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Maryland Medical Malpractice Summary
MARYLAND
Statutes of Limitations Statutory Cap on Attorneys' Fees
Contributory or Comparative Negligence Periodic Payments
Joint and Several Liability Collateral Source Rule
Contribution Pre-Judgment Interest
Vicarious Liability Patient Compensation Funds
Expert Testimony Immunities
Damage Caps Arbitration
Statutes of Limitations
Any medical malpractice action must be filed either within five years from the date when the injury was committed or three years from the date when the injury was discovered, whichever is earlier. Md. Code Ann., Cts. & Jud. Proc. § 5-109 (1995). Against a minor, the statute does not begin to run until a claimant has reached the age of eleven, and if the action involves a foreign object or injury to the reproductive system, the statute does not begin to run until the claimant is sixteen. Id . Maryland's highest court has held that the five-year part of the statute is not measured from the date treatment ends and does not violate the state constitution. Hill v. Fitzgerald , 304 Md. 689, 501 A.2d 27 (1985).
A wrongful death action brought by the decedent's dependents must be filed within three years after death. Md. Code Ann., Cts. & Jud. Proc. § 3-904 (1995). This statute applies to a wrongful death action brought on a medical malpractice theory, while § 5-109 applies to a survival action brought by the decedent's estate. Geisz v. Greater Baltimore Medical Center , 313 Md. 301, 545 A.2d 658 (1988).
Contributory or Comparative Negligence
Maryland is one of the few remaining states that recognizes the traditional common law doctrine of contributory negligence. Harrison v. Montgomery County Bd. of Ed. , 295 Md. 442, 456 A.2d 894 (1983). Thus, any negligence by a claimant will bar his recovery completely.
Joint and Several Liability
Joint tortfeasors are jointly and severally liable; each must assume and bear the responsibility for the misconduct of all. Carroll v. Kerrigen , 173 Md. 627, 197 A. 127 (1938); Cooper v. Bikle , 334 Md. 608, 640 A.2d 1120 (1994).
Contribution
A joint tortfeasor who pays more than his pro rata share has a right of contribution against other joint tortfeasors whose liability was extinguished by the judgment or settlement and who have not paid their pro rata share. Md. Code Ann., Cts. & Jud. Proc. § 3-1402 (Supp. 1997). The tortfeasors' pro rata shares are determined by dividing the judgment equally among the tortfeasors. Lahocki v. Contee Sand & Travel Co. , 41 Md. App. 579, 398 A.2d 490 (Ct. Spec. App. 1979), rev'd on other grounds sub nom. General Motors Corp. v. Lahocki , 286 Md. 714, 410 A.2d 1039 (1980).
Vicarious Liability
In Maryland, a hospital may, under appropriate circumstances, be held responsible for the negligent acts of its independently- contracted physicians, based on principles of apparent agency. Mehlman v. Powell , 281 Md. 269, 378 A.2d 1121 (1977) (holding that an apparent agency relationship existed because the hospital did nothing to indicate an emergency physician's true status as an independent contractor).
Expert Testimony
Within 90 days of filing a medical malpractice claim with the Health Claims Arbitration Office, a claimant must file a certificate from a qualified expert attesting to departure from standard of care and that the departure was the proximate cause of the alleged injury. Md. Code Ann., Cts. & Jud. Proc. § 3-2A-04 (Supp. 1997). The section contains qualifications the expert must meet. Id . See Arbitration for a discussion of the necessity of initiating arbitration before filing a lawsuit.
Damage Caps
Maryland imposes a limit on recoverable non-economic damages for any personal injury cause of action for medical malpractice accruing after July 1, 1986. Md. Code Ann., Cts. & Jud. Proc. § 11-108 (Supp. 1997). The limit was originally $350,000, but for causes of actions arising on or after October 1, 1994, the limit has been increased to $500,000. Id . Beginning October 1, 1995, and every October 1 thereafter, the limit on non-economic damages is increased by $15,000. Id . Non-economic damages include pain and suffering, inconvenience, physical impairment, disfigurement, loss of consortium, and other non-pecuniary damages, but not punitive damages. Id . The damage cap applies to each "direct victim" of the tort and all those claiming injury by or through him. Id. ; Oaks v. Connors , 339 Md. 24, 660 A.2d 423 (1995) (a single cap applies to the injured person's claim and the spouse's consortium claim). This statute does not violate Maryland's constitution. Murphy v. Edmonds , 325 Md. 342, 601 A.2d 102 (1992).
Prior to the 1994 amendment, the statute had been held not to apply to wrongful death cases. United States v. Streidel , 329 Md. 533, 620 A.2d 905 (1993). However, the statute now provides that the cap applies to wrongful death, and that the total recovery of all beneficiaries in a wrongful death case cannot exceed 150 percent of the cap. Md. Code Ann., Cts. & Jud. Proc. § 11-108 (Supp. 1997).
Statutory Cap on Attorneys' Fees
When attorneys' fees are in dispute, the claimed fees must first be approved by the arbitration panel or court. Md. Code Ann., Cts. & Jud. Proc. § 3-2A-07 (1995).
Periodic Payments
Maryland courts and arbitration panels are afforded the power to order that future damages be paid in the form of periodic payments, subject to adequate security. Md. Code Ann., Cts. & Jud. Proc. § 11-109 (1995). Upon the death of a claimant receiving periodic payments, the unpaid balance for future medical expenses reverts to the defendant. Id .
Collateral Source Rule
In Maryland, evidence of the claimant's receipt of payments from collateral sources may not be admitted to reduce his damages. Schreiber v. Cherry Hill Construction Co. , 105 Md. App. 462, 660 A.2d 970 (Ct. Spec. App.), cert. denied , 340 Md. 500, 667 A.2d 341 (1995).
Pre-Judgment Interest
Maryland law does not recognize pre-judgment interest on tort claims for personal injury. Lawhorne v. Employers Ins. Co. of Wausau , 343 Md. 111, 680 A.2d 518 (1996).
Patient Compensation Funds and Physician Insurance
Maryland does not have a patient compensation fund or a program of state-sponsored liability insurance for physicians.
Immunities
Under Md. Code Ann., State Gov't § 12-104 (Supp. 1997), the state has waived its sovereign immunity to the extent of $100,000 per claim. However, such immunity still applies with respect to punitive damages and pre-judgment interest. Md. Code Ann., Cts. & Jud. Proc. § 5-522(a) (Supp. 1997). A claimant must provide written notice of his claim within one year of the injury. If the claim is denied, a lawsuit must be filed within three years after the cause of action arises or the claim is barred. Md. Code Ann., State Gov't § 12-106 (Supp. 1997).
The liability of any local government in Maryland is capped at $200,000 per claim and $500,000 per occurrence. Md. Code Ann., Cts. & Jud. Proc. § 5-303 (Supp. 1997). Local governments are immune from liability for punitive damages. Id. The purchase of liability insurance does not waive the entity's immunity. See Quecedo v. Montgomery County, 264 Md. 590, 287 A.2d 257 (1972) (holding that in the absence of statute to the contrary, a county that maintains liability insurance does not waive its immunity).
Charitable hospitals carrying liability insurance in an amount not less than $100,000 are not liable for damages in excess of the limits of coverage. Md. Code Ann., Cts. & Jud. Proc. § 5-632 (Supp. 1997). However, that immunity does not extend to the employees of charitable hospitals. Wood v. Abell , 268 Md. 214, 300 A.2d 665 (1973).
Arbitration
Until recently, all claims for medical malpractice had to be reviewed by an arbitration panel under the aegis of the Health Claims Arbitration Office. Md. Code Ann., Cts. & Jud. Proc. § 3-2A-02 (1995). The law formerly allowed a waiver of arbitration if agreed by all parties, Md. Code Ann., Cts. & Jud. Proc. § 3-2A-06A (Supp. 1997), but for claims filed after October 1, 1995, unilateral waiver is permitted. Md. Code Ann., Cts. & Jud. Proc. § 3-2A-06B (Supp. 1997).
If the arbitration panel determines that a health care provider is liable to the claimant or claimants, it then itemizes and apportions damages. Md. Code Ann., Cts. & Jud. Proc. § 3-2A-05 (1995). Although any party may reject the panel's findings, those findings are admissible and presumed correct in any subsequent court proceedings, unless vacated by the court. Md. Code Ann., Cts. & Jud. Proc. § 3-2A-06 (1995). If a subsequent verdict is not more favorable to the rejecting party, the rejecting party is liable to the other for costs. Id .
Copyright © 1990-1998 McCullough, Campbell & Lane. All Rights Reserved.
Revision Date: February 6, 1998
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General Information about Medical Malpractice
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Medical Malpractice
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General Introduction
How big is the problem? Medical malpractice is a
bigger problem than most people want to admit.
Approximately 80,000 people die in the United States each
year due partly to medical malpractice (based on an
extensive study entitled "Patients, Doctors and
Lawyers: Medical Injury, Malpractice Litigation, and
Patient Compensation in New York," published by the
Harvard Medical Practice Study in 1990, a report to the
State of New York). These statistics have since been
confirmed by other studies performed in California and
New Jersey. Meanwhile, a RAND Corporation Study regarding
health care quality by Mark A. Schuster, M.D., Ph.D.,
Elizabeth A. McGlynn, Ph.D, and Robert H. Brook, M.D., Sc.D.
revealed that autopsy studies showed rates between 35 and
40% of missed diagnoses with most resulting in death.
Numerically, this is more than three fully loaded jumbo
jets crashing every week with no survivors. That number
of airplane crashes would mobilize many commissions,
government investigations, and a huge effort to prevent
the crashes. Unfortunately, since medical malpractice
injuries happen separately and privately, the effect is
not the same.
Even more disturbing, these numbers are only based on
hospital statistics . They do not include deaths from
missed diagnoses or medical negligence that occurred in
clinics, private doctors' offices, or other treatment
facilities.
Claims filed. At the same time, surprisingly few
claims are filed. Only 2 percent of people injured by
physicians' negligence seek compensation through a
lawsuit (according to a 1991 article in the New England
Journal of Medicine). A separate report from the Harvard
School of Public Health ("Harvard Medical Practice
Study") found slightly higher numbers. Their
research found that only one in eight patients that
suffers due to medical negligence ever files a lawsuit
and only one in sixteen recovers any damages. However,
despite the slightly higher percentage, the study
concluded, "Our data make clear, then, that the
focus of legislative concern should be that the
malpractice system is too inaccessible, rather than too
accessible, to the victims of negligent medical treatment."
Insurance. Many people do not realize that their
physician is not required to be insured. If not insured,
there is little hope of collecting compensation if the
doctor injures an innocent patient through malpractice.
For details on how insurance premiums have greatly
exceeded insurance payouts for many years, see Insurance Statistics . (Summary: for
the period 1984 through 1995, Hawai`i medical malpractice
insurers took in $191.5 million in premiums, and paid out
only $84 million in claims.) According to the U.S.
Congressional Budget Office, medical malpractice
insurance premiums amount to less than 1% of health costs.
Local regulation. There is little effective
regulation of quality by the state licensing board. Only
about 2,000 doctors (one-third of one percent) are
disciplined each year. Usually, the charges involve
substance abuse or financial fraud. Rarely is a physician
disciplined for injuring a patient through medical
malpractice.
If I think medical malpractice might
have happened, but I don't really know, what should I do?
First, be aware of the statute of limitations. You
may have a valid claim, but if you wait too long, the
claim is lost even if it is valid. The general rule is
that the claim must be filed within two years after the
malpractice, or two years after you reasonably should
have known there was malpractice. However, there are a
number of tricky exceptions, so do not give up just
because two years may have passed already. As a general
rule, delay helps the other side more than it helps you.
Second, you can generally forget about evaluating the
claim yourself, or trying to "work it out" with
the doctor or clinic or hospital. Usually, the "real"
decision-maker is the doctor's insurance carrier (if your
doctor is even insured, some are not), and the doctor's
attorney. These people are not paid to help you, or to be
candid with you. They are paid to defeat your claim. You
need an experienced professional to help you evaluate
your claim. Without an attorney, the doctor's attorney
and insurance company usually will not take you seriously.
Contact us, or any other law firm experienced in
medical malpractice cases. There is no charge for an
initial evaluation of your case. These cases are very
different from other kinds of personal injury cases such
as car accidents. Special rules and laws apply, and
special tactics and strategies are important. If your
case has any merit at all, an experienced attorney should
be willing to sit down with you and explain all your
options, without charge. Then you can make a full and
informed decision about whether or not you want to go
forward.
Generally, what must I prove? In every
medical malpractice case in Hawai`i, you must be able to prove
three things: (a) breach of the standard of care; (b) causation,
and (c) damages.
Breach of the standard of care. You must prove
that the doctor made a mistake -- a mistake which a
reasonable and prudent doctor would not have made under
the same circumstances. Generally, this requires an
expert witness (another doctor) to come forward and
testify that your doctor did make a mistake. As you can
imagine, this is not an easy process, since doctors do
not like to testify against each other. Finding good
expert witnesses is the critical part of most medical
malpractice cases.
Causation. In addition to showing the doctor made
a mistake, you have to show the doctor's mistake caused
an injury to you. To look at it another way, the reason
people go to see doctors is because they are sick. Even
the best medical treatment may be useless. So, you have
to be able to show that IF the doctor had not made the
mistake, then the patient would have gotten better, or
would not have been injured as much. Again, it is
critical to get an expert witness who is willing to
testify to this.
Damages. Finally, you have to show what damages
resulted from the doctor's mistakes. This could be
anything from death to serious injury. It may include
lost wages, medical bills, agony, mental suffering, or
the loss of a loved one. Often, economists and other
experts are necessary to calculate and present these
damages in court.
What is the process of a medical
malpractice claim in Hawai`i? Generally, a medical malpractice
claim in Hawai`i follows a series of steps.
Get the medical records. It is usually impossible
to accurately evaluate a medical malpractice claim
without obtaining all relevant medical records. If you
want to obtain your own medical records, we have provided
a sample letter . Unfortunately,
the hospitals and doctors often charge high rates for
obtaining these records. Charges of 50 cents to $1.00 per
page, or more, are common. Pursuant to Hawai`i Revised
Statutes, Section 622-57, the law says:
If a patient . . . requests copies of his or
her medical records, the copies shall be made
available to the patient unless in the opinion of the
health care provider it would be detrimental to the
health of the patient to obtain the records. If the
health care provider is of the opinion that release
of the records to the patient would be detrimental to
the health of the patient, the health care provider
shall advise the patient that copies of the records
will be made available to the patient's attorney upon
presentation of a proper authorization signed by the
patient.
If an attorney for a patient asks a health care
provider for copies of the patient's medical records
and presents a proper authorization from the patient
for the release of the information, complete and
accurate copies of the records shall be given to the
attorney within a reasonable time not to exceed ten
working days.
Reasonable costs incurred by a health care
provider in making copies of medical records shall be
borne by the requesting person.
Expert opinion. After getting the medical records,
an experienced attorney can often make a preliminary
evaluation; however, more often, the attorney will want
to discuss the records with an expert witness, or send
the records to a potential expert witness for evaluation.
This is where the high costs of a medical malpractice
case really begin. (A well-qualified expert witness will
often charge $250.00 to $400.00 per hour to review all
the records and render an opinion, and there is no
guaranty the first one will testify for you. Sometimes it
takes 2-3 experts before you find one who is willing to
testify for you.) However, usually your attorney will
"front" or pay these costs for you, and only
get them back if they win the case through a settlement
or trial verdict.
Medical Claims Conciliation Panel. The Medical
Claims Conciliation Panel ("MCCP") is part of
the Department of Commerce and Consumer Affairs, State of
Hawai`i. The law requires that most medical malpractice
claims in Hawai`i first go through the MCCP process.
Basically, this involves non-binding arbitration, where
three persons act as judges and listen to evidence about
your claim and issue a decision. The MCCP decision is not
binding. Even if you lose at the MCCP, you can still file
a lawsuit. At the same time, if you win, the doctor or
hospital is not required to pay. In other words, no
matter what the MCCP does, either side can still require
the case go to court.
Circuit court lawsuit. After the MCCP panel makes
its decision, unless the case settles (which is rare),
you will then need to file your circuit court lawsuit.
The lawsuit will usually take 1-2 years to resolve,
either through settlement or trial.
Kaiser cases. People who have health care coverage
through Kaiser Permanente (Kaiser doctors or the Kaiser
clinics) will probably not be able to file lawsuits, but
will instead have to file for binding arbitration. This
is usually required by the Kaiser health plan documents
you or a family member signs when they become eligible
for Kaiser coverage, often through an employer's health
plan. The bottom line is that most Kaiser plan
participants give up their right to go to court, and
instead agree to resolve any complaints through binding
arbitration. This method has advantages and disadvantages
to regular court, which your attorney can explain in
detail depending on the particular nature of your case.
Military cases. Cases involving Tripler Army
Medical Center do not go through the MCCP process, and
they are filed in federal court as opposed to state court.
However, they first go through a Federal Tort Claims
Process the federal government has set up. These cases
usually end up as a judge trial, which has advantages and
disadvantages over a jury trial.
Problem Doctors and Statistics on
Disciplinary Action
Check Whether Your
Doctor has Defaulted on Government Loans
Public
Citizen's Ranking of Serious Doctor Disciplinary Actions per 1,000
MDs (1997) : Hawai`i's poor performance in disciplining
doctors has ranked it in the bottom 12 states for the past seven
years.
E-mail
Your Ideas
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Medical malpractice insurance reform:Yes
Pittsburgh, PA
Tuesday
May 14, 2002
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Medical malpractice insurance reform:Yes The bill before the state Legislature is vital to reining in outrageous costs that can cripple the medical profession and harm patients Sunday, March 10, 2002 By Gerald W. Pifer, M.D.
Pennsylvania physicians are experiencing a silent crisis, but one that is no less serious because of its relative lack of visibility.
Gerald W. Pifer, M.D., is president of the Allegheny County Medical Society.
The malpractice crisis that has sent physicians' insurance premiums skyrocketing as much as 40 percent this year is not something that typically grabs headlines or makes for good soundbites on the evening news. In fact, the crisis is not something most patients even think about. Yet it could have a profound affect on the quality of health care in Pennsylvania if the situation is not eradicated.
Patients seeking medical care from practitioners in some specialties have already experienced a taste of what could be a larger problem. Obstetric/gynecology patients in some parts of the state, such as Philadelphia, already have to wait weeks, if not months, to get appointments to see their physicians. Many physicians are eliminating high-risk surgical procedures such as those performed by obstetricians, neonatalogists and others. This curtailing of services comes at a cost to patients, as these procedures could be very beneficial. Other physicians are opting to retire early or relocating to other states where conditions are better.
Young physicians aren't coming here to practice, either, even those with local ties. Many of our medical school graduates are seeking residency programs in other states, and are starting practices in those states after completing their residencies. Our practicing physicians here often bemoan the difficulty they have finding partners to join their practices, saying it takes months, if not years, depending on their specialty.
Because the practice climate in Pennsylvania involves capitated fees from many of our managed care companies, physicians are feeling pressured on both ends of their practices and are under increasing pressure to leave the practice of medicine or curtail their services. Most physicians have not seen increases in reimbursement from insurers in over five years, and have, in fact, experienced cuts in reimbursement. They have no ability to raise fees to reflect their costs.
While the climate is unfavorable toward physicians today, problems may only be exacerbated if the climate does not change in Pennsylvania. Just last week, a major insurer, Princeton Insurance Co., announced that it was pulling out of Pennsylvania. Another carrier, MIIX, was downgraded by A.M. Best in their rating. A third company, Medical Protective, filed for a 45 percent rate increase with the Pennsylvania Insurance Department. When a true physician shortage does occur locally, it will take eight to 10 years to fill those vacancies.
There is help on the horizon, however, in the form of legislation passed by the state House of Representatives and awaiting Senate consideration when it reconvenes tomorrow.
The bill, House Bill 1802 -- the Medical Care Availability and Error Reduction Act -- would be greatly beneficial to physicians and patients and would indeed invoke real reform.
The bill calls for the phasing out of the commonwealth's Medical Professional Liability Catastrophic Loss (CAT) Fund and placing this responsibility in a private market. Immediate financial relief from the bill would result in discounts at the CAT Fund level of 5 percent this year and 10 percent each of the next two years. A reduction in mandatory coverage from the current requirement of $1.2 million per year to $1 million would also be a first step toward lowering premiums for professional liability insurance for physicians.
A Venue Commission would also study the problem of "venue shopping" in which attorneys try to get their cases moved to a county, or courtroom, that would most likely be favorable toward their client -- in Pennsylvania, that's Philadelphia.
Perhaps the most important provisions are the gains in patient safety, however.
The bill calls for the appointment of an independent authority to analyze medical errors and suggest remedies to improve patient safety and makes the reporting of serious events mandatory, including penalties for noncompliance. The reporting of serious events would also be publicly available, although there are provisions to protect the confidentiality of the committee. Further protections include prohibitions on discovery and testimony in legal actions. Another provision requires all medical facilities to have a patient safety plan, including a patient safety office and committee.
Other provisions require experts testifying in court to have proper credentialing in the specialty about which they are testifying. Another stipulation calls for the opportunity to make periodic payments in an award so those patients can have a steady stream of income to cover their ongoing medical expenses. The amended bill no longer contains a cap on noneconomic, or "pain and suffering" awards, leaving Pennsylvania in the minority of states in the nation with no ceiling on awards. Even without the cap that had been included in the first House version, the bill would stand to reduce administrative and legal costs and give more money to the injured parties.
The bill would also modify the collateral source rule, meaning that injured patients generally will be prohibited from recovering damages that were already paid for by collateral sources such as private health and disability insurance. Currently in Pennsylvania, the defense is not allowed to tell a jury about this. Patients will still be able to tell the jury about their expenses, however, even if they cannot recover for the expense.
Still another provision says that future noneconomic damages will be paid in periodic payments over up to a 20-year period, unless the claimant opts to have those damages reduced to present worth, using a payment methodology similar to that available to lottery winners. A guaranteed steady stream of income to cover ongoing medical expenses would benefit some patients who are sometimes ill-equipped to invest that large sum of money wisely to ensure that their future needs are met.
The medical malpractice problem in Pennsylvania isn't just a "physician income" problem, as personal injury lawyers like to characterize it. Lengthy trials are a major expense for every hospital, nursing home and short and long-term care facility in our community. Seven out of 10 cases filed are discontinued or found in favor of hospitals and physicians.
But the costs of defending those cases are high. And those costs are passed on indirectly to each of us through our health insurance costs. As we all know, the cost of health insurance is a critical factor in establishing a climate that keeps businesses and attracts new businesses. Many other states have changed their systems to control legal costs.
Physicians don't want special treatment. We are responsible for our actions. But we do want a system of justice that is fair and addresses patients' best interest. Physicians have come to the conclusion that the legal system today serves only the best interest of personal injury lawyers. Surely, we can do better than this.
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AMMD: Medical - Legal Review, Malpractice
Screening
Alexander Mead MD
medical review consultant
900 Lincoln St. #781
Denver, CO 80203-2712
303-331-2866 | fax 303-692-9216
email: ammd@well.com
AMmd provides attorneys, insurers, and institutions
with prompt, cost-effective case review -- potential
medical malpractice, quality and utilization concerns,
medical-legal issues -- across a broad spectrum of adult
medicine, surgery, and injury.
On this page --
Medical-legal case review, malpractice
screening for attorneys
Independent medical review for
institutions
Reviewer's experience
Requesting a case review
Fees and payment protocol
Links to other useful legal, medical, and
expert pages
Medical - legal case review for attorneys
Medical malpractice -- case screening for
merit
Interactions of illness, preexisting conditions,
injury, apportionment
Research, litigation support for defense and
plaintiffs
Locating testifying experts
I review records and medical-legal issues involving
adult medicine, surgery, and injury. Where I would
qualify as an expert witness (Internal Medicine and
Cardiology), I am willing to testify. In the majority of
cases I review, I would not be the best testifying expert
(not in active clinical practice for 4 years), but can be
extremely helpful in assessing the merits of potential
cases. My clients enjoy the advantages of prompt service,
very reasonable fees, and accurate, honest opinions.
While I've mainly been asked to evaluate potential
plaintiffs' cases, I also have substantial experience
consulting for defense attorneys and insurers in strict
liability and professional malpractice matters.
As an experienced medical reviewer, I can help you
distinguish "bad outcome" from true medical negligence,
identify responsible parties, help attorneys and clients
understand complex problems and terminology, get full
relevant documentation, and locate appropriate testifying
experts where needed.
Independent medical review for institutions
For institutional review bodies, I offer impartial,
timely, and reasonably-priced assessment of quality of
care questions -- please contact me to discuss your
situation.
Reviewer's experience
I was in full time Cardiology and Internal Medicine
practice in Denver for many years (Board Certified in
both), but since 1987 have concentrated on review of
medical cases across a wide spectrum of settings and
specialties. Most of these reviews, literally thousands
of cases, were done for the federally chartered peer
review organization, the Colorado Foundation for Medical
Care (CFMC), for whom I have consulted extensively on
quality and utilization issues. I was the principal
physician consultant at CFMC on the Uniform Clinical Data
Set project (algorithmic quality screening) from 1990
until 1994, and the Colorado Medical Practice Study
(in-hospital medical injury) in 1995-6, and have
participated in numerous other quality assessment
studies.
Over the past 8 years, I have also evaluated over 60
complex auto insurance claims, involving sequential
injuries, preexisting illnesses and injuries, and
apportionment.
In the last several years, I have also reviewed
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the country concerning medical malpractice and other
medical-legal issues (references available on request).
In the last 3 years, I have been deposed once as an
expert witness in a medical malpractice case and once in
an auto insurance liability case.
Requesting a case review
You can discuss a new case or any medical question
with me by phone without obligation or charge. We'll
discuss what records will be needed and how they should
be sent (by US mail only for the main address above; to
use other carriers, please contact me first).
For most cases, the initial screening review will take
from 2 to 4 hours and will be done within 7-10 days of
getting the records. After my review, we'll discuss the
case's merits by phone. I will help you to decide if
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process, I'm happy to discuss any questions with your
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If a written report is required, that will usually
take an additional 4 to 8 hours. If the records are
massive, the facts of the case extremely complex, or
literature research is needed, more time could be
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It will help if you have the records organized before
sending them: they should be in sequence, first records
on top. Indexing is helpful but not essential; binding
and page numbering are usually counterproductive at this
stage as there is virtually always duplication and
disorder to be dealt with. Send pages loose and
unnumbered if possible.
Fees and payment protocol
Preliminary phone discussion of a new or potential
case -- no charge. Assessment of case merits, analysis,
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consultation are billed at $120 per hour. Screening most
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are billed at $200 per hour, including travel time to and
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Links to other important legal and medical
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Legal Resource Sites --
legal research, expert finders, malpractice law, much
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online journals and texts, doctors' credential
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Good web sites to find other "experts" online:
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FindLaw Experts
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Law
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For further information, call 303-331-2866 (leave message
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