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Medical Malpractice Exclusion Clause | Medical Malpractice Insurance Policy

According to Joseph’s Incorporated, proof of negligence is decided on the basis of a balance of probabilities. If you want to pursue a case, the onus is on you to prove negligence, as well as damage due to the negligence (see “Burden of proof”, below). Medical experts have to provide relevant, credible, reliable information, as it is certain that opposing lawyers will look for any opportunity to discredit them.
While it’s impossible to know to what extent Aanning’s testimony influenced the outcome, the jury sided in favor of his colleague — and, ever since, Aanning said, he has felt haunted by his decision. Now, 77 and retired, he decided to write about his choice and why he made it in a recent column for his local newspaper, The Yankton County Observer. He also posted the article in the ProPublica Patient Safety Facebook group. Aanning, who is a member, called it, “A Surgeon’s Belated Confession.”
Is our situation unique? According to the MPS report, in the United States there have been two waves of legal reforms prompted by medical malpractice claims: one in the mid-80s and another in the early 2000s. Reforms were driven by an increase in insurance premiums and concerns about access to health care. Since 2000, 29 states in the US have introduced limitations on damages; some limit both “economic” and “general” damages (compensation for pain and suffering), while others cap only general damages.
Furthermore, we all inform our patients to some degree about the risks and benefits of procedures, meds, etc. Never have I heard that one's own track record or disciplinary history should be included. And in this case we don't for what the doc was disciplined or what led to the death. It may or may not have been relevant to Willis. The real issue here is whether he failed to warn her of the possibility of the perforation. The only thing going for the plaintiff here is that she likely claims that she would have chosen a different surgeon had she known the truth. Easy to say in retrospect when plaintiff and attorneys stand to gain $$. And apparently the same complication could as easily have occurred with a different surgeon anyway.
Medical tests can be divided into two broad categories: diagnostic tests and screening tests. Diagnostic tests are administered to patients who exhibit signs of a disease or condition, such as a woman with a lump in her breast or a man with pain and pressure in his chest. Screening tests, on the other hand, are performed on patients who are considered to be at risk of developing a disease or condition – for example, routine mammograms for women and PSA screenings for men.
There are lots of laws applicable to punish physicians who make affirmative bad judgments as to medical care and treatment. But there is no law that affirmatively compels a physician to prescribe or provide medication that the physician does not believe is in the patient's best interests. This doctor told you that he lacks the knowledge to conclude that the drug you wanted was correct for a patient in your circumstances. Given that fact, he had no legal choice but to decline to provide that drug.
Medical malpractice cases almost always require medical experts to testify about the proper standard of care that should have been provided under the circumstances. These are often physicians who practice within the same type of medicine that the physician defendant practices in. These individuals are usually tasked with the responsibility of explaining that the defendant deviated from the standard of care and that this deviation resulted in the patient suffering the harm alleged in the complaint.
However, a study comparing states with tort reform to states without found little evidence that these measures actually stopped doctors from behaving defensively (Waxman et al. 2014). It remains to be seen whether tort reform measures can actually improve medical care, or if they just limit the amount of compensation that a plaintiff can receive to a figure lower than what is necessary to ensure proper care for the injuries they have suffered.
A study by Michelle M. Mello and others published in the journal Health Affairs in 2010 estimated that the total annual cost of the medical liability system, including "defensive medicine," was about 2.4 percent of total U.S. health care spending.[53] The authors noted that "this is less than some imaginative estimates put forward in the health reform debate, and it represents a small fraction of total health care spending," although it was not "trivial" in absolute terms.[53]
For help on choosing a good medical malpractice attorney, read Nolo's article Finding a Personal Injury Lawyer . Or, you can go straight to Nolo's Lawyer Directory for a list of personal injury attorneys in your geographical area (click on the "Types of Cases" and "Work History" tabs to learn about a particular lawyer's experience, if any, with medical malpractice claims).
As for the marital stress, how did it get to court? Let's say the couple asks the psychiatrist if she's been divorced. I say she must either say yes, or say I won't tell you. Her choice. It would not be OK for her to lie. At that point the couple can find someone else. No damages. No court. When you say "must be disclosed," do you mean the court would hold that the psychiatrist should volunteer the information? First you would need an expert to testify to that. Then there would have to be damages, and proximate cause. Seems like a real stretch.
For example, the Fourth Circuit Court of Appeals held that a Fort Bragg Army Sergeant was injured while he was driving after a mandatory physical training exercise to his on-base residence to shower and change clothes before reporting to his next duty assignment was active duty and was barred from suing under Feres. Courts generally hold that an off-duty, but not on leave service member injured in a car wreck is barred from suit by Feres.
Doctor's surgeries also have a legal duty to provide an acceptable level of care to their patients. This will take into consideration issues such as waiting times, diagnoses and administration. If the surgery fails to reach the standards reasonably expected of the medical profession, and this directly harms their patients, the doctor's surgery will have been negligent.
According to a 2006 study, medication errors harm approximately 1.5 million people in the United States every year. Medication errors can occur many ways -- from the initial prescription to the administration of the drug. For example, a patient might be harmed if the doctor prescribes the wrong medication. Or the patient might be harmed by medication that the doctor prescribes to treat a misdiagnosed condition. In a hospital setting, the right drug might be given to the wrong patient.
The Indiana Medical Malpractice Act spells out the procedures to follow if you suspect that you have a hospital malpractice claim or any type of medical malpractice lawsuit. The first step is to obtain your medical records and have medical experts review them and determine whether the hospital or hospital staff involved in your treatment provided substandard care that caused your injury.

The philosophy of our law firm regarding damages is simple: obtain the maximum monetary recovery possible for each client. We accomplish this by relying on our decades of experience to diligently prepare our cases for trial and aggressively advocate for our clients. Our financial resources, technological tools and access to outstanding experts in various fields allow us to provide top-notch representation to our clients.


Medical malpractice is the most common legal claim lodges against doctors. A medical malpractice claim arises when a doctor failed to treat the patient in conformance with the accepted medical standard of care and the patient suffered some injury as a result. The medical standard of care is the type of care that another physician in a similar community practicing in the same type of medicine would have provided within the same circumstances. 

In order to establish negligence and sue the NHS, your solicitor will need to obtain expert evidence from a medical expert in the relevant medical field. So, if your claim is against a GP then normally your solicitor will obtain expert evidence from another GP. An experienced solicitor will know suitable and highly respected medical practitioners in numerous areas of specialty who are able to serve as a medical expert. The medical expert will review your medical records and in most cases needs to give you a medical examination before preparing his or her report.

I have the same expectations of psych MDs, by the way. the issues may be harder to define, but certainly how much experience in treating a particular area, licensure, malpractice, etc. are legitimate questions. I don't have to know the doc's personal experiences of medical/MH/life issues to determine skills, but a doc should be able to give a carefully reasoned explanation of own skills/limitations. With psychiatry, I always thought it was incumbent upon the doc to have self knowledge sufficient to identify and appropriately refer clients who he/she cannot treat - ie, if you are in the midst of your own messy divorce, don't take on new clients with marital issues, etc. Yes, life is not always this neat and tidy, but isn't that why psych MDs have their own clinical supervision??


After a suit is filed, both parties gather information from the other. For example, the plaintiff’s attorney will request their client’s medical records from the defendant. There will then be interrogatory forms (a set of written questions to clarify facts) submitted by each attorney to the opposing party, and depositions (formal meetings in which an individual  –  such as the plaintiff, the defendant, or an expert for either party  –  is questioned under oath). A record of these depositions is taken for potential use in court. Usually, the people who attend the deposition include attorneys for both parties and the court reporter. In some cases, the plaintiff or defendant can also choose to attend to observe, but does not talk or ask questions. Sometimes, the defendant and their attorney will agree to settle the case prior to court  –  that is, the defendant pays the plaintiff a mutually agreed upon amount called a “settlement.”
The more common (and some believe more reliable) approach used by all federal courts and most state courts is the 'gatekeeper' model, which is a test formulated from the US Supreme Court cases Daubert v. Merrell Dow Pharmaceuticals (509 U.S. 579 [1993]), General Electric Co. v. Joiner (522 U.S. 136 [1997]), and Kumho Tire Co. v. Carmichael (526 U.S. 137 [1999]). Before the trial, a Daubert hearing[15] will take place before the judge (without the jury). The trial court judge must consider evidence presented to determine whether an expert's "testimony rests on a reliable foundation and is relevant to the task at hand." (Daubert, 509 U.S. at 597). The Daubert hearing considers 4 questions about the testimony the prospective expert proposes:

You all have failed to see one major issue – I for instance am a professional who has been successful for years;however do to sports was prescribed pain meds, that accidentally led to addiction… No I would not be interested in suing the initial doctors for the initial treatments; however, it is the so called rehab outpatient programs some which are very prestigious as the one I used. That first consultation led to this drug, that drug, to full blown high doses to the point if I stop I cannot work would essentially be hospitalized for a minimum a month, so you think those Doctors or places shouldn’t be sued? It has also led to extreme depression among other issues and I have never once abused my medication in treatment like the losers you speak of who take Methadone or other substances and try to mix to still get those old effects. If you all didn’t have your head in the sand you may understand. Unbelievable comments.
Before you sue your doctor for medical malpractice, take some time to consider whether you believe your case meets the threshold for a medical malpractice claim. Did your doctor breach the medical standard of care and did that breach cause you to suffer damages? Be honest with yourself. But for your doctor’s breach of the standard of care, would your injuries have occurred? If your answers are “yes” and “no” to those questions, your case may have a shot. If you can allege, with expert support, that your doctor breached the standard of care, and but for his breach your injuries would not have occurred, your case will likely not be immediately dismissed.
Differential diagnosis is a systemic method used by doctors to identify a disease or condition in a patient. Based upon a preliminary evaluation of the patient, the doctor makes a list of diagnoses in order of probability. The physician then tests the strength of each diagnosis by making further medical observations of the patient, asking detailed questions about symptoms and medical history, ordering tests, or referring the patient to specialists. Ideally, a number of potential diagnoses will be ruled out as the investigation progresses, and only one diagnosis will remain at the end. Of course, given the uncertain nature of medicine, this is not always the case.
There are two steps to complaining. The first is to makes a complaint to the NHS hospital trust or Primary Care Practice where the treatment was received, under their own complaints procedure (which they will provide on request). If you are unsatisfied with the response you receive, you can then move to the second stage, which is to refer the matter to the Parliamentary and Health Service Ombudsman.

I believe I have answered your question and I hope you a better understanding of your legal issue as a result. As you know, I am only the messenger and can not create favorable law if it doesn't exist, so please don't hold it against me if the legal result is not what you wish. If your question was in fact answered appropriately please click the GREEN "ACCEPT" button NOW, in order that it be recognized as such and I receive credit for my work from the company. Your promptness is greatly appreciated. In addition, Positive "FEEDBACK" and BONUSES are also appreciated. If you need additional related follow up on this particular question afterwards, don't hesitate to Reply and I'm happy to help you. And if you would like my assistance in the future, just put my name, STEPHANIE JOY, in your title or first sentence of post. Please keep in mind that I can only respond to your post and the information contained in it, as I do not know what you know unless you describe it fully. Also, due to site tech reasons, oftentimes I am initially only able to see the first part of your post, so I apologize in advance if it means more interactions between us. At times, there can also be a delay of an hour or more in between my answers because I may be helping other customers or taking a break, or if it is late at night, I may have to go get some shut eye til morning, but rest assured, I'll be back for you. Thanks!


I have tried to work with local psychiatrists and pain management providers to limit addictive medications to our mutual patients. I often find many providers claim lack of awareness to patient addictions and even document the same in notes. This seems disingenious at times since searches of state prescription monitoring programs can easily review multiple refills and multiple providers. This leaves me to address this with the patient and create a “preferred provider” network of more “attentive” providers, to put it politely.
It might have something to do with the government plans for GP,s to work -8am -8pm -SEVEN days a week –AND – consult with patients on Skype and email. But that just one of the issues GP DR Sarah says in her blog – which to me sounds fair comment– patient.info/blogs/sarah-says/2014/04/gp-extended-hours-great-in-theory-but/ To me this is just a devious government action to justify full privatisation of the NHS . A step at a time–public anger– bad GP,s -government- we can help — then the next “problem ” initiated by the government till – the SUN newspaper – GP,s “damaging” patients health and – look how “good ” the American system is (full privatisation ) we should get it here , and all the Lemmings jump off the cliff in agreement. I should add the rich Lemmings survive, pity about the poor.

Expert witnesses must be qualified by the Court, based on the prospective experts qualifications and the standards set from legal precedent. To be qualified as an expert in a medical malpractice case, a person must have a sufficient knowledge, education, training, or experience regarding the specific issue before the court to qualify the expert to give a reliable opinion on a relevant issue.[14] The qualifications of the expert are not the deciding factors as to whether the individual will be qualified, although they are certainly important considerations. Expert testimony is not qualified "just because somebody with a diploma says it is so" (United States v. Ingham, 42 M.J. 218, 226 [A.C.M.R. 1995]). In addition to appropriate qualifications of the expert, the proposed testimony must meet certain criteria for reliability. In the United States, two models for evaluating the proposed testimony are used:

In the past, a lawyer acting for a wronged patient might have advised his or her client first to report the matter to the Health Professions Council of South Africa (HPCSA), the professional body mandated to register health professionals and ensure practitioners are fit to practise, before proceeding with a civil case in the courts. Even though the HPCSA does not have the power to arbitrate on compensation, the rationale was that an HPCSA ruling and censure of the doctors concerned would improve the chances of a patient succeeding in a civil case.
Let’s suppose that the doctor prescribed a medication that was wrong for you and you had an adverse reaction. But you were also prone to strokes, and you had a stroke. Unless the medication is known to increase the risk of strokes, the medication did not cause your condition, so while the doctor was negligent, he or she did not cause your predicament through that negligence.
However, an attorney may be able to help you file a law suit against the negligent physician.  When seeking your legal expert, the single most important factor is the attorney’s reputation.  If you hire an attorney that is notorious for settling claims for less than they’re worth, you are less likely to receive the money you deserve.  For more information on attorneys and the legal processes involved in medical malpractice law suits, please read our article Medical Malpractice and the Legal Process
The key in proving a medical malpractice claim based on misdiagnosis or delayed diagnosis is to compare what the treating doctor did (or didn't do) to how other competent doctors within the same speciality would have handled the case. If a reasonably skillful and competent doctor under the same circumstances would not have made the diagnostic error, then the treating doctor may be liable for malpractice. (To learn more about proving a misdiagnosis claim, see Nolo's article Medical Malpractice: Misdiagnosis and Delayed Diagnosis.)

When contributory negligence first appeared in the repertoire of personal injury lawyers, the standards of proof needed to succeed were quite high and very severe. Originally, under the doctrine of contributory negligence if it were shown that the plaintiff contributed in any way to his injuries, he was barred from any recovery. This has been modified over time to permit the plaintiff to recover even if he contributed to his injuries, as long as his fault is under 50 percent. In these cases, recovery is relative to fault. For instance, if a jury finds a party’s injuries worth $100,000 and holds that the party was 25 percent at fault, the party’s recovery would be $75,000. On the other hand, if the jury found the party 60 percent at fault, the party would be barred from any recovery.
While both doctors in the above example should be able to diagnose the flu or pneumonia with relative ease, it would be more difficult to argue that the rural doctor was negligent for missing a diagnosis of some type of exotic disease usually only seen in people from foreign countries. On the other hand, the big city infectious disease expert would likely be negligent in not making the same diagnosis.
A hospital can be held liable for the negligence of its employees. Typically,  nurses are hospital employees. And in some cases, medical technicians and paramedics are also employed by a hospital. As long as the employee was doing something job-related when he or she injured the patient (who would be the plaintiff in the case), the plaintiff can sue the hospital over the injury.
A medical malpractice action must be commenced within one year after the cause of action accrues. However, if, at the time the injury occurs, the claimant is a minor or of unsound mind, the one-year statutes are tolled until the disability is removed (the minor reaches 18) Ohio Rev. Code Ann. § 2305.16. However, with the passage of time it can be more difficult to pursue the case as memories can fade or witnesses may have moved away. We recommend contacting our office right away for a free consultation to make sure you understand all of your rights and to have all of your questions answered.

This means that you need to find a qualified medical expert that is willing to attend a deposition and testify in court that you were injured by a health care provider’s negligence. Just who is qualified to testify as a medical expert witness is subject to a host of complicated and restrictive rules. An experienced plaintiff’s medical malpractice attorney will have a better network to draw from, but tracking down a qualified expert willing to testify on your behalf can be quite difficult, particularly if your case is a close call. Also, medical experts don’t work for free -- expect to pay a significant hourly rate. Some attorneys might front the medical expert expenses if they really think you have a winning case, but don’t count on it . . . and make sure to ask about your responsibility for litigation expenses up front.
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