Juries sit for days or weeks to determine verdicts. Juries are a fundamental concept in our American system. Why do some continue to question the wisdom of juries? Only a juror who sat through a case understands the evidence in that case.

Florida attorney Bob Carroll cites to the following verdicts in his blog of this date. Do these look like frivilous lawsuits?

A jury in New York awarded the mother of a baby who suffered severe brain damage at birth $29.3 million against the hospital because the baby was not timely delivered (Stephanie Muniz an infant, et al. v. New York Methodist Hospital, et al., No. 3245/00, N.Y. Sup., Kings Co.).

In West Virginia a family was awarded $17 million on March 27 for injuries their baby sustained at birth which rendered her a spastic quadriplegic (Mark and Lori Pochron, et al. v. Monongalia General Hospital, et al., No. 03-FC-4, W.Va. Cir., Monongalia Co.).

A Wisconsin jury awarded a woman $8.38 million against a doctor who rendered her stomach and intestines useless during the course of a procedure designed to prevent heart burn (Jessica Greenfield v. Dean Health System and Paul Huepenbecker, No. 4CV32, Wis. Cir., Dane Co.).

In Texas a woman who was rendered quadriplegic as a result of a rollover accident was awarded $29,515,196.41 against auto manufacturers and a tire manufacturer (Rose Marie Munoz v. Ford Motor Company, et al., No. 03-3353-B, Texas Dist., Neuces Co., 117th Jud.).

In nearby Orlando, Florida, the estate of a cable layer was awarded $2,857,000 against an electrical contractor for his death caused by a dangerous electrical conduit in a commercial building's attic (Eugene Dixon, et al. v. M.R. Pride Electric Co., No. 04CA-2275, Fla. Cir., Orange Co., 9th Jud.).

Ever wonder when you as a parent become liable for an accidents or intentional injuries caused by your child?

Nevada law addresses this in two statutes:

First, NRS 41.470 provides:

1. Except as otherwise provided in NRS 424.085, any act of willful misconduct of a minor which results in any injury or death to another person or injury to the private property of another or to public property is imputed to the parents or guardian having custody and control of the minor for all purposes of civil damages, and the parents or guardian having custody or control are jointly and severally liable with the minor for all damages resulting from the willful misconduct.

2. The joint and several liability of one or both parents or guardian having custody or control of a minor under this section must not exceed $10,000 for any such act of willful misconduct of the minor.

3. The liability imposed by this section is in addition to any other liability imposed by law.

Next, NRS 41.472 adds:

1. If a parent, guardian or other person legally responsible for a minor under the age of 18 years:

(a) Knows that the minor has previously been adjudicated delinquent or has been convicted of a criminal offense;

(b) Knows that the minor has a propensity to commit violent acts; or

(c) Knows or has reason to know that the minor intends to use the firearm for unlawful purposes,

and permits the minor to use or possess a firearm, any negligence or willful misconduct of the minor in connection with such use or possession is imputed to the person who permits such use or possession for all purposes of civil damages, and, notwithstanding the provisions of subsection 2 of NRS 41.470, that person is jointly and severally liable with the minor for any and all damages caused by such negligence or willful misconduct.

2. As used in this section, "firearm" has the meaning ascribed to it in NRS 202.253.

The following is an editorial published on April 20, 2006 in USA Today:

"Whose side are they on?

The thought of a surgeon taking a scalpel to the wrong limb, organ or patient sends chills down the spine of anyone who has been in a hospital.

Eighty-four cases of what's known in the business as "wrong-site surgery" were reported in the USA last year. But that's just the "tip of the iceberg," because many hospitals across the country aren't obligated to account for such blunders publicly, says Dennis O'Leary, who heads a group that inspects health care facilities.

The chances of wrong-site surgery are slim -- about one in 113,000 operations, a study published Tuesday in Archives of Surgery notes. Still, any incident is unacceptable. In one typical case, instead of removing a benign tumor from Doug McCoy's right ear last September, surgeons at Maricopa Medical Center in Phoenix operated on his left ear -- which had no tumor.

In an effort to eliminate such blunders, surgeons have been required since 2004 to mark the spot they plan to cut while consulting with their patient before the operation. Nurses are supposed to call a "time out" in the operating room to conduct a final safety check to ensure that the right procedure is performed on the right patient.

So why do these catastrophic mistakes keep happening? Mainly because systems designed to prevent errors are faulty, or not followed, researchers say.

Some surgeons who think they'd never make such a stupid mistake often ignore safety protocols. Stubborn resistance to standardized conduct is part of the culture of medicine.

Airline pilots overcame this barrier long ago. Even the most experienced pilots must run through a checklist before taking off. It may be embarrassing for surgeons to be asked if they know for sure which side -- or patient -- they're about to operate on. But it's a lot less embarrassing than making a grievous error. Swallowing a little pride may save a limb, or a life.

Hazards in hospitals. Surgical screw-ups are a small part of a much larger patient-safety problem in hospitals.

Incidents such as bedsores, post-operative infections and failure to diagnose and treat conditions that develop in the hospital continued to plague American hospitals, according to a new study of Medicare patients by HealthGrades, a health care ratings company.

The study found that 1.24 million patient safety incidents occurred in nearly 40 million hospitalizations from 2002 to 2004. Those incidents were associated with 250,000 potentially preventable deaths and $9.3 billion of excess costs. For the second straight year, incidents increased slightly.

What can be done? Only 23 states have mandatory error-reporting systems, and standards of measurement aren't consistent. More states need to adopt rigorous reporting systems, and they should publicly release the type and number of patient safety incidents at each hospital. Exposure can spur progress.

That's what Minnesota has done, and it's ranked as the nation's top state for improving patient safety. A unique program there allows fiercely competitive hospitals to work together to share data, highlight best practices and implement tested solutions. As a result, Medicare patients in Minnesota had a nearly 30% lower risk of a safety incident compared with New Jersey, listed as the worst state.

Progress in reducing medical errors has been painfully slow. Speeding improvements requires making safety a top priority, publicly identifying hospitals that miss the grade and rewarding those that exceed it."

Thanks to Michael Kaplen's braininjury blog for these observations regarding Tom Baker's insightful book on how the insurance industry continues to contribute to a reduction in the quality of health care in America:

In a new book entitled, The Medical Malpractice Myth,Tom Baker, Connecticut Mutual Professor of Law and director of the Insurance Center at the University of Connecticut, uses empirical evidence to dismantle the myths that permeate the national debate over medical malpractice and liability insurance costs.

Baker, who spoke yesterday at a briefing for congressional staff on medical malpractice, writes that the real problem is too much medical malpractice, not too much litigation. Most people do not sue, which means that victims - not doctors, hospitals, or liability insurance companies - bear the lion's share of the costs of medical malpractice

Here are some of Baker's Key Findings:

Medical Malpractice Is An Epidemic

Medical errors kill up to 100,000 Americans each year. (p. 9)
1 in every 100 hospitalized patients becomes a victim of negligent care. (p.29)

Insurance Costs Are Low

Medical malpractice premiums account for less than 1 percent of all heath care spending. (p.9)
The average physician paid less than $12,000 for malpractice insurance. (p.66)

Insurance Rate Changes Are Not Related to Litigation

Medical malpractice insurance premiums rise and fall because of the "boom and bust" nature of the insurance underwriting cycle. (p. 51)
The tort system has "little or nothing to due" with the fluctuations in insurance premiums. (p.45)

Tort Reform Hurts Patient Safety

"All the research that has been done so far points in the same direction: tort reform does not improve hearth-care outcomes" (p. 148)
"Research suggests that a least some kinds of tort reforms might have a detrimental effect on health." (p. 148)

Doctors Are Not Fleeing

There are more doctors per capita than ever before. (p. 143-144)
There are isolated access to health care problems, but they do not really have anything to do with malpractice lawsuits. (p.155)

Malpractice Suits are Rare; Usually Meritorious

Less than 3% of malpractice victims file suit. (p.63)
The rate of malpractice suits has declined over the past 15 years. (p.37)
"Research clearly rejects the claim that most medical malpractice lawsuits are frivolous.: (p. 86)

Tort Driven Defensive Medicine Is A Myth

"Defensive medicine is a trumpted up charge." (p.155)
"The overall impacto f this defensive medicine on health-care costs is not very large." (p. 134).

I sat with a client this morning who reminded me once again of a simple concept that's almost always overlooked by doctors: the concept of accepting responsibility. How many malpractice cases would be averted if a doctor simply accepted responsibility and apologized?

Doctors might answer that no cases would be averted. They might say that our legal system has created an atmosphere in which accepting responsibility for a medical mistake and apologizing only guarantees a lawsuit.

I don't think so. I can't even count how many clients over the years have told me 1) that they have no interest in suing thier doctor, or any doctor; but 2) that they are so frustrated by a doctor's defensiveness, or downright disappearance, after something went wrong that they are motivated to explore a legal solution.

My experience with doctors is that many are honest and caring individuals. But even the most honest doctors often feel that they must conceal mistakes in order to avoid the legal system. Few consider that most patients, even those who are harmed through a medical mistake, want to avoid lawyers and the legal system as much as they do.

Many doctors would be surprised to learn that acceptance of responsibility sooner often avoids the need to deal with the legal system later altogether.

As I indicated a blog or two ago, cases that are appealed from arbitration or fail in mediation may proceed into Nevada's Short Trial Program. Here's an overview of that program:

-A presiding judge is appointed and hears all motions.

-The parties exchange document and witness lists and meet for a pretrial conference to chart out the course of the case.

-The case is calendared and set for trial to commence not later than 120 days from the date the judge was assigned.

-Parties may quote from depositions rather than call witnesses, and other evidentiary rules are relaxed.

-Expert witnesses may be used but the use of live expert testimony is discouraged.

-A jury of 4 to 6 members is chosen.

-A judgment may not exceed $40,000.00 per plaintiff.

-Diehard parties may appeal a case within the Short Trial Program directly to the Nevada Supreme Court.

I'll discuss incentives and financial risks built into Nevada's ADR system in my next blog or two.

The Nevada judicial system has continued to refine its attempt to route smaller cases (generally those with a value of under $40,000) away from district court jury trials and through a series of alternative dispute resolution programs.

In Washoe County, Nevada, there are two basic choices in cases of this nature.

First, parties can proceed through arbitration. In this form of alternative dispute resolution, the parties each strike two names from a list of five arbitrators and an arbitrator is chosen and sets the basic rules for discovery and an arbitration hearing. Evidentiary rules are often highly relaxed and most arbitrations take less than half a day. Also, arbitration hearings occur faster than trials, with most completed within six to eight months of filing a complaint.

The parties present their cases at the arbitration hearing and the arbitrator hears evidence and makes an award to the prevailing party.

Parties may also opt intially to proceed through a structured mediation program. Mediation, unlike arbitration, is a process in which a decision is not made by a third party. Rather, an appointed mediator works with the parties (who are usually in separate rooms) and attempts to bring them together to a mutually acceptable (or mutually unacceptable) resolution.

If a party is dissatisfied with an arbitration result, or if mediation fails to bring the parties together, litigants can opt to then proceed into Nevada's Short Trial program. More on this next blog.

I sat in a settlement conference the other day with a district court judge. My clients are three young girls who lost their father after he was prematurely discharged from the hospital with a dangerous cardiac condition and died shortly thereafter. The defendant cardiologist, concerned with his reputation and honor, was upset that he had been sued. The implication was that lawyers (me, in particular), and the legal system, were the source of his problems.

I hear this sort of thing every now and then and I'm always amazed. After all, in Nevada, lawyers don't sue doctors - doctors sue doctors.

Nevada law requires that every plaintiff obtain a medical review from a qualified specialist prior to filing a malpractice complaint. All malpractice complaints must be filed with an appropriate expert affidavit.

In the case at hand, a highly qualified well-credentialed cardiologist opined that the defendant cardiologist was negligent and should have taken corrective action. Our case would not have been filed but for the opinion of another cardiologist.

Medical malpractice lawsuits in Nevada would not exist but for doctors who testify against other doctors.

USA Today reports that 'wrong site' surgeries are on the rise.

"Despite years of patient-safety efforts, an increasing number of health care facilities have reported mistakenly removing the wrong limbs or organs, slicing into the wrong side of bodies and performing surgery on the wrong patients. 'It's getting worse,' says Dennis O'Leary, who heads the non-profit Joint Commission on Accreditation of health care Organizations, which inspects more than 15,000 hospitals and surgical centers nationwide and sets patient safety requirements and guidelines. Last year, health care facilities reported 84 operations to the commission that involved the wrong body part or the wrong patient. While some states require hospitals to report such blunders, many hospitals across the nation are not obligated to account for them publicly."

Robert Davis, USA Today, 4/17/06

Punitive damages are meant to punish intentional or exceptionally stupid (my term, not the legislature's) conduct.

Punitive damages are available in Nevada auto accident cases under certain limited circumstances. NRS 42.010 provides as follows:

42.010. Exemplary and punitive damages: Injury caused by operation of vehicle after consumption of alcohol or controlled substance

1. In an action for the breach of an obligation, where the defendant caused an injury by the operation of a motor vehicle in violation of NRS 484.379 or 484.3795 after willfully consuming or using alcohol or another substance, knowing that he would thereafter operate the motor vehicle, the plaintiff, in addition to the compensatory damages, may recover damages for the sake of example and by way of punishing the defendant.

2. The provisions of NRS 42.005 do not apply to any cause of action brought pursuant to this section.

This set of observations come from the Greedy Trial Lawyer blog at http://www.greedytriallawyer.com. I reproduce this here in an attempt to occasionally touch upon the unsavory relationship between our pharmaceutical companies and our politicians:

In the closing days of the 2005 legislative year, Senate Majority Leader Bill Frist and the White House fail to obtain the needed support for a proposal to shield flu vaccine manufacturers from injury claims related to side effects of their products. Eschewing the democratic process, Frist rolls the desired language into a Defense Appropriations Bill without the knowledge of the House-Senate Conference Committee that was charged with reconciling the House and Senate versions of the bill. It seems merely coincidental that Frist has received $271,000 in campaign contributions from the pharmaceutical industry since 1989, or that the industry contributed nearly $800,000 to the Bush campaigns in 2000 and 2004.

In January, the FDA -- another organization touting its unceasing concern for the health of ordinary Americans -- pre-empts state prescription drug product liability laws by updating the agency's rules on drug labels. State Attorneys General are outraged and demand to see the new policy in order to comment before it takes effect. The FDA refuses. In a letter to the FDA, Illinois senator and president of the National Conference of State Legislatures Steve Rauschenberger writes that "This attempt to insert pre-emption language is a thinly veiled attempt on the part of the FDA to confer upon itself authority it does not have by statute and does not have by way of judicial ruling."

Fast-forward to March 2006. The "National Uniformity for Food Act" passes through the House of Representatives and begins winding its way through the Senate. Though touted by the Grocery Manufacturers Association as "a single set of food safety and warning standards that will help consumers to make educated choices," in reality the act is an attempt to trump state regulations by putting everything under the control of the FDA.

The FDA's protection of its "clients" might make sense if states did a poor job protecting consumers, but clearly this isn't the case. For example, California laws against lead content in calcium supplements fostered the removal of lead from most products long before the issue registered on the FDA's radar. The increased power of the FDA might even make sense if drug manufacturers did a competent job testing their products, but this isn't the case either. According to a recent study by Knight-Ridder, there was one adverse drug reaction per every 16,300 prescriptions in 1992. By 2003, the ratio had risen to one in 9,000.

Sadly, these and other quasi-legal sweetheart deals between government and industry occur with numbing frequency, and it seems unlikely there will be any public outrage on this issue. But at the very least, consumers should be suspicious the next time they see an ad from a drug company proclaiming how much it cares.

I've long had the idea that it's best not to go to the hospital at night or on weekends. It's clear that in Nevada, like many states, hospital staffing levels differ between day and night, weekend and weekday. If you are seriously ill, I strongly urge you to have a friend or relative stay with you overnight during your hospitalization. While this may be extremely burdensome, or simply downright impossible, I believe that there are good reasons to have an observer/advocate with you when you need one.

Dr. Joseph Mercola cites a report from the New England Journal of Medicine for the following thoughts in this regard:

Lower levels of hospital staffing on weekends may increase the risk of death among patients with some life-threatening disorders.

A study of nearly 3.8 million emergency hospitalizations in Canada found that patients with certain medical conditions were more likely to die if they were admitted on a Saturday or Sunday compared with patients admitted from Monday through Friday.

For instance, patients with a ruptured abdominal aortic aneurysm -- a tearing in the artery wall that causes potentially fatal bleeding -- were 28% more likely to die when they were admitted on a weekend, the investigators found.

Also, patients with pulmonary embolism, in which an artery in the lung is blocked with a clot or other material, or acute epiglottitis, an infection that causes severe swelling of the structure that closes the windpipe when a person swallows, were also at increased risk of death if they were brought to the hospital on a weekend.

The findings support the results of previous studies. The rate of death among infants born on a Saturday or Sunday is slightly higher than the death rate among babies born during the week, for instance, while patients who overdose on drugs may fare worse on the weekends.

The researchers note that working on the weekend is unpopular and that people who work on a Saturday or Sunday may have less experience than those who work during the week.

For more, see, The New England Journal of Medicine August 30, 2001; 345:663-668