Medical Malpractice Suits Research Articles

Legal mechanisms and procedures in alleged medical negligence: A review of Indian laws and judgments.

Medical malpractice suits are quite common in developed countries leading to an increase in malpractice insurance. Recent trends indicate that India is at the cusp of a medical malpractice crisis. There has been a rise in medical negligence cases filed against doctors, though often the allegations are frivolous. In such cases, doctors can be considered as the second victim of medical negligence. Members of the medical fraternity do not learn much about law during their training and are often naïve regarding various options available to counter such cases as well as relevant legal doctrines. Doctors thus not only need to remain updated on medical knowledge and skills but also obtain knowledge of legal paradigms. We aim to raise awareness among doctors about handling negligence cases in various forums and share insights through relevant literature, court judgments and government orders. We also map the process of handling complaints, procedures followed in various courts and the different levels of remedies available for doctors.

Help, I've been sued! Demystifying the steps of malpractice litigation for the emergency radiologist.

Being sued can have significant emotional and psychological impact and has implications on the wellness of emergency radiologists. A better understanding of the steps involved in a medical malpractice suit can help defuse some of the anxiety of litigation. This process starts with the inception of the case, the summons, and complaint, then progresses to discovery, including document production, interrogatories, and deposition, and thereafter to settlement or trial. The discussion includes a number of tips and outlines a number of pitfalls inherent in litigation. It is hoped that this discussion will alleviate some of the anxiety that accompanies this long and arduous process.

Analysis of the Reasons for Medical Malpractice Litigation Due to Facet Injections.

Introduction As the use of facet joint injections (FJI) increases, practitioners performing FJI may be at increased risk of legal liability.Malpractice claim analysis is performed by several specialties as it provides valuable insight into patient values and methods to mitigate the risk of malpractice litigation pertaining to a specific procedure or treatment. Malpractice analysis regarding FJI may provide clinicians with a better understanding of the reasons that lead to malpractice due to FJI, thereby allowing practitioners to improve the quality of care delivered to patients whilst mitigating the incidence of malpractice. The aim of our study was to analyze the reasons for malpractice litigation due to FJI by querying Westlaw and VerdictSearch, two well-established legal databases widely used in medicolegal research. Methods We queried the Westlaw Edge and VerdictSearchlegal databases utilizing the terms "facet injection" and "spine". Our database queries yielded 1026 results on Westlaw Edge and 545 results on VerdictSearch. Cases were reviewed and categorized by two independent reviewers based on the grievance(s) levied by the plaintiff. Discrepancies between reviewers were resolved by a third reviewer. Inclusion criteria for case relevance were defined as a basis of litigation resting on malpractice claims filed between the years 2000-2022 directly pertaining to FJI. Additional data collected included the date of the case hearing, verdict ruling, location of filed claim, payment or settlement amount, and sustained injuries. Results Of all 1571 cases reviewed, 1568 cases were excluded due to a basis of litigation unrelated to FJI. Of the three cases pertaining to FJI, the first case involved an alleged procedural error on the part of the anesthesiologist, whereby the anesthesiologist misplaced the needle during FJI, resulting in quadriplegia due to a cervical spine infarction. The plaintiff also contended that the pre-procedural timeout was improperly conducted as the practitioner utilized iohexol as the injected contrast material despite the patient's well-documented allergy to iohexol. The jury deemed both the practitioner and hospital negligent, and a plaintiff verdict was issued. The second case was filed under a basis of litigation alleging delayed diagnosis and treatment on the part of an emergency medicine physician. The court acquitted the physician, and a defense verdict was issued.The third case was filed under a basis of litigation of alleged deviation from the standard of care on the part of the anesthesiologist, whereby the anesthesiologist performing the FJI did not use fluoroscopy.The court affirmed fluoroscopy is not dictated as the standard of care for FJI and issued a defendant verdict. Conclusion This study provides insight into the risk of medical malpractice suits brought on by facet joint injection. Our findings suggest that despite the high prevalence of facet joint injections performed annually, there is limited legal liability associated with the procedure. Nevertheless, there are certain reasons a malpractice claim may be filed due to facet injection, including gross procedural error resulting in patient paralysis, delay in treatment or diagnosis, and deviation from the established standard of care.As such, treatment decisions regarding facet joint injection should not be influenced by medicolegal concerns and remain predicated on patient care needs and standard of care.

The Anatomy of a Malpractice Lawsuit.

Abstract Medical malpractice lawsuits can be a source of emotional, physical, and financial distress for both providers and patients. A thorough understanding of the medical malpractice process's history and current landscape will help providers navigate malpractice challenges. Given the impact and prevalence of medical malpractice, in this paper, the authors sought to dissect the intricate anatomy of a medical malpractice lawsuit. This includes a comprehensive and detailed report of tort reform, the criteria of a medical malpractice suit, and a description of the court proceedings. In addition, the authors also performed an extensive review of the medicolegal literature and have provided recommendations for healthcare providers to avoid these lawsuits in their practice. Level of Evidence: 5

Lessons in liability: Examining medical malpractice suits against general surgeons in Maryland

BackgroundAlthough medical malpractice lawsuits pose a significant burden, there is a paucity of research on physician-specific characteristics influencing lawsuits against surgeons. Our objective was to identify factors associated with general surgeons being named in malpractice cases. MethodsThis was a cross sectional study of Maryland general surgeons, using malpractice data from a publicly accessible judiciary database. Case number per decade and lifetime lawsuit status were modeled with linear and logistic regression. ResultsMale surgeons had a higher average lawsuit volume (p = 0.002) and were more likely to be named in a malpractice case (p < 0.001). In regression analysis, a second graduate degree was a predictor of average cases per 10 years (p = 0.008) and male gender predicted lifetime lawsuit status (OR = 1.73, p = 0.046). ConclusionsMale gender was associated with increased odds of being named in a malpractice lawsuit. Identifying this difference is a preliminary step in developing interventions to reduce lawsuits amongst surgeons.

Lessons in Liability: Examining Medical Malpractice Suits Against General Surgeons in Maryland

Lessons in Liability: Examining Medical Malpractice Suits Against General Surgeons in Maryland

Mental health crisis in healthcare providers in the COVID-19 pandemic: a cross-sectional facility-based survey

ObjectivesDuring a pandemic, healthcare providers experience increased mental and physical burden. Burnout can lead to treatment errors, patient mortality, increased suicidal ideation and substance abuse as well as medical malpractice...

The changing landscape of military medical malpractice: from the Feres Doctrine to present.

Medical malpractice suits within the military have historically been limited by the Feres Doctrine, a legal precedent arising from a Supreme Court decision in 1950, which stated that active-duty personnel cannot bring suit for malpractice against either the United States government or military healthcare providers. This precedent has increasingly become a focus of discussion and reform as multiple cases claiming malpractice have been dismissed. Recently, however, the National Defense Authorization Act of 2020 initiated the first change to this precedent by creating an administrative body with the sole purpose of evaluating and settling claims of medical malpractice within the military's $50 billion healthcare system. This article seeks to present the legal history related to military malpractice and the Feres Doctrine as well as discuss the potential future implications that may arise as the Feres Doctrine is modified for the first time in 70 years.

Status of current medicolegal reform in the United States: a neurosurgical perspective.

There are approximately 85,000 lawsuits filed against medical practitioners every year in the US. Among these lawsuits, neurosurgery has been identified as a "high-risk specialty" with exceptional chance of having medical malpractice suits filed. Major issues affecting the overall medicolegal environment include tort reform, the formation of medical review panels, the increasing practice of defensive medicine, and the rising costs of medical insurance. In this study, the authors provide a concise update of the current medicolegal environments of the 50 states and provide a general guide to favorable and unfavorable states in which to practice neurosurgery. Data were acquired related to state-by-state medical review panel status, noneconomic damage caps, economic damage caps, and civil suit filing fees. States were placed into 5 categories based on the status of their current medicolegal environment. Of the 50 states in the US, 18 have established a medical review panel process. Fifteen states have a mandatory medical review process, whereas 3 states rely on a voluntary process. Thirty-five states have tort reform and have placed a cap on noneconomic damages. These caps range from $250,000 to $2,350,000, with the median cap of $465,900. Only 8 states have placed a cap on total economic damages. These caps range from $500,000 to $2,350,000, with the median cap of $1,050,000. All states have a filing fee for a medical malpractice lawsuit. These costs range from $37 to $884, with the median cost for filing of $335. Medicolegal healthcare reform will continue to play a vital role in physicians' lives. It will dictate if physicians may practice proactively or be forced to act defensively. With medicolegal reform varying greatly among states, it will ultimately dictate if physicians move into or away from certain states and thus guide the availability of healthcare services. A desirable legal system for neurosurgeons, including caps on economic and noneconomic damages and availability of medical review panels, can lead to safer practice.

Do Professionalism Lapses in Medical School Predict Problems in Residency and Clinical Practice?

Recognizing that physicians must exhibit high levels of professionalism, researchers have attempted to identify the precursors of clinicians' professionalism difficulties, typically using retrospective designs that trace sanctioned physicians back to medical school. To better establish relative risk for professionalism lapses in practice, however, this relationship must also be studied prospectively. Therefore, this study investigated the sequelae of medical school professionalism lapses by following students with medical school professionalism problems into residency and practice. Beginning in 2014, 108 graduates from Harvard Medical School and Case Western Reserve University School of Medicine who appeared before their schools' review boards between 1993 and 2007 for professionalism-related reasons were identified, as well as 216 controls matched by sex, minority status, and graduation year. Prematriculation information and medical school performance data were collected for both groups. Outcomes for the groups were studied at 2 points in time: ratings by residency directors, and state medical board sanctions and malpractice suits during clinical practice. Compared with controls, students who appeared before their schools' review boards were over 5 times more likely to undergo disciplinary review during residency (16% vs 3%, respectively) and almost 4 times more likely to require remediation or counseling (35% vs 9%, respectively). During clinical practice, 10% of those who had made review board appearances were sued or sanctioned vs 5% of controls. Logistic regression for these outcomes indicated, however, that professional lapses in medical school were not the only, or even the most important, predictor of problems in practice. Students with professionalism lapses in medical school are significantly more likely to experience professionalism-related problems during residency and practice, although other factors may also play an important predictive role.

Informed consent in medical malpractice suits: An analysis of Beukes v Smith

In this case note we make two salient observations regarding the recent Supreme Court of Appeal judgment in Beukes v Smith. First, the judgment shows that when assessing alleged wrong fulness, the court is concerned with whether the health-care user did in fact provide informed consent, and not with formalities such as making notes of consultations. Secondly, the SCA assumed that the health-care user was using pain medication, and further assumed that she was not attentive during the consultation; hence her version of events was rejected. This line of assumption-based reasoning introduces a new anti-patient prejudice in our law, which is clearly unconstitutional, and should be rectified by the SCA at the earliest opportunity.

Reduction of burden of proof in medical malpractice suit

대상판결은 수술을 받은 후 후유장해가 발생한 환자가 수술 의사를 상대로 손해배상을 청구한 사안에서, 후유장해가 발생했다는 사실만으로 의료상 과실을 인정할 수 없음에도 그에 관한 심리를 제대로 하지 않았거나 증명책임에 관한 법리를 오해함으로써 의사의 과실을 인정하였다는 이유로, 의료과오소송에서의 증명책임 경감과 관련하여 종래의 판례에 따라 의사의 배상책임을 인정한 원심판결을 파기하였다. 대상판결의 결론이 타당한지 여부의 검토를 위한 전제로서 환자 측의 증명책임 경감에 관한 여러 학설과 재판례들을 검토하였다. 이를 통하여 현재 대법원은 사실상 추정론에 근거하여 ‘간접사실에 의해 과실과 인과관계를 동시에 추정’하거나 ‘일반인 상식에 기초한 과실의 증명과 인과관계의 추정’이라는 두 가지 방식을 병용하고 있다는 점을 확인하였다. 대상판결의 판시내용에는 다음과 같은 세 가지 점에서 문제가 있다. 첫째, 93다52402 판결이 설시하는 ‘일반인의 상식’의 불명확성과 그 판결의 무분별한 원용이 문제 된다. 대상판결은 그 판지와 무관한 위 판결의 요지를 원용하는 설시를 함으로써 그 의미 등에 관하여 혼선을 초래하고 있는바, 그 문제의 해결을 위해서는 93다52402 판결이 의료과실이 명백한 일부 사안에서나마 증명책임 감경의 역할을 할 수 있도록 법원이 구체적인 의료행위 준칙을 제시하든가, 증명책임 감경의 방식을 종전과 같이 동시추정으로 일원화하는 결단을 하여야 한다. 둘째, 동시추정 방식에 과도한 한계를 인정하고 있다는 점이다. 환자 측에 과실에 대한 개연성 있는 간접사실의 증명책임을 부여하면서 그 한계로 의사에게 무과실책임을 증명하도록 하여서는 안 된다는 판례의 사안들은 대부분 ‘다른 원인 개입 가능성의 배제 불가’라는 사정과 관련되어 있는바, 그 ‘다른 원인’과 관련하여 법원의 자의적 판단이 개입할 수 있다는 점, 그럼에도 다른 원인의 개입가능성의 배제에 관하여 환자 측에게 증명책임을 부담시키는 것은 무기 대등의 원칙상 부당하다. 셋째, 환자 측에게 의사의 과실 등과 관련하여 너무 높은 증명책임을 부여하고 있다는 점이다. 특히 합병증 등과 관련하여 후유장해가 발생한 영역이 의사가 지배하는 범위 안에 있는 점, 정보나 증거의 측면에서 후유장해가 일반적으로 인정되는 합병증의 범위 내라는 의사의 증명이 환자가 그것이 합병증의 범위를 벗어났다고 증명하는 것보다 훨씬 용이할 것으로 보이는 점 등을 종합하면, 후유장해가 일반적으로 인정되는 합병증의 범위 내라는 사실에 관한 증명책임을 의사에게 부담시키는 것이 옳다. 결론적으로 의료소송에서 환자 측의 주요사실에 대한 증명책임을 환경침해소송 등보다 더욱 낮은 수준으로 경감시켜야 하고, 나아가 과실에 관한 증명책임의 전환이나 인과관계의 추정 등에 관한 입법적 검토도 필요하다고 생각한다.In a case that a patient who suffered from disability after surgery demanded compensation for damage against a medical doctor who performed the surgery, judgement annulled the original decision that the medical doctor should compensate for damage with regard to reduction of burden of proof in medical malpractice proof according to precedents on the ground that original decision acknowledged medical doctor’s malpractice by misunderstanding a principle of law regarding burden of proof without hearing the case properly despite the point that medical malpractice cannot be acknowledged based on only the fact disability occurred. This study examined lots of theories, judgements and precedents regarding reduction of burden of proof on the patient side as a precondition for examination of whether above mentioned judgement is right. This study found that Supreme Court of Korea uses ‘simultaneous presumption of negligence and causal relationship based on indirect fact’ and ‘proof of malpractice based on ordinary people’s common sense and presumption of causal relationship’ jointly. Above mentioned judgement has three problems. Firstly, ‘ordinary people’s common sense’ described by 93 DA 52402 judgement is uncertain and the judgement cited imprudently. The judgement cited the point of verdict which is not related to the gist of decision causing confusion regarding its meaning and therefore it is necessary for the court to present rules on medical practice so that 93 DA 52402 judgement can play a role in reduction of burden of proof in matters which medical malpractice is clear or to make a decision to unify method of reduction of burden of proof as simultaneous presumption as before to solve in order to solve above mentioned problem. Secondly, the judgement acknowledged excessive limit over simultaneous presumption method. Cases of precedents that demand a patient to prove medical doctor’s malpractice and does not ask medical doctor to prove absolute liability are related to circumstances of ‘impossibility of exclusion of likelihood of intervention of other reasons’ and demanding a patient to prove exclusion of likelihood of intervention of other reasons is not reasonable in terms of principle of equality of parties considering the fact that court’s arbitrary judgement can intervene ‘other reasons’. Thirdly, the judgement imposes excessively high burden of proof regarding medical doctor’s malpractice on a patient. It is reasonable to impose burden of proof regarding fact that disability is within the scope of generally accepted complication on medical doctor considering that area which disability occurred regarding complication is within the scope that medical doctor control and it is easier for medical doctor to prove that disability is within the scope of generally accepted complication than to prove that it goes beyonds the scope of complication in terms of information or evidence. In conclusion, it is necessary to reduce burden of proof regarding main facts on patient side in medical suit to lower level than environmental infringement suit and review presumption of causal relationship or convert burden of proof regarding negligence.

Impact of an educational initiative targeting non-radiologist staff on overall notification times of critical findings in radiology.

The timely reporting of critical findings is considered by the Joint Commission as one of the main patient safety goals. Delays in critical radiological findings communication are directly related to delayed treatment initiation and death, constituting a major cause of medical malpractice suits. The aim of this study was to evaluate the impact of an educational initiative performed to reduce the notification times of critical radiological findings. All records of critical findings reported in the Radiology Department were evaluated. The notification times before and after performing the educational intervention taking into account the patient type, study, and critical diagnosis were calculated, evaluated, and compared. T test and chi-square test were used for statistical analysis, considering a p value less than 0.05 to indicate statistically significant differences. We included 1949 reports, 805 before (41.3%) and 1144 (58.7%) after the intervention. Before the intervention, the mean time of critical finding report was 2.85h for emergency patients and 3.07h for hospitalized patients. After the intervention, a statistically significant decrease in the notification time was observed with a mean of 1.37h for emergency patients and 2.43h in the hospitalization patients. A statistically significant increase was observed in the proportion of reported findings in less than 15min (7.08%, p< 0.01), 45min (45.55%, p< 0.01), 60min (55.86%, p< 0.01), and 120min (80.68%, p< 0.01). The healthcare process in the Department of Radiology involves multiple actors who must be sensitized in the identification and reporting of critical radiological findings in order to reduce the notification times. Ensuring effective communication of critical findings is indispensable to ensure timely medical treatment.

Prevention of medical malpractice and disputes through analysis of lawsuits related to coronary angiography and intervention.

Background/AimsPossible fatal complications arising from coronary angiography (CAG), percutaneous coronary intervention (PCI), and coronary artery disease itself, are likely to cause medical disputes. Presenting the current status and reasons for judgments given in lawsuits related to CAG/PCI, this study aimed to identify ways to prevent unnecessary disputes and medical malpractice suits related to CAG/PCI through lawsuit analysis.MethodsA total of 13 cases (20 judgments) found in the Supreme Court of Korea’s Written Judgment Management System from 1998 to 2017 were analyzed.ResultsCoronary artery injury was the most common causative complication that led to lawsuits (n = 6, 46%). Six cases (46%) were ruled in favor of the plaintiff for violation of duty of care (n = 4) and duty of explanation (n = 2), respectively. Cases that violated duty of care included two errors in intra-procedure device manipulation, one in pre-procedure diagnosis, and one in management of post-procedure complication. Lack of explanation regarding the risk of complications was pointed out in both cases that violated duty of explanation. The average awarded amount for the damages was 114,436,064 Korean won.ConclusionsPhysicians need not fear unfair judgments so long as they follow standard of care because the Court consistently looked at the probability, the foreseeability, and the evidence. Therefore, maintaining standard of care is important. Besides, specific, detailed, and comprehensible explanations, including the risk of complications in addition to the necessity of procedures, are important to ensure the patient clearly understands the possible risk of adverse outcomes.

Characterization of medical malpractice claims against obstetricians affiliated to FEPASDE in Colombia 1999–2014

Introduction: Medical malpractice claims have been increasing at a constant rate worldwide, resulting in a burden for practitioners as well as for the health system. In obstetrics, the problem is even greater considering that it is one of the medical specialties with the largest number of medical malpractice suits. Objective: To characterize medical malpractice claims in the area of obstetrics in Colombia from the perspectives of the physician, the patient, the institution, the medical care provided, and the legal proceeding. Materials and methods: Historical descriptive cohort of closed medical malpractice cases between 1999 and 2014 filed against obstetricians affiliated to a special solidarity fund for support in lawsuit cases. Simple random sampling (n = 279) in a universe of 982 proceedings. Variables related to the proceeding, the obstetrician, the institution, medical care, and the patient were measured. Results: The most frequent lawsuits were related to ethics (44.4%). The proportion of unfavorable rulings was 7.7%, more frequently in civil cases (31.8%). The prevalence of lawsuits was higher in private institutions (60%). The majority of the cases were related to patients in the second half of the gestation period (86%). In 74.7% of the cases, legal action was initiated as a result of events occurring during childbirth. The most frequent cause was neonatal compromise (38.9%), followed by fetal compromise (24.7%). Conclusion: Care during childbirth, fetal, and neonatal demise are critical sources of medical malpractice claims.

Medical Malpractice Suits Proliferate in the Philippines

"Medical Malpractice Suits Proliferate in the Philippines." Journal of Legal Medicine, 37(sup1), pp. 61–62

No fault compensation in perinatal medicine in Japan-from results for 8 years.

No fault compensation in perinatal medicine has been established to provide aid to patients in the event of disability due to a medical accident during delivery and to strive to resolve disputes quickly that contributes to reduce medical malpractice suit in the field of perinatal medicine. Furthermore, this system is aimed to establish a mechanism that achieves higher quality of obstetric care by analyzing the causes of accidents. This system is operated by Japan Council for Quality Health Care and 99.9% of childbirth facilities in Japan registered with this compensation system. Compensation system has two major functions including compensation and cause analysis and recurrence prevention based on cases. Compensation eligibility is reviewed in the Review Committee at the organization in Japan Council for Quality Health Care and currently 1,717 cases are judged as eligible cases out of 2,250 since 2009. The cause of each eligible case is analyzed in the Cause Analysis Committee one by one. The Cause Analysis Committee has 7 independent subcommittee and each subcommittee members are consistent of obstetricians, neonatologists, pediatricians, midwives and lawyers. Original cause analysis report is sent to childbirth facility and patient's family. Questionnaire survey demonstrated that 73% of childbirth facilities and 65% of patient family were satisfied with the cause analysis report. The number of medical lawsuit in obstetrics and gynecology is significantly decreased compared to those in all medical departments since the compensation system was introduced suggesting that these cause analysis reports may contribute the decrease in medical lawsuits. The major purpose of the Recurrence Prevention Committee is striving to prevent future cases of cerebral palsy and to improve the quality of obstetric care. To accomplish the purpose, the committee routinely collect information from individual cases and analyze quantitatively and epidemiologically. Furthermore the committee choose subject from cases to discuss for future prevention and provide wide public disclosure of the information with recommendation. The committee issued 6 reports until now and these reports have been distributed to childbirth facilities, perinatal medicine-related scientific society and administrative agencies.

Navigating the Maze of New Regulations in the Final Rule

Navigating the Maze of New Regulations in the Final Rule

Lessons Learned From Reviewing Breast Imaging Malpractice Cases

There are very few, if any, winners in most medical malpractice lawsuits. The plaintiff, often the victim of disease, and the defendant medical personnel both suffer emotional, financial, psychological, professional, and opportunity costs through this avoidable experience. In year 2000, 86,480 malpractice claims were filed [ 1 National Association of Insurance CommissionersStatistical compilation of annual statement information for property/casualty insurance companies in 2000. Washington, District of Columbia, National Association of Insurance Commissioners2001 Google Scholar ], and in 2004, the financial burden of medical malpractice totaled $28.7 billion across all specialties [ 2 Tillinghast study: U.S. tort costs reach a record $260 billion. Insurance J 2006. Available at: http://www.insurancejournal.com/news/national/2006/03/13/66411.htm. Accessed April 28, 2014. Google Scholar ]. Specifically in radiology, there is a 50% chance that a radiologist will face at least one lawsuit by the age of 60 years [ 3 Baker S.R. Whang J.S. Luk L. et al. The demography of medical malpractice suits against radiologists. Radiology. 2013; 266: 539-547 Crossref PubMed Scopus (32) Google Scholar ]. The subspecialty of breast imaging is the greatest recipient of malpractice litigation, with claims of “failure to diagnose” or “delay in diagnosis” [ 4 Cannavale A. Mariangela S. Mancarella P. Passariello R. Arbarello P. Malpractice in radiology: what should you worry about?. Radiol Res Pract. 2013; (Available at:) (Accessed April 28, 2014)http://www.hindawi.com/journals/rrp/2013/219259/ PubMed Google Scholar , 5 Dick J.F. Gallagherz T.H. Brenner J.R. et al. Predictors of radiologists' perceived risk of malpractice lawsuits in breast imaging. AJR Am J Roentgenol. 2009; 192: 327-333 Crossref PubMed Scopus (42) Google Scholar , 6 Berlin L. Hall F.M. More mammography muddle: emotions, politics, costs and polarization. Radiology. 2010; 255: 311-316 Crossref PubMed Scopus (64) Google Scholar ]. Lessons Learned From Reviewing Breast Imaging Malpractice CasesJournal of the American College of RadiologyVol. 11Issue 12PreviewThere are very few, if any, winners in most medical malpractice lawsuits. The plaintiff, often the victim of disease, and the defendant medical personnel both suffer emotional, financial, psychological, professional, and opportunity costs through this avoidable experience. In year 2000, 86,480 malpractice claims were filed [1], and in 2004, the financial burden of medical malpractice totaled $28.7 billion across all specialties [2]. Specifically in radiology, there is a 50% chance that a radiologist will face at least one lawsuit by the age of 60 years [3]. Full-Text PDF

Robert J. Shalek, Ph.D., J.D.

We are saddened to report the death of Dr. Robert J. Shalek, who passed away at the age of 93 on April 20, 2015. Robert J. Shalek, Ph.D. was born in Chicago, IL in 1922. He earned his undergraduate degree in physics from the University of Illinois in Champaign. After graduating, he served in the US Army for 3 years as a Signal Corp officer. He returned home to Texas where his parents had moved and entered the graduate program at the Rice Institute (now Rice University). He earned two masters degrees (physics and mathematics) and went on to earn a Ph.D. in biophysics in 1953. Dr. Shalek was the second Rice Physics Fellow in the Department of Physics at the MD Anderson Hospital [currently The University of Texas MD Anderson Cancer Center (MDACC)]. During this time, he worked with Leonard Grimmett on one of the world's first 60Co units. Upon receiving his Ph.D. he spent a postdoctoral year at the Royal Cancer Hospital (now called the Royal Marsden Hospital) in London, England under the guidance of W. V. Mayneord, the Head of the Physics Department and author of the “Mayneord F factor.” After this postdoctoral year he returned to the Department of Physics at MDACC. He published over 100 scientific papers before retiring in 1985 after working at MDACC for 35 years. Among his many contributions to Medical Physics, he was Chairman of the Department of Radiation Physics (1961–1984) at MDACC following Dr. Leonard Grimmett and Dr. Warren Sinclair, both very experienced medical physicists from England. He and Dr. Gilbert Fletcher, the chairman of the Department of Radiation Therapy at MDACC from 1948 to 1981, recognized the need for medical physics quality assurance for national multi-institutional clinical trials and as such, along with the AAPM, proposed a center of physics quality assurance for clinical trials. He ultimately was awarded the first National Cancer Institute grant to create the Radiological Physics Center (RPC) and was its first Director from 1968 until 1985. He was one of AAPM's founding charter members and served as the AAPM's seventh president in 1966. He became a fellow of the AAPM and was awarded ASTRO's Gold Medal in 1996. He was the second recipient of the AAPM's William D. Coolidge Award in 1972 and the sixth recipient of the Marvin M. D. Williams Professional Achievement Award in 1994. His career has encompassed both basic research and the application of physics to clinical problems. His basic research included studies of oxygen reactions following radiation interactions1 and the proportion of direct and indirect radiation action in living cells.2 His clinically related work included the dosimetry of external treatment beams, brachytherapy dosimetry, and quality assurance in radiotherapy physics.3 In the 1960s he wrote one of the seminal papers4 on ferrous sulfate (Fricke) dosimetry that made chemical dosimetry available in the clinic. Also in the 1960s, he and his trainee (and later, colleague) Marilyn Stovall published a series of articles describing the MD Anderson method for implant dosimetry using computerized techniques.5–9 These publications helped disseminate these methods and enabled many institutions to introduce what were for the time very advanced brachytherapy calculation techniques. From right to left, Dr. Shalek, Dr. Hanson, and Dr. Ibbott at a reception in 2001 for Geoff Ibbott, the new RPC Director. While working at MDACC, Dr. Shalek studied law at the University of Houston during the evenings and received his J.D. in 1983. He lectured regularly on legal questions in medical physics and regularly gave professional legal advice to physicists. He also participated in medical malpractice suits, usually as an expert witness. Bob was especially proud of his book, Medical Physicists and Malpractice10 (authored with David Gooden) that outlines the legal framework of liability risk in radiation therapy, the impact on clinical physicists, and practical approaches for avoiding and managing such lawsuits. Dr. Shalek is survived by his wife Elaine V. Shalek, 6 children, 9 grandchildren, and 4 great grandchildren. His accomplishments in medical physics will be long remembered. Equally well known is the way he conducted himself throughout his career, always as a man of high principle and character. He truly was a credit to our profession and is remembered fondly by so many whose lives he touched during his incredibly successful and meaningful career.