Because many attorneys who handle professional liability cases are not also involved in cases challenging government regulations, they may not be familiar with the weight that the courts often give to regulations and regulatory preambles such as those discussed in last month's article on the new Emergency Medical Treatment and Labor Act (EMTALA) regulations. This article should aid in filling any such gaps in the attorney's experience.

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Under the "lost chance" theory, a claimant's recovery is limited by the odds or likelihood that the event would have or will occur -- a departure from the "all-or-nothing" rule of recovery, whereby a claimant receives the full measure of damages if, but only if, the injury is "reasonably certain." If, for example, it is shown that there is a 20% chance that the plaintiff will suffer future harm, the plaintiff will be awarded 20% of what he or she would have been awarded had he or she sustained the injury.

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Recent rulings of importance to you and your practice.

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Increasingly alarmed by the real and imagined inequities of the medical malpractice system, physicians across the country have been looking everywhere for relief. They have lobbied for law reform at both state and federal levels, they have rallied and protested, and some have even gone "on strike." With so much angst and anger among so many affluent professionals, it was only a matter of time before an astute entrepreneur figured out a way to cash in on the problem. Which brings us to Dr. Jeffrey Segal, a North Carolina neurosurgeon and the founder of a new insurance plan called "Medical Justice," which he promotes as a deterrent to malpractice litigation. It is an intriguing idea that just might work. Then again, it might only be a clever marketing ploy.

The Emergency Medical Treatment and Labor Act (EMTALA), which imposes requirements on hospitals with emergency departments to screen and stabilize anyone who comes to the emergency department seeking treatment, can provide the basis for a private civil action against the hospital if a person is injured by the hospital's violation of its requirements. New regulations clarifying hospitals' obligations under EMTALA went into effect November 10, providing new guidance on how the federal agency charged with enforcing the statute interprets its terms.

As part of discovery, the attorney would want to determine the origin of a particular medical record and seek explanations for whatever spoliation has occurred, whether physical (destruction or absence of the record) or content spoliation (an inaccurate account of the medical care). The place to begin, then, is with those responsible for enforcing medical record rules and regulations: the Chief of Staff and the hospital medical record librarian.

The legislative package of the American Medical Association aimed at limiting suits against doctors and hospitals has been unusually successful this year.…

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