Drunk Driving Punitive Damage Bill Fails

March 27, 2012

I wrote last week about a bill pending in the Maryland House of Delegates that would authorize punitive damages against drunk drivers who caused "injury or wrongful death while operating a motor vehicle." For whatever reason, the House of Delegates Judiciary Committee rejected the bill which means it is not happening in 2012.

Risk/Utility in Strict Liability Design Defect Claims

March 27, 2012

The Pennsylvania Supreme Court stuck down a $5 million verdict in an Ethicon endocutter design defect case last week, finding that the trial court was not restricted to considering only one use of the device, and that it properly applied a risk-utility analysis. The case talks about product liability risk-utility analysis in the Restatement (Third) of Torts. You can read the court's opinion here.

Plaintiff, a 40 year old mother, underwent gastric bypass surgery (Technically, she is the plaintiff's decedent. I use "plaintiff" because my refusal to use plaintiff's names on this blog, a stance that sometimes makes recitation of the facts awkward in wrongful death cases.). To cut and resection plaintiff's stomach, her doctors utilized an ETS-Flex45 Articulating Endoscopic Linear Cutter - called an an "endocutter" - made by Johnson & Johnson, subsidiary Ethicon Endo-Surgery (Let's say charitably that both of these companies are frequent flyer product liability defendants.). The device was designed for use in less-invasive endoscopic surgery, but also was marketed for use in traditional "open" surgery in which a large incision is used to view internal organs.

After complications, Plaintiff's doctors conducted a second surgery and discovered that staples were absent in two small sections and attributed the problem to "mechanical staple failure." Sadly, Plaintiff's stomach contents had leaked into her abdominal cavity, causing sepsis, and her eventual death.

Plaintiff's Estate filed a wrongful death lawsuit contending that the endocutter was unreasonably dangerous because it was not equipped with a means to either measure the thickness of the tissue being stapled or lock the device if the tissue thickness was incorrect. Plaintiff's Estate contended that had the endocutter been designed with with this capability, it would have prevented the staple line failure that caused Plaintiff's death.

An Allegheny County, Pennsylvania jury agreed, finding the endocutter's defective design caused the woman's wrongful death and awarded $ 5 million, finding that the endocutter was defectively designed.

The big issue in the case was the application of the risk/utility analysis required in a products liability action to determine whether a product is unreasonably dangerous. In this case, the endocutter at issue was marketed for multiple recognized uses, but the injury to the plaintiff was caused by only one of those uses. So the question is whether the trial court's risk-utility analysis should be limited to the use that caused the plaintiff injury or should it consider all of the uses of the product.

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Punitive Damages for Drunk Drivers in Maryland

February 13, 2012
Punitive Damages Against Drunk Drivers Who Cause Car Accidents in Maryland?

There is a bill in the Maryland General Assembly that would authorize punitive damages against drunk drivers who caused "injury or wrongful death while operating a motor vehicle." Punitive damages would be available against drunk drivers: (1) With a blood alcohol concentration of over .15; or (2) With a blood alcohol concentration of over .08, and was driving on a suspended or revoked license or had entered a plea of nolo contendere or received probation before judgment within the last 5 years.

The Maryland Chamber of Commerce opposes this bill. Why? I really think it is because the Maryland Chamber is run by the true believers who care about some issue far more strongly than furthering the interests of Maryland businesses. That mission includes a strong opposition to anything their gut tells them that Maryland personal injury lawyers might support. Seriously. If Maryland trial lawyers put out a statement that Jeremy Lin should be the focal point of the Knicks' office even when Carmelo Anthony returns, the Maryland Chamber of Commerce would immediately put out a statement renouncing Lin (citing the fact that Carmelo is from Baltimore or something). It is just silly. (Minority Report: their opposition makes perfect sense. They are worried about the slippery slope of punitive damages affecting Maryland businesses and they are two steps ahead in the chess match. Personally, I don't give them that much credit.)

So let me set the Chamber's mind at ease. Economically, Maryland car accident attorneys would get no real benefit from punitive damages in drunk driving injury and death cases. Why? Because punitive damages are not covered by insurance. Which means the drunks have to come up with the cash themselves. My firm has collected $0.00 from people individually over the last ten years. Collecting money from people individually is just very difficult. In almost every case, the juice is not worth the squeeze unless the defendant goes by the name John Rockefeller. Lawyers handling car accident cases will not see their revenues rise a half of a percent by getting drunks to pony up punitive damages.

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Increasing the Value of Wrongful Death Cases

February 2, 2012

Caps on non-economic damages make it impossible to receive true fair value in wrongful death claims in Maryland (and in most states). Accordingly, personal injury lawyers need to turn over every possible stone to maximize the economic damages in wrongful death cases. Often overlooked, even by the best wrongful death lawyers - at least until they get the case to an economist - is the decedent's employer funded benefits. The problem is, in many wrongful death cases an economist is not used either because the plaintiffs' lawyer thinks he does not need one, or because the case reaches a settlement long before an economist is engaged. As a result, employee funded benefits are not always included in the calculus. Fifteen years ago, if you left out these benefits, the overall value of your case suffered a little. In 2012, with health insurance and other employee benefits skyrocketing, if you don't include these in your damages in a wrongful death case, you are leaving as much as 25% of the value of the claim on the table.

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Confidential Settlements

September 12, 2011

Pat Malone writes a guest blog on Don Keenan's Trial Blog arguing that confidential settlements undermine public safety and justice. His point is that confidential settlements make it harder for future plaintiffs to get evidence and information they need to bring out all of the facts about the defendant's conduct.

Specifically, Malone suggests:

    Here’s one tip for avoiding last-minute pressure from the defense to cave into a secrecy agreement: Be proactive. Tell the defense counsel at some appropriate point – such as with any settlement demand letter or in a pre-mediation communication – that you will not agree to secrecy because of the ethical issues. This can be one item on a list of settlement conditions.

Pat Malone is an extremely well respected lawyer who not only gets great results for his client, but also graciously spends a lot of time helping other personal injury lawyers. I also agree with his premise: there is doubt doubt that confidential settlements make it harder for the next plaintiff. This also make the company less accountable, too, in the big picture.

But here's the problem: people who have been badly injured, even the best of people, have a hard time focusing on the global interests of plaintiffs everywhere when they are fighting and scrapping to be compensated for their injuries. And I have a hard time telling them that they should.

Let me give you a case in point. We recently settled a case with a Fortune 500 company. No discussion of confidentiality in the settlement discussions. You know what comes next. They send a release with a confidentiality clause. We balk. They say, "Okay, let's try the case."

Boy, I hate being bullied by big companies. I try hard not to take these things personally. But they were so arrogant in the way they delivered their ultimatum. They never would had the guts to play it through and I knew it. So we plotted a "file a motion to enforce the settlement and, in the off chance we lose, we try it" strategy. In angry detail. With our feathers up and blood boiling, we forgot, ah, that we have a client. So we call the client. She could not care less about confidentiality. She wants to execute the settlement and get her money.

So what do you do? I know what we did: we put our hurt pride on a shelf and sent the client the release.

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Inside the Mind of a Car Accident Claims Adjuster

July 26, 2011

This post was supposed to be about Medicare set-asides but I started with such a long intro about the psychology of claims adjusters that I'll just hit the Medicare issue in a later post. (Or I'll completely forget about it.)

To understand claims adjusters, you have to get inside the labyrinth that is the claims adjuster's mind. (Why labyrinth? I'm just trying to use mildly inflammatory language. I'll stop.) Insurance claims adjusters are more Pete Rose than Barry Bonds: they get paid for singles, not home runs. The great things a claims adjuster does vanish into thin air; the mistakes live on. Ironically, plaintiffs' lawyers operate in the exact opposite world: hit a few million dollar verdicts in a row and everyone forgets your losses. Reason #42,353 why plaintiffs' attorneys and insurance adjusters are the Montagues and Capulets.

Accident lawyers have a misconception about this, thinking adjusters get hugs from the higher ups for ripping off a plaintiffs' lawyer in a settlement negotiation. Actually, hugs is the wrong word - they do get hugs. But, mostly, that's it. The way to make a name for yourself is not by screwing plaintiffs' lawyers but by not screwing up yourself. Make sure everyone likes you and, more importantly, don't make any mistakes. Overpaying on an accident case is not that big of a screw up: but failure to have a death certificate in the file before paying a wrongful death case? That is a federal crime in the insurance world. Under-reserving a case? That's an aggravated felony.

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Maryland Local Government Tort Claims Act

July 18, 2011


The Maryland Court of Appeals decided another case in the ongoing saga that continues to burn forests that is the Maryland Local Government Tort Claims Act.

First, it is worth noting: the LGTCA is stupid. Really stupid. There is just no reason in 2011 why we put unreasonable burdens on people that are hurt by local government. Personal injury lawyers blow or miss the LGTCA de facto "state of limitations" to give notice of a claim all of the time. Most of those lawyers should know better. But in this case, there is just no reason why the Plaintiff (actually, the estate of the decedent in this case) should have to know about complying with the Local Government Tort Claims Act.

President Obama was asked a tough question at one of the debt ceiling press conferences this week: why do - in massive numbers - the American people shrug off the debt ceiling? The President said - in so many words - the American people know nothing about the subject. Sounds condescending but then he adds the caveat that is germane here: they shouldn't. People are too busy with their lives - their jobs, their kids, American Idol, and whatnot - that they don't have time to focus on the nuances of the debt ceiling.

Same goes with the Local Government Tort Claims Act. You have to realize: the sad reality is that most lawyers handling car accident cases don't understand the Local Government Tort Claims Act. Why do we expect people on the street to understand and follow these rules?

(Brief Post Interruption: Ultimately, if you read the case, you know I'm retrofitting the facts to fit my narrative. There was a lawyer involved in the case early on who - putting it politely - could have set this case up a little better. And plaintiff - who filed a tort claim but was not injured in an accident - didn't really lose the case for failure to provide sufficient notice under the LGTCA but for failure to allege compliance with the LGTCA in the Complaint. I think this is the wrong call, too. I'll get to that point, I promise. But the court makes pretty clear they would have hammered him on the notice if it had been alleged in the Complaint. )

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Medicare Liens: New and Better Law?

May 26, 2011

Almost two years ago now, Medicaid/Medicare liens became even more difficult to deal with as the law pushed to the lawyers and insurance companies the obligation of confirmation and resolution of Medicare/Medicaid liens. I'm sure betting an insurance company has yet to receive a fine for not verifying a lien before paying a personal injury settlement. But nobody wants to be the first.

Medicare, Medicaid and State Children's Health Insurance Program Extension Act of 2007 created so many headaches people starting fighting back. In Haro v. Sebelius, an Arizona case in U.S. District Court, Medicare beneficiaries (and, interestingly, a personal injury lawyer in his own capacity) challenged - as a class - two things: (1) Can Medicare/Medicaid (hereinafter "Medicare because I'm sick of the slash) “require prepayment of a reimbursement claim before the correct amount is administratively determined where the beneficiary either appeals or seeks a waiver of the MSP reimbursement claim?, and (2) Are personal injury lawyers financially responsible for reimbursement if they do not hold or immediately turn over to Medicare their clients’ personal injury settlement awards.

Personal injury lawyers are completely in a pickle on these liens. Our clients want their money; we want to get them the money they are entitled to get. The question is whether personal injury attorneys are precluded from giving the clients their settlement money until after Medicare’s claim has been satisfied, and, let's be honest, whether Medicare can recover the reimbursement claim directly from the attorney if the client fails to pay the reimbursement claim after the settlement money has been turned over to the client.

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Wrongful Death Verdict in Prince George's County

March 17, 2011

The Washington Post reports on an $11.5 million wrongful death verdict against the Prince George’s County Police Department, finding a police officer liable for a fatal shooting. I'm reiterating my ongoing objection to the Washington Post's refusal to tell us how much is actually collectable after a personal injury verdict, a complaint I made just last week.

The Post did the same thing in this story. I really think the Washington Post is the best newspaper I've ever read. Can't someone provide this information to us?

Refer Your Personal Injury Cases to Us. Seriously.

December 9, 2010

The Insurance Journal reports a rise in legal malpractice claims. Incredibly, there has been no hand wringing about increased malpractice rates for lawyers or fears that lawyers will no longer be able to keep their practices open as their insurance rates rise. We have never had a legal malpractice claim yet our rates continue to increase. No one cries for us.

A part of the rise in the number of legal malpractice claims is countersuits against lawyers who are suing their clients to pay their bill. But I think the larger problem is what the article calls "door law," a phrase I have never heard before but I really like. Door law is when lawyers take any client who walks through the door who might generate a fee. When law firms step outside their areas of expertise, bad things are going to happen.

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Maryland Comparative Negligence on the Way?

November 19, 2010

Certainly, the title is a little hyperbolic. But at the Maryland Court of Appeals Rules Committee meeting this morning, a memorandum was issued from Chief Judge Robert M. Bell requesting a study of how other jurisdictions have dealt with the comparative negligence doctrine.

Just a study, mind you. But this memo jumps right to the heart of the matter.

    If the Court were to consider replacing the doctrine of contributory negligence, a common law doctrine in Maryland, with some form of comparative negligence with some sort form of comparative fault:

    (a) whether in the Committee's view, the Court could effect that change by Rule, as opposed to judicial decision.

    (b) if the Court were to consider the adoption of such a Rule, what form and content of the Rule should be; and

    (c) what related legal principles, such as joint and several liability, would need to be considered concurrently.

Well thank you for not beating around the bush, Judge Bell. There is also a specific request for the consideration of views of the Maryland Defense Counsel, the Maryland Association for Justice, and the Maryland State Bar Association.

Timely, I wrote about the interplay between joint and several liability and comparative negligence this week. In terms of what position these groups take, I think it will all depend on joint and several liability. If joint and several liability remains unchanged, Maryland plaintiffs' lawyers would support comparative negligence and Maryland defense attorneys would be obligated to make a big stand in opposition (although that is a lot of show, many self-interested defense lawyers get that more opportunities for plaintiffs' is more opportunities for them). But if it is a swap of comparative for abolishing joint and several liability, this becomes a more, for lack of a better word, nonpartisan issue where fractions are going to split off within the interest groups.

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Mediation Article with Judge Clifton J. Gordy

May 12, 2010

The Maryland Daily Record published a three part series over the last month on mediation in Maryland personal injury cases, a piece I wrote with the Honorable Clifton J. Gordy . You can read the articles on-line but you have to be a subscriber to the Daily Record to read the entire article.

  • Part I of Mediation in Personal Injury Cases
  • Part II of Mediation in Personal Injury Cases
  • Part III of Mediation in Personal Injury Cases

Maryland's Wrongful Death Statute

May 11, 2010

Not often, but at least a few times a year, our law firm gets a wrongful death case in Maryland where, regardless of the facts, there is no claim. In this case, the victim, who may be loved by family and friends, has no wrongful death claim because the victim has no spouse, children, or living parents.

Noneconomic and economic measures in Maryland do not provide money damages for loss of life of the victim on their own behalf. The lack of joy that comes with being alive and missing out on a life goes uncompensated. So if you have no spouse, dependents, or children and are negligently killed by another person and you die instantly, there is no recourse in Maryland law for a wrongful death claim or any other meaningful claim outside of your funeral expenses.

Accordingly, a doctor can see that a patient has no primary or secondary wrongful death beneficiaries and know that there is no possibility of a wrongful death medical malpractice claim.

Do I think this happens where doctors feel free to take a risk with a patient because the patient's death by definition could not bring about a wrongful death claim? No, I really don't. But the whole idea that you could recklessly kill someone with no consequences of any kind is a bad thing.

The answer? Change the law to have an entirely new damage claim in Maryland for loss of the enjoyment of life for the victim? Whatever you may think of the idea, there is absolutely no inertia to change the current state of the law.

So what could we do that is more practical to solve the problem? I think the answer is simple. Allow siblings, grandchildren and other clearly defined relatives into a third contingency tier of wrongful death beneficiaries. It would open up only a few new claims but we could all know that there will be accountability when someone is killed by someone else negligence. I think that this would be justice.

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Wrongful Death Compensation: How Much?

April 27, 2010

I stumbled on an interesting Chicago Law Review article today by Eric Posner (Judge Richard Posner's son) and Cass Sunstein (now with the Obama administration). I like Sunstein's views on a number of issues, including animal rights.

The subject article is how the legal system assigns money damages to the loss of human life in wrongful death cases with an eye towards creating greater uniformity. The authors approach this question like it was a mathematical equation to be solved. For grief, the authors conclude that $500,000 is a good starting place, suggesting this formula as the paradigm to determine compensation in wrongful death cases:

To derive a willingness to pay (WTP) to avoid grief from a spouse's death, one would need to (1) determine the average length of time that the grief persists (for example, until remarriage); (2) find an equivalent happiness difference in an area of life that has been reliably monetized (for example, willingness to pay to avoid disease or depression); (3) convert this difference into annual units; and (4) multiply (1) by (3).

I understand the goal of uniformity and I even understand the formula. The problem is homogenizing the equation for everyone. Values vary because juries vary but also because facts vary wildly from case to case. Moreover, the formula is artificially low because it uses how much you will spend to avoid a loss to determine how you value the loss. For example, if you are willing to pay $5 to avoid a 1/100,000 risk of death to your spouse, than the loss of your spouse is worth $500,000.

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Should You Ask for an Amount in Opening?

April 26, 2010

Paul Luvera discusses a tough issue for Plaintiff's lawyers: do you clue the jury in during your opening statement as to how much you are going to ask for in closing? I struggle with this and often opt for a middle ground. I lay out the foundation of what I'm going to ask for: medical bills, wages, and the formula I think is appropriate (x per day for the rest of her life). This way, I'm getting them used to the idea without having to spit out a number without any evidence.

As Paul points out, a one size fits all rule is difficult because each case depends on different facts. One critical question has to be considered: is the cap an issue? If what you have is clearly a cap case and minimal or no economic damages, you can dial back a bit on the damages argument which might help you avoid the risk of losing credibility. Because every time you ask for money - which is what a plaintiffs' lawyer does by definition - you do lose some measure of credibility with a jury.

One of the issues in this post - raising the damage amount in voir dire - is not of much interest to Maryland personal injury lawyers because our voir dire is so ridiculously limited.

Paul also points out that David Ball feels pretty strongly about putting up a number in opening. Which is reason enough to consider it in every case.

My Mediation Article with Judge Gordy

April 13, 2010

Yesterday, the Maryland Daily Record published the first of a three part series I wrote with retired Judge Clifton J. Gordy (now a mediator and arbitrator) on mediation in serious personal injury and wrongful death claims. The article is for both plaintiff and defense lawyers looking to make mediations as productive as possible. Take a look at yesterday's article and look in coming editions for the final two parts.

MAIF

March 24, 2010

The Maryland Daily Record has an interesting article today on the Maryland Automobile Insurance Fund (MAIF).

For out-of-state readers, MAIF is a unique animal: a state-run insurance company for drivers that cannot get car insurance from private insurers. Most states deal with this problem by forcing private insurance companies to insure high-risk drivers. In Maryland, we have created a huge state-run insurance company to insure the risk.

To me, MAIF is like stare decisis. I don't think we would make the decision all over again to create a state agency. One good piece of evidence: no other state has followed suit and created their own version of MAIF. But now that we have it, there is no inertia to tear it down.

The Daily Record article talks about efforts in the Maryland legislature to essentially stop MAIF from acting like an insurance company. What's the problem? Insurance companies are threatened by MAIF because they are stealing market share. One of the lobbyist quoted in the article complaining about MAIF works for Agency Insurance, which also insurers a lot of high risk drivers. This isn't the first time an insurance company that markets to high risk drivers has complained about MAIF. (See this September 2, 2008 post.)

These same insurance companies also grab on to the up-with-people populist sentiment against bonuses for anyone connected to public funding, pointing to the $1.2 million in bonuses MAIF paid last year. They jump on the fact that MAIF Executive Director M. Kent Krabbe is the one who recommended the bonuses to the board and that Krabbe got $36,000 for himself.

I'm as big of a MAIF critic as anyone is. I think they are just plain obstructionists when it comes to paying valid claims and I think their approach often costs them money. They won't try a high risk case but they also won't offer their policy limits until after they spend a fortune in legal fees defending the case. I have said in the past I don't disagree with insurance companies' tactics of playing hard ball with personal injury lawyers in an effort to maximize their profits. Too many Maryland accident lawyers settle at the first sight of money or a potential trial. But hanging around in a wrongful death case - which they have done multiple times with us - when I know they are just going to offer the policy before trial - is just a poor business strategy. (This is one wrongful death case involving MAIF that settled just before trial, just to give you an idea.) Good companies have more than one gear. MAIF just has the one. At some point, turning the boat north and speeding up when there is an iceberg in your path is a bad idea. Particularly when your plan is to jump off when the iceberg gets real close.

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Dram Shop in Maryland

March 11, 2010

A wrongful death lawsuit has been filed against a Chattanooga, Tennessee bar after a car accident killed a woman just a few days before Christmas. The case is an interesting twist on the classic dram shop case. The suit alleges that the bar gave its employees free alcohol and allowed one man to leave the bar obviously intoxicated. The employee stayed at the bar and drank "free alcohol" after his shift ended at 3 a.m. Around 7:00 a.m., the defendant struck and killed a pedestrian, an employee on her way to work at Unum Insurance. The defendant, stand up guy that he apparently is, fled the scene and tried to fake a carjacking. Apparently this is an insurmountable stunt to pull off when you are drunk.

What really adds teeth to the Plaintiff's wrongful death lawsuit is a city ordinance prohibiting bar workers from drinking where they work, even when off duty. Clearly, the violation of the ordinance was a factor in causing this woman’s death. If the case goes to trial, there are going to be arguments by defense lawyers about the purpose and intent of the statute and whether this was the harm that the ordinance was trying to avoid. But I would suspect it was at least a purpose, if not the purpose, of the statute.

Maryland has rejected dram shop and social host liability in DWI accident claims. Going against the grain as a parent and lawyer who handles accident cases, I have believed and written in the past that I oppose dram shop liability claims in Maryland.

I’m not so sure anymore. I would really like to see data as to the number of wrongful deaths that occur in Maryland from DWI/DUI accidents where the person became intoxicated at a bar, or even at a bar where they are employed. Of course, the more salient question is one on which we will never get a definitive answer: how many deaths have occurred as the result of a server in a bar or restaurant who knows a patron (or employee) is drunk but does nothing to stop them?

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Settlement Negotiating Psychology: “Tit for Tat” Negotiating Ploys

December 10, 2009

Gauging the next “move” based solely upon how much the other side has budged- “tit for tat” negotiations with no bearing on one’s own case evaluation is another common mediation mistake. It is understandable that negotiators and mediation participants desire proportionality and reciprocity in adjusting demands and counteroffers. The problem is that many adjusters think that plaintiffs have no ceiling on the amount that they can demand, whereas defendants can never offer anything less than zero. For this reason, arguments that, “We’ve come down by $100,000 so you need to come up by $100,000” often fall on deaf (adjuster or defense lawyer) ears.

Defense lawyers often set up mediations better than personal injury lawyers. The defendant's lawyer will call you and ask for a demand. You decide to be reasonable. So when you show up at the mediation, the range is between reasonable and zero. That is the wrong psychology to settle a case.

The best way to address this problem: if defendant puts you in this game, don't be above the game with your reasonableness. Your opening demand under this dynamic should mirror the defendants’ maximum exposure. Most states now have caps on non-economic damages. Add up your economic damages: past and future medical expenses, past and future lost wages, loss of earning capacity, vocational training and/or rehabilitation. Add that number to the amount allowed under the applicable non-economic damages cap. This should be a good approximation of the maximum exposure on the claim. With any luck you will be right around the amount of the reserve the insurance carrier has set for the claim. This should help in estimating the settlement value of the case on the continuum between maximum value and zero. This will let you calibrate your demands to where you want to end up on a case, not necessarily to match the other side amount for amount.

This tactic only works in a case where it is possible a jury would give such an award. Not likely but "best day possible." If you are demanding the cap in a soft tissue injury claim, you are also sending the wrong message. Similarly, when you demand $5 million in a case where your cap is $2 million, you are sending the same "I'm not exactly sure what I'm doing" message.

New Massachusetts Opinion on Duty and Foreseeability

June 18, 2009

A hospital did not breach a duty of care as a matter of law to a police office who was injured responding to a traffic accident allegedly caused by a just-released colonoscopy patient, Massachusetts' highest court has ruled, affirming the trial court below.

The police officer responded to an emergency report of a pedestrian-automobile accident. On his way to the scene of the reported accident, Plaintiff's police car was hit by another car, causing what were apparently pretty serious injuries. The pedestrian involved in the accident to which the Plaintiff was responding had earlier that day undergone sedation after a colonoscopy at Brockton Hospital. Plaintiff's theory of the case was had the hospital provided an escort for the patient/pedestrian, he would not have had to respond and the accident would not have occurred.

Specifically, Plaintiff argued that a duty of care existed under two theories to back door the foreseeability problem: (1) a "special relationship" the hospital had with the patient and with Plaintiff, (2) a voluntary assumption of a duty of care by the hospital to protect third parties from harm caused by "impaired" patients.

The case generated some attention. Amicus briefs filed by the Massachusetts Academy of Trial Attorneys in support of Leavitt, and by the Massachusetts Defense Lawyers Association and the Professional Liability Foundation, Ltd., in support of the hospital.

The Massachusetts high court found that both theories were not distinctions from the duty and foreseeability problem in finding that a hospital owes a duty of care to a nonpatient third party to prevent a sedated patient from causing injury after the patient leaves the hospital.

Whether negligence extends to "an innocent third-party bystander" was recently decided in Maryland in Gourdine v. Crews. In that case, the family of a man killed in an auto accident brought a lawsuit against Eli Lily claiming that his death was caused by a diabetic who blacked out while under treatment with two insulin medications.

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