Medical Malpractice Law in Virginia

Medical Malpractice Law in Virginia
Publication Date: 2008
Electronic Forms: 13
Available Formats: Print (363 pages, looseleaf, 1 volume)
  Electronic (searchable PDF via flash drive, CD, or immediate download)
  Both Print and Electronic formats
  Individual chapters available for download
Product #: 862

Information

Content Highlights:
  • Statutes and Rules
  • Theories Of Recovery And Defenses
  • Interviewing The Client
  • Investigating The Factual Background
  • Expert Review
  • Written Discovery
  • Depositions
  • Negotiation And Settlement
  • Trial

2016 Edition In Production. Purchase the current edition today and receive the 2016 edition without charge.

This book provides numerous checklists and forms for seasoned medical malpractice attorneys and also guides an attorney accepting his or her first medical malpractice case through extensive analyses of how to evaluate the strengths and weaknesses of claims. Each chapter is written jointly by a plaintiff’s attorney and a defense attorney. Understanding the issues and tactics from both perspectives enhances understanding of why particular methods and tools are effective.


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Table of Contents

CHAPTER LIST

1. Statutes And Rules

2. Theories Of Recovery And Defenses

3. Interviewing The Client

4. Investigating The Factual Background

5. Expert Review

6. Written Discovery

7. Depositions

8. Negotiation And Settlement

9. Trial

CHAPTER 1: STATUTES AND RULES  (back to top)

1.1 HISTORY AND PURPOSE

1.2 PROCEDURES UNDER THE MEDICAL MALPRACTICE ACT
      1.201 Scope of the Medical Malpractice Act
      1.202 Pleadings

1.3 MEDICAL MALPRACTICE REVIEW PANELS
      1.301 Procedural Requirements for Requesting a Panel
      1.302 Designation of Panel and Judge
      1.303 Miscellaneous Consequences of Requesting a Panel
      1.304 Panel Members
      1.305 Discovery
      1.306 Request for Hearing
      1.307 Notice Before Hearing
      1.308 Evidence
      1.309 Executive Session if No Hearing Is Held
      1.310 Judicial Authority at Hearing
      1.311 Removal or Inspection of Record
      1.312 Subpoenas
      1.313 Conduct of an Ore Tenus Hearing
      1.314 Due Date of Panel Opinion
      1.315 Significance for Trial
      1.316 Record
      1.317 Costs

1.4 LIMITATION ON RECOVERY

1.5 STANDARD OF CARE AND EXPERT TESTIMONY
      1.501 Necessity of Expert Testimony
      1.502 Threshold for Qualification
      1.503 Factfinder Determines Standard of Care
      1.504 Examples

1.6 INCONSISTENCIES BETWEEN THE MEDICAL MALPRACTICE RULES AND THE ACT
      1.601 In General
      1.602 Rescinding a Panel
      1.603 Notification
      1.604 Date for Convening the Panel

1.7 OTHER VIRGINIA STATUTES
      1.701 Communications Between Physicians and Patients
      1.702 Patient Records
      1.703 Discoverability of Incident Reports

1.8 STATUTES OF LIMITATIONS
      1.801 Personal Injury
      1.802 Wrongful Death
      1.803 Persons Under a Disability
      1.804 Fraud

1.9 VIRGINIA AND FEDERAL TORT CLAIMS ACTS
      1.901 Federal Tort Claims Act
      1.902 Virginia Tort Claims Act

1.10 PERSONS EXEMPT FROM LIABILITY FOR MEDICAL NEGLIGENCE
      1.1001 Emergency Care
      1.1002 Nonemergency Care
      1.1003 Laboratory Tests

APPENDIX 1-1: CHECKLIST FOR BRINGING AN ACTION UNDER THE FEDERAL TORT CLAIMS ACT (FTCA)

APPENDIX 1-2: REQUEST FOR MEDICAL MALPRACTICE REVIEW PANEL

CHAPTER 2: THEORIES OF RECOVERY AND DEFENSES  (back to top)

2.1 THEORIES OF RECOVERY

2.2 STANDARDS OF LIABILITY

2.3 STATUTE OF LIMITATIONS AND THE CONTINUING TREATMENT RULE
      2.301 Statute of Limitations in General
      2.302 Extension of Statute of Limitations for Foreign Objects, Fraud, Concealment, and Intentional Misrepresentation
      2.303 Minors
      2.304 Continuing Treatment Rule
      2.305 Wrongful Death
      2.306 Incapacitated Persons

2.4 DAMAGE AWARDS
      2.401 Limits on Recovery
      2.402 Punitive Damages
      2.403 Prejudgment Interest
      2.404 Wrongful Death
      2.405 Emotional Distress
      2.406 Contributory Negligence
      2.407 Contribution and Indemnity

2.5 IMMUNITY FOR HEALTH CARE PROVIDERS
      2.501 Sovereign Immunity
      2.502 Charitable Immunity
      2.503 Good Samaritan Rule
      2.504 Peer Review Activities
      2.505 Health Care Providers Investigating Complaints of Drug or Substance Abuse or Impairment of Health Care Professionals
      2.506 Laboratory Results and Examinations

2.6 VIRGINIA TORT CLAIMS ACT
      2.601 Introduction
      2.602 Exceptions
      2.603 Procedural Requirements
      2.604 Limits on Recovery
      2.605 Implications for Pretrial Settlement

2.7 ASSAULT AND BATTERY
      2.701 Introduction
      2.702 Medical Malpractice Act Applies
      2.703 Expert Testimony Not Required
      2.704 Informed Consent Distinguished

2.8 INFORMED CONSENT
      2.801 Overview
      2.802 Disclosure of Risks
      2.803 Causation
      2.804 Exceptions

2.9 VICARIOUS LIABILITY AND AGENCY
      2.901 Overview of the Master-Servant Relationship
      2.902 Scope of Employment
      2.903 Medical Malpractice Actions
      2.904 Specific Cases

2.10 VIRGINIA BIRTH-RELATED NEUROLOGICAL INJURY COMPENSATION ACT
      2.1001 Introduction
      2.1002 Birth-Related Neurological Injury Defined
      2.1003 Act Is Exclusive Remedy
      2.1004 "Participating" Providers
      2.1005 No Cap on Recovery
      2.1006 Statute of Limitations
      2.1007 Miscellaneous

CHAPTER 3: INTERVIEWING THE CLIENT  (back to top)

Plaintiff's Perspective

3.1 INTRODUCTION

3.2 INITIAL INTERVIEW
      3.201 In General
      3.202 Initial Agreement
      3.203 Client Questionnaire
      3.204 Credibility of the Client
      3.205 Credibility of the Claim

3.3 WHAT TO GET FROM THE CLIENT
      3.301 Initial Interview
      3.302 Medical Records
      3.303 Potential Witnesses, Photographs, and Employment Records
      3.304 Monetary Considerations

3.4 WHAT TO TELL THE CLIENT
      3.401 In General
      3.402 Informed Consent
      3.403 Reality Check
      3.404 Strengths and Weaknesses
      3.405 Procedure
      3.406 Statute of Limitations
      3.407 Written Opinions Before Service of Process

3.5 TURNING DOWN THE CASE
      3.501 Certified Letter
      3.502 Statute of Limitations
      3.503 Retaining Files

Defendant's Perspective

3.6 ACTION UPON REFERRAL OF CASE
      3.601 In General
      3.602 Determine Case Status
      3.603 Contact Client
      3.604 Draft Initial Communication

3.7 ACTION BEFORE INITIAL MEETING
      3.701 In General
      3.702 Contacting Insurer
      3.703 Contacting Plaintiff's Attorney
      3.704 Meeting with Insurer
      3.705 Reviewing File
      3.706 Reviewing Medical Records
      3.707 Medical Research

3.8 INITIAL MEETING
      3.801 In General
      3.802 Purpose of Meeting
      3.803 Participants
      3.804 Discussion
      3.805 Timetable
      3.806 Conclusion

3.9 INSTITUTIONAL CLIENT

APPENDIX 3-1: FEE AGREEMENT

APPENDIX 3-2: INITIAL LETTER TO PLAINTIFF

APPENDIX 3-3: INITIAL LETTER TO DEFENDANT

CHAPTER 4: INVESTIGATING THE FACTUAL BACKGROUND  (back to top)

Plaintiff's Perspective

4.1 APPLYING DARWINIAN CONCEPTS TO CASE SELECTION: "ONLY THE STRONGEST SURVIVE"
      4.101 Defendants' Advantages
      4.102 Elements Necessary for Prima Facie Case
      4.103 Clients to Avoid
      4.104 Elements of a Viable Claim
      4.105 Active Participation of Client

4.2 INITIAL INVESTIGATION
      4.201 In General
      4.202 Medical Records
      4.203 Interviews
      4.204 Chronology and Time Lines
      4.205 Identification of Defendant's Practice Guidelines
      4.206 Medline, FDA, and FOI Searches
      4.207 Courthouse Check
      4.208 Virginia Board of Medicine

Defendant's Perspective

4.3 MEDICAL RECORDS
      4.301 Obtaining Medical Records
      4.302 Release of Confidential Information
      4.303 Subpoenas
      4.304 Types of Medical Records That Can Be Obtained
      4.305 Interpreting Medical Records

4.4 OTHER DOCUMENTS
      4.401 Documents Relating to Incident
      4.402 Other Sources
      4.403 Patient Information Documents
      4.404 Practitioner Information Documents
      4.405 General Medical Information

4.5 TESTIMONIAL EVIDENCE
      4.501 In General
      4.502 Lay Witnesses
      4.503 Expert Witnesses
      4.504 Treating Health Care Personnel

APPENDIX 4-1: SAMPLE CHRONOLOGY

APPENDIX 4-2: ABBREVIATIONS IN MEDICAL RECORDS

APPENDIX 4-3: EQUIVALENTS AND SYMBOLS

APPENDIX 4-4: ORGANIZATIONS PUBLISHING PRACTICE GUIDELINES

CHAPTER 5: EXPERT REVIEW  (back to top)

5.1 INTRODUCTION

5.2 DETERMINING THE TYPES AND NUMBER OF EXPERTS REQUIRED
      5.201 Establishing a Prima Facie Case
      5.202 Standard of Care Experts
      5.203 Qualifications for Standard of Care Experts
      5.204 Causation and Damage Experts

5.3 FINDING EXPERTS
      5.301 In General
      5.302 Community Practitioners and Academicians
      5.303 Medical Literature and Medline
      5.304 Professional Locating Services
      5.305 Referral from Attorneys and Legal Publications

5.4 DETERMINING WHICH EXPERTS WILL BE MOST EFFECTIVE
      5.401 In General
      5.402 Credibility
      5.403 Ability to Testify
      5.404 Tailoring Experts to a Particular Case

5.5 EXPERT REVIEW
      5.501 In General
      5.502 Initial Contact and Selection
      5.503 Preparing for the Expert's Review

5.6 CERTIFICATION REQUIREMENT
      5.601 In General
      5.602 Content of Certification
      5.603 Certification Form
      5.604 Discoverability of Certifying Expert

5.7 NUMBER OF EXPERTS TO BE RETAINED
      5.701 Initial Review
      5.702 Litigation

5.8 DOCUMENTATION OF EXPERT OPINIONS
      5.801 Internal Memorandum
      5.802 The Expert Designation
      5.803 Provide Copy of Designation to All Experts

5.9 PREPARING EXPERTS FOR DEPOSITION AND TRIAL
      5.901 Preparing for Deposition
      5.902 Preparing for Trial
      5.903 Use of Medical Treatises, Periodicals, or Pamphlets at Trial
      5.904 Use of Expert's Own Practices as Evidence of the Standard of Care

5.10 DISQUALIFICATION OF EXPERTS

5.11 WHEN EXPERT WITNESSES MAY NOT BE NEEDED
      5.1101 The Res Ipsa Loquitur Exception
      5.1102 Layman's Common Knowledge Issue Exception

APPENDIX 5-1: SAMPLE LETTER REQUESTING CERTIFICATION

APPENDIX 5-2: SAMPLE LETTER VERIFYING CERTIFICATION

APPENDIX 5-3: CHECKLIST FOR EVALUATING POTENTIAL EXPERTS

CHAPTER 6: WRITTEN DISCOVERY  (back to top)

6.1 INTRODUCTION

6.2 SCOPE OF DISCOVERY
      6.201 In General
      6.202 "Not Privileged"
      6.203 "Relevant to the Subject Matter Involved in the Pending Action"
      6.204 "Reasonably Calculated to Lead to the Discovery of Admissible Evidence"

6.3 TYPES OF WRITTEN DISCOVERY
      6.301 Interrogatories
      6.302 Requests for Production of Documents
      6.303 Subpoena Duces Tecum
      6.304 Alternatives to Subpoena Duces Tecum
      6.305 Requests for Admission

6.4 OBJECTIONS TO WRITTEN DISCOVERY
      6.401 Grounds in General
      6.402 Undue Burden
      6.403 Materials Prepared in Anticipation of Litigation
      6.404 Work Product Doctrine
      6.405 Privilege Under Section 8.01-581.17
      6.406 Motion to Quash Subpoena Duces Tecum
      6.407 Improper Objections

6.5 SUPPLEMENTATION OF DISCOVERY RESPONSES
      6.501 Mandatory Supplementation
      6.502 Other Supplementation

6.6 PROTECTIVE ORDERS
      6.601 Grounds for Motion
      6.602 Forms of Relief
      6.603 Expenses of Motion
      6.604 Case Law

6.7 REMEDIES FOR FAILURE TO MAKE WRITTEN DISCOVERY
      6.701 Motion to Compel
      6.702 Sanctions for Failure to Comply with Discovery Order
      6.703 Sanctions for Failure to Respond to Written Discovery
      6.704 Section 8.01-271.1 and Rule 1:4(a)

6.8 PRETRIAL ORDERS AND WRITTEN DISCOVERY
      6.801 Agreed Orders
      6.802 Uniform Pretrial Scheduling Order

6.9 WRITTEN DISCOVERY IN FEDERAL COURT
      6.901 In General
      6.902 Federal and Virginia Rules Compared
      6.903 Eastern District of Virginia
      6.904 Western District of Virginia
      6.905 Pretrial Orders

6.10 IMPORTANT SUBJECTS OF WRITTEN DISCOVERY
      6.1001 Plaintiff's Perspective
      6.1002 Defendant's Perspective
      6.1003 Subjects to Be Discovered by Both Parties

APPENDIX 6-1: MEDICAL RECORDS RELEASE AUTHORIZATION

APPENDIX 6-2: DEPOSITION NOTICE COVER LETTER AND REQUEST FOR SUBPOENA DUCES TECUM

APPENDIX 6-3: NOTICE OF DEPOSITION UPON WRITTEN QUESTIONS

APPENDIX 6-4: DIRECT QUESTIONS TO BE PROPOUNDED TO THE CUSTODIAN OF MEDICAL RECORDS

APPENDIX 6-5: ORDER

APPENDIX 6-6: SUBPOENA FORMS

APPENDIX 6-7: PLAINTIFF'S INTERROGATORIES AND REQUEST FOR PRODUCTION OF DOCUMENTS

APPENDIX 6-8: DEFENDANT'S INITIAL INTERROGATORIES TO PLAINTIFF

APPENDIX 6-9: DEFENDANT'S FIRST REQUEST FOR PRODUCTION TO PLAINTIFF

APPENDIX 6-10: WRITTEN DISCOVERY CHECKLISTS

CHAPTER 7: DEPOSITIONS  (back to top)

Plaintiff's Perspective

7.1 PREPARING TO DEPOSE THE DEFENDANT

7.2 PREPARING TO DEPOSE A NONPARTY

7.3 PREPARING THE PLAINTIFF

7.4 DEPOSITION GUIDELINES
      7.401 Planning the Deposition of the Defendant
      7.402 Preparing the Medical Records
      7.403 Procedural Manuals
      7.404 Deposition of the Expert
      7.405 Expert Bias

7.5 SUMMARY

Defendant's Perspective

7.6 PRELIMINARY MATTERS
      7.601 Reviewing and Analyzing the File
      7.602 Meeting with the Client
      7.603 Meeting with the Experts
      7.604 Reviewing Applicable Law
      7.605 Informal Interview as Alternative to Deposition
      7.606 Timing of Discovery

7.7 TAKING THE DEPOSITION OF THE PLAINTIFF OR OTHER FACT WITNESS
      7.701 Preparing for Deposition
      7.702 The Deposition Itself

7.8 DEFENDING A DEFENDANT'S DEPOSITION
      7.801 In General
      7.802 Reviewing the File
      7.803 Preparing the Defendant for Deposition
      7.804 Protecting the Defendant During the Deposition
      7.805 Incident Reports
      7.806 Defendant's Policies and Procedures
      7.807 Dual Role of Defendant

7.9 TAKING AN EXPERT'S DEPOSITION
      7.901 Before the Deposition
      7.902 During the Deposition

7.10 DEFENDING AN EXPERT'S DEPOSITION
      7.1001 Timing of Deposition
      7.1002 Preparing the Expert Deponent
      7.1003 Protecting the Expert During the Deposition
      7.1004 Discovery of Expert's Knowledge of Attorney Work Product

APPENDIX 7-1: SAMPLE MEDICAL CHART AND TIME LINE

CHAPTER 8: NEGOTIATION AND SETTLEMENT  (back to top)

8.1 GENERAL CONSIDERATIONS
      8.101 Plaintiff's Perspective
      8.102 Defendant's Perspective

8.2 STRATEGIES AND TACTICS
      8.201 Plaintiff's Perspective
      8.202 Defendant's Perspective

8.3 MEDIATION AND ARBITRATION
      8.301 Mediation
      8.302 Arbitration

8.4 SPECIAL CONSIDERATIONS
      8.401 Settlements for Infants
      8.402 Wrongful Death Claims
      8.403 Structured Settlements
      8.404 Special Needs Trusts for Disabled Plaintiffs
      8.405 Statutory Liens
      8.406 National Practitioner Data Bank
      8.407 Statutory Cap
      8.408 Claims Against the Commonwealth

APPENDIX 8-1: ARBITRATION AGREEMENT

CHAPTER 9: TRIAL  (back to top)

Plaintiff's Perspective

9.1 STRATEGIC PLANNING
      9.101 In General
      9.102 Threshold Dilemmas for the Plaintiff
      9.103 Overcoming the Dilemmas

9.2 VOIR DIRE
      9.201 In General
      9.202 Goals
      9.203 Areas of Inquiry
      9.204 Avoiding Mention of Insurance

9.3 OPENING STATEMENT
      9.301 Goals
      9.302 Exploiting the Case's Drama
      9.303 Using Visual Aids

9.4 WITNESSES AND OTHER PROOF
      9.401 Deciding Which Witnesses to Call
      9.402 Alternatives to Calling a Witness
      9.403 Depositions
      9.404 Defendant as Adverse Witness

9.5 DIRECT EXAMINATION OF STANDARD OF CARE EXPERT
      9.501 Qualification
      9.502 Statutory Standard of Care
      9.503 Custom Does Not Equal Standard of Care
      9.504 Presumption That Expert Is Qualified
      9.505 Using the Presumption
      9.506 Checklist for Out-of-State Expert
      9.507 Using Experts from a Related Field of Medicine
      9.508 Using Other Testimony to Support Qualification
      9.509 Using a Frequent Testifier

9.6 PROOF OF CAUSATION
      9.601 In General
      9.602 Other Possible Causes
      9.603 Loss of Possibility of Survival

9.7 MEDICAL RECORDS
      9.701 "Shopbook Rule"
      9.702 Other Means of Introducing Medical Records
      9.703 Use of Records During Trial

9.8 MEDICAL LITERATURE
      9.801 In General
      9.802 Strategy

9.9 DEMONSTRATIVE EVIDENCE
      9.901 Uses
      9.902 Sources
      9.903 Computers
      9.904 Admissibility

9.10 CROSS-EXAMINATION OF DEFENSE EXPERTS
      9.1001 In General
      9.1002 Qualifications
      9.1003 Bias
      9.1004 Basis of Opinion
      9.1005 The Opinion Itself

9.11 OTHER EVIDENTIARY ISSUES
      9.1101 Negligence of Nonparties
      9.1102 Habit Evidence
      9.1103 Deadman's Statute
      9.1104 Evidence of Patient's Awareness of Risk
      9.1105 Background of Defendant
      9.1106 Complication Rates

9.12 JURY INSTRUCTIONS
      9.1201 In General
      9.1202 Supreme Court Scrutiny
      9.1203 Standard of Care
      9.1204 Proximate Cause
      9.1205 Concurring and Supervening Causes
      9.1206 Other Possible Causes
      9.1207 Foreseeability of the Injury

9.13 CLOSING ARGUMENT
      9.1301 Planning
      9.1302 Use of Instructions
      9.1303 Counsel Should Not Get Ahead of the Jury Emotionally
      9.1304 Discussing Money

Defendant's Perspective

9.14 STRATEGIC PLANNING
      9.1401 In General
      9.1402 Threshold Issues for the Defendant

9.15 VOIR DIRE
      9.1501 Preparation of Voir Dire
      9.1502 Jury Selection

9.16 OPENING STATEMENT
      9.1601 Introduction
      9.1602 Presentation
      9.1603 Specifics

9.17 PRESENTATION OF WITNESSES
      9.1701 Defendant Called as an Adverse Witness: Direct Examination by Defense?
      9.1702 Order of Witnesses

9.18 CROSS-EXAMINATION OF THE PLAINTIFF'S FACT WITNESSES
      9.1801 The Plaintiff
      9.1802 Family Members

9.19 CROSS-EXAMINATION OF THE PLAINTIFF'S EXPERTS
      9.1901 Standard of Care and Causation
      9.1902 Damages

9.20 MOTIONS TO STRIKE

9.21 DIRECT EXAMINATION OF THE DEFENSE EXPERT
      9.2101 Qualifications
      9.2102 Bias
      9.2103 Medical Literature
      9.2104 Theory of the Case

9.22 EXAMINATION OF THE DEFENDANT

9.23 JURY INSTRUCTIONS

9.24 CLOSING ARGUMENT
      9.2401 Planning
      9.2402 Use of Instructions
      9.2403 Role of Emotion
      9.2404 Discussing Money

TABLE OF AUTHORITIES

INDEX

Authors

Editor

Malcolm P. McConnell, III

Authors

Dana A. Dews

Mary M. H. Priddy

Lynne J. Fiscella

Mary Elizabeth Sherwin

T. Daniel Frith, III

Thomas B. Shuttleworth

Michael L. Goodman

Thomas G. Smith

Charles F. Hilton

Lewis T. Stoneburner

Carolyn C. Lavecchia

Christine Thomson

Kathleen M. McCauley

Thomas W. Williamson, Jr.

Walter H. Peake, III

Carlyle R. Wimbish, III

Elizabeth Guilbert Perrow

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