The demise of Flea, who live-blogged his medical malpractice trial

May 31, 2007

Stunning news. The Boston Globe on Flea, his trial and how his blogging ultimately led from a possible victory to settlement:

As Ivy League-educated pediatrician Robert P. Lindeman sat on the stand in Suffolk Superior Court this month, defending himself in a malpractice suit involving the death of a 12-year-old patient, the opposing counsel startled him with a question.

Was Lindeman Flea?

Flea, jurors in the case didn’t know, was the screen name for a blogger who had written often and at length about a trial remarkably similar to the one that was going on in the courtroom that day.

In his blog, Flea had ridiculed the plaintiff’s case and the plaintiff’s lawyer. He had revealed the defense strategy. He had accused members of the jury of dozing.

With the jury looking on in puzzlement, Lindeman admitted that he was, in fact, Flea.

The next morning, on May 15, he agreed to pay what members of Boston’s tight-knit legal community describe as a substantial settlement — case closed.

There is no anonymity on the web. If you blog under a pseudonym, people will find out who you are if they really wanted to. So with that in mind, blog as if the whole world is reading and knowing who you are.

It’s unfortunate for all concerned. For Flea obviously. But also for the medical blogosphere. The strength of blogging is its inherent openness and allowing the curtain to be “pulled back”. Now, every post will be filtered through this question: “Will this ever come up in a malpractice trial against me?”

Flea, we’ll miss you and sorry to see things turn out this way.

Update:
Plaintiff attorney Eric Turkewitz called it correctly and has a roundup of the ordeal:

Finally, this case was a tragedy for two parents, and a nightmare for a doctor. If the parents had lost the trial, it would have added yet another layer of extraordinary emotional trauma. If Flea lost, it would no doubt been emotionally difficult for him. A settlement allows each to move on with their lives without the additional fallout of a jury’s verdict. The parents might feel they had their day in court and that the settlement was based on the merits, while Flea might feel it was based on his own carelessness with his writing and the concerns a jury might not like the way his legal team was trying to manipulate the jury. Neither won and neither lost. And sometimes that is all for the best.

MetaFilter comment:
“But when I look at this case, I wonder what we’ve lost. Expert analysis of issues in the pediatric and medical community. Transparancy into the behind-the-scenes aspects of our legal proceedings. Eloquent and insightful content, now gone because your opinion can be a legal liability.”

N=1:
“Bloggers have no real protections against the invasion of their privacy. The healthcare blogging community is the poorer for the loss of Flea’s insights, passions and wit.”

Update 2 -
The Boston Globe with blogger reaction, including mine:
“‘It’s a little bit sad in a way. The whole purpose of blogging is to be open and pull back the curtain to talk about how it really is,’ he said. ‘So the question is, how realistic is that? I think that’s what physicians and other health professionals are wrestling with right now. It’s part of the growing pains of the medical blogosphere.’”

symtym:
“Arrogance, ignorance, or both? Dr. Lindeman’s most potent defense was his character””a character the Flea so thoroughly impeached””case over and settled. Hosea 8:7. For they sow the wind And they reap the whirlwind.”

Mary Johnson
:
“Anyway, a lot of people will be mulling this one over for a long time to come. The lawyers are already spinning it as a ‘win-win’ (I expect Flea doesn’t feel that way). Doctor-bloggers are bemoaning ‘the loss’ of expert analysis, transparency, insight, passion, wit (it’s a long list . . . for the physician known in the blogosphere as ‘Flea’ is a gifted writer).”

Althouse:
“Here’s a tip. Don’t blog anonymously unless you’re ready to accept all the consequences that would come if everyone suddenly knew it was you. Congratulations to the lawyer who figured out that she should ask that question on cross. You know, I love to support bloggers, but this doctor totally deserved what he got.”

Update 3 -
David Catron:
“Flea’s case wasn’t settled on the merits. It was settled because of a few intemperate posts on his blog. Now, there will be lawyers and paralegals all across the country trolling the web for blog posts by anyone connected with a medical defendant. Will they be doing so in states where tort reform has been enacted? I doubt it.”

#1 Dinosaur:
“Flea — and all of us — have a right to blog anonymously. This also means we should have the right not to be compelled to renounce that anonymity. Anonymous blogging didn’t have anything to do with the medical case at hand. What business did the attorney have bringing it up in court at all? Answer: she didn’t. So I repeat, where the HELL was Flea’s lawyer when that question was asked?”

OnThePharm:
“It saddens me when a case is settled not on the facts of the case, but rather on issues that are only tangentially related to the matter at hand, at best. That said, perhaps Flea was confident in his anonymity, but probably shouldn’t have been.”

Ami Chopine:
“It is you and it will sadly be the general public, who do not understand the nature of Flea’s blogging. He was anonymous. We could not check. But Flea’s articles, sharp as they’d sometimes been, had always consisted of sound science. Moreso, the frustration he often expressed was a mark of his compassion for the children under his care. In the blogging world, he was a model of integrity and compassion.

If you accuse of bloggers who defended him of ‘not having the whole picture’, you must accuse yourself of the same thing.

To the lawyer, Mulvey, who claims to have read his entire blog: where is your integrity? Is it truth or power that you love? Is it compassion or money?”

Update 4 -
Kinohi Nishikawa:
“. . . the prosecution was able to cast doubt on the Lindeman’s character — precisely because ‘Flea’ and ‘the real 3-D doctor’ turned out to be the same person, the same ‘cocky bastard.’ Here Lindeman’s metacommentary doesn’t realize its own ironic condition of possibility: that forcefully stating the difference between Flea and the ‘real’ doctor only serves to underscore their inextricability. (You know the type: ‘Really, I’m not like that — in fact, I did it just to remind myself how different I really am!’) This rhetorical move amounts to Lindeman denying his very real investment in Flea as both a cathartic release and an agent, however modest, of public opinion.”

Eric Turkewitz:
“Saltzman informed me during our conversation yesterday that Flea’s attorneys were unaware of the blog, which means of course, that Flea didn’t tell them and he wasn’t prepped by his attorneys on the subject on how to deal with it if it should come up.”

David Harlow:
“This takes the questions about propriety of physician blogging to a whole new level.”

Update 5 -
Orac:
“My bottom line on this is simple. The case of Flea is not the dire signal about the demise of the medical blogosphere that some have been making it into and that I briefly fell for. Rather, it’s a wake-up call about reality. The First Amendment guarantees us freedom of speech and allows us to speak with anonymity. However, just as it does not insulate us from being offended by other people’s speech, it also does not insulate us from the consequences of what we say publicly.”

Notes of an Anesthesioboist:
“The discovery process can’t stay the same after this – it hasn’t been the norm to request blogs, myspace pages, and such, but attorneys are now clearly going to have to take various types of records into account and adapt to the Internet age.”

#1 Dinosaur:
“Although a doctor’s personality, appearance and demeanor on a witness stand are seen as proxies for behavior with patients, I fail to see how actions (or writings) outside the courtroom or exam room have any relevance to the questions that come up in a malpractice trial. I know that’s how the world *does* work. My question is, should it? I say no.”



Related posts:

  1. Flea on trial: Day one
  2. Poll: Should a doctor blog his medical malpractice trial?
  3. A doctor is sued, and blogs his malpractice trial
  4. Demise of the medical blogosphere?
  5. Charlie Weis: Malpractice trial reactions
  6. Flea and the plaintiff’s attorney
  7. More Flea analysis


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{ 59 comments }

1 Anonymous June 2, 2007 at 1:54 pm

Why should I appreciate that if I’m a consumer or a taxpayer? Perhaps if I’m a shareholder in an insurance company, it might bother me, but probably not, given how profitable they have been on a consistent basis. I’ve probably done quite well.

But if you’re saying we must cap damages because it costs us all money, then perhaps we shouldn’t stop there. Let’s cap CEO salaries, let’s cap the cost of fuel, let’s cap the cost of clothes. It would save us all money, right?

I’m not like you – I don’t think my fellow man is so ignorant as to be led around by the nose by “wiley” attorneys. After all, I think the defense gets lawyers too. And most studies say judges agree with juries the majority of the time – but maybe they’ve been tricked as well!

2 Anonymous June 2, 2007 at 7:02 pm

“And most studies say judges agree with juries the majority of the time – but maybe they’ve been tricked as well!”

Or bought. Are your judges elected? Ours are, and guess who funds at least some of these campaigns…well-heeled trial lawyers. This is part of the reason venue-shopping exists, the other reason is juries comprised of an undereducated populace that is favorably inclined to plaintiffs and easily influenced by emotional factors in awarding noneconomic damages. BTW, I’m sure OJ agrees with you about the wisdom of your fellow man!

3 Anonymous June 2, 2007 at 11:32 pm

So exactly why would you want judges. Nice citation of OJ – I’m sure that proves your point, just like anyone who says all doctors are negligent drunks has their point proven by this guy:

http://www.boston.com/news/globe/magazine/articles/2004/03/21/what_went_wrong/

4 KC Saul June 3, 2007 at 6:19 pm

Everyone has pressures. Some of us read medical blogs for insight — you may or may not ever hire an interior decorator but everyone needs a doctor.

Tell me something: When does losing a malpractice case ever make a dent in a doctor’s license? What is it that a doctor has to do to get his license yanked? I don’t mean, “Oh, he’s been convicted of drug diversion, a felony, so he automatically loses the license, but tomorrow he can apply to get it back and he will.” I mean, license yanked. Do not pass go, do not collect $150K a year.

I am not speaking to the merits of Flea’s case, because it’s clear that everyone’s strayed off the subject. Let’s get back to it: No one knows what impact the blog has on the case.

Flea settled the case after he was cross-examined. I take it that the attorney for the plaintiff did not stand up and ask one question — about the blog — and sit down again.

Procedurally, where was the case? Was that the end of all the evidence?

Everyone here — including the Globe — is inferring that the blog caused the settlement. We know no such thing.

Before prejudging a case, please remember that a factual nuance can mean a lot. Here is one link to the facts of the McDonald’s Coffee verdict, for instance.

The point is, no one knows what the facts are in Flea’s case. It is a terrible idea that he blogged about his case. It is absolutely arrogant. Ironically, one of the things that patients complain about is the extent to which doctors seem to think they know everything about everything and dismiss patient concerns. Sometimes patient concerns should be dismissed, but you know, sometimes they’re real.

His lawyer, who, by the way, probably incurred significant education debt himself, would probably have preferred that he not post about the case in the blog. Had he not, I’d hazard a guess that the blog might have been a lot less useful.

Incidentally, your private e-mails could possibly be subject to discovery in certain matters as well, depending on the facts of the case.

5 Anonymous June 3, 2007 at 11:13 pm

If so many of you Doc’s actually like Flea and you knew it was foolish, and risky to do what he did, blogging his trial, then why didn’t you try to stop him? Isn’t that what “friends” do? If you know someone is doing something that could cause them harm, shouldn’t a friend warn them of danger? I read every one of his post about this trial and not one of you tried to make him realize what he was doing.

I guess the excitement and drama of it all was far more important than friendship? Everyone of you knew where this could lead, and quite frankly, I think you guys are gossip whores.

6 Nicole June 4, 2007 at 7:35 pm

I have to disagree with Anon 11:13PM, as there WERE numerous comments on Flea’s blog where readers suggested to Flea that blogging about a case in real time would probably be a bad idea. Certainly those individuals were acting as “good friends,” and trying to advise what they thought was in Flea’s best interest. I guess Anon 11:13 was not actually a reader of Flea’s blog…

In fact, Flea never revealed on the blog whether his case was real-time vs. being reported historically, so many readers probably assumed that he was not talking about something that was happening currently.

I’m very sorry that Flea was “unmasked” without his consent. His anonymous blog was one of my favorites — well written, with both good science and an authentic voice.

7 Anonymous June 4, 2007 at 9:47 pm

Yes Nicole I was most definitely a regular reader of Flea. In fact I had read him since the day he started his blog.

I stand corrected! You’re right! I do recall him being warned on his blog of danger. It was Eric Turkowitz that was doing the warning. Kind of ironic isn’t it, that the only person who saw fit to warn him was a N.Y. personal injury Lawyer!

Everyone knows he WAS NOT WARNED on his blog by anyone except Eric.

8 Nicole June 5, 2007 at 10:23 am

Anon 9:47 wrote-

>Everyone knows he WAS NOT WARNED
>on his blog by anyone except
>Eric.

Unfortunately, we can’t go back to the comments on Flea’s blog now, because then I could point out several other comments, besides Erik T’s, where people mentioned things like “I hope you’re not doing this in real time” and so on. From my memory, at least two of those comments were from females, and at least one was left non-anonymously.

Since comments can actually be left at any time after a post, you might consider the possibility that there were warning-type comments that *I* read that were actually left after the point in time where YOU read the comments…meaning that you could be a faithful reader of the blog and still miss some of the comments (because they were actually left after you last read the comment section of a particular post.)

Since we can’t access those comments anymore, we will have to just agree that your recollections are different from my recollections.

By the way, I do regret my sarcastic comment about you not being a reader of Flea’s blog. Obviously that was motivated by anger, and not very well considered before I posted it.

What puzzles me is why you feel that this perceived lack of warnings translates to readers being “gossip whores.”

Did you yourself believe that Flea was doing something dangerous? If so, why didn’t YOU warn him?

Speaking for myself, I didn’t post a warning for several reasons. (1) I read warnings posted by others. (2) I assumed he was not posting about the event in real time, and therefore did not think there was a real threat of unmasking from his posts (perhaps this was a bit naive, in retrospect).

Here’s an argument you could make that I would agree with. Some readers probably DID perceive a danger, and many of those readers apparently did not try to protect Flea by warning him. Those readers probably did Flea a disservice by not sharing their concerns.

However, I don’t think you can assume anything about their motivations for remaining silent, and your conclusion that “the excitement and drama of it all was far more important than friendship” seems quite unfounded. Why would you think people that respected Flea and/or considered him a “friend” intentionally allowed him to get himself into trouble? Do you really view most people so negatively? Do you judge everyone you come in contact with this harshly?

By the way, I respect your right to comment anonymously, but practically speaking, it’s easier to have a dialogue if you use some type of identifier that people can refer to. Maybe you could call yourself “John” or “PB&J” or “the commenter formerly known as Anon who thinks everyone let Flea down” or whatever. :)

9 Elizabeth June 19, 2007 at 7:02 pm

“Everyone knows he WAS NOT WARNED on his blog by anyone except Eric.”

I personally warned him, multiple times, nonanonymously. (Of course, I’m also a lawyer, so maybe I don’t count.)

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