There are several different reasons that patients (or next of kin) call lawyers regarding potential medical malpractice. Understanding the motivation for the call is important in evaluating the merits of a case during the vetting process.

Two of those reasons are on display now at NY Emergency Medicine, in an extraordinary post by Dr. Brian Fletcher, a fourth year emergency medicine resident recounting a story from his internship. It involves a horrifying code that occurred while he was doing a bedside procedure on a 70 year old man who had undergone surgery some days before. Read that post and come back. It's very much worth a few minutes of your time.

OK, welcome back. Two possible reasons why a medical malpractice attorney might be consulted popped right out at me during the story, and I've added two more to a short list below.

1. An unexpected result and a betrayal of trust: We don't know from the story about what transpired after the code with respect to the patient's family. It is strictly a post through the eyes of the young doctor that went through it. But if a family isn't leveled with, if they think information is being held back from them, then a family may feel a betrayal of trust. It's pretty darn rare to get a call from someone that trusts their doctor, so something must have happened not only with respect to the medicine but with respect to the personal relationship between doctor and patient. (This is one reason doctors are urged to apologize for errors.) One of the most important questions any lawyer asks a potential client regarding the prospect of litigation is, "What will the other side say is the reason this happened?" This will often lead to clues as to whether the matter is worth the time and money to investigate further by paying for the medical records.

2. The hospital rumor mill. A substantial number of calls are generated by nurses, technicians, doctors or others whispering into the ears of the family about what they heard and urging that a lawyer be consulted. As can be seen from Dr. Fletcher's story, a lot of people with no first hand knowledge like to talk. It's old fashioned gossip that often should be appropriately discounted. The important question here is trying to find out what the storyteller really knows.

3. Money, money, money. This is not part of Dr. Fletcher's story, but it tacked on here because I'm rounding up the reasons for the initial inquiry to the lawyer. Money is an easy motivation to discover because, during the initial consult before you even have a chance to evaluate the case, the person asks, "What's the case worth?" Anyone with a lick of common sense knows that all parts of the story must then be appropriately discounted, and if the client's testimony is essential to proving the case (as opposed to being documented on medical records) it is likely a case not worth taking.

4. Outrage. This is usually motivated by a desire to make sure that other patients don't undergo the same fate. The Dennis Quaid case of his twins getting overdosed with heparin is a classic example. Nobody expects that the Quaids need the money from any suit. They have a point to make. And they are not alone. Many, many people, struck by tragedy from the loss of a close family member or injury to a child, will make the call based on nothing less than raw emotion.

Since investigating and litigating potential medical malpractice cases is long, expensive and difficult, any lawyer that is doing their job properly is declining inquiries at a rate of 95-98%. But that initial call is how it all starts.

Other posts on the subject:

• Medical Malpractice - Vetting the Case
• Medical Malpractice Economics
• Medical Malpractice - A Primer
• No, Your Medical Malpractice Case Will NOT Settle Fast

Addendum 3/19/08 -- From TortsProf Sheila B. Scheuerman: "Sorry Works!" - Apology to Prevent Med Mal Claims

Addendum 3/21/08: Why we've never been sued for medical malpractice (Ralph Caldroney @ Medical Economics via Kevin, M.D.)

Labels: Medical Malpractice