Articles Posted in Medical Malpractice

In a civil lawsuit, opposing parties are required to share some information related to their claims and defenses during the discovery process.  If a dispute arises, the parties are expected to resolve the matter between themselves and turn to the court for intervention only as a last resort.  A January 17, 2018 case before the Special Appeals Court demonstrates how these issues may come up in a Maryland medical malpractice claim.

The plaintiff in the case alleged that the defendants were negligent in performing an upper endoscopy procedure that was necessary to treat the decedent’s esophageal cancer.  During the procedure, the decedent’s esophagus was perforated, which the doctor treated with a stent.  Two weeks later, the doctor had to perform a second surgery to repair the perforation.  In the six months following the surgeries, the decedent suffered from a variety of health problems.  She had a preexisting history of chronic pancreatitis that worsened and required surgery on her pancreas.  During her recovery from the pancreatic surgery, the decedent developed complications, including sepsis, and died six days later.

The plaintiff filed suit against the hospital, alleging that the doctor was negligent and breached the standard of care when he perforated the decedent’s esophagus and that this breach started the decline that ultimately caused her death seven months later.  Following a trial, the jury returned a verdict in favor of the defendant.  The plaintiff appealed and challenged the trial court’s decision to admit the defendant’s expert witness and certain evidence into trial.  Specifically, he argued that the defendant made an expert witness designation that was not complete and also failed to identify physical exhibits in a timely manner.

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Although the Maryland Health Care Malpractice Claims Act (HCA) covers most injuries arising out of medical malpractice, some injuries seemingly overlap with ordinary negligence.  In a January 19, 2018 case, the Court of Appeals of Maryland examined whether claims for negligence and other related causes of action alleged a medical injury within the meaning of the HCA.

In the case, the plaintiff and her husband sued a nursing care facility for injuries the plaintiff suffered during her stay there.  The plaintiff’s injuries were caused when she fell from her bed, allegedly caused by the defendant’s failure to properly secure her mattress to the bed frame.  A mechanical lift was used to raise the plaintiff from the floor, but the lift released and dropped her again onto the floor instead of returning her to the bed.

The lawsuit was dismissed by the trial court for failure to file with the Health Care Alternative Dispute Resolute Office (ADR Office) first.  The plaintiffs appealed the decision.  The basic question on appeal was whether the plaintiffs’ claims were medical injuries.  If the claims alleged were found to be medical injuries within the HCA, they were required to file them in the ADR Office as a condition precedent to their court action.  If not, they were free to bring their claims as a non-medical negligence case in the circuit court.

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The requirements for filing a medical malpractice lawsuit can be complicated, but a Maryland medical malpractice attorney can help clients avoid dismissal on procedural grounds.  A November 6, 2017 case before the Court of Special Appeals illustrates some of the problems caused by failing to comply with the conditions precedent to the filing of a medical malpractice complaint.

The plaintiff in the case filed a lawsuit against his doctor without legal counsel, alleging that the doctor misdiagnosed his cardiovascular disease as acid reflux.  The defendant waived arbitration, and the matter was transferred to the circuit court.  The defendant moved to dismiss the plaintiff’s complaint for failing to file a certificate of a qualified expert within 90 days of filing his claim, and failing to file his complaint in the circuit court within 60 days of the defendant’s election to waive arbitration and transfer.  The circuit court granted the defendant’s motion to dismiss, and the plaintiff appealed.

The Health Care Malpractice Claims Act provides the procedures for all lawsuits by a person against a health care provider for a medical injury with damages in excess of the jurisdictional limit.  The Act creates a mandatory arbitration system for all medical malpractice claims.  Before bringing a civil action in court, therefore, a plaintiff must first file a claim with the Health Care Alternative Dispute Resolution Office, and they must file a certificate and report of a qualified expert within 90 days.

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If you have been injured by negligent medical treatment, you may be able to bring a Maryland medical malpractice claim against the health care provider who was responsible.  In a recent medical malpractice case, the plaintiff won on his claim against his neurosurgeon and was awarded compensation for his losses by the jury.  The defendant appealed the matter to the Court of Special Appeals of Maryland, which issued a ruling on September 1, 2017.

The plaintiff in the case had suffered years of neck and shoulder pain and numbness in his right hand.  The defendant performed surgery to remove damaged discs from the plaintiff’s cervical spine.  The plaintiff’s recovery was difficult, and some five months after the operation, the plaintiff tested positive for a Staph infection.  At trial, the plaintiff’s expert witness testified that the defendant and his staff were too slow in diagnosing and treating the infection.  The jury returned a verdict in favor of the plaintiff, finding that the defendant was negligent.

The primary issue on appeal was whether the jury instructions were proper.  The jury in the case was given instructions in terms of the standard of care that should be employed by a reasonably competent health care provider engaged in a similar practice and acting in similar circumstances.  However, in addition, an instruction was provided on the general negligence concept of foreseeable circumstances, describing how a reasonable person changes their conduct according to the circumstances and danger that is known or would be appreciated by a reasonable person.  On appeal, the defendant argued that the jury instruction sounding in general negligence principles was prejudicial.

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The timing of a Maryland medical malpractice case is important.  If filed too late, the defendants may invoke the statute of limitations to prevent the action from proceeding.  In a July 20, 2017 case, the Court of Special Appeals of Maryland decided whether the lower court correctly dismissed the plaintiff’s case as barred by the statute of limitations. 

The defendant had performed hip-replacement surgeries on the plaintiff in 2005 and 2010.  Although the plaintiff experienced significantly worse pain after the 2010 procedure, the defendant never informed her that her symptoms were anything other than normal results of a successful surgery.  The plaintiff consulted another orthopedic surgeon on December 6, 2010, who informed her that she would need a corrective surgery.  On January 7, 2011, the plaintiff opened a letter from her insurance company, advising that there had been a recall of certain prosthetic hip components, and it was likely that she had received one of the recalled components when the defendant performed her right hip replacement in April 2010.  The plaintiff filed her malpractice claims against the defendant on January 2, 2014.

In Maryland, the statute of limitations requires professional liability claims against health care providers to be filed within the earlier of:  (1) five years from the time the injury was inflicted; or (2) three years from the date the injury was discovered.  The key issue in the case was when the plaintiff became aware of facts that would have caused a reasonable patient to investigate a potential malpractice claim against the defendant.  That issue was complicated by the fact that, in the field of medicine, an unsuccessful result alone does not necessarily establish negligence on the part of the health care provider.  Instead, to establish a claim of medical injury, a plaintiff must prove not only a bad result but also a breach of the standard of care that was a proximate cause of the bad result.

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Faulty medical care can result in further injuries, expenses, and stress for the patient.  Some plaintiffs take legal action by filing a medical malpractice claim, as in a May 31, 2017 case decided by the Court of Special Appeals of Maryland.  The plaintiff in the case brought a medical negligence action against a hospital, based solely on vicarious liability, alleging that her physician negligently performed a laparoscopic hysterectomy and caused an injury to her uterus.  The plaintiff won at trial, and the jury awarded her approximately $425,000 in damages.  The hospital filed an appeal.

The primary issue for the appeals court to decide was whether the plaintiff could lawfully bring her negligence claim against the hospital based on the doctrine of respondeat superior after she had voluntarily dismissed her claim against the doctor with prejudice.  Respondeat superior is a legal doctrine that holds an employer vicariously liable for a tort committed by its employee while acting within the scope of his employment.  In Maryland, the plaintiff may sue an employer based on the wrongful conduct of its employee without suing the employee as well.  To establish the liability of the employer in such cases, the plaintiff need only prove that the employee committed the tort and did so while acting within the scope of his employment.

There are, however, two situations under Maryland law in which the settlement of a claim against the employee will preclude vicarious liability on the part of the employer:  (1) the exoneration of the employee; and (2) the plaintiff’s release of her claim against the employee.  On appeal, the hospital argued that the dismissal of the plaintiff’s claim against her doctor with prejudice constituted a release of liability against both the doctor and the hospital.  The issue is one that has not been decided uniformly across the country.

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The Court of Appeals of Maryland recently explained its position regarding evidence of superseding causes of injury by non-parties in a medical malpractice case decided on May 24, 2017.  The family of a deceased patient sued several doctors and hospitals that had treated the patient before his stroke.  Before trial, the plaintiffs had settled with or dismissed their claims against all of the defendants except one radiologist and his employer.  The plaintiffs alleged that the doctor was negligent when interpreting the patient’s radiological images, leading to the patient’s fatal stroke six days later.  After the trial, the jury found in favor of the defendants, and the plaintiffs appealed.

The key question for the Court of Appeals was whether the defendant could present evidence of negligence on the part of non-party doctors who had subsequently treated the patient as intervening and superseding causes of harm to the patient.  The plaintiffs argued that evidence of the non-parties’ negligence was irrelevant and immaterial to the issue of whether the defendant violated the standard of care in his treatment of the patient, and the evidence tended to mislead the jurors into believing the non-parties who had settled were the responsible parties, rather than the defendant.  The plaintiffs also contended that the trial court improperly applied the doctrine of intervening and superseding causes in the context of a medical negligence action involving acts of multiple concurrent tortfeasors.

The four elements required for a negligence action are duty, breach, causation, and damages.  Causation-in-fact may be found if it is more likely than not that the defendant’s conduct was a substantial factor in producing the plaintiff’s injuries.  However, the issue of superseding causation is not even relevant unless the antecedent negligence of a third person is a substantial factor in bringing about the injury and could not have been anticipated by the defendant.

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Family members may have legal recourse against someone who negligently caused their loved one’s serious injury or death.  In a May 2, 2017 opinion, the Court of Special Appeals of Maryland reviewed a jury verdict in favor of the plaintiff in a medical malpractice and wrongful death action.  After her son committed suicide, the plaintiff filed suit against his doctor and the hospital, alleging that they had negligently discharged her son from involuntary inpatient psychiatric treatment and caused his death by suicide.

Following the trial, a jury awarded the plaintiff $6,112 in economic damages and $2,300,000 in non-economic damages, which were capped at $695,000, the statutory limit on non-economic damages imposed by Maryland law.  Despite the jury’s verdict, however, the trial court entered a judgment notwithstanding the verdict in favor of the defendants.  The plaintiff appealed.

In order to prevail on a claim of medical malpractice in Maryland, a plaintiff must prove the applicable standard of care, that the standard of care was violated by the defendant, and that the violation proximately caused the injury for which damages are sought.  The duty of care in a medical malpractice action is to exercise the degree of care or skill expected of a reasonably competent health care provider in the same or similar circumstances.  Generally, the nature and scope of the duty owed and whether the standard of care was breached is proven by expert testimony.

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The Court of Special Appeals of Maryland reviewed an interesting medical malpractice case on March 17, 2017 concerning a botched appendectomy.  The plaintiff in the case alleged that her doctor failed to completely remove her appendix when he performed the surgery.  She brought suit against the doctor for negligence and breach of contract.  After the circuit court granted the defendant’s motion to dismiss her breach of contract claim, the plaintiff appealed to the higher court.

In October of 2011, the plaintiff went to the hospital complaining of abdominal pain.  The defendant diagnosed her with acute appendicitis and recommended that she undergo a laparoscopic appendectomy to remove her appendix.  In performing the surgery, the defendant removed most of the plaintiff’s appendix, but left the “stump” in place.  The plaintiff alleged that by leaving a portion of the appendix in her body, she experienced severe pain and required an additional surgical procedure that she had performed by another doctor.  She argued that the defendant was liable for breach of contract because he had a contractual obligation to perform an appendectomy, which is the removal of the appendix, not a portion of the appendix.

In Maryland, the failure of a physician to exercise reasonable care and medical skill, i.e., medical negligence, is generally not governed by contract law, despite the contractual nature of the doctor-patient relationship.  Rather, to establish a breach of contract claim where the facts relate to a physician’s performance of a medical procedure, the plaintiff must show that the physician made an additional promise or warranty that is separate and apart from the physician’s agreement to properly perform the procedure.  The legal rationale for not imposing any contractual liability on the physician is that, when considering the unpredictability of medical results and the differences in individual patients, it would be unlikely that the physician could in good faith promise a particular outcome.  Therefore, absent unique circumstances, medical malpractice cases are typically viewed under negligence law and not determined by the laws of contract.

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In Maryland, a medical malpractice action must be filed against a health care provider within a certain time period, or it may be dismissed.  In a February 22, 2017 decision, the Court of Special Appeals of Maryland reviewed a negligence claim filed by the plaintiff against her podiatrist, which had been dismissed by the circuit court as barred by the statute of limitations.

In 2010, the defendant operated on the plaintiff to correct pain in her right foot by placing a screw near her second toe.  After several follow-up visits in which the plaintiff complained of continued pain, the defendant performed a second surgery to remove the screw.  When the plaintiff’s condition did not improve by June of 2011, the defendant referred her to another doctor.  The second doctor diagnosed her with a bunion deformity that could require a third surgery and significant recovery period.  In August of 2014, the plaintiff filed a medical negligence claim against the defendant.  The circuit court granted the defendant’s motion for summary judgment, ruling that the statute of limitations on the plaintiff’s claim began to run in June of 2011.

In Maryland, a civil action for damages against a health care provider must be filed within the earlier of five years from the time the injury was committed, or three years of the date the injury was discovered.  Under the discovery rule, the statute of limitations begins to run when the wrong is discovered, or when it should have been discovered with due diligence.  Under the latter alternative, awareness is implied from knowledge of circumstances which should put a person of ordinary caution on notice.

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