Kevin, M.D. - Medical Weblog

The only evidence that the doctor followed the appropriate standard of care is a quote from his lawyer. Do you think that might just be a little bit one-sided? The jury found against the doctor. Do you think they were stupid? Seriously, do you think that 12 jurors listening to the case were bamboozled? What about the doctor(s) who testified for the plaintiffs. Liars? Seriously, do you think that the doctors who testified that the obvious thing to do was transfer immediately were wrong? How long did the tests take? Did the initial phone consult miss important or information not offered by Occhinno?

There's plenty of room for malpractice in that description of the case and there's a possibility of a miscarriage of justice, but until more is known I'll put the jury's verdict against the defense attorney's quote any day of the week and any impartial, rational person should.
 

Interestingly, this case would not have been effected by caps.
 

WHy is that CJD? Is it because an Andover prep school student would have presumably a high earning potential?

Ahh--the rich get richer and healthier. If you don't have a high earning potential, I wonder if doctors really have the same incentive to treat you well.
 

Because their award for noneconomics was under most cap limits.
 

They break down the economic damages in the article (1.8 million for lost wages). The Concord Monitor has a more complete description.

http://nl.newsbank.com/nl-search/we/Archives?p_action=doc&p_docid=10AEA4B35EFA0319&p_docnum=1

The boy was at Franklin Hospital for 12 hours before being airlifted to the other hospital where he died 2 hours later. One wonders how his condition was deteriorating during that time in Franklin's ER. Franklin Hospital was not included in the suit (withdrawn) although they were initially. One wonders what the nurses who were in the ER at that time said at the trial or in their depositions.

Kevin, you are exactly right. Had he practiced an earlier "defensive transfer" to Dartmouth, he would not have been sued and the boy might be alive although since there was an initial 3 hour delay before he got to the hospital, there is no guarantee of that.
 

$1.8 million for lost wages? What exactly was the work this 16-year-old was doing that this was the loss? A death is tragic, but are you telling me that he had dependents at that age whose losses were counted at trial? What was the occupation, signing trust-fund checks? This sounds like outright jury misconduct. You have to wonder where the judge was in all this. Outrageous judgments like these cause rational people to lose faith in the sensibility of the jury system and the fairness of civil jurisprudence in the U.S. Maybe the European and British systems are fairer after all.

CJD and your caps jab. You are right, though, non-economic caps won't protect you from fake claims of economic losses based on pipesmoke and mirrors. Maybe we need economic caps as well.
 

Anonymous, as usual, your lack of knowledge of a subject outside of medicine causes you to look silly.

$1.8 million is not that much for a lifetime of work, plus the value of his household services and fringe benefits (Social Security and the like). If he only had a constant rate of earnings of $30,000 for 40 years of work, that alone is $1.2 million.

Just imagine if they'd assumed the average physician's salary!! Of course, he'll never have the opportunity to make that kind of money, will he?
 

Maybe the European and British systems are fairer after all.

Where medical malpractice is concerned, there is no "maybe" about it.
 

Well, the British system is certainly "fairer" to doctors and the corporate medical-industrial complex. Consumers be damned
 

So I guess you support European style healthcare as well? If you do, then I can see why you would support European style legal systems. After all, you don't need to compensate for economic injury with such a vast social safety net.

Oh wait, you don't support universal health care, do you? Why? Because you might not make as much money. Isn't it interesting what causes us to pick and choose what we like?
 

If you are going to have European-style healthcare, I hope you don't mind waiting for specialty care and procedures. And you will need a European-style education system that doesn't hobble graduates with debt too. Eight weeks vacation, my money back for my education, fewer liability worries, where do I sign up?
 

Thank you for illustrating why picking and choosing this part of a society or that part is silly.
 

Dr. Kevin, was this an EMTALA transfer? How could a doctor transfer an acutely ill patient to a facility that wants him to do more tests before they accept the patient? Aren't there federal laws about these kinds of transfers?
 

This was a transfer from a small regional, community hospital (< 50 beds) to a tertiary care facility (> 400 beds). Reading between the lines (meaning I'm engaging in wild speculation), the doctor was not just slow in transferring, but was slow in treating as well. At some point it became obvious that the kid was in serious trouble (when did he lose consciousness?) and they lifeflighted him to Dartmouth where he died. It's unclear if he was going to the regular hospital or the children's facility at Dartmouth. Another thing that is not reported, but I understand to be the case is that the doctor did not contact or coordinate with the NH Poison Control Center which should have happened.
 

I'm curious (no pun intended to our resident lawyer), but does Dartmouth share in any of the liability if it is true that they requested additional testing? In my field (high risk ob), we rarely ask for additonal testing before transfer. We just need/want stable patient(s).
 

Well, as I said in the first post, I'd lay good money that the actual story is not as the lawyer stated. The dog the didn't bark is that both hospitals didn't get sued nor settled (even though Franklin was initially named).

(More wild speculation) The conversation could have easily went something like:

O: I got an acute aspirin overdose
D: We don't have a bed right now. How's he doing?
O: He seems pretty stable. I've done x,y, and z. His stats and labs are a, b, and c.
D: That's good. What do you want to do? Should I try to find a bed?
O: I'm not sure I need to transfer him. Maybe I'll just watch him.
D: Ok. Do these tests and let us know immediately if anything changes.
O: Ok. THanks.

Hours later as the helicopter lifts off from Franklin everyone has the sick feeling of a situation that went horribly wrong. Is that malpractice or simple human error? The jury made it's decision.

Everything above is wild speculation.
 

The distinction isn't between malpractice and simple human error. It's whether the actions met the standard of care for the locale. An error may or may not be malpractice.
 

It's whether the actions met the standard of care for the locale.

No it's not. It's whether the plaintiff's hired gun "experts" can make the jury think the actions were below the non-defined "standard of care" for the locale.
 

"Anonymous, as usual, your lack of knowledge of a subject outside of medicine causes you to look silly.

$1.8 million is not that much for a lifetime of work, plus the value of his household services and fringe benefits (Social Security and the like). If he only had a constant rate of earnings of $30,000 for 40 years of work, that alone is $1.2 million."

Funny how you avoided the question. CJD. $1.8 million to whom, exactly? I don't need your education on how in a normal case a plaintiff might claim an economic loss, that is if there are dependents for whom the deceased was a source of support and income. But just how does a presumably unmarried, unemployed school student
who dies quickly as a result of a self-inflicted poisoning leave anyone short of $1.8 million in economic losses? What kind of ludicrous tale-spinning made by a forensic economist came up with that figure? That would even be hard to peg for a plaintiff estate that represented a deceased with a wife and small children. And how does a jury not find the "victim" at least partially (if not entirely) responsible for his loss, unless you think someone else poisoned him? There is definitely something about this case that isn't right, judge and jury be damned.
 

I'm so tired of this "deviation from standard of care" nonsense.

The law requires nothing more than an expert who disagrees with your treatment.

since when does one person define a "standard of care"?

Standard of care is defined by a community, not an individual.
 

Anonymous, you continue to show your ignorance.

The "standard of care" and the actions which define meeting it will be laid out by both the plaintiff's AND defense (remember, they have lawyers too, and nearly unlimited funds for experts) experts, subject to rigorous cross examination on their findings.

The $1.8 million is awarded to his estate, and in my state there would be a probate proceeding which will divide it among the statutory heirs.

And you clearly misunderstand the economist's role. He merely determines the value of the economic loss. The fact that you think it would be hard to peg illustrates your lack of knowledge of yet another profession.

But it's good to see that your ignorance hasn't kept you from having an opinion. If nothing else, you're consistent.
 

Of course it's not based solely on one individual's opinion. That individual will have to lay out a foundation for their opinion. A foundation that will be rigorously picked over by both sides attorney's and the other expert.

Are you guys incapable of determining if another physician's actions were negligent and fell below what a reasonably prudent physician would have done? Is each physician truly a king of their own medical island such that you can't imagine questioning them?
 

Enough of your offensive bufoonery an ad-hominem argument, CJD. Just because you say in your unsupported reply that I don't understand what a forensic economist does, (which is not true, and which you cannot show otherwise as you have absolutely no knowledge of my work and educational background) does not make what you say true or what I say false. Most of those thoughtful people reading and contributing are capable of seeing through the smoke you are making.

So explain, since you seem to think you know otherwise, how does a rational economist base a valuation of $1.8 million on the economic productivity of a 16-year old who is not earning anything or supporting anyone? What sort of a fiction does he/she create to come up with a figure like that to tell to a jury? Who exactly, except for the government, which has lost a taxable future earner (and that too, speculatively) can claim to have suffered an economic loss? His prep school that now has a seat to fill? His parents who wanted to rely on him for support in their dotage? $1.8 million is a lot of money, and this is quoted as an economic
figure, something that should, in a fair system be based on verifiable hard facts, not just wishes and speculations and "what ifs".

CJD, you seem ready enough to defend the medicolegal system as it is, at least ready enough to claim I know nothing of the law without showing a shred of evidence to back you up, so defend this.
 

This is ridiculous. Anonymous makes stupid, troll comments and then cries foul because he appears to be a fool and a liar. Anonymous, all I know of you is the idiocy you display in your comments and I wish cjd would simply ignore you. It's very simple, lost wages are based on expected working life and expected income during that time. It does not matter that the victime was not working. Had he not died, he would have entered the labor force. I don't know you, but you have displayed no inkling of grasping basic concepts in what you have written so far so I have to assume you are ignorant. In fact, the stupidity you have displayed over and over again makes me doubt you are really an MD.
 

To be clear, I believe it is the victim that had the economic loss. It matters not a whit that he is dead. His estate has a right to the loss caused by the tort.
 

No, Elliott, you are forgetting a point made in many other places, particularly by CJD. One argument made by the supporters of those who want no caps on non-economic damages is that in cases where the plaintiff is not someone who has an occupation and a family with support requirements upon which one can fairly make valuations, the presumed economic valuation of the lost life--precisely because there is no generated income or lost support--is zero. Those who argue against caps say that non-economic caps therefore undervalue lives. Now it seems to me that CJD, if he believes that making high economic valuations on non-earning lives is fair play--and I assume he does since he criticized me for questioning this practice to the extent that he suggested I was wrong and didn't know anything about what I was writing about--wants things both ways. If you can argue differently, I am all ears. But if all you can say is that I am a "fool and a liar" and have nothing to show why, then you impeach yourself.

Sure an economist can say if this person lived so many years into the future, and earned a median income based on certain assumption about education, length and quality of employment, savings, investment, retirement that a figure could be created--entirely speculatively, mind you--that would represent an asset value of that person's estate. My question is just who exactly has lost anything? No one has answered that except in the vaguest sense of the "estate". If that is true, then I think one argument against caps on non-economic
damages has been substantially weakened, to wit: it is the only way to fairly value the lost life of non-income earning individuals. So which is it?

And Elliott, if I can have enough respect for you as a commentator to consider the questions you raise worthy of addressing, I think you can find enough decency within yourself not to unjustly call me a fool and a liar. I am an expert on a few things, and am more broadly educated and experienced on others, and I know the difference between the two.
 

And there is more than one anonymous poster on this thread.
 

How can so many people be afraid of being identified even by a pseudonym?

Frankly, I'm surprised they attributed earnings to this person. I would think those damages would have been far too speculative UNLESS NH has a specific provision that allows you to do so.

Or maybe he actually had some sort of business. It's not unheard of. It's hard to tell from the article. Having not seen the evidence, I'd just be speculating. I'm not a doctor - I have to see the evidence to make a decision.
 

This is hilarious. Where was the honest forensic economist who should have testified that with ideal care (immediate transfer, full bore medical/surgical treatment at the Big House hospital), the patient who swallowed the aspirin would survived but would have been grievously injured, lingering on for decades in a half alive, half dead state, in excruciating pain, with disfiguring/mutilating scars, unable to engage in gainful employment, unable to enjoy the consortium of his parents, siblings, and future spouse/partner/offspring. He would have lifetime medical bills in seven figures minimum, bankrupting his family. They could possibly find a psychiatrist who would testify that the poor kid has Post Traumatic Stress Disorder, and is liable to shoot up the grocery store if they run out of his favored size box of Captain Crunch cereal. That would be a great legal case, with damages that would trifle the award actually arrived at. Who to sue? Perhaps C-JD and Elliott could enlighten us.
 

There seems to be a certain consistent tone in comments in most/all of the Anonymous comments. If they are separate individuals and you do not want to be lumped together then there is a mechanism for correcting that problem. It does not even require that you give up being anonymous since as cjd points out pseudonyms are possible.

Your argument against economic damages has consistently been about who this person supported which is an interesting philosophical argument, but totally irrelevant to the question. You have briefly touched upon the nature of his work, but the main argument again and again is who? not what?

I am not a lawyer, but I have some economic training and the economic loss here seems obvious to me although I can't know whether it meets the legal definition. The boy was going to a New England prep school so that conjures up images of the upper crust to me with the inside track to lucrative jobs. Even without his family being rich , I know that he was college bound and male. The 1.8 million is likely way too low for the expected value of a true economic analysis if you exclude deductions which I believe "lost wages" calculations do.

Finally, in the comments that I attribute to you, you have disparaged the boy, the judge, the jury, cjd, expert witnesses, and pretty much anyone who thinks that there is a place for medical malpractice as it is presently practiced (not perfect, but maybe not broken). I don't think I see any respect in the tone you adopt towards other commentors with the possible exception of your last post.
 

Since none of us have seen the trial (speak up, if I am wrong, here) and thus we are relying on this short news story for our facts, much of the discussion has been abstracted to general issues about med mal, jury behavior and attorney behavior. That doesn't make the discussion meritless, but it does limit what we can say about the case and the judgment.

To Elliott and CJD, I am a physician/surgeon but from an un-typical educational background. I also have a degree in government, and some work experience some time ago in legislation and lobbying in Congress. At this point, my policy interests are mostly personal. I have been an expert witness in my field on more than one occasion. I am not an economist. I am not a lawyer. I have worked with and for lawyers before I went into medicine, and have close family members who are lawyers. I don't pretend that that makes me any sort of legal expert of any kind, but I have seen enough of legal practice to know a little of what moves the legal world.

Now about the case. A jury saw fit to award $1.8 million in economic damages. If you think that is something trivial, then you are much better off than I. I think awards like that should have very solid reasons for being made. Do I question its value? Unless you can show me why I shouldn't, I do. You may be able to make the case that economic damages should be given based on some estimation of the value of an asset accumulation based on some actuarial determinations for 16-year olds. If you can, I would like to hear it. As things stand, I am not convinced, unless you can show otherwise, how the premature death of anyone whose occupation was not income-earning or and who had no dependents who have suffered a loss of support
could have such a high economic value placed on his death. That is not to disparage anyone, mind you, or to suggest that the death, self-inflicted in whole or part, isn't tragic, or that he won't be missed, or anything of the kind. Nor is that to be understood as my making blanket excuses for malpractice or that victims of malpractice shouldn't be compensated.

Do I think the attorney for the plantiff had a personal as well as a professional interest in convincing a jury to award big economic damages here? Sure, unless he is taking only a fixed fee. Do I think that the jury was unreasonably swayed to favor the plaintiff's estate? I can't be sure, but I suspect so because of the post-judgment settlement. If the trial case was rock-solid, why give up what you've won, unless you know as a good lawyer, your jury award won't likely hold on appeal and that your client will end up with less than what is offered at post-judgment settlement.

Which makes me think that neither the judge nor the jury got it right, and the plaintiff's counsel knew that too.
 

One of the hardest things for me to do is convince anyone of something that seems "intuitively obvious" to me. I'll try. First I want to dispense with the idea that it mattered at all who this person supported. The little I know about the calculation of lost wages suggests to me that that is not a considerations. Second my understanding of these cacluations is that there is no dedcuction for living expenses or taxes. Third I believe there MAY be some element of emotion for the jury in that there is no provision apparently for just saying you owe this much because the boy died and we think it was (partially) your fault. That doesn't mean I think the jury came to a wrong conclusion; I'm just acknowledging that it was probably not a dry, factual deliberation.

If the boy had been a graduate from medical school and completed his residency and fellowship with an offer to work at Kaiser then you would say you could calculate a nubmer even if he hadn't actually started working. Working that backwards a little, let's say that he had graduated college and was accepted at medical school. Would you still say that there was no way to calculate lost wages. I think that there is even acknowledging the washout rate for student doctors, I there is a reasonable case to be made to suggest that this person would have been a high wage earner. Now at some point, the chain of reasoning becomes too tenuous for the law, but not for an economist. I believe the 1.8 million for lifetime earnings for a reasonbly intelligent boy bound for college with good connections is too low since it works out to only 60k per year for a 30 year working life. If he was ivy league bound (and that would have been known by this point in his life) then 60k per year is below the expeted value of his earnings potential. Even if he was only going to go to the University of NH, then 60k may be too low, but I'd have to do some research. It is exteremely doubtful that he wasn't going to go to college because he was going to a prep school.

Finally, a couple points you raised to cast doubt on the jury's verdict are that there was a post trial settlement. The way I read the report, the settlement was pre-verdict and not post-verdict. Also, you asked why someone might negotiate a settlement if there wasn't doubt about their case. I can think of two reasons right off the top of my head. The first is risk aversion which is the primary motivation for all settlements. The second is non-economic elements of the settlement that could not have been offered by the Court such as an apology or maybe some provision to never practice in New Hampshire. I don't know if these are feasibly legally, but they seem like reasonable elements to a settlement that might motivate a family that doesn't need the money.
 

I just wanted to say that the following was a very persuasive (and incisive) argument imo:


"One argument made by the supporters of those who want no caps on non-economic damages is that in cases where the plaintiff is not someone who has an occupation and a family with support requirements upon which one can fairly make valuations, the presumed economic valuation of the lost life--precisely because there is no generated income or lost support--is zero. Those who argue against caps say that non-economic caps therefore undervalue lives. Now it seems to me that CJD, if he believes that making high economic valuations on non-earning lives is fair play--and I assume he does since he criticized me for questioning this practice to the extent that he suggested I was wrong and didn't know anything about what I was writing about--wants things both ways."


-- CJM
 

Yes its possible for one doctor to make an honest determination that another doctor screwed up.

But thats still NOT a "standard" of care. One or two people does not define a standard.

Standards are defined by organizations governing the practice of medicine. Groups like the American College of Obstetrics and Gynecology.

ACOG sets teh "standard" of practice, not 2 "hired gun" experts.
 

"Standard of practice" is an outright lie by the legal community to make it seem like anybody who is found guilty of malpractice is de facto guilty of violating something that many doctors in that specialty practice.

"Standard of care" as practiced in med mal is nothing more than 2 dueling experts arguing. To even suggest that 2 dueling experts is capable of defining a breach of "standard of care" is a total joke.

Here's another example of how lawyers dont even believe that "standard of care" nonsense they spout to begin with.

John Edwards and his trial lawyer cronies made their fortune off of Cerebral Palsy cases. They found "hired gun" experts who said that CP was caused by prolonged labor and delivery, failure to interpret fetal heart monitors, use of forceps during L/D, etc.

The ACOG examined the science of cerebral palsy and published an exhaustive report stating that the current scientific evidence precludes the vast majority of CP cases being casued during delivery. In other words, 95% of hte time, CP is determined early in gestation and has nothing to do with L/D procedures.

If lawyers really believed in teh "standard of care" theory, then CP lawsuits should drop substantially. But thats not what happened. CP lawsuits are as popular as ever, despite the ACOG report.

So dont feed us lies about how a "standard" has to be violated. Thats a total red herring argument and you know it.
 

Are there any cases where somebody swallowed 300 pills of aspirin and made it alive ? What are the mortality and morbidity ? It is good you are so generous, actually you will pay some of that money.
 

I don't know about aspirin overdose survival and neither did the Dr.

Part of the problem in this case was that the doctor failed to call the Poison Control Center. That is standard practice. Now whether they could have advised him in a way that would have avoided the boy's death, I don't know, but there was an error and it doesn't take an expert to realize that.
 

""One argument made by the supporters of those who want no caps on non-economic damages is that in cases where the plaintiff is not someone who has an occupation and a family with support requirements upon which one can fairly make valuations, the presumed economic valuation of the lost life--precisely because there is no generated income or lost support--is zero. Those who argue against caps say that non-economic caps therefore undervalue lives. Now it seems to me that CJD, if he believes that making high economic valuations on non-earning lives is fair play--and I assume he does since he criticized me for questioning this practice to the extent that he suggested I was wrong and didn't know anything about what I was writing about--wants things both ways."

CJM, 1.8 million as the present value for a lifetime of earnings is not that high of a number.

Frankly, I don't know how they got economic damages for this kid. We'd have to review the evidence. As I said before, the only people I know who can make determinations without seeing the evidence are physicians.
 

I think it's funny that people criticize the John Edwards cases and cite the ACOG study as proof he tricked the jury. Why? Because the logic falls apart.

One, the ACOG study didn't say that malpractice NEVER causes CP, it said it was rare.

Two, no one knows what the percentage of CP malpractice victories versus total number of children with CP there are out there is. It could be 1% for all they know.

Three, no one who criticizes him for handling those cases HAS ACTUALLY SEEN THE MEDICAL RECORDS.

You'd think you'd need to know some of those things before having an informed opinion.
 

I am amazed by the amount of passion all of you have put into posting your opinions of this case, and they are just that...opinions. Some of you have used the words evidence and fact. Assuming that none of you were personally a witness or knew someone involved in this lawsuit, what do you know of the evidence in this case? What is a fact? A fact is something that can be proven...not speculation.
If you want to consider that the patient took 300 tablets of aspirin a fact you may do so, but it would be next to impossible to swallow that quantity of pills. It is a noted fact that the patient was treated at Franklin Regional, and then transferred to Dartmouth. Does anyone here know any other FACTS in this case? Does anyone here have first hand knowledge of what happened during this patient's course of treatment?
Doctors take an oath prior to entering practice and in that oath it states "First do no harm" Sure there are doctors who are grossly neglegent, but does that not mean that everytime someone sues for malpractice the doctor must be at fault. It is ignorant to state that 12 jurors cannot be wrong. That implys that the legal system is infailable. To believe the above regarding the legal system would make even you a biased juror in this case.
I pose this question to those who believe that 12 jurors cannot be wrong: What drives human beings to make decisions? One major factor would be emotion. Tell me how does a doctor compete for the jury's attention and impartiality against a grieving mother?
This is a tragic event, and I feel for the family, but suing a doctor for their son's suicide because he couldn't save him is a tragedy in itself. No amount of money in this world can ever replace that child.
As for the doctor's life after this case...does anyone here realize the impact it has on both his professional and personal life? To find a doctor guilty of negligence based on sympathy only proves the legal system to be flawed. Medicine is also flawed. One thing they both have in common is humans, and humans themselves are flawed. Let's not forget that.
 

I am neither a physician nor a lawyer. I have friends in both professions. In my most drastic moments of need, say in a dark alley in the dead of night with my back against the wall...at some critical moment when when I need help the most, I'll bet on the doctors and leave the lawyers home anytime.
My knowledge of this case is limited to some second hand accounts of the testimony in the case, and to the news coverage surrounding it.
The death of a young person is always tragic. However, that should not mean that "someone has to pay".
Does the young man bear any responsibility for his actions? The fact is that he deliberately tried to kill himself. He succeeded. The jury assigned no responsibility to him for having done that. Dr. Occhino was assigned full responsibility by the jury. Is this justice for the Physician?

Does the youth's family bear any responsibility despite the fact that testimony in the case established that the family did not reply to email correspondence from the boy's school indicating that he scored very high on a potential suicide test? The jury said no. Is this justice? Clearly this is a sympathy votge and is not related to the facts surrounding the case.
Testimony showed that the boy did not seek medical treatment for 3 hours after ingesting the aspirin. He was then held in the ER for several more hours before being transferred to Intensive care and Dr. Occhino. Does the emergency room staff bear any responsibility? Should they? I really don't know, but the jury said "they're not the ones being sued".
Get it? Legally maneuvering by the hospital that was disclosed in the case established that side deals kept Franklin Hospital from being sued in the case.

Franklin agreed to pay a settlement if the plaintiffs lost the case against Occhino. Therefore, the plaintiffs couldn 't lose and had to proceed against Occhino, even if just to lose so that they could collect a settlement

Slick legal move.....leave the lone doctor out there all by his lonesome. So what if he might be innocent. Does any of this make anyone sick?

Oh yeah, what about the expert testimony indicating that there wasn't a single case in the medical literature concerning an aspirin overdose of the magnitude described in this case, but that there were 12 cases in the literature concerning ignificantly lower overdoses, and that all 12 of those victimes died. Yet, this jury expected anyone to save him?
The boy took 3 times the lethal dose of aspirin. He tried to kill himself. He succeeded. That's it.

This was nothing more than a, "he's a doctor, he can afford it, and I feel bad for the boy's family so they should get something" verdict.

Here's the really good news. Cases like this will result in even more defensive medicine. That translates into higher medical insurance costs, unnecessary tests, major inconvenience for patients and their families, and medicine based upon fear of being sued, rather than what is best for the patient.

This jury ignored the evidence and voted with the hearts. Great for the boys family. Not so great for a doctor who appeared to have, based on the evidence in the case, practiced good medicine.
 

You can't have it both ways. Either it was a massive overdose that needed aggressive treatment involving a transfer to an ICU or it was ok to treat at Franklin. The only way that you can reconcile thos two ideas is to argue that the boy was as good as dead when he got to the emergency room. Maybe he was but I don't think that's a winning strategy and if that was the defense then it ranks right up there with the Mike Tyson defense. (This guy is a big, mean, sexually aggressive male. Everyone knows that. The only reason a woman would have gone up to his room was to have sex so it had to be consensual.)
 

"at some critical moment when when I need help the most, I'll bet on the doctors and leave the lawyers home anytime."

Depends on what the help is. If a doctor leaves your child needing a lifetime of care and uninsurable, you're not going to get top quality care from another doctor without some money in your pocket.

How do you propose you get that?
 

Elliot,
I don't know what you do for a living but I would be shocked to find out that you are employed in any medical profession.
It is already known that this kid took a massive overdose of aspirin and warranted transfer to ICU. For your information Franklin Hospital has an ICU and Mitchell was transferred from the ER to the ICU. He later was transferred to Dartmouth Hospital due to increasing Aspirin levels that could possibly...key term..possibly.. warrant dialysis as a treatment. Dialysis is not available at every hospital and carries with it some very serious risks. Also...dialysis is not a "quick" treatment. It takes hours to set up and perform on any patient. As the doctor's lawyer stated " The consulting physician requested further testing be done, and that he be called with results" No transfer was accepted at that time. Now if you knew anything about law, especially when it comes to Medical Law, you would know that there are federal laws that prohibit the transfer of any patient unless a higher level of care is needed and there is an accepting physician at the receiving hospital. It doesn't sound to me like Dr Occhino had any physicians at Dartmouth who were willing to accept Mitchell prior to further testing. Once that additional testing was completed only then was Dartmouth willing to accept. Unfortunately Mitchell died shortly after arrival at Dartmouth. Tell me...knowing the above...who really is truly to blame for this unfortunate event?
By the way what on earth does the Mike Tyson case have anything to do with a medical malpractice lawsuit?!
 

Some defenses and arguments are just stupid to make (because they are stupid in and of themselves or because they are unlikely to persuade) like the one made in the post I was responding to. The Mike Tyson defense was likely to lose (even if there was any truth to it). The defense that was being argued in that post (your post?) was likely to lose since it tried to argue that the doctor did everything right (in not transferring earlier for aggressive treatment) and the boy was likely to die anyway because of how massive the overdose was which would be obvious to anyone (so that poster argued).
 

Let's try to keep this simple.

Since we have limited facts surrounding the case, it is probably a mistake to wildly speculate on gaps in the information we have.

In the spirit of keeping things simple, we should assume that the medical professionals involved in this case did what they could and may or may not have made some errors in judgement. The facts we have do not allude to much else (a court judgement does not a fact make). Sometimes we're wrong, sometimes we're right...hopefully the latter is more frequent. Let's focus on where we know there's fault. There is at least one person that we know did not make the right decision...the deceased. He, apparently over an ex-girlfriend, decided to take his own life. Only 16, he did not think of all those he would affect in his family. It's a terrible shame, but he caused this tragedy. You can play the 'what if?' game all day with the speculative data floating around the Internet, but I can guarantee you that if the boy had not purposely overdosed on aspirin, he would not have died that night nor would Dr. Occhino have needed to face a hired team of pickpockets. This is a fact, I believe, we can all agree on.

In regards to the 1.8 million dollar settlement, it's interesting to me that this can be defended. Getting past the fact that even if he was transferred to Dartmouth right way, he could have died, and if he didn't die that night, he could have very well tried again. Someone that takes 20 aspirin is asking for help; someone taking 300 is trying to kill themself. Who is planning on using this 1.8 million? Let me guess, the boy had been groomed his entire life to get a job in a cushy firm in order to support is family? I don't think so. Additionally, and this becomes a bit of speculation on my part, but if the parents of this child were more involved in their son's life, they may have noticed the problems he was having. Boys that go to the type of prepatory school he went to are not known for having doting, involved parental figures.

Without all of the facts, it's wise to start with the simplest causes/reasons instead of playing John Grisham with the details. It's kind of like a movie or book that states at the beginning "based on true events." We know that maybe one or two of the events actually happened, but any of the dialogue in-between is conjured.

As you can see, I don't purport to know what happened, but neither do any of you. And if any of you have ever served on a jury, you would understand that they do not get all of the facts, but just the facts the wonderful judge allows. NH and Vermont are known well for the (lack of)jurisprudence on child sex offense cases, so why is it so hard to believe that the judge wanted to give a 'win to the little guy at any cost?'

Okay. I guess my simple statement expanded into a bit more. I am sure all of you legal and medical geniuses will have a lot to say about my comments, so I look forward to non-abrasive replies.

Regards,
Sean