stands, it would be almost invariably impossible to establish a causal link between failure to enhance to redress fatigue, and the harm that allegedly resulted. Even where a link between fatigue and harm can be established, it will be extremely difficult to show that taking an enhancer would have averted the harm. We focus on the most likely context in which such claims might arise--clinical negligence--and on the most efficacious enhancing drug currently available-modafinil. © The Author 2014. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. Sports physicians, ethics and antidoping governance: between assistance and negligence.

    PubMed

    Dikic, Nenad; McNamee, Michael; Günter, Heinz; Markovic, Snezana Samardzic; Vajgic, Bojan

    2013-07-01

    Recent positive doping cases and a series of mistakes of medical doctors of the International Federation of Basketball have reopened the debate about the role of medical doctor in elite sport. This study shows that some sports physicians involved in recent positive doping cases are insufficiently aware of the nuances of doping regulations and, most importantly, of the list of prohibited substances. Moreover, several team doctors are shown to have exercised poor judgement in relation to these matters with the consequence that athletes are punished for doping offences on the basis of doctors' negligence. In such circumstances, athletes' rights are jeopardised by a failure of the duty of care that (sports) physicians owe their athlete patients. We argue that, with respect to the World Anti Doping Code, antidoping governance fails to define, with sufficient clarity, the role of medical doctors. There is a need for a new approach emphasising urgent educational and training of medical doctors in this domain, which should be considered prior to the revision of the next World Anti Doping Code in 2013 in order to better regulate doctor's conduct especially in relation to professional errors, whether negligent or intentional.

  16. The medical and scientific evidence in alleged tubocurarine poisonings. A review of the so-called Dr. X case.

    PubMed

    Siegel, H; Rieders, F; Holmstedt, B

    1985-01-01

    The problem of proving the presence or absence of a poison in a buried cadaver is the central theme of this presentation. Certain general questions are posed which may serve to guide those seeking to determine the cause of death in buried cadavers and allegedly due to a poison. Medicolegal and scientific evidence is presented from the court records of five deaths which were alleged homicides due to intravenous tubocurarine. As to the medical evidence: The prosecution claimed absence of adequate medical causes but full congruence with intravenous tubocurarine as the cause of death. The defense claimed and presented its evidence, including history, clinical picture, gross and microscopic pathological findings--for the deaths having occurred from competent natural causes in all but one case. In that one case the cause was undetermined. In two of the four cases evidence was presented for the mechanism of death and why they died at the time that they did. As to the forensic toxicological evidence: The prosecution claimed qualitative identification but with no particular quantitative detection or identification limits of tubocurarine in the remains based on results of combinations of HPLC followed by RIA and of some selected ion direct inlet mass spectrometry. The defense corroborated--along with a quantitative estimate--the presence of a substantial concentration of tubocurarine in the liver specimen of one case. However the chain of custody of this particular specimen was compromised for a period of several days between post-exhumation autopsy and submission to the prosecution toxicologists. With respect to all the other specimens examined by the defense, direct inlet mass spectrometry failed to show ions which are critical for establishing the identity of tubocurarine. The defense also presented results of experiments which showed that the tissues of the cases in question destroyed tubocurarine at such a rate that no reasonably conceivable administered amount could

  17. 40 CFR 717.10 - Allegations subject to this part.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... REACTIONS TO HEALTH OR THE ENVIRONMENT General Provisions § 717.10 Allegations subject to this part. (a... 40 Protection of Environment 31 2014-07-01 2014-07-01 false Allegations subject to this part. 717.10 Section 717.10 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC...

  18. Effectiveness of Child Advocacy Centers and the multidisciplinary team approach on prosecution rates of alleged sex offenders and satisfaction of non-offending caregivers with allegations of child sexual abuse: a systematic review.

    PubMed

    Nwogu, Ngozi N; Agrawal, Lynet; Chambers, Stephanie; Buagas, Archiel B; Daniele, Rose Mary; Singleton, Joanne K

    2016-01-15

    Child sexual abuse is a multifaceted issue that negatively affects the lives of millions of children worldwide. These children suffer numerous medical and psychological long-term adverse effects both in childhood and adulthood. It is imperative to implement evidence- based interventions for the investigation of this crime. The use of Child Advocacy Centers and the multidisciplinary team approach may improve the investigation of child sexual abuse. To evaluate the effectiveness of Child Advocacy Centers and the multidisciplinary team approach on prosecution rates of alleged sex offenders and satisfaction of non-offending caregivers of children less than 18 years of age, with allegations of child sexual abuse. Children under 18 years, of any race, ethnicity or gender with allegations of child sexual abuse. Other participants included in this review are non-offending caregivers of children with allegations of child sexual abuse, and alleged sex offenders. Type of intervention : The use of Child Advocacy Centers and the multidisciplinary team approach on child sexual abuse investigations. Types of outcomes : Prosecution rates of alleged sex offenders and the satisfaction of non-offending caregivers of children with allegations of child sexual abuse. Types of studies: This review includes quasi-experimental and descriptive studies. The search strategy aimed to find published and unpublished articles in the English language published from 1985 through April 2015 for inclusion. The databases searched include: PubMed, CINAHL, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), Health Source: Nursing/Academic Edition, Criminal Justice Periodicals, ProQuest Dissertations & Theses and Criminal Justice Collections. An additional grey literature search was conducted. Two reviewers evaluated the included studies for methodological quality using standardized critical appraisal instruments from the Joanna Briggs Institute. Data were extracted using

  19. True and False Allegations of Child Sexual Abuse: Assessment and Case Management.

    ERIC Educational Resources Information Center

    Ney, Tara, Ed.

    This book addresses the clinical, legal, and ethical issues arising in child sexual abuse cases; the assessment and case management of allegations; research issues; and practice recommendations. Chapter titles are as follows: "Assessing Allegations in Child Sexual Abuse: An Overview" (Tara Ney); "The Nature of Allegations of Child…

  20. Court decisions on medical malpractice.

    PubMed

    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

  1. Negligent Liability of College Counselors

    ERIC Educational Resources Information Center

    Sampson, James P., Jr.

    1977-01-01

    Discusses college counselors' liability for negligence in the performance of their duties, citing the only two court decisions involving college counselor negligence. Summarizes the circumstances in which college counselors may or may not be held negligent, and identifies present and future trends in counselor liability. (JG)

  2. The Essential Need for Research Misconduct Allegation Audits.

    PubMed

    Loikith, Lisa; Bauchwitz, Robert

    2016-08-01

    Nearly 90 % of allegations of biomedical research misconduct in the United States are dismissed by responsible institutions without any faculty assessment or auditable record. Recently, members of the U.S. Congress have complained that the penalties for those against whom findings of research misconduct are made are too light and that too few grant funds associated with research misconduct have been recovered for use by other researchers and taxpayers. Here we discuss the laws that empower federal agencies that can oversee investigations of biomedical research misconduct: the Office of Research Integrity (ORI) and the Office of the Inspector General (OIG), both located within the Department of Health and Human Services (HHS). Research misconduct investigations pertaining to U.S. physical sciences funded through the National Science Foundation (NSF) are overseen by the NSF's OIG. While OIGs may provide some improvement over the ORI in the handling of research misconduct, we have found that a much more serious flaw exists which undermines an ability to conduct performance audits of the effectiveness by which allegations of research misconduct are handled in the United States. Specifically, sufficient data do not need to be retained by U.S. research institutions funded by HHS or NSF to allow effective audit of why allegations of research misconduct are dismissed before being seen by faculty inquiry or investigative committees. U.S. federal Generally Accepted Government Auditing Standards (GAGAS/Yellow Book), if applied to the research misconduct oversight process, would allow a determination of whether the handling of allegations of biomedical research misconduct actually functions adequately, and if not, how it might be improved. In particular, we propose that independent, external peer review under GAGAS audit standards should be instituted without delay in assessing the performance of ORI, or any other similarly tasked federal agency, in handling allegations of

  3. 46 CFR 5.29 - Negligence.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Negligence. 5.29 Section 5.29 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE INVESTIGATION REGULATIONS-PERSONNEL ACTION Definitions § 5.29 Negligence. Negligence is the commission of an act which a reasonable...

  4. Clinical negligence and duty of candour.

    PubMed

    Shekar, Vinita; Singh, Mark; Shekar, Kishore; Brennan, Peter

    2011-12-01

    The Department of Health is considering imposing a legal duty of candour on health care providers to ensure that an apology and explanation are given to patients when errors occur during medical treatment. This aims to improve quality of care and reduce adverse events during medical treatment. We present the current system of clinical negligence and the future of medical ethics. We discuss relevant cases with regard to duty of candour, and highlight the existence of serious imbalances in which patients' rights and corresponding ethical duties of professionals predominate over the responsibilities of patients themselves. It is known that most adverse events arise because of multiple factors for which no individual should be blamed. To improve healthcare services there is a need for a system in which lessons can be learnt from mistakes, and services can be improved in the interest of patient safety, and for transparency in the broad principles on which the decisions are based within which clinical performance is supervised and monitored. Copyright © 2010 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Negligence and Athletic Events.

    ERIC Educational Resources Information Center

    Mawdsley, Ralph D.

    2001-01-01

    Although athletic events generate their share of negligence lawsuits, the relatively small number, compared with other education areas, suggests that defenses (like assumption or risk and contributory negligence) have a better fit in athletics. Implications of newer litigation trends involving coaches' misconduct and interpretation of state…

  6. Interviewing Youthful Suspects in Alleged Sex Crimes: A Descriptive Analysis

    ERIC Educational Resources Information Center

    Hershkowitz, Irit; Horowitz, Dvora; Lamb, Michael E.; Orbach, Yael; Sternberg, Kathleen J.

    2004-01-01

    Objective: To introduce and evaluate a structured interview protocol designed for investigative interviews of youthful alleged perpetrators of child sexual abuse. Method: Seventy-two alleged perpetrators ranging from 9 to 14 years of age (M=12 years) were interviewed by 1 of 13 experienced youth investigators, employed by the Israeli Ministry of…

  7. An investigation into alleged 'hauntings'.

    PubMed

    Wiseman, Richard; Watt, Caroline; Stevens, Paul; Greening, Emma; O'Keeffe, Ciarán

    2003-05-01

    In cases of alleged hauntings, a large number of seemingly trustworthy witnesses consistently report experiencing unusual phenomena (e.g. apparitions, sudden changes in temperature, a strong sense of presence) in certain locations. The two studies reported here explored the psychological mechanisms that underlie this apparent evidence of 'ghostly' activity. The experiments took place at two locations that have a considerable reputation for being haunted-Hampton Court Palace (Surrey, England) and the South Bridge Vaults (Edinburgh, Scotland). Both studies involved participants walking around these locations and reporting where they experienced unusual phenomena. Results revealed significantly more reports of unusual experiences in areas that had a reputation for being haunted. This effect was not related to participants' prior knowledge about the reputation of these areas. However, the location of participants' experiences correlated significantly with various environmental factors, including, for example, the variance of local magnetic fields and lighting levels. These findings strongly suggest that alleged hauntings may not necessarily represent evidence for 'ghostly' activity, but could be, at least in part, the result of people responding to 'normal' factors in their surroundings.

  8. 29 CFR 1626.4 - Information concerning alleged violations of the Act.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 4 2014-07-01 2014-07-01 false Information concerning alleged violations of the Act. 1626.4 Section 1626.4 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES-AGE DISCRIMINATION IN EMPLOYMENT ACT § 1626.4 Information concerning alleged violations...

  9. 29 CFR 1626.4 - Information concerning alleged violations of the Act.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Information concerning alleged violations of the Act. 1626.4 Section 1626.4 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES-AGE DISCRIMINATION IN EMPLOYMENT ACT § 1626.4 Information concerning alleged violations...

  10. 29 CFR 1626.4 - Information concerning alleged violations of the Act.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 4 2013-07-01 2013-07-01 false Information concerning alleged violations of the Act. 1626.4 Section 1626.4 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES-AGE DISCRIMINATION IN EMPLOYMENT ACT § 1626.4 Information concerning alleged violations...

  11. 29 CFR 1626.4 - Information concerning alleged violations of the Act.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 4 2011-07-01 2011-07-01 false Information concerning alleged violations of the Act. 1626.4 Section 1626.4 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES-AGE DISCRIMINATION IN EMPLOYMENT ACT § 1626.4 Information concerning alleged violations...

  12. 29 CFR 1626.4 - Information concerning alleged violations of the Act.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 4 2012-07-01 2012-07-01 false Information concerning alleged violations of the Act. 1626.4 Section 1626.4 Labor Regulations Relating to Labor (Continued) EQUAL EMPLOYMENT OPPORTUNITY COMMISSION PROCEDURES-AGE DISCRIMINATION IN EMPLOYMENT ACT § 1626.4 Information concerning alleged violations...

  13. Reassessment of the NRC`s program for protecting allegers against retaliation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    1994-01-01

    On July 6, 1993, the Nuclear Regulatory Commission`s (NRC`s) Executive Director for Operations established a review team to reassess the NRC`s program for protecting allegers against retaliation. The team evaluated the current system, and solicited comments from various NRC offices, other Federal agencies, licensees, former allegers, and the public. This report is subject to agency review. The report summarizes current processes and gives an overview of current problems. It discusses: (1) ways in which licensees can promote a quality-conscious work environment, in which all employees feel free to raise concerns without fear of retaliation; (2) ways to improve the NRC`smore » overall handling of allegations; (3) the NRC`s involvement in the Department of Labor process; (4) related NRC enforcement practices; and (5) methods other than investigation and enforcement that may be useful in treating allegations of potential or actual discrimination. Recommendations are given in each area.« less

  14. Negligent exposures to hand-transmitted vibration.

    PubMed

    Griffin, Michael J

    2008-04-01

    If the negligence of an employer results in the disability in an employee, the employer is responsible, in whole or in part, for the disability. The employer is wholly responsible when the worker would not have developed the disability if the employer had taken all reasonable preventative measures. The employer is only partly responsible if the worker would probably have developed some disability even if the employer had taken all reasonable precautions. The employer's responsibility may be estimated from the difference between the actual disability of the worker and the disability that the worker would have suffered if the employer had taken all reasonable preventative measures. This paper considers alternative ways of apportioning negligent and non-negligent exposures to hand-transmitted vibration. The equivalent daily vibration exposure, A(8), used in current EU Directives is shown to be unsuitable for distinguishing between the consequences of negligent and non-negligent exposures because the risks of developing a disorder from hand-transmitted vibration also depend on the years of exposure. Furthermore, daily exposures take no account of individual susceptibility or the practicality of reducing exposure. The consequences of employer negligence may be estimated from the delay in the onset and progression of disorder that would have been achieved if the employer had acted reasonably, such as by reducing vibration magnitude and exposure duration to the minimum that was reasonably achievable in the circumstances. This seems to be fair and reasonable for both employers and employees and indicates the consequences of negligence-the period of the worker's life with disease as a result of negligence and the period for which their employment opportunities may be restricted as a result of the onset of the disorder due to negligence. The effects of negligence may be estimated from the delay in the onset of disease or disability that would have occurred if the employer

  15. 25 CFR 42.3 - How should a school address alleged violations of school policies?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false How should a school address alleged violations of school... RIGHTS § 42.3 How should a school address alleged violations of school policies? (a) In addressing alleged violations of school policies, each school must consider, to the extent appropriate, the...

  16. 25 CFR 42.3 - How should a school address alleged violations of school policies?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false How should a school address alleged violations of school... RIGHTS § 42.3 How should a school address alleged violations of school policies? (a) In addressing alleged violations of school policies, each school must consider, to the extent appropriate, the...

  17. 75 FR 45685 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Notice of Filing of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-03

    ... list (see current List 7 titled Misrepresentation/Omissions, List 9 titled Negligence/Breach of... claims alleging misrepresentation/ omissions (see current List 8, Item 1), negligence/breach of fiduciary... claims alleging misrepresentation/ omission (see current List 8, Item 2), negligence/breach of fiduciary...

  18. Negligence in Defamation before "Gertz."

    ERIC Educational Resources Information Center

    Stevens, George E.

    1979-01-01

    Discusses negligence in defamation cases before the United States Supreme Court's decision in "Gertz v Robert Welch, Inc."; shows that courts have varied in what actions by reporters and editors they have considered negligent. (GT)

  19. Clinical Correlates of Alleged Satanic Abuse and Less Controversial Sexual Molestation.

    ERIC Educational Resources Information Center

    Leavitt, Frank

    1994-01-01

    This study found that 39 women alleging satanic ritual abuse and 47 women reporting less controversial forms of sexual trauma as children were characterized by high but nondiscriminating levels of psychiatric pathology. Patients alleging satanic ritual abuse reported higher levels of dissociation, in the range often exhibited by patients with…

  20. Characteristics of alleged homicide offenders with and without schizophrenia in Sichuan, China.

    PubMed

    Chen, Xiacan; Zhang, Xueli; Wong, Stephen C P; Yang, Min; Kong, Di; Hu, Junmei

    2018-04-01

    Little is known about the characteristics of people with and without schizophrenia who have been charged with homicide in China. Our research question was what differences are there between alleged homicide offenders with and without psychosis? All archival records of alleged homicide cases referred for assessment to the West China Forensic Central Medical Service during 1998-2006 were retrieved. The centre serves a large catchment area in the mainly rural province of Sichuan. A random 20% of cases with schizophrenia and all cases without psychosis were selected for comparison. Demographic, criminological and mental health data were extracted from the records, and violence was rated by using the Violence Risk Scale (Chinese version). The two groups differed significantly in age, education, occupation, marital status and relationships to victim. The estimated risk of reoffending was higher in the schizophrenia group than the non-psychotic group, even after controlling for demographic differences. Despite many individuals reporting long histories of mental illness, about 40% of those with schizophrenia had never had any psychiatric treatment and less than 4% were in treatment at the time of the alleged homicide. The tendency for homicidal people with schizophrenia to be older, less educated and more socially isolated than their non-psychotic peers is similar to experience in Western countries, but the apparently higher risk scale scores of the Chinese schizophrenia group and their greater tendency to attack strangers are different. The lack of reported previous engagement with mental health services by a clearly ill and risky group of people is a likely explanation. Similar rural problems compared with better served urban areas have been reported in the Chuvash Republic. The case for better rural mental health services seems strong. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  1. Department of Energy: Allegations about the Director of the Office of Minority Economic Impact

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    1986-01-01

    Rosslee G. Douglas was nominated to be Director of the Office of Minority Economic Impact in March 1981. She requested a reorganization (proposed reduction in force) of her office May 1985. Shortly after she proposed the RIF, allegations were made that the purpose of her proposal was to get rid of two employees whom she did not trust. Other allegations were made against Mrs. Douglas, including allegations that she abused travel, telephone, and Department of Energy motor pool privileges, and that she engaged in illegal contracting practices. GAO found support for some of the allegations regarding the proposed RIF.

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

    PubMed

    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

  3. Plato alleges that God forever geometrizes

    NASA Astrophysics Data System (ADS)

    Ne'Eman, Yuval

    1996-05-01

    Since 1961, the experimental exploration at the fundamental level of physical reality has surprised physists by revealing to them a highly geometric scenery. Like Einstein's (classical) theory of gravity, the “standard model,” describing the strong, weak, and electromagnetic interaction, testifies in favor of Plato's reported allegation.

  4. 7 CFR 276.3 - Negligence or fraud.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Negligence or fraud. 276.3 Section 276.3 Agriculture... Negligence or fraud. (a) General. If FNS determines that there has been negligence or fraud on the part of..., pay to FNS a sum equal to the amount of coupons issued as a result of such negligence or fraud. (b...

  5. Alleged sexual abuse at a day care center: impact on parents.

    PubMed

    Dyb, Grete; Holen, Are; Steinberg, Alan M; Rodriguez, Ned; Pynoos, Robert S

    2003-08-01

    This report describes the cascade of stressful events and secondary life changes experienced by parents in a case of alleged sexual abuse at a day care program. The study evaluated parents' Posttraumatic Stress Disorder (PTSD) symptoms and general psychological responses to the stressful events 4 years after the alleged abuse, and explored predictive factors of parental distress. A total of 39 parents were interviewed about stressful events, life changes, and social support. Current distress reactions, psychological wellbeing, and locus of control were assessed with a battery of standardized measures. Hearing about the sexual abuse, testifying in court, hearing the verdict, and being exposed in media reports were all rated by the parents as distressing events. The majority of the parents experienced secondary life changes after the alleged sexual abuse. Four years after the alleged sexual abuse, one-third of the parents reported a high level of PTSD Intrusive symptoms and one-fourth reported a high level of PTSD Avoidance symptoms. There was a significant positive correlation between a measure of psychological wellbeing and PTSD. Secondary life changes and locus of control significantly predicted PTSD. This study demonstrates that the alleged sexual abuse of children in day care and the resulting events in the legal system and the media constitute significant and chronic stressors in the lives of the children's parents. These findings underscore the need to expand the focus of trauma-related sequelae from the child victim to their parents and family.

  6. Toward safer practice in otology: a report on 15 years of clinical negligence claims.

    PubMed

    Mathew, Rajeev; Asimacopoulos, Eleni; Valentine, Peter

    2011-10-01

    To determine the characteristics of medical negligence claims arising from otological practice. Retrospective analysis of medical negligence claims contained in the National Health Service Litigation Authority (NHSLA) database. Claims relating to otology and neurotology between 1995 and 2010 were obtained from the NHSLA database and analyzed for cause of injury, type of injury, outcome of claim and costs. Over 15 years there were 137 claims in otology, representing 26% of all the claims in otolaryngology. Of these, 116 have been closed, and 84% of closed claims resulted in payment. Of the 97 successful claims, 63 were related to operative complications. This included six cases of wrong side/site surgery, and 15 cases of inadequate informed consent. The most common injuries claimed were hearing loss, facial paralysis, and additional/unnecessary surgery. Middle ear ventilation and mastoid surgery were the procedures most commonly associated with a successful claim. There were 15 successful claims of misdiagnosis/delayed diagnosis, with chronic suppurative otitis media the condition most frequently missed. There were nine successful claims related to outpatient procedures, of which seven were for aural toilet and six claims of medical mismanagement, including three cases of ototoxicity from topical medications. There were also four successful claims for morbidity due to delayed surgery. This is the first study to report outcomes of negligence claims in otology. Claims in otology are associated with a high success rate. A significant proportion of claims are not related to surgery and represent areas where safety should also be addressed. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

  7. Informed consent: a socio-legal study.

    PubMed

    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.

  8. Do Allegations of Emotional Maltreatment Predict Developmental Outcomes beyond that of Other Forms of Maltreatment?

    ERIC Educational Resources Information Center

    Schneider, M.W.; Ross, A.; Graham, J.C.; Zielinski, A.

    2005-01-01

    Objectives:: To understand the features of child abuse/neglect (CA/N) allegations in cases with emotional maltreatment (EMT) allegations, as well as the features of the EMT allegations themselves, and to describe any associations of EMT with distinct impairments of children's behavior, emotion and functioning. Method:: The sample consisted of 806…

  9. Safety Tips: Avoiding Negligence Suits in Chemistry Teaching.

    ERIC Educational Resources Information Center

    Gerlovich, Jack A.

    1983-01-01

    Discusses various aspects related to negligence on the part of chemistry teachers. Areas addressed include negligence in tort law, avoiding negligence suits, proper instructions, proper supervision, equipment maintenance, and other considerations such as sovereign immunity, and contributory versus comparative negligence. (JN)

  10. Assessing Historical Abuse Allegations and Damages

    ERIC Educational Resources Information Center

    Wolfe, David A.; Jaffe, Peter G.; Leschied, Alan W.; Legate, Barbara L.

    2010-01-01

    Practitioners may be called upon to assess adults who have alleged child abuse as a minor and are seeking reparations. Such assessments may be used by the courts to determine harm and assess damages related to their claim or testimony. Our clinical/research team has conducted many such evaluations and reported the findings pertaining to the…

  11. 25 CFR 11.1014 - Medical examination.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false Medical examination. 11.1014 Section 11.1014 Indians... ORDER CODE Juvenile Offender Procedure § 11.1014 Medical examination. The children's court may order a medical examination for a minor who is alleged to be a juvenile offender. ...

  12. 25 CFR 11.1014 - Medical examination.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true Medical examination. 11.1014 Section 11.1014 Indians... ORDER CODE Juvenile Offender Procedure § 11.1014 Medical examination. The children's court may order a medical examination for a minor who is alleged to be a juvenile offender. ...

  13. 25 CFR 11.1014 - Medical examination.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false Medical examination. 11.1014 Section 11.1014 Indians... ORDER CODE Juvenile Offender Procedure § 11.1014 Medical examination. The children's court may order a medical examination for a minor who is alleged to be a juvenile offender. ...

  14. 25 CFR 11.1014 - Medical examination.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Medical examination. 11.1014 Section 11.1014 Indians... ORDER CODE Juvenile Offender Procedure § 11.1014 Medical examination. The children's court may order a medical examination for a minor who is alleged to be a juvenile offender. ...

  15. 25 CFR 11.1014 - Medical examination.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false Medical examination. 11.1014 Section 11.1014 Indians... ORDER CODE Juvenile Offender Procedure § 11.1014 Medical examination. The children's court may order a medical examination for a minor who is alleged to be a juvenile offender. ...

  16. Report on FAA's Alleged Discrimination Against White Males

    DOT National Transportation Integrated Search

    1996-11-08

    This report responds to a complaint received by the Office of Inspector General (OIG), Department of Transportation (DOT), alleging the Federal Aviation Administration (FAA) discriminated against white males, wasted funds, and compromised safety.

  17. Contributory Negligence. Law and the School Principal

    ERIC Educational Resources Information Center

    Walden, John C.

    1974-01-01

    One of the most frequently used legal defenses against the charge that a school employee or district has been negligent is contributory negligence. Contributory negligence means that the injured person failed to exercise the required standard of care for his own safety and, therefore, contributed to his own injury. (Author/WM)

  18. ADA Title I allegations and the Mining, Quarrying, and Oil/Gas Extraction industry.

    PubMed

    Van Wieren, Todd A; Rhoades, Laura; McMahon, Brian T

    2017-01-01

    The majority of research about employment discrimination in the U.S. Mining, Quarrying, and Oil/Gas (MQOGE) industries has concentrated on gender and race, while little attention has focused on disability. To explore allegations of Americans with Disabilities Act (ADA) Title I discrimination made to the Equal Employment Opportunity Commission (EEOC) by individuals with disabilities against MQOGE employers. Key data available to this study included demographic characteristics of charging parties, size of employers, types of allegations, and case outcomes. Using descriptive analysis, allegation profiles were developed for MQOGE's three main sectors (i.e., Oil/Gas Extraction, Mining except Oil/Gas, and Support Activities). These three profiles where then comparatively analyzed. Lastly, regression analysis explored whether some of the available data could partially predict MQOGE case outcomes. The predominant characteristics of MQOGE allegations were found to be quite similar to the allegation profile of U.S. private-sector industry as a whole, and fairly representative of MQOGE's workforce demographics. Significant differences between MQOGE's three main sector profiles were noted on some important characteristics. Lastly, it was found that MQOGE case outcomes could be partially predicted via some of the available variables. The study's limitations were presented and recommendations were offered for further research.

  19. 42 CFR 93.402 - ORI allegation assessments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false ORI allegation assessments. 93.402 Section 93.402 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES ON...

  20. An Update on Negligence. A Legal Memorandum.

    ERIC Educational Resources Information Center

    Gluckman, Ivan

    This newsletter defines common law negligence, discusses recent trends in common law negligence, cites litigation, and establishes guidelines to assist school administrators in the avoidance of such tort action. The success or failure of a negligence suit most commonly turns on one of three factors: duty, breach of that duty, and proximate cause…

  1. 25 CFR 42.5 - When can a school use ADR processes to address an alleged violation?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false When can a school use ADR processes to address an alleged... RIGHTS § 42.5 When can a school use ADR processes to address an alleged violation? (a) The school may address an alleged violation through the ADR processes described in § 42.4, unless one of the conditions...

  2. 25 CFR 42.5 - When can a school use ADR processes to address an alleged violation?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false When can a school use ADR processes to address an alleged... RIGHTS § 42.5 When can a school use ADR processes to address an alleged violation? (a) The school may address an alleged violation through the ADR processes described in § 42.4, unless one of the conditions...

  3. 25 CFR 42.5 - When can a school use ADR processes to address an alleged violation?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... school must address alleged violations through the formal disciplinary proceeding described in § 42.8. ... 25 Indians 1 2013-04-01 2013-04-01 false When can a school use ADR processes to address an alleged... RIGHTS § 42.5 When can a school use ADR processes to address an alleged violation? (a) The school may...

  4. 25 CFR 42.5 - When can a school use ADR processes to address an alleged violation?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... school must address alleged violations through the formal disciplinary proceeding described in § 42.8. ... 25 Indians 1 2014-04-01 2014-04-01 false When can a school use ADR processes to address an alleged... RIGHTS § 42.5 When can a school use ADR processes to address an alleged violation? (a) The school may...

  5. 25 CFR 42.5 - When can a school use ADR processes to address an alleged violation?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... school must address alleged violations through the formal disciplinary proceeding described in § 42.8. ... 25 Indians 1 2012-04-01 2011-04-01 true When can a school use ADR processes to address an alleged... RIGHTS § 42.5 When can a school use ADR processes to address an alleged violation? (a) The school may...

  6. Impact of miscommunication in medical dispute cases in Japan.

    PubMed

    Aoki, Noriaki; Uda, Kenji; Ohta, Sachiko; Kiuchi, Takahiro; Fukui, Tsuguya

    2008-10-01

    Medical disputes between physicians and patients can occur in non-negligent circumstances and may even result in compensation. We reviewed medical dispute cases to investigate the impact of miscommunication, especially in non-negligent situations. Systematic review of medical dispute records was done to identify the presence of the adverse events, the type of medical error, preventability, the perception of miscommunication by patients and the amount of compensation. The study was performed in Kyoto, Japan. We analyzed 155 medical dispute cases. We compared (i) frequency of miscommunication cases between negligent and non-negligent cases, and (ii) proportions of positive compensation between non-miscommunication and miscommunication cases stratified according to the existence of negligence. Multivariate logistic analysis was conducted to assess the independent factors related to positive compensation. Approximately 40% of the medical disputes (59/155) did not involve medical error (i.e. non-negligent). In the non-negligent cases, 64.4% (38/59) involved miscommunication, whereas in dispute cases with errors, 21.9% (21/96) involved miscommunications. (P negligent dispute cases were compensated (94/96), the frequency of positive compensation in non-negligent cases was significantly higher if miscommunication was perceived: 78.9% (30/38) with miscommunication and 52.4% (11/21) with non-miscommunication (P < 0.05). The presence of medical error and patients' perception of miscommunication were important predictors of positive compensation (odds ratio: 36.9 and 3.6, respectively.) Medical disputes can occur without negligence and may have costly consequences. Medical staffs need to understand that not only the 'presence of medical errors', but also 'patients' perception of miscommunication', especially in cases with a non-negligent adverse event, can cause serious medical disputes. To prevent future disputes or claims, there is a strong

  7. Educational Negligence Suits.

    ERIC Educational Resources Information Center

    Tracy, Destin Shann

    1980-01-01

    Reviews recent cases on educational malpractice, examines the case a student would have to make to succeed in court, reviews three policy factors that limit the effectiveness of negligence claims, and proposes limitations on an educational malpractice cause of action. (IRT)

  8. 77 FR 14490 - Defense Federal Acquisition Regulation Supplement: Alleged Crimes By or Against Contractor...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-12

    ... Federal Acquisition Regulation Supplement: Alleged Crimes By or Against Contractor Personnel (DFARS Case... (DFARS) to expand coverage on contractor requirements and responsibilities relating to alleged crimes by or against contractor personnel. DATES: Comment Date: Comments on the proposed rule should be...

  9. Suggestibility and compliance among alleged false confessors and resisters in criminal trials.

    PubMed

    Gudjonsson, G H

    1991-04-01

    This paper describes a study which compares the interrogative suggestibility and compliance scores of 20 alleged false confessors and 20 subjects who had persistently denied their involvement in the crime they were charged with in spite of forensic evidence against them (labelled 'resisters'). The two groups were 'matched' for age, sex, intelligence, memory recall capacity, and the seriousness of the offence. It was hypothesized that the resisters would score significantly lower on tests of suggestibility and compliance than the alleged false confessors. The findings were confirmed at a high level of significance. A separate analysis of 14 resisters and 72 alleged false confessors, where IQ and memory were used as covariates rather than 'matching' the two groups on the relevant variables, gave almost identical results. The clinical implications of the findings are discussed.

  10. 28 CFR 115.68 - Post-allegation protective custody.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Post-allegation protective custody. 115.68 Section 115.68 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Adult Prisons and Jails Official Response Following An Inmate...

  11. 28 CFR 115.68 - Post-allegation protective custody.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Post-allegation protective custody. 115.68 Section 115.68 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Adult Prisons and Jails Official Response Following An Inmate...

  12. 28 CFR 115.68 - Post-allegation protective custody.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Post-allegation protective custody. 115.68 Section 115.68 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Adult Prisons and Jails Official Response Following An Inmate...

  13. 40 CFR 717.10 - Allegations subject to this part.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... REACTIONS TO HEALTH OR THE ENVIRONMENT General Provisions § 717.10 Allegations subject to this part. (a... writing and signed. (2) Implicate a substance that caused the stated significant adverse reaction by one...

  14. 40 CFR 717.10 - Allegations subject to this part.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... REACTIONS TO HEALTH OR THE ENVIRONMENT General Provisions § 717.10 Allegations subject to this part. (a... writing and signed. (2) Implicate a substance that caused the stated significant adverse reaction by one...

  15. Psychological aspects of sexual functioning among cleric and noncleric alleged sex offenders.

    PubMed

    Haywood, T W; Kravitz, H M; Grossman, L S; Wasyliw, O E; Hardy, D W

    1996-06-01

    Cleric sexual misconduct with minors is a problem receiving increased attention from the media, victims groups, and church authorities. Mental health professionals are increasingly being asked to assist church and civil authorities to help better understand the problem of cleric sexual misconduct with minors. In the current study we compared self-reported sexual functioning among cleric alleged child molesters, noncleric alleged child molesters, and normal control subjects. We hypothesized clerics would differ from nonclerics and normals in reported sexual functioning. Our sample included 30 Roman Catholic clerics and 39 nonclerics who were alleged to have engaged in sexual misconduct with minors, and 38 normal control subjects, all of whom took the Derogatis Sexual Functioning Inventory (DSFI) as part of their forensic psychiatric evaluation. Our results indicated clerics were more likely to report fewer victims, older victims, and victims of male gender than noncleric alleged child molesters. Clerics differed from nonclerics and normal control subjects on several dimensions of self-reported sexual functioning. Lower offense rate histories among clerics suggest that, as a group, clerics may be less seriously psychologically disordered than noncleric child molesters. Low DSFI scores among Roman Catholic clerics may be accounted for in part by their unique training and socialization process. Future studies should attempt to study the influence of social desirability on DSFI scores. Normative data from nonoffending celibate clergy are needed.

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

    PubMed Central

    Otaki, Yasuhiro; Ishida, Makiko DaSilva; Saito, Yuichi; Oyama, Yasuaki; Oiso, Giichiro; Moriyama, Mitsuru

    2017-01-01

    Background: Despite an increasing awareness of the risk of medical errors, few data sources are available to highlight the characteristics and patterns of medical errors in the clinical management of rheumatoid arthritis (RA). The present study aimed to evaluate medical malpractice claims associated with the management of RA and other autoimmune connective tissue diseases (ACTDs). Methods: We analyzed 38 ACTD-associated closed claims extracted from a total of 8530 claims processed between July 2004 and June 2014 by the Tokyo headquarters office of Sompo Japan Nipponkoa Incorporated, a leading malpractice insurer in Japan. Results: RA was the most common ACTD assessed in this study, accounting for 20 cases. Although the male-to-female ratio among these cases was 5:15, in accordance with the general demographic distribution of RA, the proportion of patients older than 60 years (77.8%) was relatively high as the general range of RA susceptibility is 30–50 years. The analysis of allegation types among RA cases revealed statistically significant differences from non-RA cases (Fisher's exact test) as well as the following key findings: diagnosis-related allegations were absent (P < 0.01), whereas medication-related allegations were distinctively common (P = 0.02). Clinical processes related to the assessment process were most vulnerable to breakdown and leading to negligence identified with subsequent medication-related allegations, particularly among RA cases. 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. PMID:28584209

  17. Sexual Abuse Allegations by Children with Neuropsychiatric Disorders

    ERIC Educational Resources Information Center

    Lindblad, Frank; Lainpelto, Katrin

    2011-01-01

    All Swedish court cases from 2004 and 2006 concerning alleged child sexual abuse (sexual harassment excluded) were identified through criminal registers. Fourteen cases (one boy) concerned a child with a neuropsychiatric disorder. The diagnostic groups were mental retardation (10 cases), autism (three cases), and ADHD (one case). Psychiatric…

  18. Claims for compensation after alleged birth asphyxia: a nationwide study covering 15 years.

    PubMed

    Andreasen, Stine; Backe, Bjørn; Øian, Pål

    2014-02-01

    To analyze compensation claims with neurological sequela or death following alleged birth asphyxia. A cohort study. A nationwide study in Norway. All claims made to The Norwegian System of Compensation to Patients (NPE) concerning sequela related to alleged birth asphyxia, between 1994 and 2008. A total of 315 claims of which 161 were awarded compensation. Examination of hospital records, experts' assessments and the decisions made by the NPE, the appeal body and courts of law. Characteristics of deliveries resulting in intrapartum asphyxia and causes of substandard care categorized in eight groups. In the 161 compensated cases, 107 children survived (96 with neurological sequela), and 54 children died. Human error was a frequent reason of substandard care, seen as inadequate fetal monitoring (50%), lack of clinical knowledge and skills (14%), noncompliance with clinical guidelines (11%), failure in referral for senior medical help (10%) and error in drug administration (4%). System errors were registered in only 3%, seen as poor organization of the department, lack of guidelines and time conflicts. The health personnel held responsible for substandard care was an obstetrician in 49% and a midwife in 46%. Substandard care is common in birth asphyxia, and human error is the cause in most cases. Inadequate fetal monitoring and lack of clinical knowledge and skills are the most frequent reasons for compensation after birth asphyxia. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

  19. Records of medical malpractice litigation: a potential indicator of health-care quality in China

    PubMed Central

    Wang, Zhan; Jiang, Mengsi; Dear, Keith; Hsieh, Chee-Ruey

    2017-01-01

    Abstract Objective To assess the characteristics and incidence of medical litigation in China and the potential usefulness of the records of such litigation as an indicator of health-care quality. Methods We investigated 13 620 cases of medical malpractice litigation that ended between 2010 and 2015 and were reported to China’s Supreme Court. We categorized each case according to location of the court, the year the litigation ended, the medical specialization involved, the severity of the reported injury, the type of allegation raised by the plaintiff – including any alleged shortcomings in the health care received – and the outcome of the litigation. Findings The annual incidence of medical malpractice litigation increased from 75 in 2010 to 6947 in 2014. Most cases related to general surgery (1350 litigations), internal medicine (3500 litigations), obstetrics and gynaecology (1251 litigations) and orthopaedics (1283 litigations). Most of the reported injuries were either minor (1358 injuries) or fatal (4111 deaths). The most frequent allegation was of lack of consent or notification (1356 litigations), followed by misdiagnosis (1172 litigations), delay in treatment (1145 litigations) and alteration or forgery of medical records (975 litigations). Of the 11 014 plaintiffs with known litigation outcomes, 7482 (67.9%) received monetary compensation. Conclusion Over our study period, the incidence of litigation over potential medical malpractice increased in China. As many of the cases related to alleged inadequacies in the quality of health care, records of medical malpractice litigation in China may be worth exploring as an indicator of health-care quality. PMID:28603309

  20. Guidance for Inspecting Alleged Cases of Pesticide-Related Bee Incidents

    EPA Pesticide Factsheets

    Explains how to conduct an investigation into an alleged pesticide-related incident involving bee deaths including general information on beekeeping as a reference for federal, state and tribal inspectors.

  1. Clinical negligence and the need to keep professionally updated.

    PubMed

    Tingle, John

    Nurses and doctors are under a legal duty to keep reasonably up to date; this is a fundamental aspect of their legal duty of care to their patients. A nurse or doctor could be negligent if a patient is harmed because of ignorance of well accepted and known published nursing and medical research findings. It is all a question of fact and degree and cases will turn on their own circumstances. There are a number of reported court cases which explore this issue and which contain useful guidance. These cases are discussed within the context of the new NHS and the Government's emphasis on health quality, and increasing healthcare litigation.

  2. Court Cases Alleging Employment Discrimination in Public Schools

    ERIC Educational Resources Information Center

    Speers, Gary M.

    2014-01-01

    The purpose of this research was to examine Court Cases Alleging Employment Discrimination in Public Schools by analyzing 115 law based court cases ranging during 1980-2012, through the most available publication of "West's Educational Law Digest" of 2012. Employment is a means to provide sustainable income to support the individual(s)…

  3. Plagiarism Allegations Account for Most Retractions in Major Latin American/Caribbean Databases.

    PubMed

    Almeida, Renan Moritz V R; de Albuquerque Rocha, Karina; Catelani, Fernanda; Fontes-Pereira, Aldo José; Vasconcelos, Sonia M R

    2016-10-01

    This study focuses on retraction notices from two major Latin American/Caribbean indexing databases: SciELO and LILACS. SciELO includes open scientific journals published mostly in Latin America/the Caribbean, from which 10 % are also indexed by Thomson Reuters Web of Knowledge Journal of Citation Reports (JCR). LILACS has a similar geographical coverage and includes dissertations and conference/symposia proceedings, but it is limited to publications in the health sciences. A search for retraction notices was performed in these two databases using the keywords "retracted", "retraction" "withdrawal", "withdrawn", "removed" and "redress". Documents were manually checked to identify those that actually referred to retractions, which were then analyzed and categorized according to the reasons alleged in the notices. Dates of publication/retraction and time to retraction were also recorded. Searching procedures were performed between June and December 2014. Thirty-one retraction notices were identified, fifteen of which were in JCR-indexed journals. "Plagiarism" was alleged in six retractions of this group. Among the non-JCR journals, retraction reasons were alleged in fourteen cases, twelve of which were attributed to "plagiarism". The proportion of retracted articles for the SciELO database was approximately 0.005 %. The reasons alleged in retraction notices may be used as signposts to inform discussions in Latin America on plagiarism and research integrity. At the international level, these results suggest that the correction of the literature is becoming global and is not limited to mainstream international publications.

  4. How frequently do allegations of scientific misconduct occur in ecology and evolution, and what happens afterwards?

    PubMed

    Moreno-Rueda, Gregorio

    2013-03-01

    Scientific misconduct obstructs the advance of knowledge in science. Its impact in some disciplines is still poorly known, as is the frequency in which it is detected. Here, I examine how frequently editors of ecology and evolution journals detect scientist misconduct. On average, editors managed 0.114 allegations of misconduct per year. Editors considered 6 of 14 allegations (42.9%) to be true, but only in 2 cases were the authors declared guilty, the remaining being dropped for lack of proof. The annual rate of allegations that were probably warranted was 0.053, although the rate of demonstrated misconduct was 0.018, while the rate of false or erroneous allegations was 0.024. Considering that several cases of misconduct are probably not reported, these findings suggest that editors detect less than one-third of all fraudulent papers.

  5. Suing for Negligent Teaching: An Australian Perspective.

    ERIC Educational Resources Information Center

    Williams, Peter

    1996-01-01

    Discusses, from an Australian perspective, the context of, and the legal framework for, suing in educational negligence. Examines the decision of the English Court of Appeal. Explores some of the issues an Australian court might face when confronted with a claim in educational negligence. (80 footnotes) (MLF)

  6. 13 CFR 101.301 - Who should receive information or allegations of waste, fraud, and abuse?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Who should receive information or allegations of waste, fraud, and abuse? 101.301 Section 101.301 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION ADMINISTRATION Inspector General § 101.301 Who should receive information or allegations of waste...

  7. 13 CFR 101.301 - Who should receive information or allegations of waste, fraud, and abuse?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Who should receive information or allegations of waste, fraud, and abuse? 101.301 Section 101.301 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION ADMINISTRATION Inspector General § 101.301 Who should receive information or allegations of waste...

  8. Educators' Negligence: What, Why, and Who's Responsible?

    ERIC Educational Resources Information Center

    Dunklee, Dennis R.; Shoop, Robert J.

    1988-01-01

    The authors define negligence and cite specific examples where teachers were found accountable for their negligent actions related to their profession. They report results of an informal study of teacher knowledge of tort liability that indicate educators should be more knowledgeable about education law. Recommendations are included. (CH)

  9. Long-term Medicaid excess payments from alleged price manipulation of generic lorazepam.

    PubMed

    Bian, Boyang; Gorevski, Elizabeth; Kelton, Christina M L; Guo, Jeff J; Martin Boone, Jill E

    2012-09-01

    Cost savings from the use of generic drugs versus brand-name drugs are well known. Both private and public prescription drug plans encourage the use of generic drugs through a variety of mechanisms. The magnitude of cost savings for a given generic drug is dependent on the degree to which the generic market is competitive. Should the competitive structure become compromised, higher prices and reduced cost savings may result. An alleged conspiracy between Mylan Laboratories and its active-ingredient suppliers in 1997 was associated with an increase in seller concentration in the generic lorazepam market. The Federal Trade Commission (FTC) alleged that Mylan raised costs to consumers by $120 million because of price increases for generic lorazepam from March through December 1998 and for generic clorazepate from January through December 1998. In November 2002, a settlement with Mylan was approved by the FTC, and a federal district court required Mylan to pay $147 million, including $28.2 million to state agencies including Medicaid. To (a) describe the seller concentration in the national Medicaid generic lorazepam market over a 19-year period from January 1991 through December 2009, (b) estimate the excess payments for generic lorazepam by Medicaid between 1998 and 2009, and (c) investigate potentially increased utilization and prices of 2 substitute pharmaceuticals: branded lorazepam (Ativan) and generic alprazolam (another widely used intermediate-acting benzodiazepine). Using Medicaid State Drug Utilization Data from the Centers for Medicare Medicaid Services, we calculated the 4-firm concentration ratio (CR₄) and the Herfindahl-Hirschman Index (HHI) for the Medicaid generic lorazepam market, along with pre-rebate reimbursement for pharmacy claims, number of claims (utilization), and average pre-rebate reimbursement per claim (average "price") for generic lorazepam, from 1991 through 2009. Medicaid's excess payments were estimated under 2 different assumptions

  10. Applying Negligence Doctrine to the Teaching Profession.

    ERIC Educational Resources Information Center

    Collingsworth, Terrence P.

    1982-01-01

    The author first reviews the current cases on teacher negligence and attempts to isolate the reasoning behind the courts' refusal to recognize a cause of action for educational malpractice, then develops a hypothetical case to illustrate that ordinary principles of negligence can be applied to an educational malpractice case. (Author/MLF)

  11. An Analysis of Allegations of Sexual Abuse in a Multi-Victim Day-Care Center Case.

    ERIC Educational Resources Information Center

    Bybee, Deborah; Mowbray, Carol T.

    1993-01-01

    This study applied criteria from Statement Validity Analysis (SVA) protocols to aggregate record review data of alleged sexual abuse of over 100 children in a day-care center. The use of SVA criteria supported the veritability of allegations in this case, with the data analysis reflecting consistency, logical structure, and spontaneity of…

  12. Clinician responses to sexual abuse allegations.

    PubMed

    Jackson, H; Nuttall, R

    1993-01-01

    We conducted a survey using an experimental design to identify how and to what extent specific personal and case factors affect clinicians' judgments about sexual abuse allegations. We drew a stratified random sample of 1,635 United States clinicians from national directories of clinical social work, pediatrics, psychiatry and psychology. Six hundred and fifty-six completed questionnaires were obtained, yielding a 42% response rate. We asked each subject to read and rate, on a 6 point scale, 16 vignettes alleging sexual abuse. The scale ranged from 1 (very confident it did not occur), to 6 (very confident it did occur). On average, respondents were "slightly confident sexual abuse had occurred" (M = 4.03; SD = 0.6). This finding was significantly different from a mean of 3.50, which is the expected null result. Seven case factors affected credibility ratings at the .01 level; perpetrators' race (Caucasians viewed as perpetrators more than minorities); perpetrators' relationship to victim (family members more often seen as perpetrators); victims' race (minorities more credible as victims); victims' affect (those showing negative affect more believable); age (younger victims more often seen as victimized); behavioral changes in the victim; and perpetrator's history of substance abuse. Six clinician factors were significant at the .05 level: age (younger clinicians were more credulous), gender (females more credulous), discipline (clinical social workers more credulous), theoretical orientation (family systems oriented more credulous) and personal history of sexual or physical abuse (abuse history more credulous).

  13. 19 CFR 181.62 - Commercial samples of negligible value.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Commercial samples of negligible value. 181.62... Returned After Repair or Alteration § 181.62 Commercial samples of negligible value. (a) General. Commercial samples of negligible value imported from Canada or Mexico may qualify for duty-free entry under...

  14. Negligence in Visitor Security.

    ERIC Educational Resources Information Center

    Dwyer, William O.; Murrell, Dan S.

    1985-01-01

    The park administrator's responsibility in providing security for park visitors through prevention strategies and law enforcement is discussed. Types of negligence are indicated, practice recommendations are made, and evaluative criteria for personnel selection and training are offered. Reference is made to the General Accounting Office Report and…

  15. Young Children's References to Temporal Attributes of Allegedly Experienced Events in the Course of Forensic Interviews

    ERIC Educational Resources Information Center

    Orbach, Yael; Lamb, Michael E.

    2007-01-01

    Developmental differences in references to temporal attributes of allegedly experienced events were examined in 250 forensic interviews of 4- to 10-year-old alleged victims of sexual abuse. Children's ages, the specific temporal attributes referenced, and the types of memory tapped by the interviewers' questions significantly affected the quantity…

  16. Children in Civil Law: The Tort of Negligence.

    ERIC Educational Resources Information Center

    Sheehy, N. P.; Chapman, A. J.

    1984-01-01

    Examines judgments involving children under the tort of negligence, using All England Law Reports for 1939 to 1983 and some cases from other countries. Discusses "contributory negligence,""parental liability,""responsibility,""allurement," and "res-ipsa loquitur." Suggests more use of developmental…

  17. 7 CFR 900.201 - Investigation and disposition of alleged violations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Investigation and disposition of alleged violations. 900.201 Section 900.201 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF...

  18. 7 CFR 900.201 - Investigation and disposition of alleged violations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Investigation and disposition of alleged violations. 900.201 Section 900.201 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF...

  19. 7 CFR 900.201 - Investigation and disposition of alleged violations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Investigation and disposition of alleged violations. 900.201 Section 900.201 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF...

  20. 7 CFR 900.201 - Investigation and disposition of alleged violations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Investigation and disposition of alleged violations. 900.201 Section 900.201 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF...

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

    PubMed

    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.

  2. Investigating Alleged Wrongdoing by Employees in the School Setting.

    ERIC Educational Resources Information Center

    Bump, Richard E.; And Others

    One of the most frequent problems confronting employers is the need to investigate allegations of or suspicions that an employee has been involved in misconduct and take appropriate action when the evidence substantiates the wrongdoing. School district employers are no exception. Respect and trust in the school working environment are achieved by…

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

    PubMed

    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.

  4. Inspection Report: FAA's Alleged Circumvention of National Performance Review Staffing Requirements

    DOT National Transportation Integrated Search

    1996-12-09

    This report responds to a complaint received by the Office of Inspector General : (OIG), Department of Transportation. The complainant alleges the Federal : Aviation Administration (FAA) planned to circumvent National Performance : Review (NPR) staff...

  5. An exploration of the effects of clinical negligence litigation on the practice of midwives in England: A phenomenological study.

    PubMed

    Robertson, Judith H; Thomson, Ann M

    2016-02-01

    to explore how midwives׳ personal involvement in clinical negligence litigation affects their midwifery practice. descriptive phenomenological study using semi-structured interviews. in 2006-2007 in-depth interviews were conducted in participants׳ homes or at their place of work and focused on participants׳ experience of litigation. Participants were recruited from various regions of England. 22 National Health Service (NHS) midwives who had been alleged negligent. clinical practice affected was an increase in documentation, fear of practising outside clinical guidelines and electronic fetal monitoring of women at low obstetric risk; these changes were not widespread. Changes in practice were sometimes perceived negatively and sometimes positively. Forming a good relationship with childbearing women was judged to promote effective midwifery care but litigation had affected the ability of a minority of midwives to advocate for women if this relationship had not been established. Litigation could result in loss of confidence leading to self-doubt, isolation, increased readiness to seek medical assistance and avoidance of working in the labour ward, perceived as an area with a high risk of litigation. A blame culture in the NHS was perceived by several midwives. In contrast an open non-punitive culture resulted in midwives readily reporting mistakes to risk managers. Litigation lowered midwifery morale and damaged professional reputations, particularly when reported in the newspapers. Some midwives expressed thoughts of leaving midwifery or taking time off work because of litigation but only one was actively seeking other employment, another took sick leave and one had left midwifery and returned to nursing. litigation can have a negative effect on midwives׳ clinical practice and morale and fosters a culture of blame within the NHS. education regarding appropriate documentation, use or non-use of electronic fetal monitoring and the legal status of clinical

  6. Analysis of Factors Associated With Rhytidectomy Malpractice Litigation Cases.

    PubMed

    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

  7. [Analysis of the causes of cancer negligence and low survival in the patients with malignant neoplasms of ENT and oral cavity in the city of Moscow].

    PubMed

    Sdvizhkov, A M; Kozhanov, L G; Shatskaia, N Kh; Belov, E N

    2014-01-01

    The objective of the present study was to elucidate the causes of late detection of malignant neoplasms of ENT and oral cavity and low survival of the patents with these tumours in Moscow. The secondary objective was to elaborate the organizational measures for reducing the level of negligence and mortality from these malignancies among the city population. It was shown that the main cause behind the negligence is the late application of the patients for the medical assistance. Next in importance are asymptomatic clinical course of the disease in the absence of the pathognomonic and early signs of malignant neoplasms, a combination of several pathologies, imperfection of medical knowledge, and the poor resolving power of the modern methods. It is emphasized that the lack of vigilance against cancer among the practicing health providers is one of the main causes of medical errors. A few ways to address the problem of negligence with respect to malignant neoplasms of ENT and oral cavity in Moscow are proposed.

  8. Medical Malpractice: The Experience in Italy

    PubMed Central

    2008-01-01

    At the present time, legal actions against physicians in Italy number about 15,000 per year, and hospitals spend over €10 billion (~US$15.5 billion) to compensate patients injured from therapeutic and diagnostic errors. In a survey summary issued by the Italian Court for the Rights of the Patient, between 1996 and 2000 orthopaedic surgery was the highest-ranked specialty for the number of complaints alleging medical malpractice. Today among European countries, Italy has the highest number of physicians subject to criminal proceedings related to medical malpractice, a fact that is profoundly changing physicians’ approach to medical practice. The national health system has paid increasingly higher insurance premiums and is having difficulty finding insurance companies willing to bear the risk of monetary claims alleging medical malpractice. Healthcare costs will likely worsen as Italian physicians increasingly practice defensive medicine, thereby overutilizing resources with the goal of documenting diligence, prudence, and skill as defenses against potential litigation, rather than aimed at any patient benefit. To reduce the practice of defensive medicine and healthcare costs, a possible solution could be the introduction of an extrajudicial litigation resolution, as in other civil law countries, and a reform of the Italian judicial system on matters of medical malpractice litigation. PMID:18985423

  9. 28 CFR 115.21 - Evidence protocol and forensic medical examinations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Office on Violence Against Women publication, “A National Protocol for Sexual Assault Medical Forensic... allegations of sexual abuse, the agency shall follow a uniform evidence protocol that maximizes the potential.... (c) The agency shall offer all victims of sexual abuse access to forensic medical examinations...

  10. 28 CFR 115.21 - Evidence protocol and forensic medical examinations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Office on Violence Against Women publication, “A National Protocol for Sexual Assault Medical Forensic... allegations of sexual abuse, the agency shall follow a uniform evidence protocol that maximizes the potential.... (c) The agency shall offer all victims of sexual abuse access to forensic medical examinations...

  11. 28 CFR 115.21 - Evidence protocol and forensic medical examinations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Office on Violence Against Women publication, “A National Protocol for Sexual Assault Medical Forensic... allegations of sexual abuse, the agency shall follow a uniform evidence protocol that maximizes the potential.... (c) The agency shall offer all victims of sexual abuse access to forensic medical examinations...

  12. Tobacco industry allegations of "illegal lobbying" and state tobacco control.

    PubMed

    Bialous, S A; Fox, B J; Glantz, S A

    2001-01-01

    This study assessed the perceived effect of tobacco industry allegations of "illegal lobbying" by public health professionals on policy interventions for tobacco control. Structured interviews were conducted with state health department project managers in all 17 National Cancer Institute-funded American Stop Smoking Intervention Study (ASSIST) states. Documentation and media records related to ASSIST from the National Cancer Institute, health advocates, and the tobacco industry were analyzed. The tobacco industry filed formal complaints of illegal lobbying activities against 4 ASSIST states. These complaints had a temporary chilling effect on tobacco control policy interventions in those states. ASSIST states not targeted by the tobacco industry developed an increased awareness of the industry's tactics and worked to prepare for such allegations to minimize disruption of their activities. Some self-reported self-censorship in policy activity occurred in 11 of the 17 states (65%). Public health professionals need to educate themselves and the public about the laws that regulate lobbying activities and develop their strategies, including their policy activities, accordingly.

  13. A look inside the courtroom: an analysis of 292 cosmetic breast surgery medical malpractice cases.

    PubMed

    Paik, Angie M; Mady, Leila J; Sood, Aditya; Eloy, Jean Anderson; Lee, Edward S

    2014-01-01

    Malpractice claims affect the cost and quality of health care. The authors examine litigation in cosmetic breast surgery and identify factors influencing malpractice litigation outcomes. The Westlaw database was searched for jury verdict and settlement reports related to medical malpractice and cosmetic breast surgeries. Cases included for analysis were examined for year, geographic location, patient demographics, procedure performed, alleged injury, causes of action, verdict, and indemnity payments. Of 292 cases, the most common injury sustained was disfigurement (53.1%). Negligent misrepresentation had a 98% greater chance of resolution in favor of the plaintiff (relative risk [RR], 1.98; 95% confidence interval [CI], 1.41-2.79), and fraud had a 92% greater chance of disposition in favor of the plaintiff (RR, 1.92; 95% CI, 1.32-2.80). The most common causes of action cited were negligence (88.7%) and lack of informed consent (43.8%). One hundred sixty-nine (58.3%) cases resulted in favor of the defendant and 121 (41.7%) cases were disposed in favor of the plaintiff; 97 (33.4%) cases resulted in damages awarded and 24 (8.3%) cases resulted in settlement. No significant difference was found between the medians of indemnity payments awarded to plaintiffs ($245 000) and settlements ($300 000). Based on this study, negligent or intentional misrepresentation strongly favors plaintiffs in either awarded damages or settlements in cases of cosmetic breast surgery litigation. This study emphasizes that transparency and adequate communication are at the crux of the physician-patient relationship and are tools by which plastic surgeons may reduce the frequency of litigations, thereby containing health care costs at a minimum.

  14. Negligence: What Is It? How Can It Be Avoided?

    ERIC Educational Resources Information Center

    Carpenter, Linda Jean; Acosta, R. Vivian

    1982-01-01

    The physical educator or athletic coach needs to be aware of negligence in relation to the possible athletic injuries of students. The four legal components of negligence--duty, breach, cause, and harm--are discussed. (JN)

  15. Desk Reference to the Toolkit for Assessing Potential Allegations of Environmental Injustice

    EPA Pesticide Factsheets

    This document provides an overview of tools and other reference materials to assist U.S. Environmental Protection Agency (EPA) personnel in assessing and addressing potential allegations of environmental injustice.

  16. 19 CFR 162.77a - Prepenalty notice for violation of section 593A, Tariff Act of 1930, as amended.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... aiding or procuring of, the drawback claim; (iii) Specify all laws and regulations allegedly violated... alleged violation occurred as a result of fraud or negligence; and (vi) State the estimated actual or...

  17. Forensic medical examinations conducted on complainants of sexual assault in the Forensic Medicine Institute, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, between 2006 and 2013.

    PubMed

    Engelgardt, P; Cychowska, M; Bloch-Bogusławska, E

    2014-01-01

    A total of 46 cases of alleged sexual assault were analysed from the years 2006-2013 where forensic medical examinations were conducted. The material was compared with data from literature. All the victims were female. In 9 cases (20%) a sexual assault by sexual touching was alleged, 67% of complainants (31 cases) had alleged non-consensual sexual intercourse, 6 complainants (13%) had no recollection of events. Genital area injuries were reported in 26% of sexual assault victims. Injuries of other parts of the body were found in 73% of victims. None of the subjects were positive for severe injuries such as fractures, wounds, and head trauma with loss of consciousness. The majority of complainants (29 cases, 63%) were examined within 24 hours after the incident and 6 examinees (13%) were assessed between 24 and 48 hours after the alleged sexual assault. Eleven forensic medical examinations (24%) were conducted after the lapse of more than 48 hours since the alleged incident. Twenty nine complainants admitted that they had washed their genital area after the sexual assault. Forensic swabs were taken during all forensic medical examinations.

  18. 28 CFR 0.29c - Reporting allegations of employee misconduct.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... misconduct. 0.29c Section 0.29c Judicial Administration DEPARTMENT OF JUSTICE ORGANIZATION OF THE DEPARTMENT OF JUSTICE 4-Office of the Inspector General § 0.29c Reporting allegations of employee misconduct. (a... administrative misconduct by Department employees shall be reported to the OIG, or to a supervisor or a...

  19. 28 CFR 0.29c - Reporting allegations of employee misconduct.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... misconduct. 0.29c Section 0.29c Judicial Administration DEPARTMENT OF JUSTICE ORGANIZATION OF THE DEPARTMENT OF JUSTICE 4-Office of the Inspector General § 0.29c Reporting allegations of employee misconduct. (a... administrative misconduct by Department employees shall be reported to the OIG, or to a supervisor or a...

  20. 28 CFR 0.29c - Reporting allegations of employee misconduct.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... misconduct. 0.29c Section 0.29c Judicial Administration DEPARTMENT OF JUSTICE ORGANIZATION OF THE DEPARTMENT OF JUSTICE 4-Office of the Inspector General § 0.29c Reporting allegations of employee misconduct. (a... administrative misconduct by Department employees shall be reported to the OIG, or to a supervisor or a...

  1. 28 CFR 0.29c - Reporting allegations of employee misconduct.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... misconduct. 0.29c Section 0.29c Judicial Administration DEPARTMENT OF JUSTICE ORGANIZATION OF THE DEPARTMENT OF JUSTICE 4-Office of the Inspector General § 0.29c Reporting allegations of employee misconduct. (a... administrative misconduct by Department employees shall be reported to the OIG, or to a supervisor or a...

  2. 28 CFR 0.29c - Reporting allegations of employee misconduct.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... misconduct. 0.29c Section 0.29c Judicial Administration DEPARTMENT OF JUSTICE ORGANIZATION OF THE DEPARTMENT OF JUSTICE 4-Office of the Inspector General § 0.29c Reporting allegations of employee misconduct. (a... administrative misconduct by Department employees shall be reported to the OIG, or to a supervisor or a...

  3. Preschool Child Development: Implications for Investigation of Child Abuse Allegations.

    ERIC Educational Resources Information Center

    Sivan, Abigail B.

    1991-01-01

    This article reviews research on child development relevant to the question of the veracity of mistreatment allegations made by children ages two to five years. The article covers research on thought and language, memory and learning, fears, fantasy, play, and television's effects. It is concluded that preschoolers base their play on the reality…

  4. Asymptotic density and effective negligibility

    NASA Astrophysics Data System (ADS)

    Astor, Eric P.

    In this thesis, we join the study of asymptotic computability, a project attempting to capture the idea that an algorithm might work correctly in all but a vanishing fraction of cases. In collaboration with Hirschfeldt and Jockusch, broadening the original investigation of Jockusch and Schupp, we introduce dense computation, the weakest notion of asymptotic computability (requiring only that the correct answer is produced on a set of density 1), and effective dense computation, where every computation halts with either the correct answer or (on a set of density 0) a symbol denoting uncertainty. A few results make more precise the relationship between these notions and work already done with Jockusch and Schupp's original definitions of coarse and generic computability. For all four types of asymptotic computation, including generic computation, we demonstrate that non-trivial upper cones have measure 0, building on recent work of Hirschfeldt, Jockusch, Kuyper, and Schupp in which they establish this for coarse computation. Their result transfers to yield a minimal pair for relative coarse computation; we generalize their method and extract a similar result for relative dense computation (and thus for its corresponding reducibility). However, all of these notions of near-computation treat a set as negligible iff it has asymptotic density 0. Noting that this definition is not computably invariant, this produces some failures of intuition and a break with standard expectations in computability theory. For instance, as shown by Hamkins and Miasnikov, the halting problem is (in some formulations) effectively densely computable, even in polynomial time---yet this result appears fragile, as indicated by Rybalov. In independent work, we respond to this by strengthening the approach of Jockusch and Schupp to avoid such phenomena; specifically, we introduce a new notion of intrinsic asymptotic density, invariant under computable permutation, with rich relations to both

  5. Negligent hiring liability--a primer for healthcare administrators.

    PubMed

    Bates, Norman D

    2008-01-01

    Healthcare institutions are particularly vulnerable to negligent hiring liability which holds employers responsible for their employees' improper conduct. Several methods are simple and inexpensive yet many employers neglect to employ them effectively, the author, an attorney and security management consultant, points out. In this article, he spells out what can be done to screen applicants to avoid and/or better defend against negligent hiring lawsuits.

  6. 30 CFR 291.102 - May I call the MMS Hotline to informally resolve an allegation that open and nondiscriminatory...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... resolve an allegation that open and nondiscriminatory access was denied? 291.102 Section 291.102 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR APPEALS OPEN AND NONDISCRIMINATORY ACCESS... Hotline to informally resolve an allegation that open and nondiscriminatory access was denied? Before...

  7. Negligence: What You Need To Know To Avoid Liability.

    ERIC Educational Resources Information Center

    Russo, Charles J.; Fericks, Donald J.

    1996-01-01

    To help educators understand their legal responsibilities when supervising students, this article reviews the elements of negligence (duty, breach, injury, and causation) an injured party must prove to hold an educator or school system legally accountable. The article also reviews basic defenses to negligence: immunity, comparative/contributory…

  8. Tobacco industry allegations of "illegal lobbying" and state tobacco control.

    PubMed Central

    Bialous, S A; Fox, B J; Glantz, S A

    2001-01-01

    OBJECTIVES: This study assessed the perceived effect of tobacco industry allegations of "illegal lobbying" by public health professionals on policy interventions for tobacco control. METHODS: Structured interviews were conducted with state health department project managers in all 17 National Cancer Institute-funded American Stop Smoking Intervention Study (ASSIST) states. Documentation and media records related to ASSIST from the National Cancer Institute, health advocates, and the tobacco industry were analyzed. RESULTS: The tobacco industry filed formal complaints of illegal lobbying activities against 4 ASSIST states. These complaints had a temporary chilling effect on tobacco control policy interventions in those states. ASSIST states not targeted by the tobacco industry developed an increased awareness of the industry's tactics and worked to prepare for such allegations to minimize disruption of their activities. Some self-reported self-censorship in policy activity occurred in 11 of the 17 states (65%). CONCLUSIONS: Public health professionals need to educate themselves and the public about the laws that regulate lobbying activities and develop their strategies, including their policy activities, accordingly. PMID:11189827

  9. Investigating Allegations of Inappropriate Physical Punishment of Students by School Employees.

    ERIC Educational Resources Information Center

    Pearce, Alexis C.

    1992-01-01

    Any complaint against a school employee regarding inappropriate physical punishment should be taken seriously by administrators and pursued vigorously by an investigating attorney. The standards (especially regarding probable cause and obtaining warrants) for investigating such allegations are less stringent than those imposed in criminal…

  10. 22 CFR 214.52 - Administrative review of other alleged non-compliance.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...-compliance. 214.52 Section 214.52 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADVISORY COMMITTEE MANAGEMENT Administrative Remedies § 214.52 Administrative review of other alleged non-compliance. With... International Development, 21st and Virginia Avenue, NW., Washington, DC 20523. (c) The complaint must be filed...

  11. Report: Investigation of Allegations Concerning Environmental Justice Issues in EPA Region 4

    EPA Pesticide Factsheets

    Report #10-N-0145, June 14, 2010. The OIG undertook a detailed review of the allegations to determine whether the OIG had investigative jurisdiction in terms of EPA contracts, assistance agreements, programs, or personnel involvement.

  12. Negligence--When Is the Principal Liable? A Legal Memorandum.

    ERIC Educational Resources Information Center

    Stern, Ralph D., Ed.

    Negligence, a tort liability, is defined, discussed, and reviewed in relation to several court decisions involving school principals. The history of liability suits against school principals suggests that a reasonable, prudent principal can avoid legal problems. Ten guidelines are presented to assist principals in avoiding charges of negligence.…

  13. Preschoolers' Understanding of Lies and Innocent and Negligent Mistakes.

    ERIC Educational Resources Information Center

    Siegal, Michael; Peterson, Candida C.

    1998-01-01

    Examined preschoolers' ability to distinguish innocent and negligent mistakes from lies. Found that, when asked to identify a mistake or lie about a food's contact with contaminants and identify a bystander's reaction, children distinguished mistakes from lies; they could also discriminate between lies and both negligent mistakes that generate…

  14. Cases relating to anaesthetists handled by the UK General Medical Council in 2009: methodological approach and patterns of referral.

    PubMed

    Campbell, G; Rollin, A M; Smith, A F

    2013-05-01

    The General Medical Council is the regulatory body charged with maintaining standards in the medical profession in the UK. We analysed cases relating to anaesthetists handled in 2009 using fitness-to-practise data, comparing them with the profession as a whole and examining patterns of referral. Complaints were made about 105 doctors practising in anaesthesia. The 81 anaesthetists who were investigated further were subject to a total of 225 separate allegations, median (IQR [range]) of 2 (1-3 ) allegations per anaesthetist. Anaesthetists had a lower rate of referral compared with doctors in general (0.095% vs 0.20%, respectively, p = 0.0001). They were less likely than doctors in general to be referred by an individual member of the public (27% vs 64%, respectively, p = 0.0001). As with other specialties, allegations were most commonly made about clinical care, probity and relationships with patients. On the basis of 2009 data, we calculated that a mean (95% CI) of 1 in 120 (1 in 100-145) doctors practising in anaesthesia in the UK will be referred to the General Medical Council every year. We have provided examples of allegations and made recommendations for maintaining good practice in anaesthesia. © 2013 The Association of Anaesthetists of Great Britain and Ireland.

  15. 7 CFR 1726.255 - Prior approved contract modifications related to indemnification.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... indemnitor indemnify the indemnitee for the indemnitee's own negligence, the borrower may add the words “otherwise this provision shall apply to any alleged negligence or condition caused by the Owner” so that the... destruction caused by the sole negligence of Owner, otherwise this provision shall apply to any negligence or...

  16. 48 CFR 852.228-71 - Indemnification and insurance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... negligence or alleged negligence of the Government, its officers, agents, servants, and employees, shall not... liability coverage will conform to applicable State law requirements for the service contemplated, whereas...

  17. Can You Be Charged with Negligence?

    ERIC Educational Resources Information Center

    Robinson, Joseph C.

    1982-01-01

    Ten questions regarding classroom and shop safety are presented for the teacher and school administrator to test themselves and guard against a ruling of negligence and legal liability in the performance of their jobs. (CT)

  18. 30 CFR 291.102 - May I call the MMS Hotline to informally resolve an allegation that open and nondiscriminatory...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... resolve an allegation that open and nondiscriminatory access was denied? 291.102 Section 291.102 Mineral... OPEN AND NONDISCRIMINATORY ACCESS TO OIL AND GAS PIPELINES UNDER THE OUTER CONTINENTAL SHELF LANDS ACT... allegation concerning open and nondiscriminatory access by calling the toll-free MMS Hotline at 1-888-232...

  19. Nature of Medical Malpractice Claims Against Radiation Oncologists.

    PubMed

    Marshall, Deborah; Tringale, Kathryn; Connor, Michael; Punglia, Rinaa; Recht, Abram; Hattangadi-Gluth, Jona

    2017-05-01

    To examine characteristics of medical malpractice claims involving radiation oncologists closed during a 10-year period. Malpractice claims filed against radiation oncologists from 2003 to 2012 collected by a nationwide liability insurance trade association were analyzed. Outcomes included the nature of claims and indemnity payments, including associated presenting diagnoses, procedures, alleged medical errors, and injury severity. We compared the likelihood of a claim resulting in payment in relation to injury severity categories (death as referent) using binomial logistic regression. There were 362 closed claims involving radiation oncology, 102 (28%) of which were paid, resulting in $38 million in indemnity payments. The most common alleged errors included "improper performance" (38% of closed claims, 18% were paid; 29% [$11 million] of total indemnity), "errors in diagnosis" (25% of closed claims, 46% were paid; 44% [$17 million] of total indemnity), and "no medical misadventure" (14% of closed claims, 8% were paid; less than 1% [$148,000] of total indemnity). Another physician was named in 32% of claims, and consent issues/breach of contract were cited in 18%. Claims for injury resulting in death represented 39% of closed claims and 25% of total indemnity. "Improper performance" was the primary alleged error associated with injury resulting in death. Compared with claims involving death, major temporary injury (odds ratio [OR] 2.8, 95% confidence interval [CI] 1.29-5.85, P=.009), significant permanent injury (OR 3.1, 95% CI 1.48-6.46, P=.003), and major permanent injury (OR 5.5, 95% CI 1.89-16.15, P=.002) had a higher likelihood of a claim resulting in indemnity payment. Improper performance was the most common alleged malpractice error. Claims involving significant or major injury were more likely to be paid than those involving death. Insights into the nature of liability claims against radiation oncologists may help direct efforts to improve quality of care

  20. Nature of Medical Malpractice Claims Against Radiation Oncologists

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Marshall, Deborah; Tringale, Kathryn; Connor, Michael

    Purpose: To examine characteristics of medical malpractice claims involving radiation oncologists closed during a 10-year period. Methods and Materials: Malpractice claims filed against radiation oncologists from 2003 to 2012 collected by a nationwide liability insurance trade association were analyzed. Outcomes included the nature of claims and indemnity payments, including associated presenting diagnoses, procedures, alleged medical errors, and injury severity. We compared the likelihood of a claim resulting in payment in relation to injury severity categories (death as referent) using binomial logistic regression. Results: There were 362 closed claims involving radiation oncology, 102 (28%) of which were paid, resulting in $38more » million in indemnity payments. The most common alleged errors included “improper performance” (38% of closed claims, 18% were paid; 29% [$11 million] of total indemnity), “errors in diagnosis” (25% of closed claims, 46% were paid; 44% [$17 million] of total indemnity), and “no medical misadventure” (14% of closed claims, 8% were paid; less than 1% [$148,000] of total indemnity). Another physician was named in 32% of claims, and consent issues/breach of contract were cited in 18%. Claims for injury resulting in death represented 39% of closed claims and 25% of total indemnity. “Improper performance” was the primary alleged error associated with injury resulting in death. Compared with claims involving death, major temporary injury (odds ratio [OR] 2.8, 95% confidence interval [CI] 1.29-5.85, P=.009), significant permanent injury (OR 3.1, 95% CI 1.48-6.46, P=.003), and major permanent injury (OR 5.5, 95% CI 1.89-16.15, P=.002) had a higher likelihood of a claim resulting in indemnity payment. Conclusions: Improper performance was the most common alleged malpractice error. Claims involving significant or major injury were more likely to be paid than those involving death. Insights into the nature of liability claims

  1. Negligible Sex Differences in General Intelligence.

    ERIC Educational Resources Information Center

    Colom, Roberto; Juan-Espinosa, Manuel; Abad, Francisco; Garcia, Luis F.

    2000-01-01

    Studied sex differences in general intelligence in 10,475 adults taking cognitive test batteries. Results suggest a negligible difference in general intelligence, a finding consistent with findings from quite different test batteries and subject samples. (SLD)

  2. 45 CFR 73.735-1302 - Responsibility for reporting allegations of misconduct.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Responsibility for reporting allegations of misconduct. 73.735-1302 Section 73.735-1302 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL... of misconduct. An employee who has information which he or she reasonably believes indicates the...

  3. 45 CFR 73.735-1302 - Responsibility for reporting allegations of misconduct.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Responsibility for reporting allegations of misconduct. 73.735-1302 Section 73.735-1302 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL... of misconduct. An employee who has information which he or she reasonably believes indicates the...

  4. 45 CFR 73.735-1302 - Responsibility for reporting allegations of misconduct.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Responsibility for reporting allegations of misconduct. 73.735-1302 Section 73.735-1302 Public Welfare Department of Health and Human Services GENERAL... of misconduct. An employee who has information which he or she reasonably believes indicates the...

  5. 45 CFR 73.735-1302 - Responsibility for reporting allegations of misconduct.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Responsibility for reporting allegations of misconduct. 73.735-1302 Section 73.735-1302 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL... of misconduct. An employee who has information which he or she reasonably believes indicates the...

  6. 45 CFR 73.735-1302 - Responsibility for reporting allegations of misconduct.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Responsibility for reporting allegations of misconduct. 73.735-1302 Section 73.735-1302 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL... of misconduct. An employee who has information which he or she reasonably believes indicates the...

  7. More on the alleged 1970 geomagnetic jerk

    USGS Publications Warehouse

    Alldredge, L.R.

    1985-01-01

    French and United Kingdom workers have published reports describing a sudden change in the secular acceleration, called an impulse or a jerk, which took place around 1970. They claim that this change took place in a period of a year or two and that the sources of the alleged jerk are internal. An earlier paper by this author questioned their method of analysis pointing out that their method of piecemeal fitting of parabolas to the data will always create a discontinuity in the secular acceleration where the parabolas join and that the place where the parabolas join is an a priori assumption and not a result of the analysis. This paper gives a very brief summary of this first paper and then adds additional reasons for questioning the allegation that there was a worldwide sudden jerk in the magnetic field of internal origin around 1970. These new reasons are based largely on new field models which give cubic approximations of the field right through the 1970 timeframe and therefore have no discontinuities in the second derivative (jerk) around 1970. Some recent Japanese work shows several sudden changes in the secular variation pattern which cover limited areas and do not seem to be closely related to each other or to the irregularity noted in the European area near 1970. The secular variation picture which seems to be emerging is one with many local or limited-regional secular variation changes which appear to be almost unrelated to each other in time or space. A worldwide spherical harmonic model including coefficients up to degree 13 could never properly depict such a situation. ?? 1985.

  8. Using the Child's Testimony in Defending the Alleged Child Molester.

    ERIC Educational Resources Information Center

    Castro, Carolyn D.

    Analysis of the transcript of a social worker's interview with a five-and-a-half-year-old girl allegedly sexually abused by a man focuses on how the interview was conducted and elements that suggest it should not be used as testimony. First, inconsistencies in the transcript that cast doubt on the child's reliability are noted, and the truth of…

  9. 28 CFR 115.322 - Policies to ensure referrals of allegations for investigations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Policies to ensure referrals of allegations for investigations. 115.322 Section 115.322 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Juvenile Facilities Responsive...

  10. 28 CFR 115.322 - Policies to ensure referrals of allegations for investigations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Policies to ensure referrals of allegations for investigations. 115.322 Section 115.322 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Juvenile Facilities Responsive...

  11. 28 CFR 115.322 - Policies to ensure referrals of allegations for investigations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Policies to ensure referrals of allegations for investigations. 115.322 Section 115.322 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Juvenile Facilities Responsive...

  12. Medical Evidence of Human Rights Violations against Non-Arabic-Speaking Civilians in Darfur: A Cross-Sectional Study

    PubMed Central

    Crosby, Sondra S.; Sirkin, Susannah; Heisler, Michele; Leaning, Jennifer; Iacopino, Vincent

    2012-01-01

    Background Ongoing conflict in the Darfur region of Sudan has resulted in a severe humanitarian crisis. We sought to characterize the nature and geographic scope of allegations of human rights violations perpetrated against civilians in Darfur and to evaluate their consistency with medical examinations documented in patients' medical records. Methods and Findings This was a retrospective review and analysis of medical records from all 325 patients seen for treatment from September 28, 2004, through December 31, 2006, at the Nyala-based Amel Centre for Treatment and Rehabilitation of Victims of Torture, the only dedicated local provider of free clinical and legal services to civilian victims of torture and other human rights violations in Darfur during this time period. Among 325 medical records identified and examined, 292 (89.8%) patients from 12 different non-Arabic-speaking tribes disclosed in the medical notes that they had been attacked by Government of Sudan (GoS) and/or Janjaweed forces. Attacks were reported in 23 different rural council areas throughout Darfur. Nearly all attacks (321 [98.8%]) were described as having occurred in the absence of active armed conflict between Janjaweed/GoS forces and rebel groups. The most common alleged abuses were beatings (161 [49.5%]), gunshot wounds (140 [43.1%]), destruction or theft of property (121 [37.2%]), involuntary detainment (97 [29.9%]), and being bound (64 [19.7%]). Approximately one-half (36 [49.3%]) of all women disclosed that they had been sexually assaulted, and one-half of sexual assaults were described as having occurred in close proximity to a camp for internally displaced persons. Among the 198 (60.9%) medical records that contained sufficient detail to enable the forensic medical reviewers to render an informed judgment, the signs and symptoms in all of the medical records were assessed to be consistent with, highly consistent with, or virtually diagnostic of the alleged abuses. Conclusions

  13. Medical evidence of human rights violations against non-Arabic-speaking civilians in Darfur: a cross-sectional study.

    PubMed

    Tsai, Alexander C; Eisa, Mohammed A; Crosby, Sondra S; Sirkin, Susannah; Heisler, Michele; Leaning, Jennifer; Iacopino, Vincent

    2012-01-01

    Ongoing conflict in the Darfur region of Sudan has resulted in a severe humanitarian crisis. We sought to characterize the nature and geographic scope of allegations of human rights violations perpetrated against civilians in Darfur and to evaluate their consistency with medical examinations documented in patients' medical records. This was a retrospective review and analysis of medical records from all 325 patients seen for treatment from September 28, 2004, through December 31, 2006, at the Nyala-based Amel Centre for Treatment and Rehabilitation of Victims of Torture, the only dedicated local provider of free clinical and legal services to civilian victims of torture and other human rights violations in Darfur during this time period. Among 325 medical records identified and examined, 292 (89.8%) patients from 12 different non-Arabic-speaking tribes disclosed in the medical notes that they had been attacked by Government of Sudan (GoS) and/or Janjaweed forces. Attacks were reported in 23 different rural council areas throughout Darfur. Nearly all attacks (321 [98.8%]) were described as having occurred in the absence of active armed conflict between Janjaweed/GoS forces and rebel groups. The most common alleged abuses were beatings (161 [49.5%]), gunshot wounds (140 [43.1%]), destruction or theft of property (121 [37.2%]), involuntary detainment (97 [29.9%]), and being bound (64 [19.7%]). Approximately one-half (36 [49.3%]) of all women disclosed that they had been sexually assaulted, and one-half of sexual assaults were described as having occurred in close proximity to a camp for internally displaced persons. Among the 198 (60.9%) medical records that contained sufficient detail to enable the forensic medical reviewers to render an informed judgment, the signs and symptoms in all of the medical records were assessed to be consistent with, highly consistent with, or virtually diagnostic of the alleged abuses. Allegations of widespread and sustained torture and

  14. Illicit drug exposure in patients evaluated for alleged child abuse and neglect.

    PubMed

    Oral, Resmiye; Bayman, Levent; Assad, Abraham; Wibbenmeyer, Lucy; Buhrow, Jakob; Austin, Andrea; Bayman, Emine O

    2011-06-01

    Substantiation of drug exposure in cases with alleged maltreatment is important to provide proper treatment and services to these children and their families. A study performed at University of Iowa Hospitals and Clinics showed that 30% of pediatric patients with burn injuries, which were due to child maltreatment, were also exposed to illicit drugs. The children presenting to the University of Iowa Hospitals and Clinics with alleged maltreatment have been tested for illicit substances since 2004. The objective of this study was to analyze the presence of illicit drug exposure in the pediatric subpopulation admitted to pediatric inpatient and outpatient units for an evaluation for abuse/neglect. The study design is a retrospective chart review. Using hospital databases, every pediatric chart with a child abuse/neglect allegation was retrieved. The association between risk factors and clinical presentation and illicit drug test result was assessed. Excel and SAS were used for statistical analysis. Institutional review board approval was obtained to conduct this study. Six hundred sixty-five charts met study inclusion criteria for child abuse/neglect allegation. Of those, 232 cases were tested for illicit drugs between 2004 and 2008 per the testing protocol. Thirty-four cases (14.7%) tested positive on a drug test. Positive test rates based on clinical presentation were 28.6% (18/63) in neglect cases, 16.1% (5/31) in cases with soft tissue injuries, 14.3% (4/28) in burn injuries, 10.0% (2/20) in cases with sexual abuse, 7.1% (2/28) in cases with fractures, and 4.8% (3/62) in abusive head trauma cases. There were long-term abuse findings in 129 children (55.6%). Logistic regression analysis revealed that positive drug testing was most significantly associated with clinical symptoms suggesting physical abuse or neglect versus sexual abuse (odds ratio [OR] = 6.70; 95% confidence interval [CI], 1.26-35.49; P = 0.026), no or public health insurance versus those with

  15. 28 CFR 115.122 - Policies to ensure referrals of allegations for investigations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Policies to ensure referrals of allegations for investigations. 115.122 Section 115.122 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Lockups Responsive Planning § 115...

  16. 28 CFR 115.122 - Policies to ensure referrals of allegations for investigations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Policies to ensure referrals of allegations for investigations. 115.122 Section 115.122 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Lockups Responsive Planning § 115...

  17. 28 CFR 115.122 - Policies to ensure referrals of allegations for investigations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Policies to ensure referrals of allegations for investigations. 115.122 Section 115.122 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Lockups Responsive Planning § 115...

  18. 28 CFR 115.22 - Policies to ensure referrals of allegations for investigations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Policies to ensure referrals of allegations for investigations. 115.22 Section 115.22 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Adult Prisons and Jails Responsive Planning...

  19. 28 CFR 115.22 - Policies to ensure referrals of allegations for investigations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Policies to ensure referrals of allegations for investigations. 115.22 Section 115.22 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Adult Prisons and Jails Responsive Planning...

  20. 28 CFR 115.22 - Policies to ensure referrals of allegations for investigations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Policies to ensure referrals of allegations for investigations. 115.22 Section 115.22 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Adult Prisons and Jails Responsive Planning...

  1. 7 CFR 3022.6 - Notification of USDA of allegations of research misconduct.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... misconduct. 3022.6 Section 3022.6 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE...-FUNDED EXTRAMURAL RESEARCH; RESEARCH MISCONDUCT § 3022.6 Notification of USDA of allegations of research misconduct. (a) Research institutions that conduct USDA-funded extramural research must promptly notify OIG...

  2. 7 CFR 3022.6 - Notification of USDA of allegations of research misconduct.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... misconduct. 3022.6 Section 3022.6 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE...-FUNDED EXTRAMURAL RESEARCH; RESEARCH MISCONDUCT § 3022.6 Notification of USDA of allegations of research misconduct. (a) Research institutions that conduct USDA-funded extramural research must promptly notify OIG...

  3. 7 CFR 3022.6 - Notification of USDA of allegations of research misconduct.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... misconduct. 3022.6 Section 3022.6 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE...-FUNDED EXTRAMURAL RESEARCH; RESEARCH MISCONDUCT § 3022.6 Notification of USDA of allegations of research misconduct. (a) Research institutions that conduct USDA-funded extramural research must promptly notify OIG...

  4. 7 CFR 3022.6 - Notification of USDA of allegations of research misconduct.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... misconduct. 3022.6 Section 3022.6 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE...-FUNDED EXTRAMURAL RESEARCH; RESEARCH MISCONDUCT § 3022.6 Notification of USDA of allegations of research misconduct. (a) Research institutions that conduct USDA-funded extramural research must promptly notify OIG...

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

    PubMed

    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.

  6. Chemistry, Courtrooms, and Common Sense. Part I: Negligence and Duty.

    ERIC Educational Resources Information Center

    Gass, J. Ric

    1990-01-01

    Discussed are concepts involved in legal liability for laboratory accidents. The focus of this article is on negligence, duty, and responsibility issues. Highlighted are the basis of a lawsuit, negligent tort, duty and breech of duty, and cause and harm. Thirty-one cases are cited. (CW)

  7. [Malpractice Claims Against Pediatricians - Analysis of Expert Testimonies from the Medical Service of Health Insurance Companies Between 2000 and 2014].

    PubMed

    Steinhauer, Heiko; Holzschuh, Joachim; Böhler, Thomas

    2017-11-01

    Background In Germany, few data are available on medical malpractice claims against pediatricians. On behalf of Statutory Health Insurance Companies their Medical Service (MDK) regularly offers expert testimony in case of allegations during pediatric treatment. Methods Analysis of 374 written pediatric testimonies, documented between September 1st, 2000 and August 31st, 2014. Results 193 allegations against pediatricians were analysed separately for each sector of care (35% concerning outpatients, 28% normal inpatients, and 37% patients treated in an intensive care unit, ICU). Outpatient care led more frequently to malpractice claims regarding diagnosis, most often in the case of dysplasia of the hip (n=6), meningitis (n=5), and pneumonia (n=4). In inpatients, allegations regarding treatment errors were more common and frequently associated with extravasation injury (n=7), as well as periventricular leukomalacia (n=7), sepsis (=6), and intraventricular haemorrhage (n=4) in newborn infants on ICUs. Expert testimony confirmed allegations in 43% of the outpatients, 22% of the normal inpatients and 38% of the ICU patients. Discussion and conclusion The frequency of pediatric malpractice claims seems to depend primarily on the pattern of utilization of pediatric care services. Diagnosis-related constellations leading to malpractice claims in Germany are well-known internationally. Case analysis according to medical care sectors allows comprehensible conclusions for risk management. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Strategies Courtside. Perfect or Perilous: When Is a Teacher Negligent?

    ERIC Educational Resources Information Center

    Carpenter, Linda Jean

    1994-01-01

    In today's society, teachers are more apt to be sued than ever before; it is important, therefore, that they know exactly what negligence means to themselves and their students. The framework of a negligence case (duty, breach, cause, and harm) is explained, and a teacher self-test is provided. (SM)

  9. 26 CFR 1.6662-3 - Negligence or disregard of rules or regulations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 13 2010-04-01 2010-04-01 false Negligence or disregard of rules or regulations... Penalties § 1.6662-3 Negligence or disregard of rules or regulations. (a) In general. If any portion of an... Internal Revenue Code that is required to be shown on a return is attributable to negligence or disregard...

  10. 28 CFR 115.222 - Policies to ensure referrals of allegations for investigations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... abuse and sexual harassment. (b) The agency shall have in place a policy to ensure that allegations of sexual abuse or sexual harassment are referred for investigation to an agency with the legal authority to... administrative or criminal investigations of sexual abuse or sexual harassment in community confinement...

  11. 28 CFR 115.222 - Policies to ensure referrals of allegations for investigations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... abuse and sexual harassment. (b) The agency shall have in place a policy to ensure that allegations of sexual abuse or sexual harassment are referred for investigation to an agency with the legal authority to... administrative or criminal investigations of sexual abuse or sexual harassment in community confinement...

  12. 28 CFR 115.222 - Policies to ensure referrals of allegations for investigations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... abuse and sexual harassment. (b) The agency shall have in place a policy to ensure that allegations of sexual abuse or sexual harassment are referred for investigation to an agency with the legal authority to... administrative or criminal investigations of sexual abuse or sexual harassment in community confinement...

  13. Children's religious knowledge: implications for understanding satanic ritual abuse allegations.

    PubMed

    Goodman, G S; Quas, J A; Bottoms, B L; Qin, J; Shaver, P R; Orcutt, H; Shapiro, C

    1997-11-01

    The goals of the present study were to examine the extent of children's religious, especially satanic, knowledge and to understand the influence of children's age, religious training, family, and media exposure on that knowledge. Using a structured interview, 48 3- to 16-year-old children were questioned about their knowledge of: (a) religion and religious worship; (b) religion-related symbols and pictures; and (c) movies, music, and television shows with religious and horror themes. Although few children evinced direct knowledge of ritual abuse, many revealed general knowledge of satanism and satanic worship. With age, children's religious knowledge increased and became more sophisticated. Increased exposure to nonsatanic horror media was associated with more nonreligious knowledge that could be considered precursory to satanic knowledge, and increased exposure to satanic media was associated with more knowledge related to satanism. Our results suggest that children do not generally possess sufficient knowledge of satanic ritual abuse to make up false allegations on their own. However, many children have knowledge of satanism as well as nonreligious knowledge of violence, death, and illegal activities. It is possible that such knowledge could prompt an investigation of satanic ritual abuse or possibly serve as a starting point from which an allegation is erected.

  14. The 'Negligence' Buck Stops with You!

    ERIC Educational Resources Information Center

    Stern, James

    1982-01-01

    The owner or operator of a public swimming pool is legally responsible for the health and safety of patrons who use the pool. Legal cases resulting from negligence include judgements against the owner due to: lack of lifeguard training, inattentiveness on the part of lifeguards, improper depth markings, water containing infectious organisms, and…

  15. Medical malpractice tort reform.

    PubMed

    Ottenwess, David M; Lamberti, Meagan A; Ottenwess, Stephanie P; Dresevic, Adrienne D

    2011-01-01

    A tort is generally defined as a civil wrong which causes an injury, for which a victim may seek damages, typically in the form of money damages, against the alleged wrongdoer. An overview of the tort system is detailed, specifically in the context of a medical malpractice lawsuit, in order to provide a better understanding of the practical evolution of medical malpractice litigation and its proposed reforms. Rising premiums and defensive medicine are also discussed as part of the tort reform dialogue. Because medical malpractice litigation will never disappear entirely, implementing sound risk management and compliance programs are critical to every radiology department in order to improve the safety and quality of the care that its radiologists and technologists provide.

  16. Emergency department documentation of alleged excessive use of force.

    PubMed

    Strote, Jared; Verzemnieks, Erik; Walsh, Mimi

    2013-12-01

    Patients' complaints of excessive use of force (EUOF) by police occur frequently in emergency departments (EDs). Limited, if any, education or guidelines exist for documenting alleged EUOF despite extensive instruction for other forms of potential abuse or assault. Our objective was to examine the documentation by ED staff when patients complained of EUOF. A retrospective cohort design was used, identifying every use of force over a 1-year period by a single law enforcement agency that was followed by an ED visit within 24 hours. Charts were then analyzed for complaints of excessive force. For these cases, documentation was evaluated using standards for other forms of abuse and assault. Of 187 ED visits, 32 (17%) involved patients who were unable to give a history and 20 (11%) had nontrauma evaluations only. Of the remaining 135, there were 13 documented complaints (10%) of EUOF. Of these, 8 complaints (62%) described the mechanism of injury completely and 10 complaints (77%) had a complete description of the injury. No charts discussed whether the examination was consistent with the history. Inappropriate subjective terminology was used in 7 charts (54%), and the police description of events was described as fact in 7 charts (54%). Guilt was assigned in 5 charts (39%). In one ED, EUOF complaints were not documented to the standards for other forms of alleged assault and abuse. There may be a benefit to further education and guidelines on how to deal with ED presentations of EUOF.

  17. Lawsuits After Primary and Revision Total Hip Arthroplasties: A Malpractice Claims Analysis.

    PubMed

    Patterson, Diana C; Grelsamer, Ronald P; Bronson, Michael J; Moucha, Calin S

    2017-10-01

    As the prevalence of total hip arthroplasty (THA) expands, so too will complications and patient dissatisfaction. The goal of this study was to identify the common etiologies of malpractice suits and costs of claims after primary and revision THAs. Analysis of 115 malpractice claims filed for alleged neglectful primary and revision THA surgeries by orthopedic surgeons insured by a large New York state malpractice carrier between 1983 and 2011. The incidence of malpractice claims filed for negligent THA procedures is only 0.15% per year in our population. In primary cases, nerve injury ("foot drop") was the most frequent allegation with 27 claims. Negligent surgery causing dislocation was alleged in 18 and leg length discrepancy in 14. Medical complications were also reported, including 3 thromboembolic events and 6 deaths. In revision cases, dislocation and infection were the most common source of suits. The average indemnity payment was $386,153 and the largest single settlement was $4.1 million for an arterial injury resulting in amputation after a primary hip replacement. The average litigation cost to the insurer was $61,833. Nerve injury, dislocation, and leg length discrepancy are the most common reason for malpractice after primary THA. Orthopedic surgeons should continue to focus on minimizing the occurrence of these complications while adequately incorporating details about the risks and limitations of surgery into their preoperative education. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Two brothers' alleged paternity for a child: who is the father?

    PubMed

    Dogan, Muhammed; Kara, Umut; Emre, Ramazan; Fung, Wing Kam; Canturk, Kemal Murat

    2015-06-01

    In paternity cases where individuals are close relatives, it may be necessary to evaluate mother's DNA profile (trio test) and to increase the number of polymorphic STR loci that are analyzed. In our case, two alleged fathers who are brothers and the child (duo case) were analyzed based on 20 STR loci; however, no exclusions could be achieved. Then trio test (with mother) was performed using the Identifiler Plus kit (Applied Biosystems) and no exclusions could be achieved again. Analysis performed with the ESS Plex Plus kit (Qiagen), the paternity of one of the two alleged fathers was rejected only on 2 STR loci. We made the calculations of power of exclusion values to interpret our results more properly. The probability of exclusion (PE) is calculated as 0.9776546 in 15 loci of Identifiler Plus kit without mother. The PE is calculated as 0.9942803, if 5 additional loci from ESS Plex Plus kit are typed. The PE becomes 0.9961048 for the Identifiler Plus kit in trio analysis. If both Identifiler Plus and ESS Plex Plus kits are used for testing, the PE is calculated as 0.999431654, which indicates that the combined kits are highly discriminating.

  19. Repeated Interviews with Children Who Are the Alleged Victims of Sexual Abuse

    ERIC Educational Resources Information Center

    Katz, Carmit; Hershkowitz, Irit

    2013-01-01

    Objective: The present study was designed to test the effects of repeated retrievals in the course of forensic investigations with children who are the alleged victims of sexual abuse. Method: Using the National Institute of Child Health and Human Development protocol, 56 children participated in a first free-recall interview that was followed by…

  20. Analysis of closed malpractice medical claims against Taiwanese EDs: 2003 to 2012.

    PubMed

    Wu, Kuan-Han; Wu, Chien-Hung; Cheng, Shih-Yu; Lee, Wen-Huei; Kung, Chia-Te

    2014-09-01

    The objective of the study is to examine the epidemiologic data of closed malpractice medical claims against emergency departments (EDs) in Taiwanese civil courts and to identify high-risk diseases. We conducted a retrospective study and reviewed the verdicts from the national database of the Taiwan judicial system that pertained to EDs. Between 2003 and 2012, a total of 63 closed medical claims were included. Seven cases (11.1%) resulted in an indemnity payment, 55.6% of the cases were closed in the district court, but appeals were made to the supreme court in 12 cases (19.1%). The mean incident-to-litigation closure time was 57.7 ± 26.8 months. Of the cases with indemnity paid, 5 cases (71.4%) were deceased, and 2 cases (28.6%) were gravely injured. All cases with indemnity paid were determined to be negligent by a medical appraisal. The gravely injured patients had more indemnity paid than deceased patients ($299800 ± 37000 vs $68700 ± 29300). The most common medical conditions involved were infectious diseases (27.0%), central nervous system bleeding (15.9%), and trauma cases (12.7%). It was also found that 71.4% of the allegations forming the basis of the lawsuit were diagnosis related. Emergency physicians (EPs) in Taiwan have similar medico-legal risk as American EPs, with an annual risk of being sued of 0.63%. Almost 90% of EPs win their cases but spend 58 months in litigation, and the mean indemnity payment was $134738. Cases with indemnity paid were mostly categorized as having diagnosis errors, with the leading cause of error as failure to order an appropriate diagnostic test. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. 28 CFR 115.221 - Evidence protocol and forensic medical examinations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    .... Department of Justice's Office on Violence Against Women publication, “A National Protocol for Sexual Assault... for investigating allegations of sexual abuse, the agency shall follow a uniform evidence protocol... developed after 2011. (c) The agency shall offer all victims of sexual abuse access to forensic medical...

  2. 28 CFR 115.221 - Evidence protocol and forensic medical examinations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    .... Department of Justice's Office on Violence Against Women publication, “A National Protocol for Sexual Assault... for investigating allegations of sexual abuse, the agency shall follow a uniform evidence protocol... developed after 2011. (c) The agency shall offer all victims of sexual abuse access to forensic medical...

  3. 28 CFR 115.221 - Evidence protocol and forensic medical examinations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    .... Department of Justice's Office on Violence Against Women publication, “A National Protocol for Sexual Assault... for investigating allegations of sexual abuse, the agency shall follow a uniform evidence protocol... developed after 2011. (c) The agency shall offer all victims of sexual abuse access to forensic medical...

  4. Changes in Wellbeing and Professional Values among Medical Undergraduate Students: A Narrative Review of the Literature

    ERIC Educational Resources Information Center

    Benbassat, Jochanan

    2014-01-01

    Background: Educators are concerned by the high prevalence of emotional distress among medical students, and by the alleged decline in their humanitarian values. Objective To re-examine these concerns by reviewing studies of medical students' wellbeing and development. Method Narrative review of the literature. Main findings: (a) Medical…

  5. Medical Professional Liability in Psychiatry.

    PubMed

    Martin-Fumadó, Carles; Gómez-Durán, Esperanza L; Rodríguez-Pazos, Manuel; Arimany-Manso, Josep

    2015-01-01

    The safety of patients and the risk of malpractice claims are overriding concerns in medicine and psychiatry. Claims for alleged malpractice in psychiatry managed by the Council of Colleges of Physicians of Catalonia between 1986 and 2009 were analyzed to evaluate their clinical and legal characteristics. Ninety-four malpractice claims were found in a 23-year period, mainly claims related to diagnosis (63.83%, including assessment of suicide risk) and the legal figure of serious professional negligence resulting in death (46.8%). Most claims were for hospital (62.77%), emergency (52.5%), and team (53.75%) care. The possible affected party was male (51.58%) with a mean age of 36.6 years. In one-half of the cases, the harm claimed was death. The cases involved 139 specialists, predominantly male (69.57%), with a mean age of 41 years, and of Spanish nationality (91.4%). The time between the medical act and the respective claim was 1.28 years and the time to resolution was 2.68 years. Most of the cases (77.66%) were processed through the courts. The outcome of the cases was filing or dismissal in 91 (95.77%), conviction in 2 (2.81%), and settlement in 1 (1.41%). The cumulative incidence of 0.013 claims (1.35%) in 23 years suggests that there is a very low risk of lawsuits in psychiatry, with a similarly low rate of sentences of professional liability and awards for financial compensation. Specific actions could improve clinical safety, particularly in suicide risk assessment.

  6. How Should Alternative Medicine Be Taught to Medical Students and Physicians?

    ERIC Educational Resources Information Center

    Marcus, Donald M.

    2001-01-01

    Analyzes alleged deficiencies in medical education and concludes they are based on misrepresentations (for example, that physicians ignore mind-body interactions). Examines fundamental differences between traditional and alternative medicine and asserts that physicians need additional education in order to provide guidance to patients, but that…

  7. 28 CFR 115.321 - Evidence protocol and forensic medical examinations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... allegations of sexual abuse, the agency shall follow a uniform evidence protocol that maximizes the potential... or otherwise based on the most recent edition of the U.S. Department of Justice's Office on Violence Against Women publication, “A National Protocol for Sexual Assault Medical Forensic Examinations, Adults...

  8. 28 CFR 115.321 - Evidence protocol and forensic medical examinations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... allegations of sexual abuse, the agency shall follow a uniform evidence protocol that maximizes the potential... or otherwise based on the most recent edition of the U.S. Department of Justice's Office on Violence Against Women publication, “A National Protocol for Sexual Assault Medical Forensic Examinations, Adults...

  9. 28 CFR 115.321 - Evidence protocol and forensic medical examinations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... allegations of sexual abuse, the agency shall follow a uniform evidence protocol that maximizes the potential... or otherwise based on the most recent edition of the U.S. Department of Justice's Office on Violence Against Women publication, “A National Protocol for Sexual Assault Medical Forensic Examinations, Adults...

  10. On the Firing Line: Negligence in Physical Education

    ERIC Educational Resources Information Center

    Drowatzky, John N.

    1977-01-01

    Discusses teachers' vulnerability to tort actions for negligence in physical education classes, and suggests guidelines for proper teacher behavior, based on analysis of court cases in various states. (JG)

  11. Medico-legal aspects of alleged rape victims in Lahore.

    PubMed

    Manzoor, Iram; Hashmi, Noreen Rahat; Mukhtar, Fatima

    2010-12-01

    To describe the socio-demographic along with the medico-legal characteristics of rape victims reporting to a female police station of Lahore. Observational study. Female Police Station in Shadman, Lahore, from, June 1995 to January 2009. A total of 74 cases of alleged rape victims were identified while reviewing all available police files concerning reported rapes and attempted rapes from 1995 to 2008. The data was gathered on preformed questionnaires after conducting the pilot study. All information about victims and alleged offenders were extracted from the police files including socio-demographic profile of the accused and victim both. Use of weapon, evidence of physical and genital trauma, assailant identification and his relationship with the victim, number of accused persons and location of rape was noted in each case. Examination by doctor and obtaining the specimens were also identified and was related to the outcome of the court case. Chi-square test was applied to determine the association of rape with age and educational status of the victim and the accused. A total of 74 cases of alleged rape were reported in the study period at Shadman Female Police Station. Maximum number of victims was reported in the age group 10-19 years (n=46, 62.2%). Majority of the accused belonged to 20-39 years' age group constituting 64.8% of the total. Regarding educational status 45 (60.8%) of the victims and 51 (68.9%) of the accused were illiterate. Significant association was found between the educational status of rape victims and accused (p = 0.016) but not between their ages (p = 0.862). The maximum incidence of rape was reported in unmarried (n = 55, 74.3%) and unemployed (n =61, 82.4%) women. In 14 cases (19%) use of weapon was reported. Physical trauma was reported in 29 (39%) and genital trauma in 14 (19%) cases. The accused were identified as family friends (25%) and neighbours (23%) respectively. Only 21% of the victims were examined by doctor and specimens were

  12. Perspective: Innocence and due diligence: managing unfounded allegations of scientific misconduct.

    PubMed

    Goldenring, James R

    2010-03-01

    While the incidence of fraud in science is well documented, issues related to the establishment of innocence in cases of fallacious allegations remain unaddressed. In this article, the author uses his own experience to examine issues that arise when investigators are falsely accused of scientific fraud. Investigators must understand the processes in place to protect themselves against false accusations. The present system takes a position of guilty until proven innocent, a concept that is antithetical to American principles of jurisprudence. Yet this stance is acceptable as a requirement for membership in the scientific community, more reflective of the rules within a guild organization. The necessity for proof of innocence by members of the scientific community carries obligations that transcend normal legal assumptions. Scientists must safeguard their reputations by organizing and maintaining all original image files and data relevant to publications and grant proposals. Investigators must be able to provide clear documentation rapidly whenever concerns are raised during the review process. Moreover, peer-reviewed journals must be diligent not only in the identification of fraud but also in providing rapid due process for adjudication of allegations. The success of the scientific guild rules of conduct lies in the practice of due diligence by both scientists and journal editors in questions of scientific misconduct.

  13. Report on Student Academic Integrity and Allegations of Contract Cheating by University Students

    ERIC Educational Resources Information Center

    Australian Government Tertiary Education Quality and Standards Agency, 2015

    2015-01-01

    On 12 November 2014 the Fairfax media reported allegations of cheating by students at a number of Australian higher education providers through the purchase of assignments, particularly through the MyMaster website. The Honorable Christopher Pyne MP, Minister for Education and Training, referred the matter to the Tertiary Education Quality and…

  14. Carryover negligibility and relevance in bioequivalence studies.

    PubMed

    Ocaña, Jordi; Sanchez O, Maria P; Carrasco, Josep L

    2015-01-01

    The carryover effect is a recurring issue in the pharmaceutical field. It may strongly influence the final outcome of an average bioequivalence study. Testing a null hypothesis of zero carryover is useless: not rejecting it does not guarantee the non-existence of carryover, and rejecting it is not informative of the true degree of carryover and its influence on the validity of the final outcome of the bioequivalence study. We propose a more consistent approach: even if some carryover is present, is it enough to seriously distort the study conclusions or is it negligible? This is the central aim of this paper, which focuses on average bioequivalence studies based on 2 × 2 crossover designs and on the main problem associated with carryover: type I error inflation. We propose an equivalence testing approach to these questions and suggest reasonable negligibility or relevance limits for carryover. Finally, we illustrate this approach on some real datasets. Copyright © 2015 John Wiley & Sons, Ltd.

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

    PubMed

    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.

  16. Report: Alleged Misuse of Tribal Clean Water Act Section 106 Funds in EPA Region 8

    EPA Pesticide Factsheets

    Report #12-P-0453, May 4, 2012. On the first allegation, we found that Region 8 funded tribal Section 106 programs based on the region’s review of tribal work plans and did not inappropriately withhold funds.

  17. Legal hurdles for gastroenterologists in India.

    PubMed

    Nagpal, Neeraj

    2017-05-01

    Litigation and compensation claims have started occurring with increasing frequency against gastroenterologists in India. A study of few such cases decided by Indian Courts shows that commonest reason for allegations of negligence being upheld by Indian Courts is an improper consent being taken. Professional organisations need to focus on these issues more aggressively than has been done in the past. Judgments which do not appear to be in conformity with standard medical practices need to be challenged in higher courts, failing in which they would become precedents for future similar judgments.

  18. Negligent Hiring and Retaining of Sexually Abusive Teachers.

    ERIC Educational Resources Information Center

    Regotti, Terri L.

    1992-01-01

    Explores negligent hiring, supervision, and retention of teachers who sexually abuse students. Examines the issue of defamation and suggests school policy that will work toward eradication of sexual abuse of students by teachers. (33 references) (MLF)

  19. Medication errors: immunisation.

    PubMed

    Bird, Sara

    2006-09-01

    Case histories are based on actual medical negligence claims or medicolegal referrals, however certain facts have been omitted or changed by the author to ensure the anonymity of the parties involved. This article outlines a medication error involving childhood immunisation and examines the underlying causes of the incident. Advice about how to deal with a patient and their family when things go wrong is provided.

  20. [Medical fault or professional negligence? Case studies in two recovery nutrition centers in Niger].

    PubMed

    Halidou Doudou, M; Manzo, M L; Guero, D

    2014-12-01

    In developing countries such as Niger, the risk of medical malpractice is ubiquitous in health, jeopardizing patient safety. The aim of this work was to contribute to patients' safety and respect of code of ethics and conduct in the exercise of the medical profession. The reported cases involved two children under 5 years who were admitted to nutrition rehabilitation centers, died as a result of medical malpractice. In Niger, there are no statistics on this phenomenon and a few cases found have always been considered "accident" or "fate." The establishment of an observatory collections of such information should improve their frequency, consequences and propose a prevention plan. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  1. 78 FR 13547 - Defense Federal Acquisition Regulation Supplement: Alleged Crimes By or Against Contractor Personnel

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-28

    ... Contractor Personnel AGENCY: Defense Acquisition Regulations System, Department of Defense (DoD). ACTION... (FY) 2009 and expand coverage on contractor requirements and responsibilities relating to alleged crimes by or against contractor personnel. DATES: Effective February 28, 2013. FOR FURTHER INFORMATION...

  2. Custody Evaluators' Beliefs about Domestic Violence Allegations during Divorce: Feminist and Family Violence Perspectives

    ERIC Educational Resources Information Center

    Haselschwerdt, Megan L.; Hardesty, Jennifer L.; Hans, Jason D.

    2011-01-01

    Approximately, 20% of divorcing couples in the United States require judicial intervention to reach a custody agreement. In such cases, courts often call on child custody evaluators to conduct comprehensive evaluations and recommend custody agreements and services that meet children's best interests. Estimates suggest that allegations of domestic…

  3. 7 CFR 1.51 - Claims based on negligence, wrongful act or omission.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Claims based on negligence, wrongful act or omission. 1.51 Section 1.51 Agriculture Office of the Secretary of Agriculture ADMINISTRATIVE REGULATIONS Claims § 1.51 Claims based on negligence, wrongful act or omission. (a) Authority of the Department...

  4. Does medical education erode medical trainees' ethical attitude and behavior?

    PubMed Central

    Yavari, Neda

    2016-01-01

    In the last few years, medical education policy makers have expressed concern about changes in the ethical attitude and behavior of medical trainees during the course of their education. They claim that newly graduated physicians (MDs) are entering residency years with inappropriate habits and attitudes earned during their education. This allegation has been supported by numerous research on the changes in the attitude and morality of medical trainees. The aim of this paper was to investigate ethical erosion among medical trainees as a serious universal problem, and to urge the authorities to take urgent preventive and corrective action. A comparison with the course of moral development in ordinary people from Kohlberg’s and Gilligan's points of view reveals that the growth of ethical attitudes and behaviors in medical students is stunted or even degraded in many medical schools. In the end, the article examines the feasibility of teaching ethics in medical schools and the best approach for this purpose. It concludes that there is considerable controversy among ethicists on whether teaching ethical virtues is plausible at all. Virtue-based ethics, principle-based ethics and ethics of care are approaches that have been considered as most applicable in this regard. PMID:28050246

  5. Coordination Procedures between the Scientific Integrity Official and the Office of Inspector General regarding Scientific Misconduct Allegations

    EPA Pesticide Factsheets

    Coordination Procedures between the Scientific Integrity Official and the Office of Inspector General regarding Scientific Misconduct Allegations written March 30, 2015 by the Office of the Science Advisor

  6. Learning from malpractice claims about negligent, adverse events in primary care in the United States

    PubMed Central

    Phillips, R; Bartholomew, L; Dovey, S; Fryer, G; Miyoshi, T; Green, L

    2004-01-01

    Background: The epidemiology, risks, and outcomes of errors in primary care are poorly understood. Malpractice claims brought for negligent adverse events offer a useful insight into errors in primary care. Methods: Physician Insurers Association of America malpractice claims data (1985–2000) were analyzed for proportions of negligent claims by primary care specialty, setting, severity, health condition, and attributed cause. We also calculated risks of a claim for condition-specific negligent events relative to the prevalence of those conditions in primary care. Results: Of 49 345 primary care claims, 26 126 (53%) were peer reviewed and 5921 (23%) were assessed as negligent; 68% of claims were for negligent events in outpatient settings. No single condition accounted for more than 5% of all negligent claims, but the underlying causes were more clustered with "diagnosis error" making up one third of claims. The ratios of condition-specific negligent event claims relative to the frequency of those conditions in primary care revealed a significantly disproportionate risk for a number of conditions (for example, appendicitis was 25 times more likely to generate a claim for negligence than breast cancer). Conclusions: Claims data identify conditions and processes where primary health care in the United States is prone to go awry. The burden of severe outcomes and death from malpractice claims made against primary care physicians was greater in primary care outpatient settings than in hospitals. Although these data enhance information about error related negligent events in primary care, particularly when combined with other primary care data, there are many operating limitations. PMID:15069219

  7. [Risk factors associated with mother negligence in child care].

    PubMed

    Vargas-Porras, Carolina; Villamizar-Carvajal, Beatriz; Ardila-Suárez, Edinson Fabian

    2016-01-01

    To determine the factors associated with the risk of negligence in child care during the first year of rearing in adolescent and adult mothers. This was cross-sectional correlation study with a non-probabilistic sample composed of 250 mothers during their first year of child rearing. The information was collected through the Parenting Inventory for Teenagers and Adults. 88 teenager mothers and 162 adult mothers participated in this study. In general low scores were found in all dimensions in both adolescent mothers group and adult mother group, which indicate the existence of deficiencies in the adequate maternal behavior and risk of negligent care to their children. In the group of teenage mothers there was an evident and significant correlation between the factors: maternal age and occupation dimension belief in punishment and occupation with inappropriate expectations dimension. The group of adult mothers showed significant correlation between: educational level with the dimensions of role reversal, belief in punishment and lack of empathy; socioeconomic dimension with the belief in punishment and age of the child with the lack of empathy dimension. Child rearing expectations of mothers show a high risk of negligence in child care. Therefore, nurses should promote the strengthening of the maternal role. Copyright © 2016. Published by Elsevier España, S.L.U.

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

    PubMed

    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

  9. Illegal discharges in Spanish waters. Analysis of the profile of the Alleged Offending Vessel.

    PubMed

    Martín Alonso, J M; Ortega Piris, Andrés; Pérez Labajos, Carlos

    2015-08-15

    There is at present a growing concern, on an international level, over environmental offences caused by oil discharges into the sea from vessels. The objective of the Spanish Maritime Administration is to prevent the illegal discharges of polluting substances in Spanish maritime waters by vessels in transit. To combat such discharges, since 2007 Spain has reinforced its means of response with the use of aircrafts that provide services of maritime surveillance, identifying the Alleged Offending Vessels and acting as a deterrent. The objective of the present study is both to introduce the concept and to analyze certain aspects of the so-called "Alleged Offending Vessel" (AOV) that have been detected within Spanish Search and Rescue (SAR) jurisdiction waters in the period 2008-2012, in order to build a profile of such a vessel. For this purpose, an analysis methodology is formalized based on the GINI index and Lorenz curves, associated with certain aspects of vessels: type, flag and sailing area. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. [Child sexual abuse: Description of a French population having consulted in a forensic medical service between 2011 and 2015].

    PubMed

    Hauet-Wiedemann, M; Wiedemann, A; Gatin, A; Renaud, E; Lapp, L; Franchi, A; Martrille, L; Borsa-Dorion, A

    2018-05-01

    When child sexual abuse (CSA) is suspected, the detection of anogenital anomalies is rare. In France, since 2011, most clinical examinations of children for whom CSA is suspected take place in the forensic medical service (FMS). To describe a population of children examined for suspected CSA in the FMS of the Nancy Regional University Hospital Center. Children under the age of 18 who consulted for suspected CSA in the Nancy FMS between 2011 and 2015 were included. Demographic data as well as data from questioning, the physical examination, any further examination, and the medical conclusions were collected. Three hundred and twenty-five girls and 79 boys were enrolled. The average age at the time the abuse was committed was 118.9 months. Two hundred sixty-nine (66.6%) children alleged fondling and 59 (14.6%) fellatio. Two hundred twelve victims (52.5%) described a penetration, 163 (76.9%) in the vagina and 73 (34.4%) in the anus. Significant bruises were found at the examination of 13 children, accounting for 2.5% of all victims. Thirty-four (11.7%) girls had lesions in the external genitalia and 28 (9.8%) lesions of the virginal membrane. One boy (1.3%) had a nonspecific lesion of the external genitalia. Six (8.2%) children alleging anal penetrations showed injury. The examiner concluded that clinical examinations were compatible with alleged facts for 253 (62.6%) victims. It was impossible to conclude for 116 (28.7%) children. In the case of suspected CSA, the clinical examination is frequently normal. This examination must be performed by physicians trained in child abuse, under appropriate conditions. It is important not to jump to conclusions about the reality of the alleged facts. A multidisciplinary approach, with the cooperation of the medical, social, and forensics sector is necessary. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  11. NSF's Handling of Allegations of Misconduct in Science

    NASA Astrophysics Data System (ADS)

    Manka, Aaron

    2000-03-01

    Under NSF's Office of Inspector General mandate to prevent fraud, waste, abuse, or mismanagement involving NSF's proposals and awards, our office is unique in that it also investigates allegations of misconduct in science. I will discuss our office's handling of such matters, focusing on the ethical and legal obligations of proposal submitters and awardees and the role of the scientific community. To illustrate some of these points that are of interest to the physics community, I will discuss some of our investigative activities relevant to: duplicate funding, cost sharing, and the accuracy of information in proposals. If the OSTP policy on research misconduct has been released for public comment, I will briefly discuss this policy, which is meant to be adopted by all federal funding agencies, and what it will mean for us and the community we serve.

  12. Establishing breach of the duty of care in the tort of negligence.

    PubMed

    Tingle, John

    This article, the third in a series on clinical negligence, looks at the law surrounding breach of the duty of care in negligence. It shows some of the principles that judges and lawyers use in order to decide whether a person has broken his/her duty of care in the tort of negligence. It will be seen that the principles are contained in decided court cases, some of which are quite old but are still relevant today. The focus of this article is on the rule that courts, in deciding the issue of a breach of duty of care, would judge the defendant's conduct by the standard of what the hypothetical, 'reasonable person' would have done in the circumstances of the case.

  13. 32 CFR 536.128 - Effect of disciplinary action, voluntary restitution, or contributory negligence for claims under...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... restitution, or contributory negligence for claims under the UCMJ. 536.128 Section 536.128 National Defense... action, voluntary restitution, or contributory negligence for claims under the UCMJ. (a) Disciplinary... claimant. (c) Contributory negligence. A claim otherwise cognizable and meritorious is payable whether or...

  14. A SHOCKING REQUIREMENT IN THE LAW ON NEGLIGENCE LIABILITY FOR PSYCHIATRIC ILLNESS: LIVERPOOL WOMEN'S HOSPITAL NHS FOUNDATION TRUST V RONAYNE [2015] EWCA CIV 588.

    PubMed

    Burrows, Andrew S; Burrows, John H

    2016-01-01

    The Ronayne case concerned a husband who suffered a psychiatric illness, described as an adjustment disorder, in seeing the condition of his wife who was the primary victim of admitted medical negligence. His claim for compensation, as a 'secondary victim', failed because he could not satisfy the legal requirement that there must be a sudden shocking event. This commentary criticises that requirement which appears to make no medical sense. © The Author 2016. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. Investigation of an alleged mechanism of finger injury in an automobile crash.

    PubMed

    Stacey, Stephen; Kent, Richard

    2006-07-01

    This investigation centers on the case of an adult male whose finger was allegedly amputated by the steering wheel of his car during a crash. The subject claimed to have been driving with his left index finger inserted through a hole in the spoke of his steering wheel and was subsequently involved in an offset frontal collision with a tree. The finger was found to be cleanly severed at the mid-shaft of the proximal phalanx after the crash. This injury was alleged to have been caused by inertial loading from the rotation of the steering wheel during the crash. To determine whether this injury mechanism was plausible, three laboratory tests representing distinct loading scenarios were carried out with postmortem human surrogates loaded dynamically by the subject's steering wheel. It was found that the inertial loads generated in this loading scenario are insufficient to amputate the finger. Additionally, artificially constraining the finger to force an amputation to occur revealed that a separation at the proximal interphalangeal joint occurs rather than a bony fracture of the proximal phalanx. Based on these biomechanical tests, it can be concluded that the subject's injury did not occur during the automobile crash in question. Furthermore, it can be shown that the injury was self-inflicted to fraudulently claim on an insurance policy.

  16. Forensic evaluation of medical liability cases in general surgery.

    PubMed

    Moreira, H; Magalhães, T; Dinis-Oliveira, Rj; Taveira-Gomes, A

    2014-10-01

    Although medical liability (disciplinary, civil and criminal) is increasingly becoming an issue, few studies exist, particularly from the perspective of forensic science, which demonstrate the extent to which medical malpractice occurs, or when it does, the reasons for it. Our aims were to evaluate the current situation concerning medical liability in general surgery (GS) in Portugal, the reasons for claims, and the forensic evaluations and conclusions, as well as the association between these issues and the judicial outcomes. We analysed the Medico-Legal Council (CML) reports of the National Institute of Legal Medicine and Forensic Sciences of Portugal related to GS during 2001-2010. The judicial outcomes of each case were requested from the Public Prosecutor Office (PPO) and the court. Alleged cases of medical liability in GS represented 11.2% of the total cases analysed by the CML. We estimated that in Portugal, 4:100,000 surgeries are subject to litigation. The majority of complaints were due to the patient's death (75.4%), with laparoscopic cholecystectomy surgeries representing 55.2% of cases. In 76.1% of the cases, the CML believed that there was no violation of legesartis and in 55.2% of cases, no causal nexus was found between the medical practice and the alleged harm. The PPO prosecuted physicians in 6.4% of the cases and resulted in one conviction. Finally, the importance of the CML reports as a relevant technical-scientific tool for judicial decision was evident because these reports significantly (p < 0.05) influenced the prosecutor's decision, whether to prosecute or not. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  17. Unusual case of choking due to assassin bug ( Cydnocoris gilvus).

    PubMed

    Sonar, Vaibhav; Patil, Sachin

    2018-01-01

    Choking is a form of asphyxia which is caused by an obstruction within the air passages. Here, we report a case of obstruction of the upper respiratory tract due to assassin bug ( Cydnocoris gilvus) where allegations of medical negligence were made by relatives of the deceased. Autopsy findings demonstrated that an insect was present inside the larynx, lodged at the epiglottis. Multiple haemorrhagic patches were present at the base of the tongue, larynx, epiglottis, vocal cords and tracheal bifurcation. As Reduviidae can be successfully used as a biological pest-control agents, they should be used with due precaution.

  18. Fatal ovarian hyperstimulation syndrome in an anonymous egg donor.

    PubMed

    Pooniya, Shashank; Behera, C; Mridha, A R; Bhardwaj, D N; Millo, Tabin

    2016-12-01

    Ovarian hyperstimulation syndrome is a rare, but potentially life-threatening iatrogenic disorder arising from ovulation induction or ovarian hyperstimulation for assisted reproduction techniques. We report a case of a 26-year-old multiparous woman, an anonymous egg donor, who died a few hours after undergoing a procedure to donate eggs at an in vitro fertilization clinic. Her husband alleged that medical negligence had led to her death. The autopsy confirmed death due to ovarian hyperstimulation syndrome. We know of no previous descriptions of fatal ovarian hyperstimulation syndrome in an anonymous egg donor in medico-legal literature. © The Author(s) 2016.

  19. FAA Alleged Waste and Mismanagement of Air Route Traffic Control Centers Critical and Essential Power Systems Project

    DOT National Transportation Integrated Search

    1996-10-16

    The Office of Inspector General (OIG) reviewed a complaint from Congressman Deal on behalf of a constituent. The constituent alleged waste and mismanagement occurred in the Federal Aviation Administration (FAA) Air Route Traffic Control Centers Criti...

  20. Minors and Contested Medical-Surgical Treatment.

    PubMed

    Snelling, Jeanne

    2016-01-01

    Use of the best-interests test as the legal standard to justify medical treatment (or its cessation) in respect to legally incompetent adults or minors has come under sustained critique over the years. "Best interests" has variously been alleged to be indeterminate as well as susceptible to majoritarian ideology and inherent bias. It has also been alleged to be inferior to rights-based approaches. Against the background of several particularly hard cases involving minors discussed by Gillett in a prior article in this journal, this article considers some of these critiques. It concludes that these critical accounts make significant contributions to enabling a more procedurally and substantively robust consideration of what might be in a child's best interests. However, it is argued that none of these accounts alone provide a superior framework that would justify jettisoning the concept of best interests. Further, it is suggested that best interests still has an important role in achieving patient-centered decisionmaking in this context. It concludes by suggesting a taxonomy of considerations when determining best interests.

  1. 16 CFR 1702.15 - Petitions alleging the incompatiability of child resistant packaging with the particular...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... is based upon the fact that package choice is limited by a new drug application filed with the FDA, the petition shall state the limitation of package choice and a description of a time schedule to revise the NDA in order to allow additional package choice. (c) If the allegation of incompatibility is...

  2. 16 CFR 1702.15 - Petitions alleging the incompatiability of child resistant packaging with the particular...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... is based upon the fact that package choice is limited by a new drug application filed with the FDA, the petition shall state the limitation of package choice and a description of a time schedule to revise the NDA in order to allow additional package choice. (c) If the allegation of incompatibility is...

  3. The prevalence of abnormal genital findings, vulvovaginitis, enuresis and encopresis in children who present with allegations of sexual abuse.

    PubMed

    Anderson, B; Thimmesch, I; Aardsma, N; Ed D, M Terrell; Carstater, S; Schober, J

    2014-12-01

    To assess the prevalence of vulvovaginitis, enuresis and encopresis in children who were referred for allegations of sexual abuse. A retrospective chart review of 1280 children presenting for non-acute examination after allegations of sexual abuse during a 15-year time span. Interview documentation, physical examination documentation, urinalysis, urine and vaginal cultures were reviewed. Of the 1280 children, 73.3% were female and 26.7% male. The ages of the children ranged from 6 months to 18 years (median age was 6 years). Interviews revealed that fondling contact was the most common allegation, followed by oral, vaginal, and anal penetration. Interviews also disclosed lower urinary tract symptoms, UTI, constipation, encopresis and enuresis. Physical examination revealed no abnormal genital findings in 44.7% of cases. Examinations of the vagina noted: erythema (18.1%); hymenal notching (posterior 16.8%, anterior 4.4%); vuvlovaginitis (14.0%); laceration or transection (0.6%); and bruising (0.4%). Examination of the anus noted: anal fissure/tear (14.9%); loss of anal tone (10.6%); reflex anal dilatation (9.2%); venous congestion (3.8%); and proctitis (0.9%). Vulvovaginitis was noted in 14% (131/936) and encopresis in 2.3% (21/936). Enuresis according to age was reported in 13% of 5-9 year olds, 14.7% of 10-16 year olds and 18.2% of 17-18 year olds suspected of being abused. Prevalence of vulvovaginitis and enuresis were increased, and encopresis was decreased in children with allegations of sexual abuse when compared to the general pediatric population. Physicians should continue to be aware of the possibility of the presence of these conditions in children who have been sexually abused, and offer appropriate treatment. Copyright © 2014 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  4. An Examination of Negligence, Assumption of Risk, and Risk Management in Outdoor Recreation.

    ERIC Educational Resources Information Center

    Teague, Travis L.

    This paper stresses the outdoor recreation and education professionals should understand aspects of liability, negligence, and risk management. There are four elements that must be present if a person or organization is to be considered negligent: the presence of a legal duty of care, a breach of duty, proximate cause, and actual damages. When…

  5. Injuries and allegations of oral rape: A retrospective review of patients presenting to a London sexual assault referral centre.

    PubMed

    Brew-Graves, Emmeline; Morgan, Louise

    2015-08-01

    A retrospective review was carried out of patients seen at the Haven sexual assault referral centre in South East London between January 2009 and September 2010 to determine the frequency and nature of oral injuries found in people reporting oral rape. Ninety five eligible patients were identified and relevant information was extracted from standardised Haven forms completed during forensic medical examination. The main outcome measures were prevalence, type and location of oral injury. Eighteen (19%) were found to have sustained an oral injury. The most common injury was abrasions, followed by bruising and petechiae. The lips were the most common site of injury followed by the soft palate and the inside of the cheeks. It was concluded that injuries in the mouth were not common after an allegation of oral rape. Injuries were minor and did not require treatment. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  6. Do human figure diagrams help alleged victims of sexual abuse provide elaborate and clear accounts of physical contact with alleged perpetrators?

    PubMed

    Teoh, Yee-San; Yang, Pei-Jung; Lamb, Michael E; Larsson, Anneli S

    2010-02-01

    The present study examined whether the use of human figure diagrams within a well-structured interview was associated with more elaborate and clearer accounts about physical contact that had occurred in the course of an alleged abuse. The sample included investigative interviews of 88 children ranging from 4 to 13 years of age. Children were interviewed using the NICHD Investigative Interview Protocol, and were then asked a series of questions in association with unclothed gender-neutral outline diagrams of a human body. A new coding scheme was developed to examine the types and clarity of touch-related information. Use of the HFDs was associated with reports of new touches not mentioned before and elaborations regarding the body parts reportedly touched. The HFDs especially helped clarify reports by the oldest rather than the youngest children. The clarity of children's accounts of touch was also greater when details were sought using recall prompts.

  7. How the contractualist account of preconception negligence undermines prenatal reproductive autonomy.

    PubMed

    Melanson, Glen

    2013-08-01

    Suppose a physician advises a woman to delay her planned pregnancy for a few months in order to significantly reduce the likelihood that her baby will suffer with Spina Bifida. If the woman chooses to ignore this advice and conceives soon after, I believe most people would consider it a matter of common sense that the child thus born is a victim of this woman's negligence, even if it is fortunate enough to not be burdened with Spina Bifida. This common sense judgement appeared to have been done in by the fact that the timing of conception can be identity-influencing, and so the child that is born only exists because of its mother's decision to ignore her physician's advice. However, recently, contemporary contractualist theories have been used to make sense of preconception negligence towards persons whose existence is a result of that same negligence. I will briefly discuss this interesting development and then show how this retrieval of the common sense judgement comes at a great cost to prenatal reproductive autonomy.

  8. The professional standard of care in clinical negligence.

    PubMed

    Tingle, John

    The general principle of law relating to breach of duty in the tort of negligence has been discussed during this series of articles. This article continues that discussion in relation to healthcare professionals such as nurses and doctors, and how the law affects their case. The issue of the expanded role of the nurse is also discussed.

  9. Special Report on "Allegations of Conflict of Interest Regarding Licensing of PROTECT by Argonne National Laboratory"

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    None

    2009-08-01

    In February 2009, the Office of Inspector General received a letter from Congressman Mark Steven Kirk of Illinois, which included constituent allegations that an exclusive technology licensing agreement by Argonne National Laboratory was tainted by inadequate competition, conflicts of interest, and other improprieties. The technology in question was for the Program for Response Options and Technology Enhancements for Chemical/Biological Terrorism, commonly referred to as PROTECT. Because of the importance of the Department of Energy's technology transfer program, especially as implementation of the American Recovery and Reinvestment Act matures, we reviewed selected aspects of the licensing process for PROTECT to determinemore » whether the allegations had merit. In summary, under the facts developed during our review, it was understandable that interested parties concluded that there was a conflict of interest in this matter and that Argonne may have provided the successful licensee with an unfair advantage. In part, this was consistent with aspects of the complaint from Congressman Kirk's constituent.« less

  10. Unintended, but still blameworthy: the roles of awareness, desire, and anger in negligence, restitution, and punishment.

    PubMed

    Laurent, Sean M; Nuñez, Narina L; Schweitzer, Kimberly A

    2016-11-01

    Two experiments (Experiment 1 N = 149, Experiment 2 N = 141) investigated how two mental states that underlie how perceivers reason about intentional action (awareness of action and desire for an outcome) influence blame and punishment for unintended (i.e., negligent) harms, and the role of anger in this process. Specifically, this research explores how the presence of awareness (of risk in acting, or simply of acting) and/or desire in an acting agent's mental states influences perceptions of negligence, judgements that the acting agent owes restitution to a victim, and the desire to punish the agent, mediated by anger. In both experiments, awareness and desire led to increased anger at the agent and increased perception of negligence. Anger mediated the effect of awareness and desire on negligence rather than negligence mediating the effect of mental states on anger. Anger also mediated punishment, and negligence mediated the effects of anger on restitution. We discuss how perceivers consider mental states such as awareness, desire, and knowledge when reasoning about blame and punishment for unintended harms, and the role of anger in this process.

  11. Torts.

    ERIC Educational Resources Information Center

    Evans, William J., Jr.

    This chapter examines court cases reported during 1987 of tort claims involving school officials, employees, and students. A tort is a civil wrong, other than breach of contract, for which a court provides relief in the form of damages. The most common tort alleged to have been committed by school personnel is negligence. Most negligence suits…

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

    PubMed

    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.

  13. The high cost of clinical negligence litigation in the NHS.

    PubMed

    Tingle, John

    2017-03-09

    John Tingle, Reader in Health Law at Nottingham Trent University, discusses a consultation document from the Department of Health on introducing fixed recoverable costs in lower-value clinical negligence claims.

  14. Alleged Health Effects of Electric or Magnetic Fields: Additional Misconceptions in the Literature

    DTIC Science & Technology

    1993-01-01

    investigation of mortality in men who were clarification of a few points. I did not mention the animal employed in an electromagnetic pulse (EMP) test ...and employment ing the alleged link between EMFs and cancer is based on an in the EMP test program" questionable. In addition, there is examination of...control studies can result in an overes- would be published close to the time when mine citing it timate of relative risk [Diamond and Lilienfeld

  15. 49 CFR 225.12 - Rail Equipment Accident/Incident Reports alleging employee human factor as cause; Employee Human...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... employee human factor as cause; Employee Human Factor Attachment; notice to employee; employee supplement..., AND INVESTIGATIONS § 225.12 Rail Equipment Accident/Incident Reports alleging employee human factor as cause; Employee Human Factor Attachment; notice to employee; employee supplement. (a) Rail Equipment...

  16. 49 CFR 225.12 - Rail Equipment Accident/Incident Reports alleging employee human factor as cause; Employee Human...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... employee human factor as cause; Employee Human Factor Attachment; notice to employee; employee supplement..., AND INVESTIGATIONS § 225.12 Rail Equipment Accident/Incident Reports alleging employee human factor as cause; Employee Human Factor Attachment; notice to employee; employee supplement. (a) Rail Equipment...

  17. The Lourdes Medical Cures Revisited†

    PubMed Central

    François, Bernard; Sternberg, Esther M.; Fee, Elizabeth

    2014-01-01

    This article examines the cures recorded in Lourdes, France, between 1858, the year of the Visions, and 1976, the date of the last certified cure of the twentieth century. Initially, the records of cures were crude or nonexistent, and allegations of cures were accepted without question. A Medical Bureau was established in 1883 to examine and certify the cures, and the medical methodology improved steadily in the subsequent years. We discuss the clinical criteria of the cures and the reliability of medical records. Some 1,200 cures were said to have been observed between 1858 and 1889, and about one hundred more each year during the “Golden Age” of Lourdes, 1890–1914. We studied 411 patients cured in 1909–14 and thoroughly reviewed the twenty-five cures acknowledged between 1947 and 1976. No cure has been certified from 1976 through 2006. The Lourdes phenomenon, extraordinary in many respects, still awaits scientific explanation. Lourdes concerns science as well as religion. PMID:22843835

  18. 16 CFR 1702.15 - Petitions alleging the incompatibility of child resistant packaging with the particular substance...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... is based upon the fact that package choice is limited by a new drug application filed with the FDA, the petition shall state the limitation of package choice and a description of a time schedule to revise the NDA in order to allow additional package choice. (c) If the allegation of incompatibility is...

  19. 16 CFR 1702.15 - Petitions alleging the incompatibility of child resistant packaging with the particular substance...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... is based upon the fact that package choice is limited by a new drug application filed with the FDA, the petition shall state the limitation of package choice and a description of a time schedule to revise the NDA in order to allow additional package choice. (c) If the allegation of incompatibility is...

  20. Abraham Lincoln's suit against a medical imposter who assaulted his client.

    PubMed

    Spiegel, A D; Kavaler, F

    2001-10-01

    In 1851, A. Lincoln, Esquire represented Edward Jones who charged in a law suit that his attending physician had assaulted him. Jones, also a lawyer, had sharply questioned Dr. Joseph S. Maus about his claims of attendance and graduation from Philadelphia's Jefferson Medical College, an allopathic medical school. Jones claimed that Maus became enraged at his persistent questioning and attacked him. In turn, Maus denied the allegation. He said that he was merely defending himself from Jones' blows with a large cane. Lincoln's legal approach was to argue about the state of medical education and whether Maus had really graduated from Jefferson Medical College. Acting as a peacemaker, he finally arranged to settle the dispute between Jones and Maus out of court.

  1. Medical Liability Reform Crisis 2008

    PubMed Central

    2008-01-01

    The crisis of medical liability has resulted in drastic increases in insurance premiums and reduced access for patients to specialty care, particularly in areas such as obstetrics/gynecology, neurosurgery, and orthopaedic surgery. The current liability environment neither effectively compensates persons injured from medical negligence nor encourages addressing system errors to improve patient safety. The author reviews trends across the nation and reports on the efforts of an organization called “Doctors for Medical Liability Reform” to educate the public and lawmakers on the need for solutions to the chaotic process of adjudicating medical malpractice claims in the United States. PMID:18989732

  2. Can People With Intellectual Disability Resist Implications of Fault When Police Question Their Allegations of Sexual Assault and Rape?

    PubMed

    Antaki, Charles; Richardson, Emma; Stokoe, Elizabeth; Willott, Sara

    2015-10-01

    When people alleging sexual assault are interviewed by police, their accounts are tested to see if they would stand up in court. Some tests are in the form of tendentious questions carrying implications (e.g., that the sex was consensual) damaging to the complainant's allegation. In a qualitative analysis of 19 English police interviews with people with intellectual disability (ID) defined in a variety of ways, we show how people with ID deal with the pragmatic complexity of such tendentious questions. We give examples in which the complainants detect and resist the questions' damaging implications; but we focus on occasions when the complainants do not do so. We discuss the use of tendentious questions in the light of national United Kingdom guidelines on the treatment of vulnerable witnesses.

  3. Clinical negligence claims in pediatric surgery in England: pattern and trends.

    PubMed

    Thyoka, Mandela

    2015-02-01

    We hypothesized that there has been an increase in the number of successful litigation claims in pediatric surgery in England. Our aim was to report the incidence, causes, and costs of clinical negligence claims against the National Health Service (NHS) in relation to pediatric surgery. We queried the NHS Litigation Authority (NHSLA) on litigation claims among children undergoing pediatric surgery in England (2004-2012). We decided a priori to only examine closed cases (decision and payment made). Data included year of claim, year of payment of claim, payment per claim, paid-to-closed ratio, and severity of outcome of clinical incident. Out of 112 clinical negligence claims in pediatric surgery, 93 (83%) were finalized-73 (65%) were settled and damages paid to the claimant and 20 (18%) were closed with no payment, and 19 (17%) remain open. The median payment was £13,537 (600-500,000) and median total cost borne by NHSLA was £31,445 (600-730,202). Claims were lodged at a median interval of 2 (0-13) years from time of occurrence with 55 (75%) cases being settled within the 3 years of being received. The commonest reasons for claims were postoperative complications (n=20, 28%), delayed treatment (n=16, 22%), and/or diagnosis (n=14, 19%). Out of 73, 17 (23%) closed claims resulted in case fatality. Conclusion: Two-thirds of all claims in pediatric surgery resulted in payment to claimant, and the commonest reasons for claims were postoperative complications, delayed treatment, and/or diagnosis. Nearly a quarter of successful claims were in cases where negligence resulted in case fatality. Pediatric surgeons should be aware of common diagnostic and treatment shortfalls as high-risk areas of increased susceptibility to clinical negligence claims. Georg Thieme Verlag KG Stuttgart · New York.

  4. Litigation and Liabilities: Issues in Nonpublic Schools (Negligent Hiring and Retention and Employer Liability).

    ERIC Educational Resources Information Center

    Perrotta, Robert A.

    The torts of negligent hiring and negligent retention occur when an employer breaches a duty in hiring or retaining an employee who is incompetent or unfit for the job to which the employee is assigned; and consequently, the actions of that employee proximately cause injuries to a third party. This paper examines legal issues regarding negligent…

  5. Which Sexual Abuse Victims Receive a Forensic Medical Examination?: The Impact of Children's Advocacy Centers

    ERIC Educational Resources Information Center

    Walsh, Wendy A.; Cross, Theodore P.; Jones, Lisa M.; Simone, Monique; Kolko, David J.

    2007-01-01

    Objective: This study examines the impact of Children's Advocacy Centers (CAC) and other factors, such as the child's age, alleged penetration, and injury on the use of forensic medical examinations as part of the response to reported child sexual abuse. Methods: This analysis is part of a quasi-experimental study, the Multi-Site Evaluation of…

  6. 44 CFR 11.15 - Authority to adjust, determine, compromise and settle.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL CLAIMS Administrative Claims Under Federal Tort... this part, any claim for $200 or less which is based on alleged negligence or wrongful act or omission...

  7. Medical responsibility in the United Arab Emirates.

    PubMed

    Benomran, Fawzi

    2010-05-01

    Medical responsibility in the United Arab Emirates was formerly defined and governed according to Law 7 of 1975 for the practice of medical professions, which had been a part of civil law. The passing of Law 10 of 2008, namely the "Law on Medical Responsibility in UAE", enacted on 16th December 2008 created a new framework to deal with this issue. One of its provisions required medical practitioners to hold insurance policies, so that insurance companies pays damages to the plaintiff (patient) injured as a result of a physicians' negligence. This paper outlines the issue of medical responsibility and medical negligence. The author's translation of the new law into English is included so that its full text is available for the readers, especially expatriate doctors working in the UAE. Where appropriate, a brief comparison between the old law and new laws is also presented. The objective of this paper is to provide medical practitioners with basic information about the subject in general and to this legislation in particular. It is mandatory for doctors to realize inherent risks involved in the course of their practice. A basic knowledge of the law is required to avoid pitfalls and to safeguard oneself against errors arising from ignorance of the duties and rights of the professional person. Copyright (c) 2009 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  8. Malpractice in treatment of sinonasal disease by otolaryngologists: a review of the past 10 years.

    PubMed

    Winford, Tyler W; Wallin, Jordan L; Clinger, John D; Graham, Aaron M

    2015-03-01

    Sinonasal disease is a common condition treated by otolaryngologists. Malpractice in this area is the most common litigation faced by otolaryngologists. This study analyzes malpractice in the treatment of sinonasal disease. Case series, review of legal records. Legal databases. Using 2 different computerized legal databases, the phrase medical malpractice was searched with terms related to sinonasal disease involving court cases in the past 10 years (2004-2013), yielding 26 cases. The cases were analyzed for pertinent data regarding plaintiffs, presenting complaint, practice setting, type of malpractice, resulting injury, result of verdict, and amount of reward or settlement. Chronic sinusitis (42%) was the most common presenting symptom. Many cases included multiple types of alleged malpractice, with the most common being negligent technique (38%) and lack of informed consent (27%). The most common alleged injuries included cerebrospinal fluid leak, meningitis, nasal obstruction, and orbital trauma. Defendants prevailed in 13 of 18 cases in which outcomes were known, with mean award of $225,000 and mean settlement of $212,500. The cases won by plaintiffs were all in a private practice setting. Otolaryngologists should be aware of the causes of malpractice litigation as it relates to treatment of sinonasal disease. Lack of informed consent continues to be a common allegation, and surgeons should ensure complete informed consent is obtained and well documented. A unified and complete database of medical malpractice cases is needed to allow for further analysis of specialty-related claims. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  9. 5 CFR 177.106 - Authority to adjust, determine, compromise, and settle.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... SERVICE REGULATIONS ADMINISTRATIVE CLAIMS UNDER THE FEDERAL TORT CLAIMS ACT § 177.106 Authority to adjust... alleged negligence or wrongful act or omission of an OPM employee, with the exception of claims involving...

  10. [The prevalence and influencing factors of abuse and negligence against elderly in rural areas of Anhui province].

    PubMed

    Su, Pu-yu; Hao, Jia-hu; Xiong, Li-ming; Yu, Dan-dan; Cao, Yue-ting; Fang, Yun; Jiang, Xiu-ling; Qian, Qiao-xia; Tao, Fang-biao

    2011-02-01

    To investigate the prevalence and influencing factors related to abuse and negligence against the elderly in the rural areas. 975 elderly over 60 years from 41 counties in Anhui province were included. All participants completed an anonymous questionnaire including items as: educational background, marital condition, income, child-discipline, rude action to parents, daily activities, physical functions, having chronic illness, abuse and negligence against the elderly, etc. In the last year, rates of common physical abuse, serious physical abuse, emotional abuse, financial exploitation, negligence, overall abuse and negligence against the elderly were 4.5%, 1.5%, 26.9%, 4.9%, 7.2%, 29.9% respectively. Among the 281 victims, 80.4% reported that they were suffered more than 3 times of abuse and neglect episodes, and 34.9% reported that they were suffered more than 2 forms of abuse and negligence. The primary sadism was carried out by the daughter-in-law or son-in-law (43.2%) of the elderly. Low activity on daily life and having chronic illness were the risk factors causing common physical abuse while better education was the protective factor to it. Low ability in managing daily activity of living was the risk factor causing serious physical abuse. Less active on daily life and having rude action to parents were the risk factors to emotional abuse, but being strict with their children was the protective factor to emotional abuse. Less active on daily life, often beating their children and having rude action to parents were the risk factors related to financial exploitation. Less active on daily life, having rude action to parents and having bad physical functions were the risk factors causing negligence. Less active on daily life and having rude manner to parents were the risk factors of overall elderly abuse and negligence, but being strict with their children was protective factor to the abuse and negligence against the elderly. High prevalence on abuse and

  11. [Beginners' operations and medical specialist standards : Avoidance of criminal liability and civil liability].

    PubMed

    Schneider, H

    2018-05-16

    In all phases, patients are entitled to receive medical treatment according to medical specialist standards. This does not mean that patients necessarily have to be treated by a medical specialist. Operations performed by "beginners", e. g. assistant physicians, are permitted. However, there are increased liability risks, both for the specialist and the assistant physician. Furthermore, there are risks of criminal responsibility for causing bodily harm by negligence or negligent manslaughter. This article portrays the requirements of civil liability and criminal responsibility concerning beginners' operations on the basis of cases and judgments of the Federal Court and the Higher Regional Courts in Germany. Additionally, the reception of the jurisprudence by the relevant legal literature will be discussed. Jurisprudence and legal literature categorize breaches of duty of care. Assistant physicians can be subject to contributory negligence liabilities, while specialists can bear liabilities for negligent selection, organization or supervision. Responsible specialist and assistant physicians can protect themselves (and the patient) and avoid legal risks by only performing operations adequate to their educational level or by delegating operations to beginners and ensuring intervention by a specialist by supervision of the operation which is suitable to the assistant physician's level of education.

  12. Forensic Interviews for Child Sexual Abuse Allegations: An Investigation into the Effects of Animal-Assisted Intervention on Stress Biomarkers.

    PubMed

    Krause-Parello, Cheryl A; Gulick, Elsie E

    2015-01-01

    The use of therapy animals during forensic interviews for child sexual abuse allegations is a recommendation by the Therapy Animals Supporting Kids Program to help ease children's discomfort during the forensic interview process. Based on this recommendation, this study incorporated a certified therapy canine into the forensic interview process for child sexual abuse allegations. This study investigated changes in salivary cortisol, immunoglobulin A, blood pressure, and heart rate as a result of forensic interview phenomenon (e.g., outcry) incorporating animal-assisted intervention versus a control condition in children (N = 42) interviewed for alleged child sexual abuse. The results supported significantly greater heart rate values for the control group (n = 23) who experienced sexual contact and/or indecency than the experience of aggravated sexual assault compared to no difference in HR for the intervention group (n = 19). The results suggest that the presence of the canine in the forensic interview may have acted as a buffer or safeguard for the children when disclosing details of sexual abuse. In the intervention group, children's HR was lower at the start of the forensic interview compared to the control group. Finding an effect of having a certified handler-canine team available during the forensic interview on physiological measures of stress has real-world value for children, child welfare personnel, and clinical therapists. It is suggested that animal-assisted intervention be expanded to children facing other types of trauma and to treatment programs for child survivors of sexual abuse.

  13. [Medical malpractice 2000. Malpractice from the viewpoint of expert witnesses if a malpractice insurance carrier].

    PubMed

    Maier, C

    2001-09-01

    Insurance industry statistics on medical malpractice are rare. The authors, who are in-house medical advisors of the Allianz Versicherungs-AG, report on their assessments of medical malpractice claims in 2000. Orthopedics/traumatology (24%) and gynecology/obstetrics (18%) are the medical fields in which liability demands are currently most frequent. Deviation from the medical state of the art (41%), false diagnosis (21%) and misinformation of patients (13%) are the main actual or alleged violations of the duty of care. The results, which are meant to provide a basis for future comparisons, are discussed with a view to establishing risk management strategies. On the basis of the literature and their own the authors have compiled a set of recommendations--"Ten commandments"--for decreasing medical malpractice claims.

  14. 16 CFR § 1702.15 - Petitions alleging the incompatibility of child resistant packaging with the particular substance...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... is based upon the fact that package choice is limited by a new drug application filed with the FDA, the petition shall state the limitation of package choice and a description of a time schedule to revise the NDA in order to allow additional package choice. (c) If the allegation of incompatibility is...

  15. The Alleged Crisis and the Illusion of Exact Replication.

    PubMed

    Stroebe, Wolfgang; Strack, Fritz

    2014-01-01

    There has been increasing criticism of the way psychologists conduct and analyze studies. These critiques as well as failures to replicate several high-profile studies have been used as justification to proclaim a "replication crisis" in psychology. Psychologists are encouraged to conduct more "exact" replications of published studies to assess the reproducibility of psychological research. This article argues that the alleged "crisis of replicability" is primarily due to an epistemological misunderstanding that emphasizes the phenomenon instead of its underlying mechanisms. As a consequence, a replicated phenomenon may not serve as a rigorous test of a theoretical hypothesis because identical operationalizations of variables in studies conducted at different times and with different subject populations might test different theoretical constructs. Therefore, we propose that for meaningful replications, attempts at reinstating the original circumstances are not sufficient. Instead, replicators must ascertain that conditions are realized that reflect the theoretical variable(s) manipulated (and/or measured) in the original study. © The Author(s) 2013.

  16. 78 FR 9987 - Social Security Ruling, SSR 13-1p; Titles II and XVI: Agency Processes for Addressing Allegations...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-12

    ... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2012-0071] Social Security Ruling, SSR 13-1p; Titles II and XVI: Agency Processes for Addressing Allegations of Unfairness, Prejudice, Partiality, Bias, Misconduct, or Discrimination by Administrative Law Judges (ALJs); Correction AGENCY: Social Security...

  17. 76 FR 2417 - OSHA-7 Form (“Notice of Alleged Safety and Health Hazards”); Extension of the Office of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-13

    ... DEPARTMENT OF LABOR Occupational Safety and Health Administration [Docket No. OSHA-2010-0056] OSHA-7 Form (``Notice of Alleged Safety and Health Hazards''); Extension of the Office of Management and Budget's (OMB) Approval of Information Collection (Paperwork) Requirements AGENCY: Occupational Safety...

  18. 5 CFR 6301.102 - Prior approval for certain outside activities.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... witnessed an automobile accident involving two privately owned cars on her way to work. Some time later she... plaintiff, who was injured in the car accident, in a civil case alleging negligence. The Department employee...

  19. 5 CFR 6301.102 - Prior approval for certain outside activities.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... witnessed an automobile accident involving two privately owned cars on her way to work. Some time later she... plaintiff, who was injured in the car accident, in a civil case alleging negligence. The Department employee...

  20. 5 CFR 6301.102 - Prior approval for certain outside activities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... witnessed an automobile accident involving two privately owned cars on her way to work. Some time later she... plaintiff, who was injured in the car accident, in a civil case alleging negligence. The Department employee...

  1. 5 CFR 6301.102 - Prior approval for certain outside activities.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... witnessed an automobile accident involving two privately owned cars on her way to work. Some time later she... plaintiff, who was injured in the car accident, in a civil case alleging negligence. The Department employee...

  2. How to model a negligible probability under the WTO sanitary and phytosanitary agreement?

    PubMed

    Powell, Mark R

    2013-06-01

    Since the 1997 EC--Hormones decision, World Trade Organization (WTO) Dispute Settlement Panels have wrestled with the question of what constitutes a negligible risk under the Sanitary and Phytosanitary Agreement. More recently, the 2010 WTO Australia--Apples Panel focused considerable attention on the appropriate quantitative model for a negligible probability in a risk assessment. The 2006 Australian Import Risk Analysis for Apples from New Zealand translated narrative probability statements into quantitative ranges. The uncertainty about a "negligible" probability was characterized as a uniform distribution with a minimum value of zero and a maximum value of 10(-6) . The Australia - Apples Panel found that the use of this distribution would tend to overestimate the likelihood of "negligible" events and indicated that a triangular distribution with a most probable value of zero and a maximum value of 10⁻⁶ would correct the bias. The Panel observed that the midpoint of the uniform distribution is 5 × 10⁻⁷ but did not consider that the triangular distribution has an expected value of 3.3 × 10⁻⁷. Therefore, if this triangular distribution is the appropriate correction, the magnitude of the bias found by the Panel appears modest. The Panel's detailed critique of the Australian risk assessment, and the conclusions of the WTO Appellate Body about the materiality of flaws found by the Panel, may have important implications for the standard of review for risk assessments under the WTO SPS Agreement. © 2012 Society for Risk Analysis.

  3. The General Medical Council: frame of reference or arbiter of morals?

    PubMed Central

    Hill, D

    1977-01-01

    Many members of the public think of the General Medical Council (GMC) as the body which tries doctors: the doctors' law courts, as it were. And, except in the more sober of newspapers and news reports, the 'offences ' which receive the most publicity are those concerning alleged improper relations between doctors and patients. Professor Sir Denis Hill, in the following paper, which he read in the spring of this year to the annual conference of the London Medical Group devoted to a discussion of human sexuality, chose to examine the whole function of the General Medical Council as a frame of moral reference for doctors. Judging allegations of professional misconduct by doctors is the function of the Council's Disciplinary Committee. Judging sexual misconduct forms only a small part of their work. The GMC's responsibility covers the whole notion of morals and morality as it concerns doctors in their professional work. Sir Denis Hill stresses the modern thinking that morality must be learned and that attitudes are always shifting as society alters its norms of what is moral conduct. That is not to say that all that was previously considered not to be moral has now become acceptable but rather that other concepts have entered the field of moral debate. Therefore the GMC must constantly review the frame of reference it offers to doctors and the public may be surprised to learn that that process is never static. Sir Denis Hill in this paper is speaking personally and not as a member of the General Medical Council or of any of that body's special committees. PMID:926129

  4. Establishing breach of the duty of care in the tort of negligence: 2.

    PubMed

    Tingle, John

    This article discusses the law surrounding breach of the duty of care in negligence. A mistake or error does not necessarily mean legal fault and negligence. Judges look at risks and benefits in determining what would have been the appropriate standard of care to be exercised in the circumstances and may decide that the defendant's conduct was reasonable. There are a number of interrelated factors which judges have to balance and these can be categorized as foreseeability of harm, magnitude of risk, burden of taking precautions, utility of the defendant's conduct and common practice.

  5. Delictual Negligence of Educators in Schools: The Confusing Influence of the "in loco parentis" Doctrine

    ERIC Educational Resources Information Center

    Potgieter, Johan

    2004-01-01

    This article points out that the "in loco parentis" maxim is partly to blame for introducing the confusing "reasonable parent" doctrine as the test for delictual negligence of educators in the school context. It is argued that the standard of care exercised by parents over their children is not appropriate to determine the negligence of educators.…

  6. 18 CFR 2.300 - Statement of policy concerning allegations of fraud, abuse, or similar grounds under section 601...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Statement of policy concerning allegations of fraud, abuse, or similar grounds under section 601(c) of the NGPA. 2.300 Section 2.300 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF...

  7. 18 CFR 2.300 - Statement of policy concerning allegations of fraud, abuse, or similar grounds under section 601...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Statement of policy concerning allegations of fraud, abuse, or similar grounds under section 601(c) of the NGPA. 2.300 Section 2.300 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF...

  8. 18 CFR 2.300 - Statement of policy concerning allegations of fraud, abuse, or similar grounds under section 601...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Statement of policy concerning allegations of fraud, abuse, or similar grounds under section 601(c) of the NGPA. 2.300 Section 2.300 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF...

  9. 18 CFR 2.300 - Statement of policy concerning allegations of fraud, abuse, or similar grounds under section 601...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Statement of policy concerning allegations of fraud, abuse, or similar grounds under section 601(c) of the NGPA. 2.300 Section 2.300 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF...

  10. Social evaluation of intentional, truly accidental, and negligently accidental helpers and harmers by 10-month-old infants.

    PubMed

    Woo, Brandon M; Steckler, Conor M; Le, Doan T; Hamlin, J Kiley

    2017-11-01

    Whereas adults largely base their evaluations of others' actions on others' intentions, a host of research in developmental psychology suggests that younger children privilege outcome over intention, leading them to condemn accidental harm. To date, this question has been examined only with children capable of language production. In the current studies, we utilized a non-linguistic puppet show paradigm to examine the evaluation of intentional and accidental acts of helping or harming in 10-month-old infants. In Experiment 1 (n=64), infants preferred intentional over accidental helpers but accidental over intentional harmers, suggestive that by this age infants incorporate information about others' intentions into their social evaluations. In Experiment 2 (n=64), infants did not distinguish "negligently" accidental from intentional helpers or harmers, suggestive that infants may find negligent accidents somewhat intentional. In Experiment 3 (n=64), we found that infants preferred truly accidental over negligently accidental harmers, but did not reliably distinguish negligently accidental from truly accidental helpers, consistent with past work with adults and children suggestive that humans are particularly sensitive to negligently accidental harm. Together, these results imply that infants engage in intention-based social evaluation of those who help and harm accidentally, so long as those accidents do not stem from negligence. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Neglect of Medical Evidence of Torture in Guantánamo Bay: A Case Series

    PubMed Central

    Iacopino, Vincent; Xenakis, Stephen N.

    2011-01-01

    Background In the wake of the September 11, 2001 attacks on the US, the government authorized the use of “enhanced interrogation” techniques that were previously recognized as torture. While the complicity of US health professionals in the design and implementation of US torture practices has been documented, little is known about the role of health providers, assigned to the US Department of Defense (DoD) at the US Naval Station Guantánamo Bay, Cuba (GTMO), who should have been in a position to observe and document physical and psychological evidence of torture and ill treatment. Methods and Findings We reviewed GTMO medical records and relevant case files (client affidavits, attorney–client notes and summaries, and legal affidavits of medical experts) of nine individuals for evidence of torture and ill treatment and documentation by medical personnel. In each of the nine cases, GTMO detainees alleged abusive interrogation methods that are consistent with torture as defined by the UN Convention Against Torture as well as the more restrictive US definition of torture that was operational at the time. The medical affidavits in each of the nine cases indicate that the specific allegations of torture and ill treatment are highly consistent with physical and psychological evidence documented in the medical records and evaluations by non-governmental medical experts. However, the medical personnel who treated the detainees at GTMO failed to inquire and/or document causes of the physical injuries and psychological symptoms they observed. Psychological symptoms were commonly attributed to “personality disorders” and “routine stressors of confinement.” Temporary psychotic symptoms and hallucinations did not prompt consideration of abusive treatment. Psychological assessments conducted by non-governmental medical experts revealed diagnostic criteria for current major depression and/or PTSD in all nine cases. Conclusion The findings in these nine cases from

  12. Criminal allegations in disciplinary cases involving health practitioners.

    PubMed

    Manning, Joanna

    2008-12-01

    Recently the Supreme Court of New Zealand decided that the standard of proof in disciplinary proceedings against a registered health practitioner is the ordinary, civil "balance of probabilities" standard, even in cases where criminal or serious allegations are made. Adopting recent House of Lords' case law, it rejected the existence of a third standard of proof, the "flexible" or "heightened" civil standard commensurate with the seriousness of the issue involved. Neither did the court consider direct application of the criminal, "beyond reasonable doubt" standard appropriate in disciplinary proceedings. Secondly, the court adopted a new principle that it is an abuse of process to bring a disciplinary charge against a practitioner, which is the same or substantially the same as that which he or she faced in the criminal proceedings and which resulted in an acquittal. It is not, however, an abuse to bring disciplinary charges after a criminal acquittal based on the same conduct, providing the disciplinary charges address wider aspects of the practitioner's conduct. The court was split on both issues. This column analyses the decision, supporting it on the first issue, but not the second.

  13. Manpower Substitution and Productivity in Medical Practice

    PubMed Central

    Reinhardt, Uwe E.

    1973-01-01

    Probably in response to the often alleged physician shortage in this country, concerted research efforts are under way to identify technically feasible opportunities for manpower substitution in the production of ambulatory health care. The approaches range from descriptive studies of the effect of task delegation on output of medical services to rigorous mathematical modeling of health care production by means of linear or continuous production functions. In this article the distinct methodological approaches underlying mathematical models are presented in synopsis, and their inherent strengths and weaknesses are contrasted. The discussion includes suggestions for future research directions. Images Fig. 2 PMID:4586735

  14. An Empirical Model of the Medical Match.

    PubMed

    Agarwal, Nikhil

    2015-07-01

    This paper develops a framework for estimating preferences in a many-to-one matching market using only observed matches. I use pairwise stability and a vertical preference restriction on one side to identify preferences on both sides of the market. Counterfactual simulations are used to analyze the antitrust allegation that the centralized medical residency match is responsible for salary depression. Due to residents' willingness to pay for desirable programs and capacity constraints, salaries in any competitive equilibrium would remain, on average, at least $23,000 below the marginal product of labor. Therefore, the match is not the likely cause of low salaries.

  15. MALPRACTICE AND THE QUALITY OF CARE IN RETINOPATHY OF PREMATURITY (AN AMERICAN OPHTHALMOLOGICAL SOCIETY THESIS)

    PubMed Central

    Reynolds, James D.

    2007-01-01

    Purpose A review of retinopathy of prematurity (ROP) malpractice cases will identify specific, repetitive problems in the provision of care and the reasons underlying these problems. Opportunities to improve the quality of care provided to premature infants with ROP will result. Methods A retrospective review of a series of 13 ROP malpractice cases in which the author served as a paid consultant, as well as a review of the literature for additional cases, was conducted. The series of 13 involved a review of the entire medical record as well as testimony and depositions. The characteristics of each case are tabulated, including state, date, allegations, defendants, disposition, award, the medical facts and care issues involved, and the judgment of medical error. In addition, a merit review was performed on the care in each case, and an error assessment was performed. Results The quality of care issues included neonatology failure to refer or follow up in 8 of 13, failure to adequately supervise resident care in 2 of 13, ophthalmologic failure to follow up in 6 of 13, and failure to properly diagnose and manage in 9 of 13. The latter included 4 of 13 that hinged on zone III issues and the presence or absence of full nasal vascularization with or without previous zone II disease. Merit review found negligent error by at least one party in 12 of 13. Ophthalmology error was found in 6 of 13. Malpractice, ie, negligent error causing negligent harm, was judged to be present in 9 of 13. Conclusions Negligent errors are common in malpractice cases that proceed to disposition. There are a limited number of repetitive errors that produce malpractice. An explanation of how these errors occur, coupled with the pertinent pathophysiology, afford an excellent opportunity to improve patient care PMID:18427626

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

    PubMed

    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.

  17. Stubbs v. North Memorial Medical Center.

    PubMed

    1989-11-14

    Bonnie Stubbs had cosmetic surgery performed as an outpatient at North Memorial Medical Center. The doctor took "before" and "after" photographs of the surgery which were then used in promotional material without Stubbs' consent. Stubbs alleged that the use of the photographs invaded her privacy, caused her emotional distress, and violated her rights under Minnesota's Patients' Bill of Rights. The trial court found no right to relief. The Minnesota Court of Appeals ruled that Stubbs may have a right to relief on the principle that an implied contract was breached between Stubbs and the physician. The Court of Appeals remanded the case for further proceedings in that light.

  18. Implications of Good Samaritan laws for physicians.

    PubMed

    Paterick, Timothy J; Paterick, Barbara B; Paterick, Timothy E

    2008-01-01

    Good Samaritan laws are designed to encourage individuals, including physicians, to gratuitously render medical care in emergency situations. Through these laws, immunity from civil liability is provided to physicians who act in good faith to provide emergency care gratis. Historically, emergency care involved medical assistance given to persons in motor vehicle crashes or other emergency situations in which bystanders were present. Protection of physicians from allegations of negligence was a tactic of the legislative and judicial systems to encourage active clinical participation, rather than cautious nonparticipation, in emergency care. In some states and under defined circumstances, the immunity may apply in the hospital setting, as well as in the physician's office. Legislatures have continued to amend the statutes to expand the protection provided to physicians who offer emergency care. Judicial construction of the nature and scope of physician immunity has similarly expanded.

  19. ["Street" medication in Burkina Faso: local names, social relationships, and alleged therapeutic effects].

    PubMed

    Pale, Augustin; Ladner, Joël

    2006-01-01

    This qualitative assessment, based on discussions and discourse collected in interviews with members of the general population, addresses the popular view of pharmaceutical drugs in Burkina Faso. The main results demonstrate a strong preference for drugs sold in the street and their largely "off-label" uses. These drugs not only treat defined diseases but also generate street discussions, popular images and social relationships that lead to their consumption, sometimes excessive. Furthermore, the links between the legal and illegal street markets, related in part to the legal status of different drugs, also leads to questions about good and bad, true and false. These distinctions, considered as labels, influence the population's behavior and attitude concerning street medication.

  20. The four medical theses of Samuel Hahnemann (1755-1843).

    PubMed

    Lang, Christoph Jg

    2016-05-01

    Samuel Hahnemann, the founder of homoeopathy, over a period of 33 years wrote four medical theses at three different universities. The first, in 1779 at the University of Erlangen, Franconia, dealt with agents that allegedly induce spasms, granting him a MD degree. The second two theses in 1784 dealt with obstetrical matters and were imposed upon him by the University of Wittenberg, Saxony, for becoming a medical officer, a position he apparently aspired to mostly for financial reasons. The fourth thesis in 1812 at the University of Leipzig, Saxony, his most elaborate dissertation on a toxic plant, white hellebore, served as a habilitation, allowing him to hold university lectures in order to disseminate his new ideas. © The Author(s) 2014.

  1. An Introduction to Medical Malpractice in the United States

    PubMed Central

    2008-01-01

    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. PMID:19034593

  2. An introduction to medical malpractice in the United States.

    PubMed

    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.

  3. Dissecting malpractice in pancreaticoduodenectomy cases.

    PubMed

    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.

  4. Assessing exclusionary power of a paternity test involving a pair of alleged grandparents.

    PubMed

    Scarpetta, Marco A; Staub, Rick W; Einum, David D

    2007-02-01

    The power of a genetic test battery to exclude a pair of individuals as grandparents is an important consideration for parentage testing laboratories. However, a reliable method to calculate such a statistic with short-tandem repeat (STR) genetic markers has not been presented. Two formulae describing the random grandparents not excluded (RGPNE) statistic at a single genetic locus were derived: RGPNE = a(4 - 6a + 4a(2)- a(3)) when the paternal obligate allele (POA) is defined and RGPNE = 2[(a + b)(2 - a - b)][1 - (a + b)(2 - a - b)] + [(a + b)(2 - a - b)] when the POA is ambiguous. A minimum number of genetic markers required to yield cumulative RGPNE values of not greater than 0.01 was calculated with weighted average allele frequencies of the CODIS STR loci. RGPNE data for actual grandparentage cases are also presented to empirically examine the exclusionary power of routine casework. A comparison of RGPNE and random man not excluded (RMNE) values demonstrates the increased difficulty involved in excluding two individuals as grandparents compared to excluding a single alleged parent. A minimum of 12 STR markers is necessary to achieve RGPNE values of not greater than 0.01 when the mother is tested; more than 25 markers are required without the mother. Cumulative RGPNE values for each of 22 nonexclusionary grandparentage cases were not more than 0.01 but were significantly weaker when calculated without data from the mother. Calculation of the RGPNE provides a simple means to help minimize the potential of false inclusions in grandparentage analyses. This study also underscores the importance of testing the mother when examining the parents of an unavailable alleged father (AF).

  5. 30 CFR 291.102 - May I call the BSEE Hotline to informally resolve an allegation that open and nondiscriminatory...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 2 2014-07-01 2014-07-01 false May I call the BSEE Hotline to informally... the BSEE Hotline to informally resolve an allegation that open and nondiscriminatory access was denied... open and nondiscriminatory access by calling the toll-free BSEE Pipeline Open Access Hotline at 1-888...

  6. 30 CFR 291.102 - May I call the BSEE Hotline to informally resolve an allegation that open and nondiscriminatory...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 2 2013-07-01 2013-07-01 false May I call the BSEE Hotline to informally... the BSEE Hotline to informally resolve an allegation that open and nondiscriminatory access was denied... open and nondiscriminatory access by calling the toll-free BSEE Pipeline Open Access Hotline at 1-888...

  7. 30 CFR 291.102 - May I call the BSEE Hotline to informally resolve an allegation that open and nondiscriminatory...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 2 2012-07-01 2012-07-01 false May I call the BSEE Hotline to informally... the BSEE Hotline to informally resolve an allegation that open and nondiscriminatory access was denied... open and nondiscriminatory access by calling the toll-free BSEE Pipeline Open Access Hotline at 1-888...

  8. United Kingdom General Medical Council fails child protection.

    PubMed

    Williams, Catherine

    2007-04-01

    To protect children, pediatricians must be willing to raise the possibility of abuse and not be intimidated by the consequences. We consider that the United Kingdom General Medical Council does not understand child protection matters and has no system for dealing adequately with complaints submitted by parents who claim false allegations of abuse. The actions of the General Medical Council in the recent cases of Drs Roy Meadow and David Southall conflict with current child protection laws and guidance for professionals. By deterring doctors from raising concerns about a child's safety and giving opinions on child deaths, the General Medical Council may be increasing the risk of serious child abuse. Although the rate of registrations by child protection authorities decreased by 28% between 1995 and 2005 (ie, there are fewer multiagency child protection plans), the number of criminal convictions for cruelty to or neglect of a child increased by 247% between 1998 and 2005. It is unacceptable that to date the General Medical Council has refused training in child protection offered by the Royal College of Paediatrics and Child Health.

  9. Statement of Glenn A. Fine, Acting Inspector General, Department of Defense on Department of Defense Office of Inspector General Report of Investigation on Allegations Related to USCENTCOM Intelligence Products

    DTIC Science & Technology

    2017-02-28

    systematic distortion of intelligence. Similarly, we did not find sufficient evidence to substantiate the allegations that CCJ2 leadership suppressed...CCJ2 leadership at the time, and does not 6 indicate any intent to present a rosier picture of the fight against ISIL. However, the CCJ2...to the early perception that the leadership did not trust the analysts and wanted to control the “narrative.” Similarly, the allegation raised in

  10. Medication associated with hearing loss: 25 years of medical malpractice cases in the United States.

    PubMed

    Ruhl, Douglas S; Cable, Benjamin B; Martell, David W

    2014-09-01

    Many medications have the potential for ototoxicity. To potentiate management of this risk, this study examines malpractice litigation trends of lawsuits involving hearing loss associated with medication use. As experts in hearing loss, it may benefit otolaryngologists to be familiar with this information. Retrospective review. All US civil trials. Court records of legal trials from 1987 to 2012 were obtained from 2 major computerized databases. Data were compiled on the demographics of the defendant and plaintiff, use of otolaryngologists as expert witnesses, medication used, legal allegations, verdicts, and judgments. Forty-six unique cases met inclusion criteria and were selected for review. Antibiotics (72%), specifically aminoglycosides (47%), were the most common medications cited as causing hearing loss. Eleven (22%) cases were resolved through a settlement before a verdict was reached. Verdicts in favor of the plaintiffs (37%) were awarded an average of $1,134,242. Pediatric patients were more likely to have outcomes in their favor (P = .03) compared to adults. Of the cases found in favor of the plaintiff, the most common reasons cited were inappropriate medication, dose, or duration (59%); failure to properly monitor (39%); and failure to choose a less toxic medication (18%). Physicians must be aware of the potential effects of the medications they prescribe. An understanding of potential drug interactions, proper monitoring, and appropriate substitution with less toxic medications are important to improve patient care. Analyzing litigation trends may be used to prevent future lawsuits and improve physician awareness. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  11. Assessing the effectiveness of the NICHD investigative interview protocol when interviewing French-speaking alleged victims of child sexual abuse in Quebec.

    PubMed

    Cyr, Mireille; Lamb, Michael E

    2009-05-01

    The study was designed to assess the effectiveness of the flexibly structured NICHD Investigative Interview Protocol for child sexual abuse (CSA) investigative interviews by police officers and mental health workers in Quebec. The NICHD Protocol was designed to operationalize "best practice" guidelines and to help forensic interviewers use open-ended prompts to facilitate free recall by alleged victims. A total of 83 interviews with 3- to 13-year-old alleged victims were matched with 83 interviews conducted by the same interviewers before they were trained to use the Protocol. Interviews were matched with respect to the children's ages, children-perpetrator relationships, and the types and frequency of abuse. Coders categorized each of the prompts used to elicit information about the abuse and tabulated the numbers of new forensically relevant details provided in each response. Interviewers used three times as many open-ended prompts in Protocol interviews than in non-Protocol interviews, whereas use of all other types of questions was halved, and the total number of questions asked decreased by 25%. Protocol-guided interviews yielded more details than comparison interviews. The mean number of details per prompt increased from 3 to 5 details when the Protocol was used. Even with young children, interviewers using the Protocol employed more invitations to elicit forensically relevant details. French-speaking investigators using the NICHD Protocol used open-ended prompts rather than focused questions when interviewing alleged victims. In addition, these interviewers needed fewer questions to get relevant information when using the Protocol. A French version of the NICHD Protocol is now available to police officers and social workers who investigate the alleged sexual abuse of young children in French-speaking countries. This French version allowed trained interviewers to increase the use of invitations and reduce the use of more focused and risky questions. When the

  12. 31 CFR 370.40 - Can I be held accountable if my negligence contributes to a forged signature?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Can I be held accountable if my negligence contributes to a forged signature? 370.40 Section 370.40 Money and Finance: Treasury Regulations... if my negligence contributes to a forged signature? (a) General. If your failure to exercise ordinary...

  13. Uncovering malpractice in appendectomies: a review of 234 cases.

    PubMed

    Choudhry, Amad J; Anandalwar, Seema P; Choudhry, Asad J; Svider, Peter F; Oliver, Joseph O; Eloy, Jean Anderson; Chokshi, Ravi J

    2013-10-01

    General surgery is a "high-risk specialty" with respect to medical malpractice rates, and appendicitis is one of the most common diagnoses encountered by practitioners. Our objectives were to detail issues affecting malpractice litigation regarding appendicitis and appendectomies, including outcomes, awards, alleged causes of malpractice, and other factors instrumental in determining legal responsibility and increasing patient safety. Publically available federal and state court records were examined for pertinent jury verdict and settlement reports. Information from 234 pertinent cases was collected, including alleged causes of malpractice and outcomes. Of the 234 cases included in this study, the most common factor noted was an alleged delay in diagnosis (67.1%), followed by intraoperative negligence (16.2%). Alleged deficits in informed consent, although only specifically cited as a cause of malpractice in 1.3% of cases, were found to be an important aspect of many cases. In total, 59.8% of cases were ruled in favor of the physician, 23.7% in favor of the plaintiff, and 5.5% reached a settlement. The average plaintiff award was US $794,152, and the average settlement award was US $1,434,286. An important strategy to decrease liability in a physician's practice is prompt evaluation of an appendicitis patient. An integral part of this is efficient communication between physicians practicing a wide variety of specialties, especially including practitioners in emergency medicine and general surgery. Additionally, completing a thorough informed consent explaining all aspects of the procedure including the factors we outline will not only increase patient awareness of potential risks but also protect the physician in the face of litigation.

  14. The Influence of Negligence, Intention, and Outcome on Children's Moral Judgments

    ERIC Educational Resources Information Center

    Nobes, Gavin; Panagiotaki, Georgia.; Pawson, Chris

    2009-01-01

    Piaget (1932) and subsequent researchers have reported that young children's moral judgments are based more on the outcomes of actions than on the agents' intentions. The current study investigated whether negligence might also influence these judgments and explain children's apparent focus on outcome. Children (3-8 years of age) and adults (N =…

  15. 42 CFR 457.232 - Refunding of Federal Share of CHIP overpayments to providers and referral of allegations of waste...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Refunding of Federal Share of CHIP overpayments to providers and referral of allegations of waste, fraud or abuse to the Office of Inspector General. 457.232 Section 457.232 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S...

  16. Base Rates, Multiple Indicators, and Comprehensive Forensic Evaluations: Why Sexualized Behavior Still Counts in Assessments of Child Sexual Abuse Allegations

    ERIC Educational Resources Information Center

    Everson, Mark D.; Faller, Kathleen Coulborn

    2012-01-01

    Developmentally inappropriate sexual behavior has long been viewed as a possible indicator of child sexual abuse. In recent years, however, the utility of sexualized behavior in forensic assessments of alleged child sexual abuse has been seriously challenged. This article addresses a number of the concerns that have been raised about the…

  17. Surgical malpractice in California: res judicata.

    PubMed

    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).

  18. 78 FR 5416 - Certain Frozen Warmwater Shrimp From the People's Republic of China, Ecuador, India, Indonesia...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-25

    ... so for different purposes and pursuant to a separate and distinct authority. In addition, the... negligibility threshold provided for under section 771(24)(A) of the Act. In addition, the petitioner alleges... benefited from countervailable subsidies bestowed by their respective governments. In addition to subsidies...

  19. Reference News Release: U.S. Files Complaint, Announces Settlement to Address Alleged Renewable Fuel Standard Violations by NGL Crude Logistics and Western Dubuque Biodiesel

    EPA Pesticide Factsheets

    Reference news release on the complaint against NGL Crude Logistics, LLC and Western Dubuque Biodiesel, LLC and a settlement with Western Dubuque to address alleged violations of the Renewable Fuel Standard.

  20. [Liability of pediatric nurses for professional negligence in Taiwan: a case study].

    PubMed

    Huang, Hui-Man; Sun, Fan-Ko

    2014-04-01

    Liability attribution and professional negligence in pediatric nursing are topics that have been neglected in Taiwan. (1) Identify the definitions of related criminal activities in accordance with domestic criminal law; (2) Elucidate the facts and the dispute in a current case involving a pediatric nurse; (3) Elucidate the principle of 'no punishment without law'; (4) Explore the reasons why the pediatric nurse in the current case received a verdict of 'not guilty'. A literature review and case study approach were used to analyze a sentence reconsideration of the first instance No. 1 (2011) issued by the Taiwan high court, Kaohsiung branch court. The conditions for the scrutiny of criminal activity under Taiwan criminal law are statement of facts, illegality (justifiable cause), and liability (excuse). In this case, the pediatric nurse was accused of failing to prevent an infant from suffocation and of not discharging her obligations as a nurse. The pediatric nurse rebutted the charge of criminal negligence. The intervening behaviors of the pediatric nurse were found to be legal and not culpable. In this case, the High Court and Supreme Court made a final criminal judgment based on the presumption of innocence, and the pediatric nurse was pronounced innocent of the charge. This article intends to assist pediatric nurses understand their liabilities under Taiwan's criminal law. Pediatric nurses should gain a better understanding of the nature of liability for professional negligence in order to clarify how actions that may be illegal do not necessarily make nurses culpable.

  1. Keeping Up with Healthcare Trends: IcHeart as a Medication Management Application

    NASA Astrophysics Data System (ADS)

    Kasinathan, Vinothini; Mustapha, Aida; Azah Samsudin, Noor

    2016-11-01

    According to the US governments, more than 125,000 people die each year due to failure to manage their medications, leading to approximately USD100 billion in preventable costs to healthcare systems. The core failure in medication management is attributed by patients failing to adhere their medication regimens, whether by accident, negligence, or intentional. Recognizing the importants of vigilant monitoring in medication management, this paper is set to review the latest android-based healthcare trends and propose a new mobile medication reminder application called IcHeart.

  2. The Criteria-Based Content Analysis and Its Utility in Distinguishing Between Truthful and Fabricated Criminal Allegations: A Critical Review

    DTIC Science & Technology

    1994-01-01

    systems, other European descriptions of similar statement analyses can be found in Arntzen (1970) (cited in Kdhnken & Steller, 1988), Szewczyk (1973...deals solely with the verbal content of the witness’ statement or allegation. Arntzen provided the first classification of the specific CBCA criteria...criteria as unsystematic and unconvincing. Steller and Kdhnken (1989) integrated the criteria provided by Arntzen and previous investigators to

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

    PubMed

    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.

  4. Understanding mass allegations of satanist child abuse in early modern Sweden: demographic data relevant to the Rättvik outbreak of 1670-1671.

    PubMed

    Sjöberg, Rickard L

    2003-02-01

    Demographic characteristics of 79 women who were accused of satanist child abductions in the parish of Rättvik, Sweden, in 1670-1671; 53 adults who promoted such accusations by bringing children to interrogations; and samples from the general population of Rättvik were compared. Results indicate that men were more likely to promote allegations of satanism than women and that these men were more likely to be married than the average Rättvik male. Promoters of allegations were older than average parishioners, and land-owning people who were involved in the panic owned more land than landowners who were not involved. People who were involved in the panic knew less about Luther's catechism than members of the general population. It is suggested that most of these findings may reflect a tendency of people who lived in the proximity of children to become involved in the panic.

  5. Updates in medical malpractice: an otology perspective.

    PubMed

    Ruhl, Douglas S; Littlefield, Philip D

    2015-10-01

    Most surgeons at some point are involved in a medical malpractice case. There has been an increase in the number of manuscripts that analyse malpractice databases and insurance claims, as well as commentaries on the current medicolegal climate recently. This manuscript broadly reviews articles of interest to all providers and then focuses on malpractice in otology. Medical malpractice articles (particularly topics related to otologic surgery published within the last 1-2 years) were searched. The growing body of literature can be divided into the themes of general negligence, mitigating injuries and the use of clinical practice guidelines in the courtroom as guidance for expert witnesses. Recent findings suggest that the frequency of malpractice claims may be decreasing. Hearing loss and facial nerve injury are the most common injuries associated with otologic surgery. These injuries can be costly when negligence is found. Clinic practice guidelines are slowly being used as evidence in the courtroom and there are established guidelines that an expert witness must follow should a surgeon be called to give testimony.

  6. Student Suicide.

    ERIC Educational Resources Information Center

    Zirkel, Perry A.; Gluckman, Ivan B.

    1996-01-01

    A Florida student suicide case alleging administrative and school board negligence had mixed results. School officials must be vigilant about the possibility of student suicide and put appropriate procedures into place. The connections to school may include confidential communications, curricular linkages (educational films and student journals),…

  7. 38 CFR 14.605 - Suits against Department of Veterans Affairs employees arising out of a wrongful act or omission...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... against a Federal employee, or the employee's estate, for damage to property, personal injury, or death... damage, personal injury, or death allegedly occurring as a result of malpractice or negligence committed..., or death will not lie against such personnel under the circumstances set forth in this subparagraph...

  8. Teachers' Verbal Abuse: An Update.

    ERIC Educational Resources Information Center

    Zirkel, Perry A.

    2001-01-01

    In a case involving a somewhat sarcastic elementary teacher, a Pennsylvania Commonwealth Court reversed the state commissioner of education's affirmation of her dismissal based on persistent negligence. Results of teachers' alleged verbal abuse of students depends on the nature of the claim, not just specific evidence. (MLH)

  9. Sovereign immunity: Principles and application in medical malpractice.

    PubMed

    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.

  10. 7 CFR 1.51 - Claims based on negligence, wrongful act or omission.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 1 2013-01-01 2013-01-01 false Claims based on negligence, wrongful act or omission. 1.51 Section 1.51 Agriculture Office of the Secretary of Agriculture ADMINISTRATIVE REGULATIONS... Department of Agriculture (USDA) may, subject to the provisions of the FTCA and DOJ regulations, consider...

  11. Are the results of questionnaires measuring non-cognitive characteristics during the selection procedure for medical school application biased by social desirability?

    PubMed Central

    Obst, Katrin U.; Brüheim, Linda; Westermann, Jürgen; Katalinic, Alexander; Kötter, Thomas

    2016-01-01

    Introduction: A stronger consideration of non-cognitive characteristics in Medical School application procedures is desirable. Psychometric tests could be used as an economic supplement to face-to-face interviews which are frequently conducted during university internal procedures for Medical School applications (AdH, Auswahlverfahren der Hochschulen). This study investigates whether the results of psychometric questionnaires measuring non-cognitive characteristics such as personality traits, empathy, and resilience towards stress are vulnerable to distortions of social desirability when used in the context of selection procedures at Medical Schools. Methods: This study took place during the AdH of Lübeck University in August 2015. The following questionnaires have been included: NEO-FFI, SPF, and AVEM. In a 2x1 between-subject experiment we compared the answers from an alleged application condition and a control condition. In the alleged application condition we told applicants that these questionnaires were part of the application procedure. In the control condition applicants were informed about the study prior to completing the questionnaires. Results: All included questionnaires showed differences which can be regarded as social-desirability effects. These differences did not affect the entire scales but, rather, single subscales. Conclusion: These results challenge the informative value of these questionnaires when used for Medical School application procedures. Future studies may investigate the extent to which the differences influence the actual selection of applicants and what implications can be drawn from them for the use of psychometric questionnaires as part of study-place allocation procedures at Medical Schools. PMID:27990471

  12. Are the results of questionnaires measuring non-cognitive characteristics during the selection procedure for medical school application biased by social desirability?

    PubMed

    Obst, Katrin U; Brüheim, Linda; Westermann, Jürgen; Katalinic, Alexander; Kötter, Thomas

    2016-01-01

    Introduction: A stronger consideration of non-cognitive characteristics in Medical School application procedures is desirable. Psychometric tests could be used as an economic supplement to face-to-face interviews which are frequently conducted during university internal procedures for Medical School applications (AdH, Auswahlverfahren der Hochschulen). This study investigates whether the results of psychometric questionnaires measuring non-cognitive characteristics such as personality traits, empathy, and resilience towards stress are vulnerable to distortions of social desirability when used in the context of selection procedures at Medical Schools. Methods: This study took place during the AdH of Lübeck University in August 2015. The following questionnaires have been included: NEO-FFI, SPF, and AVEM. In a 2x1 between-subject experiment we compared the answers from an alleged application condition and a control condition. In the alleged application condition we told applicants that these questionnaires were part of the application procedure. In the control condition applicants were informed about the study prior to completing the questionnaires. Results: All included questionnaires showed differences which can be regarded as social-desirability effects. These differences did not affect the entire scales but, rather, single subscales. Conclusion: These results challenge the informative value of these questionnaires when used for Medical School application procedures. Future studies may investigate the extent to which the differences influence the actual selection of applicants and what implications can be drawn from them for the use of psychometric questionnaires as part of study-place allocation procedures at Medical Schools.

  13. Clinical negligence in foot and ankle surgery: A 17-year review of claims to the NHS Litigation Authority.

    PubMed

    Ring, J; Talbot, C L; Clough, T M

    2014-11-01

    We present a review of litigation claims relating to foot and ankle surgery in the NHS in England during the 17-year period between 1995 and 2012. A freedom of information request was made to obtain data from the NHS litigation authority (NHSLA) relating to orthopaedic claims, and the foot and ankle claims were reviewed. During this period of time, a total of 10 273 orthopaedic claims were made, of which 1294 (12.6%) were related to the foot and ankle. 1036 were closed, which comprised of 1104 specific complaints. Analysis was performed using the complaints as the denominator. The cost of settling these claims was more than £36 million. There were 372 complaints (33.7%) involving the ankle, of which 273 (73.4%) were related to trauma. Conditions affecting the first ray accounted for 236 (21.4%), of which 232 (98.3%) concerned elective practice. Overall, claims due to diagnostic errors accounted for 210 (19.0%) complaints, 208 (18.8%) from alleged incompetent surgery and 149 (13.5%) from alleged mismanagement. Our findings show that the incorrect, delayed or missed diagnosis of conditions affecting the foot and ankle is a key area for improvement, especially in trauma practice. ©2014 The British Editorial Society of Bone & Joint Surgery.

  14. Medical malpractice, defensive medicine and role of the "media" in Italy.

    PubMed

    Toraldo, Domenico M; Vergari, Ughetta; Toraldo, Marta

    2015-01-01

    For many years until now, Italy has been subjected to an inconsistent and contradictory media campaign. On one hand the "media" present us with bold and reassuring messages about the progress of medical science; on the other hand they are prone to kneejerk criticism every time medical treatment does not have the desired effect, routinely describing such cases as glaring examples of "malasanità", an Italian word of recent coinage used to denote medical malpractice. Newspaper reports of legal proceedings involving health treatment are frequently full of errors and lack any scientific basis. The published data confirm the unsustainably high number of lawsuits against doctors and medical structures, accompanied by demands for compensation arising from true or alleged medical errors or mistakes blamed on the work of health structures. Currently Italian citizens have a greater awareness of their right to health than in the past, and patients' expectations have risen. A discrepancy is emerging between the current state of medical science and the capacities of individual doctors and health structures. Lastly, there is a need for greater monitoring of the quality of health care services and a greater emphasis on health risk prevention.

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

    PubMed

    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

  16. Mismanaging Concussions in Intercollegiate Football

    ERIC Educational Resources Information Center

    Moser, Austin; Miller, John J.

    2014-01-01

    In 2011, Adrian Arrington filed a class action lawsuit against the National Collegiate Athletic Association (NCAA) on behalf of himself and other athletes who had sustained concussions that resulted in long-term injuries. In the lawsuit, Arrington alleged that the NCAA employed a negligent approach to concussed student-athletes.

  17. 41 CFR 101-39.405 - Claims against the Government.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Government. 101-39.405 Section 101-39.405 Public Contracts and Property Management Federal Property... Government. (a) Whenever a GSA Interagency Fleet Management System (IFMS) vehicle is involved in an accident... against the Government based on the alleged negligence of the vehicle operator (acting within the scope of...

  18. 41 CFR 101-39.405 - Claims against the Government.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Government. 101-39.405 Section 101-39.405 Public Contracts and Property Management Federal Property... Government. (a) Whenever a GSA Interagency Fleet Management System (IFMS) vehicle is involved in an accident... against the Government based on the alleged negligence of the vehicle operator (acting within the scope of...

  19. The vaccine-autism connection: a public health crisis caused by unethical medical practices and fraudulent science.

    PubMed

    Flaherty, Dennis K

    2011-10-01

    In 1998, Dr. Andrew Wakefield, a British gastroenterologist, described a new autism phenotype called the regressive autism-enterocolitis syndrome triggered by environmental factors such as measles, mumps, and rubella (MMR) vaccination. The speculative vaccination-autism connection decreased parental confidence in public health vaccination programs and created a public health crisis in England and questions about vaccine safety in North America. After 10 years of controversy and investigation, Dr. Wakefield was found guilty of ethical, medical, and scientific misconduct in the publication of the autism paper. Additional studies showed that the data presented were fraudulent. The alleged autism-vaccine connection is, perhaps, the most damaging medical hoax of the last 100 years.

  20. Use of trauma scoring systems to determine the physician's responsibility in cases of traumatic death with medical malpractice claim.

    PubMed

    Arslan, Murat Nihat; Kertmen, Çisem; Melez, Deniz Oğuzhan; Evcüman, Durmuş; Büyük, Yalçın

    2017-07-01

    Traumatic injury is near the top of World Health Organization list of leading causes of death, and one of the major factors affecting mortality is the severity of the trauma. During medical intervention for trauma patients, some injuries may be overlooked, and this misstep may be the basis of a malpractice claim. The objective of this study was to provide a new approach to evaluating medical malpractice cases by discussing the benefits of the use of trauma scores. Cases of alleged malpractice that were discussed and concluded between 2010 and 2013 were selected from the case archive of the General Committee of the Council of Forensic Medicine (GC of CFM). Injury severity scores were calculated from the medical records of accused physicians and from the autopsy or final clinical evaluation records and compared. Between the years 2010 and 2013, 263 cases of alleged medical malpractice were discussed and concluded by the general committee. Of these, in 25 cases of patient death, the reason for admission to the hospital was traumatic injury. Various surgical specialties were involved. In these 25 cases, 34 physicians were accused of medical malpractice, and the General Committee classified the interventions of 14 physicians in 12 cases as "malpractice." Missed injuries and unrecognized diagnoses can be established by comparing the Injury Severity Score and New Injury Severity Score values in the findings of accused physicians with the subsequent findings of last evaluation or autopsy. In a medical malpractice case, calculating injury severity scores may assist an expert witness or judge to detect any unseen injuries and to determine the likely survival potential of the patient, but these values do not provide enough information to evaluate all of the evidence or draw conclusions about the entire case. All contributing factors to trauma severity should be considered along with the trauma score and other case factors.

  1. Negligence 10 Years after Gertz v. Welch. Journalism Monographs Number Ninety-Three.

    ERIC Educational Resources Information Center

    Hopkins, W. Wat

    The implications and shortcomings of court rulings on negligence in libel laws are explored in this paper. The paper first discusses the particulars of the 1974 landmark "Gertz versus Robert Welch, Inc." United States Supreme Court case, in which the court ruled that private persons as well as public figures would be required to prove…

  2. Little Albert's alleged neurological impairment: Watson, Rayner, and historical revision.

    PubMed

    Digdon, Nancy; Powell, Russell A; Harris, Ben

    2014-11-01

    In 2012, Fridlund, Beck, Goldie, and Irons (2012) announced that "Little Albert"-the infant that Watson and Rayner used in their 1920 study of conditioned fear (Watson & Rayner, 1920)-was not the healthy child the researchers described him to be, but was neurologically impaired almost from birth. Fridlund et al. also alleged that Watson had committed serious ethical breaches in regard to this research. Our article reexamines the evidentiary bases for these claims and arrives at an alternative interpretation of Albert as a normal infant. In order to set the stage for our interpretation, we first briefly describe the historical context for the Albert study, as well as how the study has been construed and revised since 1920. We then discuss the evidentiary issues in some detail, focusing on Fridlund et al.'s analysis of the film footage of Albert, and on the context within which Watson and Rayner conducted their study. In closing, we return to historical matters to speculate about why historiographical disputes matter and what the story of neurologically impaired Albert might be telling us about the discipline of psychology today.

  3. 30 CFR 285.108 - When must I notify MMS if an action has been filed alleging that I am insolvent or bankrupt?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false When must I notify MMS if an action has been filed alleging that I am insolvent or bankrupt? 285.108 Section 285.108 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE RENEWABLE ENERGY ALTERNATE USES OF EXISTING...

  4. Media Incitement: The "Born Innocent" Case.

    ERIC Educational Resources Information Center

    Stevens, George E.

    1979-01-01

    Concludes from a review of court cases that recovery of damages from a mass medium for an alleged incitement of antisocial behavior is unlikely under traditional negligence rules, even without a consideration of constitutional questions. Notes that the expense of litigation may cause the media to avoid potentially provocative communication. (GT)

  5. Liability.

    ERIC Educational Resources Information Center

    Hollander, Patricia A.

    This chapter on liability covers a number of cases alleging negligence by colleges, universities, and university hospitals filed by patients and injured students. Liability issues are also part of defamation of character suits. Oral statements are known as slander, while written statements which defame are called libel. In certain situations,…

  6. Who's afraid of EBM? Medical professionalism from the perspective of evidence-based medicine.

    PubMed

    Salloch, Sabine

    2017-03-01

    Evidence-based medicine (EBM) and medical professionalism are two prominent notions in current medical debates. However, proponents of professionalism fear a restriction in doctors' freedom to make their best decisions for individual patients caused by the influence of EBM and highly standardised decision procedures. The challenge which EBM allegedly poses to physicians' discretion forms the starting point for an analysis of the relationship between professionalism, as an inherent value system of medical practice, and EBM, as an approach to optimise the decision-making for individual patients. The analysis starts with a brief conceptual clarification of the ambiguous term "professionalism". It then focuses on three key aspects of medical professionalism which may come into conflict with the basic tenets of EBM. The potential tensions between (a) professional autonomy and clinical practice guidelines, (b) individualised care and standardisation, and (c) esoteric authority and public accountability are analysed and a suggestion for reconcilement regarding each point is made. The article closes with a summary on how a better reflection on medical professionalism may help towards a fuller understanding of EBM and vice versa.

  7. Bufo toads and bufotenine: fact and fiction surrounding an alleged psychedelic.

    PubMed

    Lyttle, T; Goldstein, D; Gartz, J

    1996-01-01

    This paper investigates the supposedly psychedelic Bufo toad and the allegedly psychedelic drug bufotenine, which is contained in the skin and glands of this toad. The bufo toad has held a place in human mythologies and medicines worldwide since archaic times. Used by ancient peoples for a variety of purposes, its most spectacular effects, according to lore, involve magical and shamanic or occult uses for casting spells and for divination. In the Middle Ages, the Bufo toad was celebrated as a panacea and persecuted as a powerful poison. More recently, in the 1960s the Bufo toad was resurrected as a countercultural icon, with people purportedly licking or smoking the secretions to get high. Bufotenine has been at the center of a scientific debate since its discovery in 1893. This paper examines the extensive literature surrounding the Bufo toad and bufotenine, and untangles many of the myths and the misinformation that continue to vex both science and popular reporting. Finally, to promote further investigation, a comprehensive bibliography is provided that charts the history of the Bufo toad and bufotenine.

  8. Paving the road to negligence: the compensation for research-related injuries in Spain.

    PubMed

    Ramiro Avilés, Miguel A

    2015-01-01

    The planned reform of the regulation of clinical trials in Spain has reopened the debate over how to regulate research-related injuries. Act 29/2006 and Royal Decree 223/2004 regulate the insurance of research-related injuries, and they include a general clause requiring mandatory insurance and imposing a no-fault compensation system; they also contain an exception clause enabling clinical trials to be carried out without insurance under some conditions, and an exclusion clause excluding compensation when there is no causal connection between injuries and a clinical trial. National legislation is under review, affecting the requirement of mandatory insurance and paving the road to a liability system based on negligence, which will affect the level of protection of the persons enrolled in clinical trials because it would not ensure compensation. Regulatory texts on individuals' participation as research subjects should include not only mandatory insurance, but also a no-fault compensation system for cases when voluntary research subjects are injured, irrespective of negligence.

  9. Court grants courier a jury trial based on fear of AIDS.

    PubMed

    1996-03-08

    A medical courier who was exposed to blood from a leaking container will be granted a jury trial in Albuquerque, NM. Courier [name removed] was splashed with blood and became alarmed because she had paper cuts on her hands. Repeated blood tests for HIV and hepatitis B were negative. A Bernallilo County judge initially dismissed [name removed]'s lawsuit when the hospital revealed that there was no HIV present in the splashed liquid. A three-judge panel of the Court of Appeals ruled to allow [name removed] a jury trial because New Mexico law no longer requires a plaintiff to prove that the defendant's actions created actual danger or physical impact. The panel determined that [name removed]'s allegations stated a cause for negligent infliction of emotional distress.

  10. Defamation actions.

    PubMed

    Tapp, A

    1999-03-01

    Registered nurses working in today's fast paced, high-tech health care environments are aware of their professional accountability and that, at some point, they may be involved in legal proceedings related to their practice. A civil lawsuit alleging negligence is the predominant concern nurses have when they turn their minds to this issue.

  11. Cruise ship's doctors - company employees or independent contractors?

    PubMed

    Dahl, Eilif

    2016-01-01

    Traditionally, cruise companies have stated that they are in the transport business but not in the business of providing medical services to passengers. They have claimed not to be able to supervise or control the ship's medical personnel and cruise ship's doctors have therefore mostly been signed on as independent contractors, not employees. A United States court decision from 1988, Barbetta versus S/S Bermuda Star, supported this view and ruled that a ship's owner cannot be held vicariously liable for the negligence of the ship's doctor directed at the ship's passengers. Some years ago a cruise passenger fell and hit his head while boarding a trolley ashore. Hours later he was seen aboard by the ship's doctor, who sent him to a local hospital. He died 1 week later, and his daughter filed a complaint alleging the cruise company was vicariously liable for the purported negligence of the ship's doctor and nurse, under actual or apparent agency theories. A United States district court initially dismissed the case, but in November 2014 the United States Court of Appeals for the Eleventh Circuit disagreed and reversed. From then on independently contracted ship's doctors may be considered de facto employees of the cruise line. The author discusses the employment status of physicians working on cruise ships and reviews arguments for and against the Appellate Court's decision.

  12. Fixational eye movement: a negligible source of dynamic aberration.

    PubMed

    Mecê, Pedro; Jarosz, Jessica; Conan, Jean-Marc; Petit, Cyril; Grieve, Kate; Paques, Michel; Meimon, Serge

    2018-02-01

    To evaluate the contribution of fixational eye movements to dynamic aberration, 50 healthy eyes were examined with an original custom-built Shack-Hartmann aberrometer, running at a temporal frequency of 236Hz, with 22 lenslets across a 5mm pupil, synchronized with a 236Hz pupil tracker. A comparison of the dynamic behavior of the first 21 Zernike modes (starting from defocus) with and without digital pupil stabilization, on a 3.4s sequence between blinks, showed that the contribution of fixational eye movements to dynamic aberration is negligible. Therefore we highlighted the fact that a pupil tracker coupled to an Adaptive Optics Ophthalmoscope is not essential to achieve diffraction-limited resolution.

  13. A no-fault compensation system for medical injury is long overdue.

    PubMed

    Weisbrot, David; Breen, Kerry J

    2012-09-03

    The 2011 report of the Productivity Commission (PC) recommended the establishment of a no-fault national injury insurance scheme limited to "catastrophic" injury, including medical injury. The report is welcome, but represents a missed opportunity to establish simultaneously a much-needed no-fault scheme for all medical injuries. The existing indemnity scheme based on negligence remains a slow, costly, inefficient, ill targeted and stress-creating system. A fault-based negligence scheme cannot deter non-intentional errors and does little to identify or prevent systems failures. In addition, it discourages reporting, and thus is antithetical to the modern focus on universal patient safety. A no-fault scheme has the potential to be fairer, quicker and no more costly, and to contribute to patient safety. No-fault schemes have been in place in at least six developed countries for many years. This extensive experience in comparable countries should be examined to assist Australia to design an effective, comprehensive system. Before implementing the recommendations of the PC, the federal government should ask the Commission to study and promptly report on an ancillary no-fault scheme that covers all medical injury.

  14. Toward "harder" medical humanities: moving beyond the "two cultures" dichotomy.

    PubMed

    Polianski, Igor J; Fangerau, Heiner

    2012-01-01

    Using the current international debate surrounding the incorporation of medical humanities into medical curricula as a starting point, the authors address both the legitimacy and didactics of teaching medical humanities to medical students. They highlight the paradox of the increasing prevalence of medical humanities in medical curricula and the often critical reception humanities courses receive. The alleged lack of empirical evidence linking such courses with improved patient care cannot alone explain the criticism they engender. After a short overview of the debate surrounding medical humanities and their inclusion in outcomes-based education, the authors outline the medical humanities block, "The History, Theory, and Ethics of Medicine," which is part of the German medical curriculum. A model developed at Ulm University exemplifies the integrated inclusion of the heterogeneous aspects of medical culture into medical education. This model emphasizes a reflexive approach (i.e., understanding how the humanities are manifested in medicine) as an alternative to the currently dominant narrative approach (i.e., liberal arts, moral development, and/or mental retreat), which has gradually been limited to a quasi-"secular religion" for doctors. This model uses established concepts from science and cultural studies as the "instruments" for seminars and courses; paradigms, discourses, social systems, and cosmologies constitute the tools for teaching and learning about the historical, theoretical, and ethical dimensions of medicine. The authors argue that this approach both precludes the need to justify the medical humanities and overcomes the dichotomy that has heretofore existed between the two cultures of science and the humanities in medicine.

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

    PubMed Central

    Bonetti, Marco; Cirillo, Pasquale; Musile Tanzi, Paola; Trinchero, Elisabetta

    2016-01-01

    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. PMID:27077661

  16. 5 CFR 177.102 - Administrative claim; when presented; appropriate OPM office.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... SERVICE REGULATIONS ADMINISTRATIVE CLAIMS UNDER THE FEDERAL TORT CLAIMS ACT § 177.102 Administrative claim... have occurred as a result of the incident. (b) All claims filed under the Federal Tort Claims Act as a result of the alleged negligence or wrongdoing of OPM or its employees will be mailed or delivered to the...

  17. Factors impacting the assessment of maternal culpability in cases of alleged fetal abuse.

    PubMed

    McCoy, Monica L

    2003-01-01

    These studies explored attitudes toward maternal culpability in cases of alleged fetal abuse. In experiment one, general culpability for the use of various substances during pregnancy was assessed as well as the impact of other potentially relevant factors. One hundred and twenty students completed the survey. Participants overwhelmingly supported treating drug use by pregnant women as a criminal offense. With regard to the assessment of more specific questions, the lack of consensus regarding what factors effect culpability is striking. Experiment two examined the possible impact of the mothers' race (White or Black) and social class (Poor or Middle class) on the assessment of culpability. One hundred and sixty-four community members responded to a survey sent to randomly selected persons in upstate South Carolina. The results indicate that at least in response to a brief, written, case scenario, neither race nor social class make a large impact on participants' sanction recommendations.

  18. Shell Chemical LP To Install $10 Million In Pollution Monitoring And Control Equipment At Norco Chemical Facility In Louisiana To Resolve Alleged Federal And State Clean Air Violations

    EPA Pesticide Factsheets

    EPA News Release: Shell Chemical LP To Install $10 Million In Pollution Monitoring And Control Equipment At Norco Chemical Facility In Louisiana To Resolve Alleged Federal And State Clean Air Violations

  19. The National Council of Churches' Alleged Leftist Bias: To What Degree Did Two Major Media Set the Agenda for Debate on the Issue?

    ERIC Educational Resources Information Center

    Gentry, Richard H.

    In January 1983, the American public read or saw hard-hitting allegations of leftist bias by the National Council of Churches (NCC) in the largest circulation magazine, "Reader's Digest," and on the top-rated television program, "60 Minutes." A study examined the extent to which the media set the agenda for debate on this…

  20. Ethical and medical dilemmas of space tourism

    NASA Astrophysics Data System (ADS)

    Marsh, Melinda

    Space tourism is an important new venture, however it raises several issues that must be addressed; namely, the medical implications associated with space flight and potential for ethical problems surrounding the safety of such travel. It seems highly likely that businesses involved in space tourism could find themselves liable for any passenger deaths or injuries, if they are found to have been negligent. This paper, therefore, discusses such issues as the medical facilities that need to be made available on board a space facility, and the companies' duty to disclose to potential passengers the risks associated with microgravity and the likelihood of space sickness, loss of bone density, disease, and pregnancy.

  1. Medical and professional ethics in sixteenth-century Istanbul: towards an understanding of the relationships between the Ottoman State and the medical guilds.

    PubMed

    Shefer, Miri

    2002-01-01

    This paper contributes to the understanding of Ottoman medical guilds, their relationship with the government, and the role played by medical ethics in this framework. Decrees by the sultans (sing. fermăn), issued in the Ottoman Imperial Council (Divăn) in Istanbul during the sixteenth century, concern themselves also with medical and ethical issues. The sheer number of these decrees may give the erroneous impression that the quality of medicine in the Ottoman Empire was low. This paper argues, however, that many of the complaints brought before the Ottoman authorities were instigated by medical guilds' members against their colleagues and competitors, not by aggravated patients demanding compensation from negligent healers. The discourse of medical ethics was raised in these cases not for its own sake, rather it embodied efforts by medical guild members to defend their economic interests and their intellectual and social status in the brutal competition in the medical realm.

  2. 7 CFR 2.31 - General Counsel.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... pursuant to the Federal Tort Claims Act, as amended (28 U.S.C. 2671-2680), and the regulations of the..., determine, compromise, and settle, pursuant to the Federal Tort Claims Act as amended (28 U.S.C. 2671-2680... allege the negligence or wrongful act of an employee of a USDA agency; and consider, ascertain, adjust...

  3. Torts

    ERIC Educational Resources Information Center

    Evans, William J., Jr.

    This chapter examines cases reported during 1988 that involved tort claims within the school context. A tort is a civil wrong, other than breach of contract, for which a court provides relief in the form of damages. Negligence is the most common tort alleged to have been committed by school personnel. In the area of products liability, the largest…

  4. Official 1996 Mock Trial Materials for the Twenty-Fourth Annual District of Columbia Public Schools Mock Trial Program. Kyle Wilkins, Plaintiff, v. New Columbia County School District, Defendant.

    ERIC Educational Resources Information Center

    Ashbrook, Alexandra M.

    This guide contains the 1996 mock trial materials for the District of Columbia mock trial program. The trial focuses on a high school student who died of a heart attack attributed to the use of steroids. The plaintiff, the student's father, alleges that the school, its principal, and track coach were negligent in the death because they failed to…

  5. Educational Malpractice in Britain.

    ERIC Educational Resources Information Center

    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…

  6. Sovereigns under Siege. How the medical profession is changing in Italy.

    PubMed

    Toth, Federico

    2015-07-01

    In this article, the concept of medical dominance is "unfolded" into four different components: 1) professional autonomy; 2) superiority over other healthcare professions; 3) influence on policy makers; 4) authority with respect to patients. These four components will serve to bring to surface the transformations which the medical profession in Italy is currently undergoing. Special emphasis is placed on the challenges that Italian physicians are facing and the strategies they are adopting to try to maintain their dominant position. Coming to conclusions, Italian physicians seem to retain their supremacy over other healthcare professions, and are particularly adept at controlling the legislative process on healthcare issues. Conversely, Italian physicians are losing their influence on patients (as evidenced by the growing number of allegations of malpractice) and complain that their professional autonomy is diminishing and their work has become far too bureaucratized. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Medical Malpractice in Dermatology-Part I: Reducing the Risks of a Lawsuit.

    PubMed

    Shah, Vidhi V; Kapp, Marshall B; Wolverton, Stephen E

    2016-12-01

    Malpractice risk is a common source of concern for the practicing physician. Dermatologists experience fewer lawsuits than most other specialists in medicine, but the risk is not negligible. All physicians should familiarize themselves with areas of potential risk and avoid medico-legal pitfalls. We present Part I of a two-part series addressing medico-legal questions common to most practitioners that cause a great deal of anxiety. Part I will focus upon risk management and prevention of future malpractice lawsuits, and Part II deals with suggestions and guidance once a lawsuit occurs. Herein, we discuss the primary sources of malpractice lawsuits delivered against healthcare practitioners including issues with informed consent, patient noncompliance, medical negligence, and inappropriate documentation, including use of electronic medical records. The overall goal is to effectively avoid these common sources of litigation. The risk management strategies discussed in this paper are relevant to the everyday practitioner and may offer physicians some degree of protection from potential liability.

  8. Fowl play? Forensic environmental assessment of alleged discharge of highly contaminated effluent from a chicken slaughterhouse

    NASA Astrophysics Data System (ADS)

    Harvey, P.; Taylor, M. P.; Handley, H. K.

    2016-12-01

    Multiple lines of geochemical and biological evidence are applied to identify and fingerprint the nature and source of alleged contamination emanating from a chicken slaughterhouse on the urban fringe of Sydney, Australia. The slaughterhouse has a long history of alleged environmental misconduct. The impact of the facility on catchment source waters by the slaughterhouse has been the subject of controversy. The facility owner has persistently denied breach of their licence condition and maintains it is `a very environmentally conscious operation'. The disputed nature of the possible sources of discharges and its contaminants required a detailed forensic environmental assessment. Water samples collected from off-site discharge points associated with the facility show highly elevated concentrations of faecal coliforms (max 68,000 cfu), ammonia-N (51,000 µg/L), total nitrogen (98,000 µg/L) and phosphorous (32,000 µg/L). Upstream and adjacent watercourses were markedly less contaminated. Water discharge points associated with the slaughterhouse and natural catchment runoff were sampled for arsenic speciation, including assessment for the organoarsenic compound Roxarsone. Roxarsone is used as a chicken growth promoter. Water draining the slaughterhouse facility contained concentrations around 10 times local background levels. The Roxarsone compound was not detected in any waters, but inorganic arsenic, As(V), was present in all waters with the greatest concentrations in waters draining from the slaughterhouse. The environmental evidence was compiled over a series of discharges events and presented to the NSW EPA. Subsequent to receipt of the data supported by their own investigations, the NSW EPA mandated that the slaughterhouse be subject to a pollution reduction program. The efficacy of the pollution reduction program to stem the release of highly contaminated effluent is currently subject to ongoing investigation using a suite of water chemistry measures including

  9. Negligence and the communication of neonatal genetic information to parents.

    PubMed

    Fay, Michael

    2012-01-01

    It is inevitable that neonatal genetic information will be communicated to parents and a potential for psychiatric injury exists where the communication is negligent. An important question in this regard is whether a health-care provider may owe a duty of care to parents when communicating accurate genetic information, or whether the courts might treat it as merely the receipt of distressing news, which hitherto attracts no liability in English Tort Law. The important role of genetic counselling in this context will likely be determinative in deciding whether communicating accurate genetic information is actionable because it arguably distinguishes the parent-physician relationship from that of messenger-recipient. If communication is accepted as being something more than the receipt of distressing news and is capable of causing 'shock', then parents will need to establish themselves as either primary or secondary victims if claims are to be reconciled with the Alcock paradigm. Claims by parents as secondary victims will be unlikely to succeed because the neonate does not fulfil the role of primary victim, although parents may be owed a duty as elevated primary victims as a result of the lack of an immediate victim. Elevating claimants to primary victim status is not without criticism and may serve to further complicate a difficult area of tort law. Alternatively, it may be open to parents to demonstrate that a duty exists subsequent to an assumption of responsibility, as the provision of genetic counselling during and after neonatal screening is indicative of health-care providers assuming responsibility for the parents' mental health. If parents are able to establish that a duty of care exists, then success of their claims will be determined by reference to breach and causation. The potential difficulties and solutions, particularly with regard to causation, are also briefly considered. It is suggested that breach will likely be determined by reference to a

  10. The effect of drawing on children's experiences of investigations following alleged child abuse.

    PubMed

    Katz, Carmit; Barnetz, Zion; Hershkowitz, Irit

    2014-05-01

    The primary aim of the study was to evaluate investigative interviews from the perspectives of the children, comparing children who drew with children who did not. One hundred twenty-five children, alleged victims of sexual abuse, were asked about their investigative experience. The uniqueness of the study is that all of the interviews were conducted according to the NICHD Protocol and that children were randomly assigned into one of the two research conditions (drawing vs. non-drawing). The results clearly demonstrate the advantage that drawing has on the children's experience of the investigation, with children in the drawing group more often reporting feelings of hope and success. This study provides practical guidelines for practitioners by emphasizing the beneficial effects that drawing can have. The study stresses the importance of integrating into forensic investigations interventions that enhance children's testimonies and ensure that the investigation is an empowering experience that generates feelings of trust, self-worth, and justice. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Process-outcome interrelationship and standard setting in medical education: the need for a comprehensive approach.

    PubMed

    Christensen, Leif; Karle, Hans; Nystrup, Jørgen

    2007-09-01

    An outcome-based approach to medical education compared to a process/content orientation is currently being discussed intensively. In this article, the process and outcome interrelationship in medical education is discussed, with specific emphasis on the relation to the definition of standards in basic medical education. Perceptions of outcome have always been an integrated element of curricular planning. The present debate underlines the need for stronger focus on learning objectives and outcome assessment in many medical schools around the world. The need to maintain an integrated approach of process/content and outcome is underlined in this paper. A worry is expressed about the taxonomy of learning in pure outcome-based medical education, in which student assessment can be a major determinant for the learning process, leaving the control of the medical curriculum to medical examiners. Moreover, curricula which favour reductionism by stating everything in terms of instrumental outcomes or competences, do face a risk of lowering quality and do become a prey for political interference. Standards based on outcome alone rise unclarified problems in relationship to licensure requirements of medical doctors. It is argued that the alleged dichotomy between process/content and outcome seems artificial, and that formulation of standards in medical education must follow a comprehensive line in curricular planning.

  12. Medical jurisprudence in the local context.

    PubMed

    Rajah, K S

    1987-04-01

    Medical jurisprudence in the local context would require the examination of a wide area. This paper focuses on liability producing conduct arising from the providing of medical services, other than liability for criminal negligent conduct. It examines the circumstances in which the physician-patient relationship emerges, in medical jurisprudence as against practice by medical practitioners. Tort law is the dominant legal theory, and reference is made to some intentional and miscellaneous torts. Implied contracts creating the relationship are touched upon, besides the reference to vicarious liability. Insanity and diminished responsibility in the criminal law, particularly the issue of whether the status quo is satisfactory and reliance on medical reports for purposes of treatment under drug laws are examined. Where abortion is performed, the question whether the husband has any right to prevent his wife from having a lawful abortion is discussed in the local context. Some thoughts on the medical (therapy, education and research) Act 1972 are expressed in relation to the living body, the corpse and the parts of the human body. The patient's right to determination and information in the light of the above legislation is also discussed.

  13. The First Record for the Americas of Loxodes rex, a Flagship Ciliate with an Alleged Restricted Biogeography.

    PubMed

    Hines, Hunter N; McCarthy, Peter J; Esteban, Genoveva F

    2016-01-01

    As the foundations of food webs, protozoa are essential to the success of an ecological system. These organisms are often overlooked, and research in the Americas is sparse. Recent samplings conducted in freshwater canals and ponds in Florida, USA, have revealed Loxodes rex, an alleged endemic ciliate species. Originally described as endemic to tropical Africa, L. rex has been considered a prime candidate for proof of microbial endemism. Our studies have shown this giant, non-encysting ciliate to be thriving in subtropical Florida. Our observations are novel and include both the first record of occurrence for the Americas and the first high-quality in vivo images for this charismatic species.

  14. Evaluating the medical malpractice system and options for reform.

    PubMed

    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.

  15. Medical incidents in developing countries: A few case studies from Nigeria.

    PubMed

    Chukwuneke, F N

    2015-12-01

    The moral worth of a clinician's, action in patients' management depends exclusively on the moral acceptability of the rule of obligation to duty on which the clinician acts. Since every rational being thinks of him or herself as an end, all people must act in such a way that they treat humanity, whether in their own person or in the person of another, always as an end and never simply as a means. A duty of care is, therefore, paramount in the relationship between clinician and patient. While litigation in healthcare system is rapidly increasing globally, which affords individual explanation and compensation for perceived wrong diagnosis and treatment; it is still rudimentary in Nigeria. This default position has made most health care providers indifferent in the presence of gross clinical negligence and medical errors. Though most Nigerians may be aware of their rights to institute legal action in situations such as, negligence with serious harm or death, but, the socioeconomic factors, cultural, and religious notions among other reasons within the society often makes litigation impossible for an individual. Attributing every medical adverse event in the course of treatment as "God's Will" and the saying "It's God's Time" for every death among most African people has also become a great impediment to curbing clinical negligence in our environment. This paper presents a few case studies from author's experience and complaints from patients during clinical practice.

  16. The Australian Medical Schools Assessment Collaboration: benchmarking the preclinical performance of medical students.

    PubMed

    O'Mara, Deborah A; Canny, Ben J; Rothnie, Imogene P; Wilson, Ian G; Barnard, John; Davies, Llewelyn

    2015-02-02

    To report the level of participation of medical schools in the Australian Medical Schools Assessment Collaboration (AMSAC); and to measure differences in student performance related to medical school characteristics and implementation methods. Retrospective analysis of data using the Rasch statistical model to correct for missing data and variability in item difficulty. Linear model analysis of variance was used to assess differences in student performance. 6401 preclinical students from 13 medical schools that participated in AMSAC from 2011 to 2013. Rasch estimates of preclinical basic and clinical science knowledge. Representation of Australian medical schools and students in AMSAC more than doubled between 2009 and 2013. In 2013 it included 12 of 19 medical schools and 68% of medical students. Graduate-entry students scored higher than students entering straight from school. Students at large schools scored higher than students at small schools. Although the significance level was high (P < 0.001), the main effect sizes were small (4.5% and 2.3%, respectively). The time allowed per multiple choice question was not significantly associated with student performance. The effect on performance of multiple assessments compared with the test items as part of a single end-of-year examination was negligible. The variables investigated explain only 12% of the total variation in student performance. An increasing number of medical schools are participating in AMSAC to monitor student performance in preclinical sciences against an external benchmark. Medical school characteristics account for only a small part of overall variation in student performance. Student performance was not affected by the different methods of administering test items.

  17. Negligence claims in UK total hip arthroplasty: a series of 167 consecutive cases.

    PubMed

    Whittingham-Jones, Paul; Williams, D; Raja, S; Bridle, S; Bircher, M

    2012-01-01

    A review of negligence reports, detailing 227 complaints from the practices of two orthopedic surgeons, was undertaken. There were demonstrable differences in the number of complaints over leg-length discrepancy; femoral fracture and cup malposition when cemented versus uncemented implants were compared. Surgeons must appreciate the less forgiving nature of uncemented hip implants and the importance of preoperative planning particularly in the presence of abnormal anatomy.

  18. Medical Malpractice Litigation Following Arthroscopic Surgery.

    PubMed

    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

  19. Threats to bioethical principles in medical practice in Brazil: new medical ethics code period.

    PubMed

    Gracindo, G C L; da Silva Gallo, J H; Nunes, R

    2018-03-15

    We aimed to outline the profile of medical professionals in Brazil who have violated the deontological norms set forth in the ethics code of the profession, and whose cases were judged by the higher tribunal for medical ethics between 2010 and 2016. This survey was conducted using a database formed from professional ethics cases extracted from the plenary of the medical ethics tribunal of the Federal Council of Medicine. These were disciplinary ethics cases that were judged at appeal level between 2010 and 2016. Most of these professionals were male (88.5%) and their mean age was 59.9 years (SD=11.62) on the date of judgment of their appeals, ranging from 28 to 95 years. Most of them were based in the southeastern region of Brazil (50.89%). Articles 1 and 18 of the medical ethics code were the rules most frequently violated. The sentence given most often was the cancellation of their professional license (37.6%) and the acts most often sentenced involved malpractice, imprudence, and negligence (18.49%). It is acknowledged that concern for the principles of bioethics was present in the appeal decisions made by the plenary of the medical ethics tribunal of the Federal Council of Medicine.

  20. Fixing past mistakes. Answers to questions about reviews, refunds, disclosures.

    PubMed

    Fitzgerald, T Jeffrey

    2003-10-01

    A medical group must address practical and legal issues when it discovers improper payments, billing mistakes or alleged misconduct. Its response has a significant impact on how the charges are resolved. A group and its providers can come under fraud and abuse investigations, whistle-blower allegations and Medicare payment reviews. Many questions arise in response to billing errors or allegations of misconduct.

  1. Forensic medical examination of adolescent and adult victims of sexual violence.

    PubMed

    Ingemann-Hansen, Ole; Charles, Annie Vesterby

    2013-02-01

    The acute care and examination of a victim of sexual violence must be carried out by a competent forensic examiner in a setting appropriate for crisis intervention, forensic evidence collection, and medical follow up. The aim of forensic evidence and biological material collection is to document an alleged physical or sexual contact between individuals and to corroborate the victim's and the assailant's history. This is why the forensic examiner is expected to be objective and in possession of specialised technical and scientific skills. These skills are addressed and recommendations are made on how to carry out a forensic examination. This includes medical and assault history, top-to-toe examination, biological material collection, and documenting injuries while obtaining the chain of custody. Yet, consensus on time limitations for forensic evidence collection is lacking. Available forensic evidence has been shown to benefit prosecution. To meet the legal system's needs, an interpretation of the findings in a written legal report is mandatory. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. US medical researchers, the Nuremberg Doctors Trial, and the Nuremberg Code. A review of findings of the Advisory Committee on Human Radiation Experiments.

    PubMed

    Faden, R R; Lederer, S E; Moreno, J D

    1996-11-27

    The Advisory Committee on Human Radiation Experiments (ACHRE), established to review allegations of abuses of human subjects in federally sponsored radiation research, was charged with identifying appropriate standards to evaluate the ethics of cold war radiation experiments. One central question for ACHRE was to determine what role, if any, the Nuremberg Code played in the norms and practices of US medical researchers. Based on the evidence from ACHRE's Ethics Oral History Project and extensive archival research, we conclude that the Code, at the time it was promulgated, had little effect on mainstream medical researchers engaged in human subjects research. Although some clinical investigators raised questions about the conduct of research involving human beings, the medical profession did not pursue this issue until the 1960s.

  3. Student Injuries and Negligence: Lessons from the International Scene with Implications for Singapore's Educators

    ERIC Educational Resources Information Center

    Teh, Kim

    2008-01-01

    Many jurisdictions are showing a trend of school-related negligence cases being taken to court. This article explores the legal principles applied by the courts in England, Australia, Canada, the United States, and New Zealand to ensure the safety of students in schools. As we look at the developments in these countries, we can see student injury…

  4. The market for precedent: shifting visions of the role of clinical negligence claims and trials.

    PubMed

    Mulcahy, Linda

    2014-01-01

    This article considers the interface between the standard setting activity of the NHS Litigation Authority, and the courts and uses the clinical negligence action as a prism through which to examine it. It is suggested that despite its many disadvantages, the clinical negligence action remains an important safety valve when internal regulatory systems fail or are insufficiently transparent to gain full legitimacy. More specifically, it explores the ways in which attitudes about the usefulness of the data contained in claims against the NHS have changed in the aftermath of a number of high profile inquiries which have focused on issues of poor performance. The article concludes that while much greater use is now been made of the data contained in claims when setting standards, strategies for prompting judicial precedent as an alternative way of mobilising standard setting behaviour remain under developed. © The Author 2014. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. HEVC optimizations for medical environments

    NASA Astrophysics Data System (ADS)

    Fernández, D. G.; Del Barrio, A. A.; Botella, Guillermo; García, Carlos; Meyer-Baese, Uwe; Meyer-Baese, Anke

    2016-05-01

    HEVC/H.265 is the most interesting and cutting-edge topic in the world of digital video compression, allowing to reduce by half the required bandwidth in comparison with the previous H.264 standard. Telemedicine services and in general any medical video application can benefit from the video encoding advances. However, the HEVC is computationally expensive to implement. In this paper a method for reducing the HEVC complexity in the medical environment is proposed. The sequences that are typically processed in this context contain several homogeneous regions. Leveraging these regions, it is possible to simplify the HEVC flow while maintaining a high-level quality. In comparison with the HM16.2 standard, the encoding time is reduced up to 75%, with a negligible quality loss. Moreover, the algorithm is straightforward to implement in any hardware platform.

  6. An overview of medical malpractice litigation and the perceived crisis.

    PubMed

    Litvin, S Gerald

    2005-04-01

    In this overview of medical malpractice litigation in the United States, practical and philosophic aspects of the so-called malpractice litigation crisis are addressed. After reviewing the historical, legal rationale for compensating victims of negligent conduct by others, attention is focused on the plight of physicians who are charged with medical negligence and the oppressive insurance premiums that impose a heavy burden on all health care providers, particularly those in the surgical fields. A variety of political solutions advanced to "correct" the problem is reviewed. A historical prospective of malpractice litigation in the United States is presented together with an analysis of various legislative proposals--many of which have already been enacted in various states that will ostensibly "cure" the problems that concern clinicians. Consideration of the various legislative proposals includes: arbitrary limits on pain and suffering awards (caps); elimination of joint and several liability; regulation of attorneys fees; elimination of the collateral source rule; abrogation of punitive damages; proposals for periodic payments; and statutes of repose. Various procedural changes in the processing of malpractice claims are reviewed and analyzed from the perspective of both fairness and efficacy.

  7. Mother's milk and the muffin man: grassroots innovations in medical marijuana delivery systems.

    PubMed

    Chapkis, Wendy; Webb, Richard J

    2005-01-01

    In the ongoing debates over medical marijuana, opponents often conflate the alleged risks of cannabis therapeutics with the acknowledged harms associated with smoking. Although smoking is the most widely used method of administering marijuana, it is not the only available means. This paper provides an account of the production, distribution, and administration of non-smokable cannabis products by members of a California health care collective, the Wo/Men's Alliance for Medical Marijuana. WAMM has developed a variety of alternative methods of administering cannabis orally and externally that challenge the rhetorical equivalence between smoking as a delivery method and botanical marijuana as a medicine. Their experience with low-cost and low-tech production techniques has enabled even the poor and uninsured among them to manage the debilitating symptoms of their illnesses and the side-effects of their often onerous courses of treatment, without smoking. The organization provides an informative example of.

  8. Court Decisions on Medical Malpractice in China After the New Tort Liability Law.

    PubMed

    Zhang, Kui; Li, Yuan; Fan, Fei; Liu, Xin; Deng, Zhen-Hua

    2016-09-01

    A new Tort Law of the People's Republic of China became effective on July 1, 2010. We undertook an analysis of medical malpractice lawsuits brought before regional courts in Beijing districts after this new Tort Liability Law went into effect. In total, 726 cases eventuating in a final verdict were collected from the Beijing district courts from 2011 to 2013 in this retrospective study; 83.7% of the 726 alleged instances of medical malpractice were confirmed to be malpractice by the final verdict. The disciplines most frequently involved with claims of medical malpractice were obstetrics and gynecology, the most frequent outcomes was death, and the most common types of case associated with malpractice was surgery related. The average length of time between the occurrence of the injury and closure of the claim was 9.2 months, and the average payment was ¥163,000. Since the introduction of the new Tort Liability Law, the average time to complete a litigation was shortened, but it has made little apparent difference otherwise.

  9. Communication-related allegations against physicians caring for premature infants.

    PubMed

    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.

  10. Abraham Lincoln loses a medical malpractice case, debates Stephen A. Douglas, and secures two murder acquittals.

    PubMed

    Spiegel, Allen D; Kavaler, Florence

    2004-02-01

    An improperly healed fracture was the most common reason for the medical malpractice crisis between the 1830s and 1860s in the United States. As a practicing lawyer in Illinois, Abraham Lincoln defended physicians in medical malpractice law suits. One of these was Dr. Powers Ritchey, who was sued for malpractice in 1855. Lincoln agreed to represent Dr. Ritchey in 1858 as the case was appealed to the supreme court of Illinois. In the interim, Lincoln defended two indicted murderers and won acquittals for both. Between the two murder trials, Lincoln debated Stephen A. Douglas while running for U.S. Senator from Illinois. Lincoln believed that Ritchey's case was poorly represented in the lower court. Ritchey's prior attorneys did not file a bill of exceptions to the testimony of the plaintiff's expert medical witnesses. Lincoln attempted to rebut the allegation of a lack of reasonable medical care and diligence by Ritchey, and he sought to secure a new trial for his client. In its decision, the supreme court of Illinois did not find any error and affirmed the lower court's judgment.

  11. The ethics of Soviet medical practice: behaviours and attitudes of physicians in Soviet Estonia.

    PubMed

    Barr, D A

    1996-02-01

    To study and report the attitudes and practices of physicians in a former Soviet republic regarding issues pertaining to patients' rights, physician negligence and the acceptance of gratuities from patients. Survey questionnaire administered to physicians in 1991 at the time of the Soviet breakup. Estonia, formerly a Soviet republic, now an independent state. A stratified, random sample of 1,000 physicians, representing approximately 20 per cent of practicing physicians under the age of 65. Most physicians shared information with patients about treatment risks and alternatives, with the exception of cancer patients: only a third of physicians tell the patient when cancer is suspected. Current practice at the time of the survey left patients few options when physician negligence occurred; most physicians feel that under a reformed system physician negligence should be handled within the local facility rather than by the government. It was common practice for physicians to receive gifts, tips, or preferential access to scarce consumer goods from their patients. Responses varied somewhat by facility and physician nationality. The ethics of Soviet medical practice were different in a number of ways from generally accepted norms in Western countries. Physicians' attitudes about the need for ethical reform suggest that there will be movement in Estonia towards a system of medical ethics that more closely approximates those in the West.

  12. The ethics of Soviet medical practice: behaviours and attitudes of physicians in Soviet Estonia.

    PubMed Central

    Barr, D A

    1996-01-01

    OBJECTIVES: To study and report the attitudes and practices of physicians in a former Soviet republic regarding issues pertaining to patients' rights, physician negligence and the acceptance of gratuities from patients. DESIGN: Survey questionnaire administered to physicians in 1991 at the time of the Soviet breakup. SETTING: Estonia, formerly a Soviet republic, now an independent state. SURVEY SAMPLE: A stratified, random sample of 1,000 physicians, representing approximately 20 per cent of practicing physicians under the age of 65. RESULTS: Most physicians shared information with patients about treatment risks and alternatives, with the exception of cancer patients: only a third of physicians tell the patient when cancer is suspected. Current practice at the time of the survey left patients few options when physician negligence occurred; most physicians feel that under a reformed system physician negligence should be handled within the local facility rather than by the government. It was common practice for physicians to receive gifts, tips, or preferential access to scarce consumer goods from their patients. Responses varied somewhat by facility and physician nationality. CONCLUSION: The ethics of Soviet medical practice were different in a number of ways from generally accepted norms in Western countries. Physicians' attitudes about the need for ethical reform suggest that there will be movement in Estonia towards a system of medical ethics that more closely approximates those in the West. PMID:8932723

  13. Juries and Medical Malpractice Claims: Empirical Facts versus Myths

    PubMed Central

    2008-01-01

    Juries in medical malpractice trials are viewed as incompetent, antidoctor, irresponsible in awarding damages to patients, and casting a threatening shadow over the settlement process. Several decades of systematic empirical research yields little support for these claims. This article summarizes those findings. Doctors win about three cases of four that go to trial. Juries are skeptical about inflated claims. Jury verdicts on negligence are roughly similar to assessments made by medical experts and judges. Damage awards tend to correlate positively with the severity of injury. There are defensible reasons for large damage awards. Moreover, the largest awards are typically settled for much less than the verdicts. PMID:19002541

  14. Review of Medical Malpractice Issues in Malaysia under Tort Litigation System

    PubMed Central

    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

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

    PubMed

    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.

  16. Model Policy on Identifying and Reporting Child Abuse and Model Policy and Rules on Procedures for Investigating Allegations of Abuse of Students by School Employees. [Revised.

    ERIC Educational Resources Information Center

    Iowa State Dept. of Education, Des Moines.

    Iowa law requires direct reporting by mandatory reporters in all schools to the Department of Human Services. State law also requires all schools to adopt a uniform procedure for investigating allegations of abuse of students by school employees. The Department of Education and the Department of Human Services have established administrative rules…

  17. Physician Assistant and Nurse Practitioner Malpractice Trends.

    PubMed

    Brock, Douglas M; Nicholson, Jeffrey G; Hooker, Roderick S

    2017-10-01

    Trends in malpractice awards and adverse actions (e.g., revocation of provider license) following an act or omission constituting medical error or negligence were examined. The National Practitioner Data Bank was used to compare rates of malpractice reports and adverse actions for physicians, physician assistants (PAs), and nurse practitioners (NPs). During 2005 through 2014, there ranged from 11.2 to 19.0 malpractice payment reports per 1,000 physicians, 1.4 to 2.4 per 1,000 PAs, and 1.1 to 1.4 per 1,000 NPs. Physician median payments ranged from 1.3 to 2.3 times higher than PAs or NPs. Diagnosis-related malpractice allegations varied by provider type, with physicians having significantly fewer reports (31.9%) than PAs (52.8%) or NPs (40.6%) over the observation period. Trends in malpractice payment reports may reflect policy enactments to decrease liability.

  18. Implementation of ICU palliative care guidelines and procedures: a quality improvement initiative following an investigation of alleged euthanasia.

    PubMed

    Kuschner, Ware G; Gruenewald, David A; Clum, Nancy; Beal, Alice; Ezeji-Okoye, Stephen C

    2009-01-01

    Ethical conflicts are commonly encountered in the course of delivering end-of-life care in the ICU. Some ethical concerns have legal dimensions, including concerns about inappropriate hastening of death. Despite these concerns, many ICUs do not have explicit policies and procedures for withdrawal of life-sustaining treatments. We describe a US Office of Inspector General (OIG) investigation of end-of-life care practices in our ICU. The investigation focused on care delivered to four critically ill patients with terminal diseases and an ICU nurse's concern that the patients had been subjected to euthanasia. The OIG investigation also assessed the validity of allegations that patient flow in and out of our ICU was inappropriately influenced by scheduled surgeries and that end-of-life care policies in our ICU were not clear. Although the investigation did not substantiate the allegations of euthanasia or inappropriate ICU patient flow, it did find that the policies that discuss end-of-life care issues were not clear and allowed for wide-ranging interpretations. Acting on the OIG recommendations, we developed a quality improvement initiative addressing end-of-life care in our ICU, intended to enhance communication and understanding about palliative care practices in our ICU, to prevent ethical conflicts surrounding end-of-life care, and to improve patient care. The initiative included the introduction of newly developed ICU comfort care guidelines, a physician order set, and a physician template note. Additionally, we implemented an educational program for ICU staff. Staff feedback regarding the initiative has been highly favorable, and the nurse whose concerns led to the investigation was satisfied not only with the investigation but also the policies and procedures that were subsequently introduced in our ICU.

  19. The School Counselors' Ideas on Features, Determinant and Intervention on Child Negligence and Abuse Cases

    ERIC Educational Resources Information Center

    Usakli, Hakan

    2012-01-01

    It is sad to know that many of the child negligence and child abuse cases, which are being frequently encountered in the society today, still remains unknown. This perhaps is due to lack of information on the part of the administrators, school counselors and other related bodies in the management of such cases. In this study, 50 school counselors…

  20. 'Where were your clothes?' Eliciting descriptions of clothing placement from children alleging sexual abuse in criminal trials and forensic interviews.

    PubMed

    Stolzenberg, Stacia N; Lyon, Thomas D

    2017-09-01

    The present study examined how children alleging sexual abuse are asked about clothing placement during abusive episodes, both in criminal trials and forensic interviews. The placement of clothing is of great importance, because it facilitates distinguishing abusive touch from non-abusive touch, as well as the severity of abuse when the touching is in fact sexual. If clothing has not been removed, then sexual abuse appears less likely and certain types of sexual contact are physically impossible (or at least highly improbable). We examined how trial attorneys ( n = 142) and forensic interviewers in investigative interviews ( n = 155) questioned 5- 12-year-olds about the location of clothing during alleged sexual abuse. To do so, we identified all question-answer pairs that included references to clothing placement, and coded for the clothing item mentioned, whether the interviewer elicited information about clothing placement or the child spontaneously provided such information, question-type, and response-type. Discussions about clothing placement were commonplace in both settings, particularly in court. Fewer than one in five question-answer pairs about clothing placement were spontaneous mentions by children; the questioner elicited most discussions. When interviewers asked wh- questions rather than yes/no and forced-choice questions, children provided more elaboration, more detailed clothing information, and were over six times more likely to describe clothing placement in a fashion that could not be captured by a single preposition (e.g., neither on nor off). The findings suggest that descriptions of clothing placement are subject to serious misinterpretation when closed-ended questions are asked.

  1. On the definition and identifiability of the alleged "hiatus" in global warming.

    PubMed

    Lewandowsky, Stephan; Risbey, James S; Oreskes, Naomi

    2015-11-24

    Recent public debate and the scientific literature have frequently cited a "pause" or "hiatus" in global warming. Yet, multiple sources of evidence show that climate change continues unabated, raising questions about the status of the "hiatus". To examine whether the notion of a "hiatus" is justified by the available data, we first document that there are multiple definitions of the "hiatus" in the literature, with its presumed onset spanning a decade. For each of these definitions we compare the associated temperature trend against trends of equivalent length in the entire record of modern global warming. The analysis shows that the "hiatus" trends are encompassed within the overall distribution of observed trends. We next assess the magnitude and significance of all possible trends up to 25 years duration looking backwards from each year over the past 30 years. At every year during the past 30 years, the immediately preceding warming trend was always significant when 17 years (or more) were included in the calculation, alleged "hiatus" periods notwithstanding. If current definitions of the "pause" used in the literature are applied to the historical record, then the climate system "paused" for more than 1/3 of the period during which temperatures rose 0.6 K.

  2. Compensation for harm: the implications for medical research.

    PubMed

    Harvey, I; Chadwick, R

    1992-06-01

    The rising incidence of medical litigation in the 1980's led to a relatively minor modification in January 1990 of the United Kingdom's negligence-based system of medical compensation, as a result of which employing Health Authorities now accept full vicarious liability for the negligent (but not other) actions of employed clinicians (Crown indemnity). During the same period, by contrast, bodies such as the Royal College of Physicians have strongly influenced locally established Research Ethics Committees towards favouring no-fault compensation for harm resulting from medical research. The discordance between these two approaches to compensation has caused anxiety during the last year. There has been particular concern about the possible discouragement of non-commercially sponsored research. Hitherto however, no data has been available to inform this discussion. This paper reports the findings of a questionnaire survey of all research ethics committees in the United Kingdom (64% response rate), which indicates that 61% of committees require no-fault compensation for at least some projects and that 33% of these committees have rejected projects solely or mainly due to the lack of such provision. Rejection is significantly more common in Health Districts which contain teaching hospitals. Our critical analysis of the arguments advanced in favour of no-fault provision for research subjects suggests that they do not place adequate emphasis upon respect for the autonomy of individuals. We consider that it is in general more consistent with such respect fully to inform research subjects of the available compensation arrangements, rather than for ethics committees to make no-fault compensation a general requirement before ethical approval is given.

  3. Tectonic-karstic origin of the alleged "impact crater" of Lake Isli (Imilchil district, High Atlas, Morocco)

    NASA Astrophysics Data System (ADS)

    Ibouh, Hassan; Michard, André; Charrière, André; Benkaddour, Abdelfattah; Rhoujjati, Ali

    2014-03-01

    The scenic lakes Tislit and Isli of the Imilchil area in the central High Atlas of Morocco have been recently promoted to the rank of "dual impact crater" by a group of geoscientists. This was promptly denied by a group of meteorite specialists, but the first team reiterated their impact crater interpretation, now restricted to Lake Isli. This alleged 40-kyr-old impact crater would be associated with the Agoudal meteorite recognized further in the southeast. Here, we show that the lake formed during the Lowe-Middle Pleistocene in a small Pliocene (?) pull-apart basin through additional collapsing due to karst phenomena in the underlying limestones. This compares with the formation of a number of lakes of the Atlas Mountains. None of the "proofs" produced in support of a meteoritic origin of Lake Isli coincides with the geology of the area.

  4. Base rates, multiple indicators, and comprehensive forensic evaluations: why sexualized behavior still counts in assessments of child sexual abuse allegations.

    PubMed

    Everson, Mark D; Faller, Kathleen Coulborn

    2012-01-01

    Developmentally inappropriate sexual behavior has long been viewed as a possible indicator of child sexual abuse. In recent years, however, the utility of sexualized behavior in forensic assessments of alleged child sexual abuse has been seriously challenged. This article addresses a number of the concerns that have been raised about the diagnostic value of sexualized behavior, including the claim that when population base rates for abuse are properly taken into account, the diagnostic value of sexualized behavior is insignificant. This article also identifies a best practice comprehensive evaluation model with a methodology that is effective in mitigating such concerns.

  5. Duty hour reform in a shifting medical landscape.

    PubMed

    Jena, Anupam B; Prasad, Vinay

    2013-09-01

    The circumstances that led to the death of Libby Zion in 1984 prompted national discussions about the impact of resident fatigue on patient outcomes. Nearly 30 years later, national duty hour reforms largely motivated by patient safety concerns have demonstrated a negligible impact of duty hour reductions on patient mortality. We suggest that the lack of an impact of duty hour reforms on patient mortality is due to a different medical landscape today than existed in 1984. Improvements in quality of care made possible by computerized order entry, automated medication checks, inpatient pharmacists, and increased resident supervision have, among other systemic changes, diminished the adverse impact that resident fatigue is able to have on patient outcomes. Given this new medical landscape, advocacy towards current and future duty hour reforms may be best justified by evidence of the impact of duty hour reform on resident wellbeing, education, and burnout.

  6. Critical control points for foods prepared in households whose members had either alleged typhoid fever or diarrhea.

    PubMed

    Michanie, S; Bryan, F L; Alvarez, P; Olivo, A B; Paniagua, A

    1988-10-01

    Hazard analysis of food preparation practices were conducted in four households and eleven others were visited to survey both food preparation practices and environmental conditions. Households selected had members who were suffering from either diarrhea of unknown etiology or alleged typhoid fever. Hazard analyses and sanitary surveys included gathering data on time-temperature exposures of foods, collecting samples of food and drinking water, sampling sewage or drains, and obtaining stool specimens from persons with diarrhea and from family controls. Food samples were tested for aerobic mesophilic colony counts and common foodborne pathogens; specimens were tested for Salmonella, Shigella, Campylobacter and Yersinia. Campylobacter was isolated from two persons purported to have diarrhea, but neither Salmonella, Shigella nor Yersinia were recovered from alleged cases or controls. Salmonella agona was recovered from a latrine. Most foods were cooked to internal temperatures to or near to boiling. Those not promptly eaten were held at ambient room or outside temperatures until a subsequent meal, until a family member returned home, or until lunch time when taken to the fields. During these intervals, microorganisms multiplied and mesophilic aerobic organisms increased often reaching 10(8)/g or greater before consumption. None of these foods were reheated before eating. Bacillus cereus was isolated from 4 of 10 samples; one sample of 'moro' (beans and rice) exceeded 10(6)/g, two other samples exceeded 10(3)/g. Staphylococcus aureus was isolated from 7 of 14 samples, one exceeded 10(5)/g. Fecal coliforms were isolated from 8 of 14 food samples, five exceeded 10(5)/g. Neither Salmonella nor Shigella were isolated from any food, the community water supplies or from vessels of water within houses. Fecal coliform counts of water were less than 3/ml, except one sample from a clay vessel (9/ml). Risks associated with cooked foods which were not promptly eaten appeared to be

  7. Negligent Liability Issues Involving Colleges and Students: Does an Ethic of Caring Heighten Institutional Liability?

    ERIC Educational Resources Information Center

    Beckham, Joseph; Pearson, Douglas

    This paper--part of a collection of 54 papers from the 48th annual conference of the Education Law Association held in November 2002--addresses the question of how and to what extent institutions of higher learning could be held liable for negligence involving students. The paper is, mainly, a review of recent case law related to the liability of…

  8. Clinical negligence in ophthalmology: fifteen years of national health service litigation authority data.

    PubMed

    Mathew, Rashmi G; Ferguson, Veronica; Hingorani, Melanie

    2013-04-01

    To categorize and understand the reasons behind ophthalmic clinical negligence claims in the National Health Service and how such claims can be avoided. Retrospective analyses of all ophthalmic clinical negligence claims between 1995 and 2009 were carried out. Data were obtained from the National Health Service Litigation Authority through the Freedom of Information Act. Claims were classified according to ophthalmic subspecialty, mean payment per subspecialty, severity, paid-to-closed ratio, and cost. One thousand two hundred fifty-three ophthalmology-related claims occurring from 1995 through 2009. Of these, 963 claims were closed over the 15-year period. Eighty-four were excluded because of insufficient case data. Retrospective analysis of all public sector ophthalmology litigation claims over a 15-year period in England. Subspecialty pertaining to claim, mean payment per claim, and severity of outcome of clinical incident. Nine hundred sixty-three claims were closed over a 15-year period, of which 67% resulted in payment. The total cost of claims was £32.1 million ($50.3 million), with a mean payment per claim of £33 300 ($52 300). The specialties with the highest mean payment per claim were neuro-ophthalmology and pediatric ophthalmology. Cataract subspecialty had the highest number of claims, accounting for 34% of all claims. Overall, the number of litigation claims in ophthalmology is low, relative to the high volume of outpatient and surgical workload. Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  9. RESEARCH RECORDS AND THE RESOLUTION OF MISCONDUCT ALLEGATIONS AT RESEARCH UNIVERSITIES

    PubMed Central

    WILSON, KENNETH; SCHREIER, ALAN; GRIFFIN, ANGEL; RESNIK, DAVID

    2014-01-01

    Accurate record keeping is an important part of the responsible conduct of research. However, there is very little empirical research on scientific record keeping. No one knows the incidence of serious problems with research records, the types of problems that occur, nor their consequences. In this study, we examined the role of research records in the resolution of misconduct allegations as a useful barometer for the incidence and types of problems that occur with records. We interviewed Research Integrity Officers (RIOs) at 90 major research universities and conducted focus groups with active research faculty. RIOs reported problems with research records in 38% of the 553 investigations they conducted. Severe problems with research records often prevented completion of investigations while problems that are more typical lengthened them by 2 to 3 weeks. Five types of poor record keeping practices accounted for 75% of the problems with incomplete/inadequate records being the most common (30%). The focus groups concurred with the findings from the interviews with RIOs, stressed the importance of the research group leader in setting and maintaining record practices, and offered additional insights. While university officials and faculty members have suspected for many years that there are serious problems with research record keeping, our study provides empirical evidence for this belief. By documenting some of the problems with record keeping in university-based research, the results of our study provide information that will be useful for policy development at academic institutions. PMID:17847607

  10. Research records and the resolution of misconduct allegations at research universities.

    PubMed

    Wilson, Kenneth; Schreier, Alan; Griffin, Angel; Resnik, David

    2007-01-01

    Accurate record keeping is an important part of the responsible conduct of research. However, there is very little empirical research on scientific record keeping. No one knows the incidence of serious problems with research records, the types of problems that occur, nor their consequences. In this study, we examined the role of research records in the resolution of misconduct allegations as a useful barometer for the incidence and types of problems that occur with records. We interviewed Research Integrity Officers (RIOs) at 90 major research universities and conducted focus groups with active research faculty. RIOs reported problems with research records in 38% of the 553 investigations they conducted. Severe problems with research records often prevented completion of investigations while problems that are more typical lengthened them by 2 to 3 weeks. Five types of poor record keeping practices accounted for 75 % of the problems with incomplete/inadequate records being the most common (30%). The focus groups concurred with the findings from the interviews with RIOs, stressed the importance of the research group leader in setting and maintaining record practices, and offered additional insights. While university officials and faculty members have suspected for many years that there are serious problems with research record keeping, our study provides empirical evidence for this belief. By documenting some of the problems with record keeping in university-based research, the results of our study provide information that will be useful for policy development at academic institutions.

  11. Never say never. Negligible carboxyhemoglobin in the victim of a smoldering mattress fire.

    PubMed

    Walter, J E; Hirsch, C S; Zumwalt, R E

    1984-09-01

    For many years, a high blood carboxyhemoglobin concentration has been used as a criterion for determining that a victim of conflagration was alive in the fire. We report a case in which a man died from the combined effects of burns and hypertensive cardiovascular disease. He had a negligible blood carboxyhemoglobin concentration, but the environmental evidence and autopsy findings are indicative of life in the fire, which arose in a smoldering mattress. We conclude that uncritical, rigid adherence to the requirement that fire victims have high carboxyhemoglobin concentrations can be misleading.

  12. Exchanging honest employment references: tiptoeing between defamation and negligent hiring.

    PubMed

    McConnell, Charles R

    2007-01-01

    In present day reference checking, many of the same organizations that seek as much information as possible about people they wish to hire resist giving out more than a bare minimum of information to other organizations. The strongest force driving this minimal reference information release is fear of legal action taken because of something said about an individual ("defamation," supposedly). Many employers seem so frightened of being sued for libel or slander that they share nothing of substance, usually not realizing that in supposedly protecting themselves against defamation charges, they are increasing the risk of negligent hiring charges. However, truthful reference information can be provided with minimal risk if it is provided in good faith, given only to those who have a legitimate need to know, is strictly job related, and is not communicated maliciously. References must always be provided objectively with information verifiable in personnel files.

  13. Compensating Injury to Autonomy in English Negligence Law: Inconsistent Recognition.

    PubMed

    Keren-Paz, Tsachi

    2018-04-10

    Recently in Shaw v Kovac, the Court of Appeal seemed to have rejected a standalone injury to autonomy (ITA) as actionable in negligence, in an informed consent case. In this article, I argue that Shaw can be explained away, and that English law recognizes ITA as actionable in a series of cases, some of which-Bhamra, Tracey, and Yearworth-were not hitherto understood to do so. However, the under-theorization in the cases leads to inconsistencies. Like cases (Rees/Yearworth; Chester/Tracey) are not treated alike; ITA is misunderstood to be about 'religious offence' (Bhamra) and property loss (Yearworth) and worse still, the more serious type 2 ITA (Rees) gives rise to a weaker remedy (of exceptional nature aside) than the less serious type 1 injury (Chester). A better understanding of the different manifestations of ITA will lead to results which are both more consistent and more justified on the merit.

  14. Illinois court seeks new course in AIDS phobia cases.

    PubMed

    1997-07-25

    The Illinois Court of Appeals ruled that plaintiffs cannot be compensated for negligent infliction of emotional distress unless there is a substantial, medically-verifiable possibility of contracting HIV. The new standard will impact a growing body of case law requiring plaintiffs to show that the fear of AIDS was predicated on actual exposure to the virus. Under the actual exposure rule, a plaintiff who injures himself with a hypodermic needle that had been used on an HIV-positive hospital patient could recover damages; another plaintiff whose needle puncture cannot be traced to HIV contamination could not be compensated. In Doe v. Northwestern University, six plaintiffs who received dental care from a university dental student who tested positive for HIV antibodies sued the university, alleging negligence. Although the plaintiff's fears of HIV infection were reasonable, the court found that they were not severe enough to warrant tort compensation since the plaintiffs had nothing to support their claims. In the case of [name removed] v. [Name removed], a medical clinic office manager, cut herself on a bloodstained scalpel left in a trash can by Dr. [name removed]. Eight months following the incident, [name removed] died of AIDS-related causes. Mrs. [Name removed] would have been entitled to recover damages under the actual exposure test; however, the case would not have prevailed under the Northwestern standard because it was known that Mrs. [Name removed] tested negative twice prior to learning of [name removed]'s AIDS diagnosis. Controversy within the Illinois courts about the actual exposure rule continues.

  15. Which sexual abuse victims receive a forensic medical examination? The impact of Children's Advocacy Centers.

    PubMed

    Walsh, Wendy A; Cross, Theodore P; Jones, Lisa M; Simone, Monique; Kolko, David J

    2007-10-01

    This study examines the impact of Children's Advocacy Centers (CAC) and other factors, such as the child's age, alleged penetration, and injury on the use of forensic medical examinations as part of the response to reported child sexual abuse. This analysis is part of a quasi-experimental study, the Multi-Site Evaluation of Children's Advocacy Centers, which evaluated four CACs relative to within-state non-CAC comparison communities. Case abstractors collected data on forensic medical exams in 1,220 child sexual abuse cases through review of case records. Suspected sexual abuse victims at CACs were two times more likely to have forensic medical examinations than those seen at comparison communities, controlling for other variables. Girls, children with reported penetration, victims who were physically injured while being abused, White victims, and younger children were more likely to have exams, controlling for other variables. Non-penetration cases at CACs were four times more likely to receive exams as compared to those in comparison communities. About half of exams were conducted the same day as the reported abuse in both CAC and comparison communities. The majority of caregivers were very satisfied with the medical professional. Receipt of a medical exam was not associated with offenders being charged. Results of this study suggest that CACs are an effective tool for furthering access to forensic medical examinations for child sexual abuse victims.

  16. Eleven-year descriptive analysis of closed court verdicts on medical errors in Spain and Massachusetts

    PubMed Central

    Giraldo, Priscila; Sato, Luke; Martínez-Sánchez, Jose M; Comas, Mercè; Dwyer, Kathy; Sala, Maria; Castells, Xavier

    2016-01-01

    Objectives To evaluate and compare the characteristics of court verdicts on medical errors allegedly harming patients in Spain and Massachusetts from 2002 to 2012. Design, setting and participants We reviewed 1041 closed court verdicts obtained from data on litigation in the Thomson Reuters Aranzadi Westlaw databases in Spain (Europe), and 370 closed court verdicts obtained from the Controlled Risk and Risk Management Foundation of Harvard Medical Institutions (CRICO/RMF) in Massachusetts (USA). We included closed court verdicts on medical errors. The definition of medical errors was based on that of the Institute of Medicine (USA). We excluded any agreements between parties before a judgement. Results Medical errors were involved in 25.9% of court verdicts in Spain and in 74% of those in Massachusetts. The most frequent cause of medical errors was a diagnosis-related problem (25.1%; 95% CI 20.7% to 31.1% in Spain; 35%; 95% CI 29.4% to 40.7% in Massachusetts). The proportion of medical errors classified as high severity was 34% higher in Spain than in Massachusetts (p=0.001). The most frequent factors contributing to medical errors in Spain were surgical and medical treatment (p=0.001). In Spain, 98.5% of medical errors resulted in compensation awards compared with only 6.9% in Massachusetts. Conclusions This study reveals wide differences in litigation rates and the award of indemnity payments in Spain and Massachusetts; however, common features of both locations are the high rates of diagnosis-related problems and the long time interval until resolution. PMID:27577585

  17. Self-neglect: adaptation of a clinical tool to the practice of the medical examiner.

    PubMed

    Sauvageau, Anny; Hunter, Brian C

    2012-09-01

    Self-neglect is the inability or unwillingness to provide for oneself the goods and services needed to live safely and independently. It is the most common allegation reported to Adult Protective Services agencies throughout the United States. Unfortunately, it seems that most medical examiners and their teams are not trained appropriately on self-neglect and forget to ask pertinent questions and document relevant observations. The most important aspect of self-neglect for the medical examiner is to recognize the diagnosis to avoid confusion with other forms of elder abuse, particularly neglect from a third party. In this context, a self-neglect scale could be a useful tool to assist the death investigation team. In the clinical field, a self-neglect severity scale was developed by the Consortium for Research in Elder Self-Neglect of Texas. It is here proposed that a self-neglect severity scale for medical examiners should be developed, to assist the investigative team in assessing these common cases. This scale is developed by modifying the clinical scale to adapt it to the particular needs of death investigation. This scale can help the medical examiner and his team in approaching these deaths in a systematic and comprehensive way.

  18. The importance of least restrictive care: the clinical implications of a recent High Court decision on negligence.

    PubMed

    Ryan, Christopher James; Callaghan, Sascha; Large, Matthew

    2015-08-01

    This paper aims to explain the meaning and implications for practice of the High Court of Australia's finding in the negligence case, Hunter and New England Local Health District v McKenna [2014] HCA 44. The facts of the case and the law of negligence are reviewed before reporting the Court's decision. The High Court found that the obligation upon doctors to provide the least restrictive option for care that was imposed by the, then applicable, Mental Health Act 1990 (NSW) was inconsistent with an obligation that might otherwise be imposed by a common law duty to have regard to the interests of those with whom a psychiatric patient may come into contact if not detained. The Court's finding underlines the importance of clinicians documenting their clinical reasoning around why their negotiated management plan was the option least restrictive of the patient's freedom and most protective of his or her human rights. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  19. Does Medical Malpractice Law Improve Health Care Quality?

    PubMed

    Frakes, Michael; Jena, Anupam B

    2016-11-01

    We assess the potential for medical liability forces to deter medical errors and improve health care treatment quality, identifying liability's influence by drawing on variations in the manner by which states formulate the negligence standard facing physicians. Using hospital discharge records from the National Hospital Discharge Survey and clinically-validated quality metrics inspired by the Agency for Health Care Research and Quality, we find evidence suggesting that treatment quality may improve upon reforms that expect physicians to adhere to higher quality clinical standards. We do not find evidence, however, suggesting that treatment quality may deteriorate following reforms to liability standards that arguably condone the delivery of lower quality care. Similarly, we do not find evidence of deterioration in health care quality following remedy-focused liability reforms such as caps on non-economic damages awards.

  20. [Analysis of judicial sentences issued against traumatologists between 1995 and 2011 as regards medical negligence].

    PubMed

    Cardoso-Cita, Z; Perea-Pérez, B; Albarrán-Juan, M E; Labajo-González, M E; López-Durán, L; Marco-Martínez, F; Santiago-Saéz, A

    2016-01-01

    Traumatology and Orthopaedic Surgery is one of the specialities with most complaints due to its scope and complexity. The aim of this study is to determine the characteristics of the complaints made against medical specialists in Traumatology, taking into account those variables that might have an influence both on the presenting of the complaint as well as on the resolving of the process. An analysis was performed on 303 legal judgments (1995-2011) collected in the health legal judgements archive of the Madrid School of Medicine, which is linked to the Westlaw Aranzadi data base. Civil jurisdiction was the most used. The specific processes with most complaints were bone-joint disorders followed by vascular-nerve problems and infections. The injury claimed against most was in the lower limb, particularly the knee. The most frequent general cause of complaint was surgical treatment error, followed by diagnostic error. There was lack of information in 14.9%. There was sentencing in 49.8% of the cases, with compensation mainly being less than 50,000 euros. Traumatology and Orthopaedic Surgery is a speciality prone to complaints due to malpractice. The number of sentences against traumatologists is high, but compensations are usually less than 50,000 euros. The main reason for sentencing is surgical treatment error; thus being the basic surgical procedure and where precautions should be maximised. The judgements due to lack of information are high, with adequate doctor-patient communication being essential as well as the correct completion of the informed consent. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  1. Lasers and losers in the eyes of the law: liability for head and neck procedures.

    PubMed

    Svider, Peter F; Carron, Michael A; Zuliani, Giancarlo F; Eloy, Jean Anderson; Setzen, Michael; Folbe, Adam J

    2014-01-01

    Although some have noted that malpractice litigation may be "plateauing," defensive medical practices are pervasive and make up a considerable proportion of the "indirect" costs medicolegal issues contribute toward our health care system. Accordingly, these trends have spurred considerable interest in characterizing factors that play a role in alleged medical negligence, along with outcomes and awards. To conduct a focused examination of malpractice litigation regarding laser procedures in the head and neck and to determine the reasons for initiating litigation as well as outcomes and awards. Retrospective analysis of the WestlawNext legal database, encompassing publicly available federal and state court records, to identify malpractice cases involving laser procedures in the head and neck. Outcomes, awards, defendant specialty, and other allegations. Most cases (28 [82%]) included in this analysis involved female plaintiffs. Of 34 cases, 19 (56%) were resolved with a defendant verdict. The median indemnity was $150 000, and dermatologists, otolaryngologists, and plastic surgeons were the most commonly named defendants. The most common procedures were performed for age-related changes, acne scarring, hair removal, and vascular lesions, although there were also several rhinologic and airway cases. Of all cases, 25 (74%) involved cutaneous procedures, and common allegations noted included permanent injury (24 cases [71%]), disfigurement/scarring (23 [68%]), inadequate informed consent (17 [50%]), unnecessary/inappropriate procedure (15 [44%]), and burns (11 [32%]). Noncutaneous procedures had higher trending median payments ($600 000 vs $103 000), although this comparison did not reach statistical significance (P = .09). Procedures using lasers represent a potential target for malpractice litigation should an adverse event occur. Although cutaneous/cosmetic procedures were noted among cases included in this analysis, as well as other head and neck

  2. On the definition and identifiability of the alleged “hiatus” in global warming

    PubMed Central

    Lewandowsky, Stephan; Risbey, James S.; Oreskes, Naomi

    2015-01-01

    Recent public debate and the scientific literature have frequently cited a “pause” or “hiatus” in global warming. Yet, multiple sources of evidence show that climate change continues unabated, raising questions about the status of the “hiatus”. To examine whether the notion of a “hiatus” is justified by the available data, we first document that there are multiple definitions of the “hiatus” in the literature, with its presumed onset spanning a decade. For each of these definitions we compare the associated temperature trend against trends of equivalent length in the entire record of modern global warming. The analysis shows that the “hiatus” trends are encompassed within the overall distribution of observed trends. We next assess the magnitude and significance of all possible trends up to 25 years duration looking backwards from each year over the past 30 years. At every year during the past 30 years, the immediately preceding warming trend was always significant when 17 years (or more) were included in the calculation, alleged “hiatus” periods notwithstanding. If current definitions of the “pause” used in the literature are applied to the historical record, then the climate system “paused” for more than 1/3 of the period during which temperatures rose 0.6 K. PMID:26597713

  3. Limiting Exposure to Medical Malpractice Claims and Defamatory Cyber Postings via Patient Contracts

    PubMed Central

    Segal, Jeffrey J.

    2008-01-01

    The documents patients sign on admission to a medical practice can constitute a legal contract. Medical practices around the country are attempting to use these documents as a prospective defense against medical malpractice claims. Protective contractual provisions are often attacked on grounds that they are legally void as a result of unconscionability. Widespread use of arbitration clauses have been met with mixed success. Arbitration clauses that limit damages available in medical negligence cases have been stricken in some states as having provisions that impose excessive entry costs on a patient starting the arbitration process. Other provisions relating to prequalification requirements for expert witnesses are now being used with increasing frequency. Clauses have even been placed in patient contracts that address cyber postings of adverse claims against physicians. Prospective patient contracts may be an effective means to limit exposure to medical malpractice lawsuits and to minimize defamatory cyber postings. PMID:19057975

  4. Limiting exposure to medical malpractice claims and defamatory cyber postings via patient contracts.

    PubMed

    Sacopulos, Michael; Segal, Jeffrey J

    2009-02-01

    The documents patients sign on admission to a medical practice can constitute a legal contract. Medical practices around the country are attempting to use these documents as a prospective defense against medical malpractice claims. Protective contractual provisions are often attacked on grounds that they are legally void as a result of unconscionability. Widespread use of arbitration clauses have been met with mixed success. Arbitration clauses that limit damages available in medical negligence cases have been stricken in some states as having provisions that impose excessive entry costs on a patient starting the arbitration process. Other provisions relating to prequalification requirements for expert witnesses are now being used with increasing frequency. Clauses have even been placed in patient contracts that address cyber postings of adverse claims against physicians. Prospective patient contracts may be an effective means to limit exposure to medical malpractice lawsuits and to minimize defamatory cyber postings.

  5. Illness Induction Syndrome: Paper I--A Series of 41 Children from 37 Families Identified at the Great Ormond Street Hospital for Children NHS Trust.

    ERIC Educational Resources Information Center

    Gray, Jenny; Bentovim, Arnon

    1996-01-01

    This study reviewed the case records of 41 British children with illnesses induced by a parent, almost always the mother. Four patterns emerged: (1) failure-to-thrive through withholding of food; (2) allegation of allergy and withholding of food; (3) allegation and fabrication of medical symptoms; and (4) active interference by poisoning or…

  6. Medical tourism in Thailand: a cross-sectional study.

    PubMed

    Noree, Thinakorn; Hanefeld, Johanna; Smith, Richard

    2016-01-01

    To investigate the magnitude and characteristics of medical tourism in Thailand and the impact of such tourism on the Thai health system and economy. In 2010, we checked the records of all visits to five private hospitals that are estimated to cover 63% of all foreign patients. We reviewed hospital records of foreign patients and obtained data on their countries of origin, diagnoses and interventions. We surveyed 293 medical tourists to collect demographic characteristics and information on their expenditure and travelling companions. To help understand the impact of medical tourism on the Thai health system, we also interviewed 15 hospital executives and 28 service providers from the private hospitals. We obtained 911,913 records of hospital visits, of which 324,906 came from 104,830 medical tourists. We estimated that there were 167,000 medical tourists in Thailand in 2010. Of the medical tourists who attended our study hospitals, 67,987 (64.8%) came from the eastern Mediterranean region or Asia and 109,509 (34%) of them were treated for simple and uncomplicated conditions - i.e. general check-ups and medical consultations. The mean self-reported non-medical expenditure was 2750 United States dollars. According to the hospital staff interviewed, medical tourism in 2010 brought benefits to - and apparently had no negative impacts on - the Thai health system and economy. We estimate that the total number of medical tourists visiting Thailand is about 10% of previous national government estimates of 1.2 million. Such tourists appear to bring economic benefits to Thailand and to have negligible effects on the health system.

  7. Does Medical Malpractice Law Improve Health Care Quality?

    PubMed Central

    Frakes, Michael; Jena, Anupam B.

    2016-01-01

    We assess the potential for medical liability forces to deter medical errors and improve health care treatment quality, identifying liability’s influence by drawing on variations in the manner by which states formulate the negligence standard facing physicians. Using hospital discharge records from the National Hospital Discharge Survey and clinically-validated quality metrics inspired by the Agency for Health Care Research and Quality, we find evidence suggesting that treatment quality may improve upon reforms that expect physicians to adhere to higher quality clinical standards. We do not find evidence, however, suggesting that treatment quality may deteriorate following reforms to liability standards that arguably condone the delivery of lower quality care. Similarly, we do not find evidence of deterioration in health care quality following remedy-focused liability reforms such as caps on non-economic damages awards. PMID:28479642

  8. Clinical psychopharmacology and medical malpractice: the four Ds.

    PubMed

    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.

  9. Eleven-year descriptive analysis of closed court verdicts on medical errors in Spain and Massachusetts.

    PubMed

    Giraldo, Priscila; Sato, Luke; Martínez-Sánchez, Jose M; Comas, Mercè; Dwyer, Kathy; Sala, Maria; Castells, Xavier

    2016-08-30

    To evaluate and compare the characteristics of court verdicts on medical errors allegedly harming patients in Spain and Massachusetts from 2002 to 2012. We reviewed 1041 closed court verdicts obtained from data on litigation in the Thomson Reuters Aranzadi Westlaw databases in Spain (Europe), and 370 closed court verdicts obtained from the Controlled Risk and Risk Management Foundation of Harvard Medical Institutions (CRICO/RMF) in Massachusetts (USA). We included closed court verdicts on medical errors. The definition of medical errors was based on that of the Institute of Medicine (USA). We excluded any agreements between parties before a judgement. Medical errors were involved in 25.9% of court verdicts in Spain and in 74% of those in Massachusetts. The most frequent cause of medical errors was a diagnosis-related problem (25.1%; 95% CI 20.7% to 31.1% in Spain; 35%; 95% CI 29.4% to 40.7% in Massachusetts). The proportion of medical errors classified as high severity was 34% higher in Spain than in Massachusetts (p=0.001). The most frequent factors contributing to medical errors in Spain were surgical and medical treatment (p=0.001). In Spain, 98.5% of medical errors resulted in compensation awards compared with only 6.9% in Massachusetts. This study reveals wide differences in litigation rates and the award of indemnity payments in Spain and Massachusetts; however, common features of both locations are the high rates of diagnosis-related problems and the long time interval until resolution. 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/

  10. Negligent Liability Issues Involving Colleges and Students: Balancing the Risks and Benefits of Expanded Programs and Heightened Supervision

    ERIC Educational Resources Information Center

    Pearson, Douglas R.; Beckham, Joseph C.

    2005-01-01

    Student affairs professionals recognize that learning experiences transcend the classroom, and they have expanded the range of programs and services available to students well beyond the laboratory and lecture hall. The authors survey judicial opinions involving institutional liability for negligence and conclude that the expansion of educational…

  11. The public debate on psychotropic medication and changes in attitudes 1990-2011.

    PubMed

    Angermeyer, Matthias C; Van der Auwera, Sandra; Matschinger, Herbert; Carta, Mauro G; Baumeister, Sebastian E; Schomerus, Georg

    2016-03-01

    Over the last 25 years, the appraisal of psychotropic drugs within the scientific community and their representation in the media has changed considerably. The initial optimism in the wake of the introduction of second-generation drugs has increasingly made room for a more critical evaluation of alleged advantages of these drugs. The question arises as to what extent this is reflected in similar changes in the public's attitudes towards psychiatric medication. Three representative population surveys on attitudes towards psychotropic medication were carried out in Germany in 1990 (N = 3075), 2001 (N = 2610) and 2011 (N = 1223), using the same sampling procedure, interview mode and instrument for assessing attitudes. In order to disentangle time-related effects, an age-period-cohort analysis was performed. Over the time period of 21 years, the German public's evaluation of psychotropic medication has become markedly more favourable. This change was mostly due to a period effect, i.e. concurrent influences of the social environment people are exposed to. Changes were much more pronounced in the 1990s, while over the following decade only a small, although statistically significant, increase in the favourable appraisal of medication was found. Age and birth cohort had only a minor effect on public attitudes. Our findings suggest that changes in the evaluation of the effects of psychotropic drugs within the psychiatric community and their representation in the media also affect public opinion. Given the ongoing debate about side effects and efficacy of psychiatric medication, future changes of public opinion can be expected.

  12. Altitude Stress During Participation of Medical Congress

    PubMed Central

    Kim, Soon Bae; Kim, Jong Sung; Kim, Sang Jun; Cho, Su Hee

    2016-01-01

    Medical congresses often held in highlands. We reviewed several medical issues associated with altitude stress especially while physicians have participated medical congress held in high altitude. Altitude stress, also known as an acute mountain sickness (AMS), is caused by acute exposure to low oxygen level at high altitude which is defined as elevations at or above 1,200 m and AMS commonly occurs above 2,500 m. Altitude stress with various symptoms including insomnia can also be experienced in airplane. AMS and drunken state share many common features in symptoms, neurologic manifestations and even show multiple microbleeds in corpus callosum and white matter on MRI. Children are more susceptible to altitude stress than adults. Gradual ascent is the best method for the prevention of altitude stress. Adequate nutrition (mainly carbohydrates) and hydration are recommended. Consumption of alcohol can exacerbate the altitude-induced impairments in judgment and the visual senses and promote psychomotor dysfunction. For prevention or treatment of altitude stress, acetazolamide, phosphodiesterase inhibitors, dexamethasone and erythropoietin are helpful. Altitude stress can be experienced relatively often during participation of medical congress. It is necessary to remind the harmful effect of AMS because it can cause serious permanent organ damage even though the symptoms are negligible in most cases. PMID:27621942

  13. Silver nanoparticles: mechanism of antimicrobial action, synthesis, medical applications, and toxicity effects

    NASA Astrophysics Data System (ADS)

    Prabhu, Sukumaran; Poulose, Eldho K.

    2012-10-01

    Silver nanoparticles are nanoparticles of silver which are in the range of 1 and 100 nm in size. Silver nanoparticles have unique properties which help in molecular diagnostics, in therapies, as well as in devices that are used in several medical procedures. The major methods used for silver nanoparticle synthesis are the physical and chemical methods. The problem with the chemical and physical methods is that the synthesis is expensive and can also have toxic substances absorbed onto them. To overcome this, the biological method provides a feasible alternative. The major biological systems involved in this are bacteria, fungi, and plant extracts. The major applications of silver nanoparticles in the medical field include diagnostic applications and therapeutic applications. In most of the therapeutic applications, it is the antimicrobial property that is being majorly explored, though the anti-inflammatory property has its fair share of applications. Though silver nanoparticles are rampantly used in many medical procedures and devices as well as in various biological fields, they have their drawbacks due to nanotoxicity. This review provides a comprehensive view on the mechanism of action, production, applications in the medical field, and the health and environmental concerns that are allegedly caused due to these nanoparticles. The focus is on effective and efficient synthesis of silver nanoparticles while exploring their various prospective applications besides trying to understand the current scenario in the debates on the toxicity concerns these nanoparticles pose.

  14. Medical innovation laws: an unnecessary innovation.

    PubMed

    Richards, Bernadette

    2016-06-01

    Objective This paper aims to demonstrate that any suggestion that there is a need for specific innovation laws is flawed. Innovation is central to good medical practice and is adequately supported by current law. Methods The paper reviews the nature of medical innovation and outlines recent attempts in the UK to introduce specific laws aimed at 'encouraging' and 'supporting' innovation. The current legal framework is outlined and the role of the law in relation to medical innovation explored. Results The analysis demonstrates the cyclic relationship between medical advancement and the law and concludes that there is no requirement for specific innovation laws. Conclusions The law not only supports innovation and development in medical treatment but encourages it as central to a functioning medical system. There is no need to introduce specific laws aimed at medical innovation; to do so represents an unnecessary legal innovation and serves to complicate matters. What is known about the topic? Over recent months, there has been a great deal of discussion surrounding the law in the context of medical innovation. This was driven by the attempts in the UK to introduce specific laws in the Medical Innovation Bill. The general subject matter - negligence and the expected standard of care in the provision of treatment - is very well understood, but not in cases where the treatment can be described as innovative. The general rhetoric in both the UK and Australia around the Medical Innovation Bill demonstrates a lack of understanding of the position of the law with regards to innovative treatment. What does this paper add? This paper adds clarity to the debate. It presents the law and explains the manner in which the law can operate around innovative treatment. The paper asserts that medical innovation is both supported and encouraged by existing legal principles. What are the implications for practitioners? The paper presents an argument that can guide the policy position

  15. Clothing damage analysis in alleged sexual assaults--the need for a systematic approach.

    PubMed

    Boland, C A; McDermott, S D; Ryan, J

    2007-04-11

    Clothing damage analysis is an integral part of the examinations carried out in sexual assault type cases. This analysis can be used to corroborate different versions of events and is at its most powerful in elucidating false allegation cases and consent cases. The purpose of this study was to determine to what extent people with varying levels of forensic awareness, experience and training could correctly carry out damage analysis. Two participant groups were asked to take part in this study. Group A ('forensic group') comprised participants at a forensic science conference, and Group B ('student group') comprised students undertaking a degree course in Forensic Science. Each group was given a practical workshop consisting of a lecture outlining common fabric types and general features observed in different damage types. Each participant was subsequently shown 25 pieces of 'damage' and asked to identify both the type of fabric construction (knit or weave) and the type of damage (cut, tear, rip, wear and tear). The ability to identify fabric construction and damage types varied within the two groups studied and across the groups. The forensic group performed better both in fabric and damage assessment than the student group. This paper suggests a systematic approach to clothing damage analysis to maximise the benefits that can be obtained from this area of forensic science and to minimise the subjectivity within the field.

  16. Examining the Effects of a Service-Trained Facility Dog on Stress in Children Undergoing Forensic Interview for Allegations of Child Sexual Abuse.

    PubMed

    Krause-Parello, Cheryl A; Thames, Michele; Ray, Colleen M; Kolassa, John

    2018-04-01

    Disclosure of child sexual abuse can be a stressful experience for the child. Gaining a better understanding of how best to serve the child, while preserving the quality of their disclosure, is an ever-evolving process. The data to answer this question come from 51 children aged 4-16 (M = 9.1, SD = 3.5), who were referred to a child advocacy center in Virginia for a forensic interview (FI) following allegations of sexual abuse. A repeated measures design was conducted to examine how the presence of a service-trained facility dog (e.g. animal-assisted intervention (AAI) may serve as a mode of lowering stress levels in children during their FIs. Children were randomized to one of the two FI conditions: experimental condition (service-trained facility dog present-AAI) or control condition (service-trained facility dog not present- standard forensic interview). Stress biomarkers salivary cortisol, alpha-amylase, immunoglobulin A (IgA), heart rate, and blood pressure, and Immunoglobulin A were collected before and after the FI. Self-report data were also collected. Results supported a significant decrease in heart rate for those in the experimental condition (p = .0086) vs the control condition (p = .4986). Regression models revealed a significant decrease in systolic and diastolic blood pressure in the experimental condition (p = .03285) and (p = .04381), respectively. Statistically significant changes in alpha-amylase and IgA were also found in relation to disclosure and type of offense. The results of this study support the stress reducing effects of a service-trained facility dog for children undergoing FI for allegations of child sexual abuse.

  17. Allegation of ethnic minorities from 1993-2008: an Equal Employment Opportunity Commission (EEOC) study.

    PubMed

    Arango-Lasprilla, Juan Carlos; Ketchum, Jessica M; Hurley, Jessica; Getachew, Almaz M; Gary, Kelli Williams

    2014-01-01

    Approximately 25% of working-aged Americans with disabilities work full or part time, yet still face discrimination despite the passing of the American's with Disabilities Act (ADA) over 20 years ago. To determine if the proportion of allegations of ADA Title I workplace discrimination with merit closed at any year between 1993 and 2008 differs among Whites, African Americans, Hispanics, and Asians; to determine if there was a change over time from 1993 to 2008 in merit closure rate within each race/ethnicity group; and to determine whether changes over time between 1993 and 2008 in the merit closure rate differ among the race/ethnicity groups. Logistic regression was used for this cross-sectional panel study to model the merit closure rate for each ethnic group from 1993 to 2008 using 318,587 charging parties from the EEOC database. All ethnic groups exhibited significant changes over time in the merit closure rate. There were significant differences in the closure rates among the race/ethnicity groups specifically at closure years 1995-2000, 2002, 2003, and 2006. Finally, there was evidence that the trends in merit closure rates over time differed significantly among the race/ethnicity groups. There was significant evidence that the proportion of claims closed with merit was significantly different among the racial/ethnicity groups.

  18. From My Own Brother in My Own Home: Children's Experiences and Perceptions Following Alleged Sibling Incest.

    PubMed

    Katz, Carmit; Hamama, Liat

    2015-08-30

    Sibling incest is an understudied field despite its high prevalence rates. The current study was designed to characterize the way children describe their experiences and perceptions following alleged sibling incest. The sample consisted of 20 forensic investigations with children who were referred to forensic investigation following suspected sibling incest. The age range of the children was between 6 and 12 years old, including 17 girls and three boys. Thematic analysis was conducted on all the interviews and the children's perceptions greatly echoed the ecological framework while they elaborated on three levels: family level, in which children discussed the context of the abuse and the disclosure; sibling level, in which children discussed their siblings' behaviors and the grooming process; and the child level, in which the children discussed their own behavior during the abuse. The discussion highlights the relevance of the ecological framework to the study's results and stresses the complexity of this phenomenon and the challenges it raises for practitioners in various contexts-child protective, forensic, and clinical. © The Author(s) 2015.

  19. Medical tourism in Thailand: a cross-sectional study

    PubMed Central

    Noree, Thinakorn; Hanefeld, Johanna; Smith, Richard

    2016-01-01

    Abstract Objective To investigate the magnitude and characteristics of medical tourism in Thailand and the impact of such tourism on the Thai health system and economy. Methods In 2010, we checked the records of all visits to five private hospitals that are estimated to cover 63% of all foreign patients. We reviewed hospital records of foreign patients and obtained data on their countries of origin, diagnoses and interventions. We surveyed 293 medical tourists to collect demographic characteristics and information on their expenditure and travelling companions. To help understand the impact of medical tourism on the Thai health system, we also interviewed 15 hospital executives and 28 service providers from the private hospitals. Findings We obtained 911 913 records of hospital visits, of which 324 906 came from 104 830 medical tourists. We estimated that there were 167 000 medical tourists in Thailand in 2010. Of the medical tourists who attended our study hospitals, 67 987 (64.8%) came from the eastern Mediterranean region or Asia and 109 509 (34%) of them were treated for simple and uncomplicated conditions – i.e. general check-ups and medical consultations. The mean self-reported non-medical expenditure was 2750 United States dollars. According to the hospital staff interviewed, medical tourism in 2010 brought benefits to – and apparently had no negative impacts on – the Thai health system and economy. Conclusion We estimate that the total number of medical tourists visiting Thailand is about 10% of previous national government estimates of 1.2 million. Such tourists appear to bring economic benefits to Thailand and to have negligible effects on the health system. PMID:26769994

  20. Variation in Acceptable Child Discipline Practices by Child Age: Perceptions of Community Norms by Medical and Legal Professionals

    PubMed Central

    Block, Stephanie D.; Poplin, Ashlee Burgess; Wang, Eric; Widaman, Keith F.; Runyan, Desmond K.

    2016-01-01

    Mandated child abuse reporters may judge specific disciplinary practices as unacceptable for young children, whereas child law professionals arbitrating allegations may be less inclusive. Do the views of these groups diverge, by child age, regarding physical discipline? Judgments of community norms across a wide range of children’s ages were obtained from 380 medical and legal professionals. Because the Parent-Child Conflict Tactics Scale (PC-CTS) can be used to assess the epidemiology of child disciplinary behaviors and as a proxy to examine the incidence or prevalence of child abuse, the disciplinary practices described on the PC-CTS were presented as triggers for questions. Significant child age effects were found for disciplinary practices classified as “harsh.” The consistencies between legal and medical professionals were striking. Both groups reflected changes in United States norms, as non-physical approaches were the most approved. We conclude that instruments estimating the prevalence of child maltreatment by parent-report should consider modifying how specific disciplinary practices are classified. PMID:27117603