Articles Posted in Medical Malpractice

On this blog, we talk about a wide variety of Maryland accidents, including slip and falls, car accidents and medical malpractice cases. The general premise behind all Maryland personal injury lawsuits is the same: state law allows those injured due to someone else’s negligence to recover financially by bringing a personal injury lawsuit against the negligent parties. However, it is important to keep in mind that different types of personal injury lawsuits may be grounded in the same basic idea but subject to very different procedural requirements. This is especially true for medical malpractice cases. Failure to follow the proper requirements could result in a plaintiff’s Maryland medical malpractice suit being thrown out, even if it would otherwise have been a winning case.

For example, take a recent state supreme court case which considered the procedural requirements for filing a medical malpractice suit. The case arose when the plaintiff sued a spa and its employee after allegedly being sexually assaulted during her massage in April of 2014. The plaintiff sued the spa (the massage therapist’s employer) for negligence in the training, supervision, and retention of the massage therapist. The defendant spa, in response, filed a motion for summary judgment. The spa argued that the plaintiff had not met the procedural requirements for filing a medical malpractice suit, since they had not filed the required certificate of good faith with the complaint. The question before the court was whether the common knowledge exception to the requirement applied—whether laypersons, using their common knowledge and without expert testimony, could decide whether the spa was negligent. If so, then the certificate was not needed because the case would not be subject to the requirement. If not, then the certificate was needed to file suit and the plaintiff’s suit must be dismissed. The common knowledge exception is common in many states, including Maryland.

The state supreme court ultimately determined that the common knowledge exception applied because no expert testimony was needed to decide this case. The court noted that the plaintiff was not claiming that the massage therapist negligently performed the massage, used improper technique, used excessive force, or anything of that nature. As such, no expert testimony was needed on the proper standard of care for massage therapists, force to be applied, or techniques. The question is one of sexual assault—which does not involve the technical or specialized knowledge of a medical professional. As such, the defendant’s motion for summary judgment had to be denied, and thus the plaintiff could move forward with her claim.

Most people know that when someone is injured in a Maryland accident of any kind, state law allows them to file a lawsuit against the negligent party. These personal injury suits can arise from car accidents, defective products, slip and fall accidents, or even dog bites. One type of claim is called a medical malpractice lawsuit, which arises from negligence on the part of a medical professional. For instance, if a surgery goes poorly because the surgeon was reckless, or if a medical professional fails to follow safety protocol when administering medication, they may be held liable in a medical malpractice lawsuit. These claims, however, can sometimes be more procedurally complicated, which can create barriers for plaintiffs if they do not follow procedural requirements carefully.

For example, take a recent state appellate case concerning the procedural requirements for filing a medical malpractice suit. According to the court’s written opinion, the plaintiff was the personal representative of the deceased’s estate. The deceased was in treatment at a hospital and receiving seven medications when she was transferred to a residential treatment facility. The hospital provided the treatment facility with the prescriptions for the medications, but not the medications themselves. The facility did not administer any of the drugs, and four days after the transfer, the patient died—allegedly from “a severe withdrawal syndrome.” The plaintiff brought suit against the hospital and the facility, alleging that they were negligent and either knew or should have known that suddenly failing to administer the medications was likely to cause severe withdrawal symptoms, including heart arrhythmias and seizures that could lead to her death.

In response, the defendants filed a motion to dismiss the plaintiff’s complaint for failing to comply with the requirements of a medical malpractice action. Many states have specific procedural requirements that a plaintiff must meet to file a medical malpractice suit. The defendants argued that the plaintiff did not meet these requirements, but the plaintiff in response argued that they did not need to meet these requirements because they were filing a claim for ordinary negligence, not medical malpractice. The trial judge denied the motion to dismiss, agreeing with the plaintiff that the complaint could be for ordinary negligence. On appeal, however, the appellate court reversed. The court found that a medical malpractice suit is one that arises from an act directly related to medical care or services, and that required the use of professional judgment or skill. In this case, the plaintiff’s claims clearly arose from such acts—the failure to render medical care or services. Because the court found that the claim was a medical malpractice one, and not an ordinary negligence one, the plaintiff was required to conform to other procedural requirements. The motion to dismiss was thus granted, since the plaintiff failed to do so.

In a Maryland malpractice case, a plaintiff may be able to bring a suit against a provider’s employer under the doctrine of respondeat superior, or vicarious liability. Vicarious liability allows an employer to be held liable for the acts of its employees, even without any fault on the part of the employer. Rather, the employer may be held liable based solely only on the employer-employee relationship. Generally, an employer may be held liable for the wrongful acts of an employee if the employee is acting in the scope of their employment. The doctrine is intended to hold employers accountable and because many times they can bear the financial burden better than an individual employee.

A state court recently heard a medical malpractice case involving the alleged vicarious liability of two different employers. In that case, the plaintiff underwent laparoscopic abdominal surgery at a hospital. She was admitted to the hospital after the surgery and her condition deteriorated. A second surgery was conducted, during which time they discovered a perforation in the plaintiff’s small bowel. She suffered catastrophic injuries that required her to undergo multiple surgeries and to be hospitalized for five months.

The plaintiff filed a medical malpractice lawsuit against the surgeon, the hospital, and the university that employed the surgeon. The plaintiff argued that the surgeon had perforated her small bowel during the first surgery, and that the staff failed to timely diagnose her condition and begin treatment. The university argued that the surgeon did not deviate from the standard of care during the surgery. It also argued that even if the surgeon did deviate from the standard of care, the plaintiff’s injuries were a result of the hospital staff’s failure to timely administer antibiotics.

When someone is injured or hurting in some way and needs surgery to fix it, it is important that they can trust their doctor to perform the surgery safely and skillfully. For the most part, surgeries in Maryland go off without a hitch. However, doctors are people just like everyone else, and sometimes they may be careless and make mistakes while performing the surgery, which can lead to serious injuries or even death. In these cases, Maryland state law allows the individuals injured, or their family if the victim dies or is otherwise incapacitated, to file a medical malpractice suit against the negligent doctor.

Like other personal injury cases, medical malpractice suits require the plaintiff to prove four main elements. First, that the defendant doctor or medical professional being sued owed the plaintiff a duty of care. In many cases, this is easily established because doctors generally owe their patients a duty of care. Second, that the defendant breached that duty of care, which typically is more difficult to prove and requires expert testimony. Third, that the breach was the proximate cause of the victim’s injuries. Lastly, that real damage occurred as a result, usually proved through medical bills and expert testimony. Failure to prove even just one of these four elements will typically result in the plaintiff’s suit being dismissed, leaving the plaintiff unable to recover for the harm they suffered.

A recent state appellate case provides an example of when a suit may be dismissed. The plaintiff suffered from temporomandibular joint syndrome, commonly referred to as TMJ, and visited the defendant oral surgeon. After several treatments did not work, the defendant performed intraoral surgery on the plaintiff. Part of the operation required using an oscillating saw, which could in some cases overheat and burn patients. Immediately after the surgery, the defendant noticed that the plaintiff’s face and lips were bruised and swollen, but assumed it was the normal swelling that occurs after surgery. However, when the plaintiff’s condition did not improve, it was discovered that she was suffering from second to third-degree burns.

The brachial plexus is a network of nerves between a person’s neck and shoulders that control one’s chest, shoulders, arms, and hands. A brachial plexus injury occurs if the nerves are stretched, compressed, or torn. A brachial plexus injury can occur during a birth, and a brachial plexus birth injury occurs in about one to three of every one thousand births. An injury can cause a loss of muscle function and even paralysis of the upper arm. Brachial plexus injuries can be the basis for a negligence claim in some Maryland birth injury cases.

A state appellate court recently decided a case involving brachial plexus injury that occurred during the course of a delivery. In that case, the mother was being treated by an obstetrician for her pregnancy. The obstetrician advised inducing labor because the mother was diabetic, in order to minimize any possible issues. The mother went forward with the elective induction. During the delivery, the doctor found that the baby’s shoulder was lodged against the mother’s public bone, and that the umbilical cord was wrapped around the baby’s neck. The obstetrician performed maneuvers to dislodge the baby’s shoulder in order to deliver the child, and the baby suffered a permanent brachial plexus injury.

A claim of negligence was filed by the parents against the obstetrician. They argued that the obstetrician failed to exercise ordinary care while delivering the plaintiffs’ baby, thereby causing the baby’s brachial plexus injury. The jury found the obstetrician was negligent and awarded the family $2.7 million in damages. However, before and after the trial, the obstetrician argued that the parents had to prove the higher standard of willful and wanton negligence because the obstetrician was providing emergency medical care at the time. Under a state statute, in cases involving the provision of emergency medical care, a plaintiff is required to prove willful and wanton negligence.

In a recent case before a state appellate court, the court considered whether a spouse could be added to a wrongful death claim after the statute of limitations had expired. In that case, a man was transported to a hospital via ambulance after he began bleeding from the area where he was receiving dialysis treatment. He died three days later. The man’s wife initially did not want to participate in the lawsuit and the man’s children sued several medical providers for wrongful death. The defendants argued that the case should be dismissed because the spouse was not a plaintiff in the suit. Under the state’s wrongful death statute, children can only bring a wrongful death claim if the deceased person does not have a surviving spouse. After the statute of limitations had passed, the plaintiffs attempted to add the wife to the claim. The trial court dismissed the suit against certain defendants because the wife had not filed the claim, but allowed it to continue against the providers.

The appeals court ruled that the court should have allowed the wife to be added. The court held that in this case, the amendment adding the spouse to the lawsuit after the expiration of the statute of limitation related back to the original complaint because it arose out of the same occurrence and the defendant would not be prejudiced. The court stated that a delay in filing was not enough to deny the amendment of the spouse. Therefore, the trial court should have added the wife to the case, and the court reinstated the case.

Possible Plaintiffs Under Maryland’s Wrongful Death Statute

When Maryland or Virginia residents are injured because of medical malpractice, the laws of the states allow them to file suit to recover against negligent medical professionals. This process can be incredibly complicated, and virtually all plaintiffs must rely on expert witnesses to make their case. Expert witnesses can testify to the court about how the injuries happened, what the defendant should or should not have done, the appropriate industry standards in a particular area, or the extent of the resulting injuries.

Recently, a Virginia appellate court considered a case involving a question of whether a plaintiff’s expert witness testimony survived a defendant’s motion to strike. After the plaintiff presents their evidence, the defendant may file a motion to strike the evidence from the record (or vice versa). If granted, it means that the court or jury cannot consider that evidence in their final decision.

In the recently decided case, the court began by describing the tragic facts. The patient, during her first pregnancy, had an incompetent cervix and had a cervical cerclage surgically placed. About a week after placement, the patient reported discomfort and pain in her abdomen, legs, and lower back to her doctor, who dismissed her concerns. Two days later, she called back about her pain and a new fever, and her doctor prescribed her some medicine via the phone, with no physical examination. Unfortunately, the patient continued to experience symptoms and called again, getting a different doctor who again prescribed her medicine via the phone, without a physical examination. Several hours later, the patient called back, and was finally directed to the hospital, where it was discovered that she had a severe infection. Her condition worsened in the hospital, and unfortunately, she passed away in the intensive care unit several days later.

Proving that a certain act is legally negligent in a Maryland medical malpractice claim hinges on the testimony of an expert witness. This is because many medical decisions are difficult for nonmedical professionals to evaluate, and expert testimony helps the jurors understand the potentially complex issues involved in a case. In fact, lawmakers have determined that expert testimony is required to successfully bring a medical malpractice claim.

Under the Maryland Health Care Malpractice Act, a plaintiff has to file a Certificate of Qualified Expert within 90 days of the filling of the claim. A plaintiff has to prove that a health care professional failed to meet the standards of practice among members of the same health care profession with similar training and experience. The Certificate of Qualified Expert is an attestation from a qualified health care provider . . . that the care provided was “not in accordance with the standards of practice among members of the same health care profession with similar training and experience situated in the same or similar communities” at the time of the acts in question. A court can review a certificate and determine whether it meets the requirements under the statute.

The expert health care provider must have had qualified experience in the defendant’s specialty, related health care field, or in the field that the defendant provided care or treatment within 5 years of the acts in question. Maryland also has a law that an expert may not devote more than 20 percent of the expert’s professional time to activities that involve providing testimony in personal injury claims. The following example shows the importance of understanding the standards required of health care providers to weigh a provider’s choices.

Recently the Supreme Court of Virginia issued an opinion stemming from a medical malpractice lawsuit against a plastic surgeon. The court addressed two common issues concerning expert witnesses and abuse of discretion that frequently occur in Maryland medical malpractice lawsuits.

According to the court’s opinion, the doctor performed a cosmetic procedure, a blepharoplasty, designed to remove puffiness and fat from the eyelids. Following the surgery, the plaintiff discovered that she was functionally blind in one eye after suffering permanent injury to her levator muscle. The plaintiff filed a medical malpractice lawsuit against the doctor, alleging that he negligently performed the surgery. At trial, the jury found in favor of the plaintiff and awarded her compensatory damages. The defendant appealed the ruling, arguing, among other issues, that the plaintiff should not have been permitted to cross-examine his medical expert on his disciplinary history.

In Maryland, plaintiffs must have a medical expert witness to support their medical malpractice lawsuit. Moreover, plaintiffs are entitled to cross-examine a defense’s expert witness. Generally, under Maryland law, an expert witness must have, clinical experience, previous consultations related to clinical practice, and taught medicine in the defendant’s specialty within five years of the negligent action. After a medical expert agrees to testify, they must obtain a Certificate of Merit. During testimony, a plaintiff is permitted to cross-examine an expert witness. Maryland Rule 5-702, mirrors the Frye standard, which allows expert testimony if it will enable the trier of fact to understand the evidence or determine an issue. Additionally, if a party objects to testimony, the court will weigh the testimony’s probative value versus its prejudicial effect to determine whether admitting the testimony is appropriate.

A Maryland Appellate Court recently issued a written opinion discussing the heightened standard for proving gross negligence in a Maryland wrongful death lawsuit. According to the court’s opinion, in early March of 2011, the victim woke up around one in the morning with chest pains. The victim’s wife called 9-1-1, reporting the chest pain and her husband’s difficulty breathing and speaking. The defendants, first responders, arrived on the scene shortly after, asked the victim about his symptoms, and did a visual assessment, concluding that he should be taken to the ambulance for further assessment. The victim walked to the ambulance himself without the aid of a stretcher. Once inside the ambulance, the defendants checked his vitals, which all appeared normal. The defendants then determined they would take him to the nearest hospital.

Approximately seven minutes after first arriving on the victim’s street, the defendants took him to the hospital. According to the defendants, the victim was comfortable and talkative during the three-minute drive. At the hospital, while waiting in the emergency room, the victim’s condition seemed to worsen, and the victim held his chest and complained about the pain for five to ten minutes until he ultimately became unconscious. At this point, he was taken immediately to receive treatment, and the defendants left the hospital and went back to work. The victim ultimately could not be resuscitated and died of a heart attack.

Maryland law allows surviving family members to seek compensation for a tragedy, and the victim’s family filed a wrongful death claim against the defendant first responders. Under Maryland law, to be successful in a claim against a first responder, the plaintiffs must prove gross negligence, as opposed to simple negligence. Gross negligence, according to the court’s opinion, is a high bar to prove. Simple negligence is falling below the ordinary level of care that a reasonable individual would use in a similar situation. Gross negligence, on the other hand, is an intentional and reckless disregard of the consequences of one’s actions or how they may affect others. This is a difficult standard, and to be considered gross negligence the conduct must be extraordinary or outrageous.

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