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National Accident Helpline

News - January 2007

NHS cuts: - 31 January 2007
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 Health commentators were forecasting that NHS cuts in medical staff will result in soaring negligence claims after it was revealed that £539million was paid last year to settle claims against hospitals. The NHS Litigation Authority (NHSLA) said £8 billion in claims was outstanding nationally. An NHSLA spokesperson said: "The rise in negligence costs is down to increases in medical technology. Victims of negligence are able to live longer and so claims have gone up. But claims in general have far outstripped inflation. Each trust is assessed on the risk posed to the public and the number and type of staff employed. Different staff present different risks. So hospitals pay a higher contribution than say a Primary Care Trust because they undertake riskier procedures." The NHSLA claims that it has an active risk-management programme in place to help raise standards of care in the NHS and help reduce the number of incidents leading to claims. And that 96 per cent of NHSLA cases are settled out of court through alternative dispute resolution (ADR).



Seroxat claim: - 29 January 2007
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 The BBC Panorama programme alleged that the manufacturer of the anti-depressant Seroxat, GlaxoSmithKline, covered up evidence about the safety of the drug which has been linked to a number of suicides. GSK refuted the allegations.



Largest awards: - 29 January 2007
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 In response to a Parliamentary question by John Hayes (C) to the Secretary of State for Health, Ms Rosie Winterton listed the ten largest settled CNST claims as at December 31, 2006, as totaling £68 million – the largest (for failure to diagnose pre-eclampsia) at £12,400,000.). The total amount spent in settleing negligence claims was £593 million.



Coroner’s inquest: - 26 January 2007
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A Hatfield coroner investigating the death of Ahil Islam who died aged 13 months after a four-hour wait in A&E has criticised two hospitals for communication failures. Ahil Islam was rushed to Watford General Hospital with burns and an infection after spilling hot tea over himself several days earlier. Coroner Edward Thomas said "inadequate transfer of information" between Watford General and the specialist burns unit at Mount Vernon, where the boy had previously been treated, could have contributed to his death. Ahil was first taken to the Watford hospital on September 30, 2005, before being transferred to Mount Vernon with three per cent burns to his arms, chest and neck. When his condition deteriorated he was taken back to Watford General by ambulance, suffering from dehydration and diarrhoea and growing increasingly weak. Left waiting in a corridor for more than an hour for an X-ray and blood test it was only when Ahil lost consciousness after another two and a half hours, that he was rushed to a resuscitation room. But it was too late for doctors to save him. A pathologist's report stated that Ahil's death was caused by an infection which poisoned the blood, and which doctors had failed to detect. West Hertfordshire Hospitals Trust stated: "We acknowledge that there were failings in the system. We have taken action to reduce the risk of this sort of incident happening in the future. We have improved communications between transferring hospitals and have introduced a Paediatric Early Warning System (PEWS), which enables our staff to closely monitor children and detect any deterioration in their condition as soon as possible. We will carefully consider the Inquest verdict and take on board the Coroner's comments and take any further action required."



Pristiq letter: - 24 January 2007
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The FDA has issued Wyeth an approvable letter for Pristiq (desvenlafaxine), saying that a satisfactory inspection of the company's Guayama, Puerto Rico facility, which is where the drug will be manufactured, is needed before the green light can be given. Wyeth will also have to take on "several post-marketing commitments," including submission of long-term relapse prevention, low dose and pediatric studies, and must provide "additional clarity" around its product education plan for physicians and patients. The good news for the firm is that the FDA does not require that any additional clinical studies be submitted prior to the approval of Pristiq, which is the follow-up to Wyeth's antidepressant Effexor (venlafaxine). "The approvable letter is in line with Wyeth's expectations and we remain on track with our plans for Pristiq," said senior executive Joseph Mahady. Pristiq is expected to have annual sales of more than $1 billion, which will compensate for the loss of earnings once the extended-release version of Effexor faces generic competition in 2010.



Prempro trial: - 24 January 2007
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The third trial against Wyeth Pharmaceuticals and its menopause drug Prempro began in Little Rock, Arkansas, where the company is defending itself against charges of negligence and intentionally misleading consumers about the drug’s connection to breast cancer. Wyeth chairman and CEO Robert Essner delivered a videotaped deposition in which he says the company was “concerned” about the breast-cancer risks associated with Prempro as far back as 1991. Wyeth is facing more than 5,000 lawsuits with regard to Prempro, a hormone-replacement drug that uses doses of estrogen and progestin to treat menopausal symptoms, including hot flushes and mood swings. The drug maker has won in the previous two cases that have gone to trial. In one trial, an Arkansas woman’s case was dismissed by the jury; in the second, a Pennsylvania couple was initially awarded a $1.5 million jury judgment before a mistrial was declared in October.  



Contraception blog: - 24 January 2007
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Genevieve Parker refers to a recent article in the Washington Post regarding the FDA's standards for the approval of various types of hormonal contraceptives. The very first sentence of the article reads, she says: "The government is considering setting higher standards for birth control drugs used by millions, saying that newer pills appear to be less effective at preventing pregnancy than those approved decades ago." Well, isn't that good to hear! Writes Genevieve. “Note that the article introduces the primary focus of the FDA as regards birth control as being how effective it is at preventing pregnancy, rather than how safe it is for the women who use it.”  Her point is, how much does the contraceptive industry really have women's health in mind? By all means, the FDA should make their approval standards more rigorous.



Alimta delay: - 24 January 2007
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The National Institute of Clinical Negligence (NICE) said that a final decision on making the chemotherapy drug Alimta, which is used to treat mesothelioma, available on the NHS nationwide will not be made for another nine months. The drug is currently only available in some parts of the country, including the North East, Liverpool and London.  Following an appeal by Alimta manufacturers Eli Lilly, NICE said it would take another look at the drug to see if the “cost per life gained” calculations could be revised and made more cost-effective as to warrant general use on the NHS. Thompsons Solicitors’ head of asbestos litigation Ian McFall said: "I would urge NICE to find some way to bring this meeting forward so a decision can be made without further delay. The very nature of mesothelioma means many sufferers cannot afford to wait until September to find out if this drug will be made available to them. I am disappointed that NICE has not had the foresight to fast track this decision so scores of people in the North East and across the UK are no longer left in limbo."  



Settlement: - 22 January 2007
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Ashleigh Cookson, 39, was awarded £3million by the High Court after fighting for more than nine years for compensation for her daughter Bronte who was left with severe physical disabilities by medical negligence at Chase Farm Hospital. Mrs Cookson was 36 weeks pregnant with Bronte when she was taken to Chase Farm on May 5, 1995. At the hospital she was not adequately monitored and Bronte suffered a lack of oxygen to the brain, resulting in her being born with cerebral palsy. Chase Farm admitted negligence in October 2005, and a final amount of £3.06million was awarded. Judge Sir Michael Wright awarded the family £600,000 in a lump sum, and periodic payments of £74,300 a year to pay for Bronte's upkeep. The London Strategic Health Authority, which manages Chase Farm Hospital, did not admit liability, but will foot the bill, in the place of the North East London Strategic Health Authority.



MPS commended: - 22 January 2007
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The Medical Protection Society (MPS), which has offices in Leeds and London, turned to an independent health insurance intermediary to find a healthcare solution for all of its workforce. Pauline Brown, Director of Human Resources for MPS explained: “We actually held a number of focus groups and employee surveys to ask what our staff wanted. We offer our members peace of mind and provide support for health professionals with legal and ethical advice, so it is only natural that we provide similar dedication to our workforce.” Employees at the organisation wanted extensive cover towards dental and optical treatments as well as money towards a health screen, specialist consultations and counselling provision. Pauline continued: “Our employees help GPs and other professionals with clinical negligence claims, legal and ethical dilemmas, disciplinary procedures, inquests and fatal accident inquiries so their days are incredibly intense and can be stressful…. Our employees also understand the value of ensuring that they remain healthy and requested cover towards treatments that can help such as health screens and consultations.”



TAG trial: - 20 January 2007
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 The trial of three former directors of The Accident Group has been scheduled to start on 14 May 2007. The trial could result in TAG directors Mark Langford, his wife Debbie and Mike Watson, the company's finance director, being banned from running a UK company for up to 15 years if found guilty. The proceedings are being brought against them by the Insolvency Service, part of the Department of Trade and Industry. In addition, the company’s liquidator, Begbies Traynor, is currently investigating the validity of an £11m dividend paid out by TAG in 2001. Six other TAG directors have already agreed not to act as company directors for several years.



MPS CEO: - 20 January 2007
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The new Chief Executive of the Medical Protection Society (MPS) is Mr Tony Mason, an actuary with a firm closely associated with the MPS and which has worked for the Department of Health. Last September, the current MPS Chief Executive, Dr John Hickey, announced his retirement as MPS chief, sparking IHCA and IMO concerns about MPS’s future role in Ireland. Mr Mason is formerly a Managing Director and now Chairman of the actuarial firm, Lane Clark and Peacock (LCP), which had conducted a review on the private practice caps for the Department of Health. The firm reviewed the effectiveness of the private practice indemnity caps and recommended that it be extended, clearing the way for the IHCA to agree to re-enter contract talks in October 2005.  Mr Mason will take up the post later this year, the MPS said. Dr Nick Davies, MPS Chairman said Mr Mason was a very experienced manager with “unrivalled experience in the professional indemnity field”.



NHS blunders: - 18 January 2007
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A Daily Mirror investigation showed that in the past 12 months alone, at least 220 hospital patients lost their lives due to negligence or incompetence. Another 1,800 patients, expecting to be made better, were actually made worse by wrong diagnoses or careless treatment. In some of the worst cases, the wrong organ was removed in operations and people were given transfusions of the wrong blood type and injected with the wrong drug. The Mirror, using the Freedom Of Information Act, discovered that more than 2,100 Serious Untoward Incidents (SUIs) - events that could cause serious harm to patients, staff or the public - were reported in 2006. Peter Walsh, head of Action Against Medical Accidents said: "Most families will never find out that their loved ones suffered because of a hospital blunder. In many NHS trusts there is a culture of denial and cover-up which means incidents are not properly investigated." The Daily Mirror invites information on NHS blunders at features@mirror.co.uk or write to NHS Horrors, Features Desk, Daily Mirror, One Canada Square, London E14 5AP. 



Prisoners’ awards: - 14 January 2007
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 The Liverpool Daily Post reported that prisoners at HMP Liverpool were awarded a £2.8m in compensation last year - by far the highest total anywhere in the country. The payout for injuries, medical negligence and unfair treatment, was responsible for more than two-thirds of the total payouts in the UK and was four times the next highest award. It also compared to just £41,000 paid out in compensation at the Walton prison in the previous year, according to Home Office figures. Shadow Home Secretary David Davis accused the Home Office of being weak in the face of "spiralling claims masquerading as human rights". 



PI reform: - 12 January 2007
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 The debate over the small claims limit for personal injury compensation looks to continue as civil servants continue to review reports on the issue. The proposal, recommended by ABI, aims to increase the small claims limit from £1,000 to £5,000. However, last month, the Law Society accused insurers of being untrustworthy and claimed the proposed increase was an attempt to pay fewer in claims. The Law Society said that its research had found that four out of five claimants did not trust their insurers to give them a fair deal. In what appeared to be a compromise solution, the Department of Constitutional Affairs recommended the limit to be raised to £2,500 but as yet has not officially published its consultation paper which was due in mid-December.



MRSA attack: - 11 January 2007
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AvMA attacked what it called “defeatism” over tackling hospital acquired infections such as MRSA and c-difficile. Chief executive Peter Walsh said: “We cannot allow defeatism to replace the complacency which preceded it in the NHS. Now that hospital infections are finally being given the priority many of us were calling for for years, we have to step up the fight rather than kid ourselves that nothing more can be done to meet the targets set by government. Lessons from abroad as well as here in the UK, such as at University College London, show that where there is a genuine commitment, dramatic reductions in infections can be achieved, preventing thousands of avoidable deaths and devastated lives”.



Victim auction: - 10 January 2007
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  An investigation by Financial Mail revealed that some solicitors pay up to £10,000 in an ‘auction’ to represent badly injured people – without the victims themselves knowing – in the hope of a slice of a big financial settlement. It has been revealed that most of the big insurers, including Direct Line, Tesco, Norwich Union and the AA, invite bids from law firms to represent their policyholders in court. Officially, insurers and solicitors are supposed to disclose the fact that such fees are paid. But research by the Solicitors Regulation Authority, formerly the Law Society, showed that fewer than 6% of firms are complying.  



QEH claims: - 09 January 2007
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 Queen Elizabeth Hospital, Kings Lynn, received 23 solicitors’ letters warning of potential claims for compensation for clinical negligence and personal injury this financial year. Over the last financial year 25 claims were made. If all were valid they could have led to payouts totalling £4.5 million. So far, three of those claims have been settled out of court without the trust accepting blame, leading to insurers paying out £24,000. Six claims were still under investigation, seven were withdrawn and the remaining nine had stalled. Of the claims received 12 were for personal injury primarily made by hospital staff involving things like falls, back injuries and accidental stabs from needles while at work.



Wife’s death: - 08 January 2007
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A widower who believed that his wife’s life could have been saved if the hospital had correctly diagnosed and treated her illness has finally won his battle for admission of liability, seven years later. 60-year old Mrs Anna Eastaff of Edgware, Middlesex was admitted to Barnet General Hospital in March 2000 after suffering with abdominal pain. She died just a few days later of an undiagnosed and untreated perforated bowel. A CT scan taken on 31 March 2000 showed clear signs of perforation but was reported as normal by the hospital’s radiologist.  Concerned that she had not been seen to correctly, Robert, Mrs Eastaff’s husband, complained to the Barnet and Chase Farm Hospitals NHS Trust. They replied that everything that could be done to save Mrs Eastaff’s life had been done. Meanwhile the hospital did not send a discharge letter to Mrs Eastaff’s GP and took six months to send the GP the post mortem result. Mr Eastaff continued to correspond with the Trust and in December 2001, out of sheer frustration, involved the Ombudsman who advised continuing with local resolution. Mr Eastaff then asked the Trust set up an independent review panel to investigate circumstances surrounding his wife’s death. The panel did not report back until October 2003. It concluded that the CT scan had been misinterpreted, but in any case it would have made no difference and that she would probably have died anyway. The panel made some recommendations and criticisms of the Trust. The Trust did not act on these and Mr Eastaff involved the Ombudsman again. In September 2005 the Ombudsman fully upheld Mr Eastaff’s complaint. Through his union UNISON, Mr Eastaff then instructed Thompsons Solicitors who obtained medical evidence confirming that if the scan had been properly read, Mrs Eastaff would have lived. A formal claim was therefore made in May 2006. The claim was never answered. In October Mr Eastaff issued court proceedings. On 14 December, the last date to file a Defence to the claim, the Trust’s solicitors finally admitted liability.  Acting for the Eastaff family, Sarah Goodman, a specialist in clinical negligence with Thompsons Solicitors, said: “Mr Eastaff has shown remarkable tenacity because throughout he believed that his wife should be alive today were it not for the incompetence of the doctors. Others would have given up, faced with the Trust’s lack of interest, straight answers or respect to Mr Eastaff and his wife.  This is an extreme but not unusual case of Trusts refusing to do anything until proceedings are started and then caving in. This is worrying because the recently enacted NHS Redress scheme will exclude a claimant’s lawyers and will leave it to Trusts to investigate and make offers in cases less than £20,000. Mr Eastaff used all the alternatives to legal action available to him and received neither admission nor apology. You question whether anything would have happened here but for legal action.”



Drug counterfeiters: - 05 January 2007
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The Medicines and Healthcare Products Regulatory Agency (MHRA) reported that the number of  drug counterfeiting cases it is investigating has doubled in the last five years. As well as an increase in targetting individuals over the internet counterfeiters are also beginning to target pharmaceutical wholesalers and, as such, are penetrating the NHS supply chain. The counterfeit drug are sometimes found to contain brick dust and paint. Over the last three years the MHRA has been developing an anti-counterfeiting strategy, which is due to be published later this year. It will set out priorities for customs officers and other enforcement agencies, as well as listing the most commonly counterfeited drugs

Risk assessment: - 04 January 2007
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 Mandy Dixon and Femi Oyebode. Discusses how risk assessments are less straightforward than is commonly perceived and are often complicated by multiple forms of uncertainty. These uncertainties arise where psychiatrists are unsure about their interpretation of information, where information is missing, or where interpretation of the risk situation is open to challenge. They centre on doubts about the accuracy and the defensibility of assessment of patients’ risk status and the need for risk containment. Like other professionals, psychiatrists adopt a range of strategies to resolve uncertainties. These strategies, which often involve some ‘risk-taking’, enable the practising clinician to make a more confident decision. There is an argument for including ‘certainty’ as a theoretical feature of risk assessment in psychiatry and for recognising it as a multifaceted phenomenon. There is also an argument for considering with greater precision the manner in which uncertainty is managed within psychiatric risk assessments British Journal of Psychiatry Psychiatric Bulletin. www.bjp.rcpsych.org.



MRSA fears: - 04 January 2007
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The Salford Advertiser reported that a Hope Hospital employee refused to obey an internal memo for fear of spreading MRSA to patients.  The memo asked equipment staff to reuse Flowtron hospital theatre boots, put on patients during surgery to prevent deep vein thrombosis. The boots, which are attached to a pump to keep the circulation going, are, according to manufacturers Huntleigh Healthcare, of Bedfordshire, designed for single patient use only.  However, the memo from acting support staff manager Chris Burns, says: "Please try to reuse Flowtron boots whenever possible, as this is a major expense for the department."  The theatre worker, who wished to remain anonymous, said: "I was absolutely horrified at his advice - it comes at a time when hospitals across the country are battling not only MRSA but the new superbug Clostridium difficile. Are we seriously expected to take the boots off one patient, after they could have been splashed with fluids during surgery, and then put them on another patient? I, for one, will continue to obey the manufacturer’s instructions and only use them once. If the company says they are single use only, then as professionals we have a duty of care to our patients to adhere to that advice." A Hope Hospital spokesperson explained that the boots do not touch a patient's skin, because fabric has already been wrapped around the leg and is discarded after each patient. The Flowtron boot is then placed over the fabric and staff wear sterile gloves which are changed after each patient: “The Trust has carried out an internal risk assessment on the use of Flowtron boots which found there was no risk associated with this type of use. In addition, the Clinical Negligence Scheme for Trusts/NHS Litigation Authority, has viewed this practice as acceptable clinical practice.”

Hempsons expand: - 02 January 2007
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 Hempsons has added another former dental practitioner to its dental team, bringing the expert advisory group to 15 lawyers. Richard Creamer, previously with RadcliffeLeBrasseur, has extensive experience acting for dentists on behalf of the profession’s indemnity organisations, in civil negligence claims and proceedings before the General Dental Council or brought by Primary Care Trusts. He has also been instructed to act for dentists in appeals to the Family Health Services Appeal Authority and the High Court. Chris Morris, Head of Hempsons’ Dental Law Team and President of the Dental Law and Ethics Forum, commented: “Richard Creamer adds further extensive experience to the team, particularly with regards to practice sales, partnership and associate disputes, civil negligence claims and proceedings at the General Dental Council.”



CNST success: - 02 January 2007
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 North Essex Mental Health Partnership Trust is the first of its kind to achieve level two standard in the Clinical Negligence Scheme for Trusts. The scheme assesses the Trust's approach to managing risks in care and treatment. It covers reporting of clinical incidents, health records, infection control and staff training. Paul Keedwell, director of nursing, said: "Obtaining level two in CNST is very good news. It shows that we take risk management and patient safety very seriously." He said it was a considerable achievement that reflected the staff's hard work.



Settlement: - 01 January 2007
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  Field Fisher Waterhouse LLP won substantial damages for a boy left with severe disabilities after errors were made by medical staff during his birth in April 1999. Seven year old Mohammed Usama Ahmed requires constant care, and will never be able to work. He has severe behavioural and educational difficulties, and is unable to talk. The professional negligence case was brought against Newham Healthcare NHS Trust, which operate the Newham General Hospital, where Mohammed was born on 30th April 1999. During labour, his mother was given Syntocinon, a drug which stimulates the uterus to produce contractions, so inducing labour. The drug contains a synthetic version of the naturally-occurring hormone oxytocin, which causes the uterus to contract during labour, and thereby expediting delivery. The baby’s heartbeat and the uterine contractions need to be monitored whilst the mother receives the Syntocinon, as excessive contractions can cause the foetal heart rate to increase. In Mohammed’s case, too much of the drug was given to his mother causing an abnormal foetal heart rate and coupling of contractions. The combination resulted in hypoxia to the foetal brain. If the dose of the drug had been reduced or stopped, the abnormalities to the foetus would not have occurred. Indeed, the very presence of the frequent contractions and foetal heart abnormalities would have led all responsible clinicians to do just that. Accordingly, Mohammed would not have suffered from any disabilities. Instead, he is now reliant on carers, and is unlikely to make substantial educational, or other, progress. FFW Head of Clinical Negligence, Paul McNeil, acted for Mohammed’s family in the action against defendants, Newham Healthcare NHS Trust. Newham settled the case, just before trial, paying Mohammed very substantial damages. Paul has specialised in clinical negligence claims on behalf of victims for over 15 years: paul.mcneil@ffw.com.



Physician dismissed: - 01 January 2007
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 A Los Angeles Court of Appeal upheld the dismissal of a UCLA student-services doctor, rejecting the claim he was fired for his advocacy of medically appropriate health care. Dr. George Sarka was employed for 14 years as a primary care physician at UCLA’s student health services’ Arthur Ashe Student Health and Wellness Center. In August 2002, the university dismissed Sarka for refusing to modify his approach to patient care to make it more consistent with his colleagues in being less wasteful of resources by relying less on diagnostic testing and more on ‘optimal clinical judgment.’” Sarka filed a grievance alleging that his termination was, in relevant part, “clearly retaliatory for advocating appropriate patient care . . . .”  The administrative hearing officer upheld the termination, and Sarka filed a petition for administrative mandate in Los Angeles Superior Court. Judge David P. Yaffe denied the petition, ruling that Sarka “was not fired for [incompetence, discipline, or] . . . for advocating for medically appropriate healthcare for the students of UCLA [pursuant to] section 2056(a) . . . . Petitioner was fired for insubordination.” Yaffe explained that as a subordinate employee, Sarka had the duty to obey orders given by his superior as long as those orders fell within the scope of his authority and were not improper.  On Sarka’s appeal Justice Richard D. Aldrich said: “Looking at the statute, its application requires expert testimony about whether a physician’s advocacy was ‘medically appropriate.’ The University substantiated its position with medical literature and references to generally accepted standards of practice in the community of primary health care physicians at SHS, at student health centers at the other University of California campuses, and at “benchmark universities” … Thus, the University’s evidence established that the University’s policies were medically appropriate for student health care at large university campuses and the reason Dr. Sarka’s failure to abide by the practice requirements was harmful to

SHS and students. By contrast, Dr. Sarka presented evidence that his performance did not fall below the standard of care. But this case is not about negligence or malpractice. What was relevant to Business and Professions Code section 2056 in this case was whether, in refusing to rely more on his own medical and clinical judgment and less on diagnostic testing, Dr. Sarka was ‘advocating for medically appropriate health care.’ Toward that end, Dr. Sarka was obligated to demonstrate that his advocacy was ‘medically appropriate’ for primary care physicians in a large university’s student health service. This he did not do.”  Justices H. Walter Croskey and Patti S. Kitching concurred: Sarka v. The Regents of the University of California,



Irish claims: - 01 January 2007
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 The Sunday Times – Ireland reported that almost 4,000 legal claims are under way against the state of which a third relate to clinical negligence against hospitals and other medical centres. The total value of the outstanding claims is believed to be about €285m, 60% of which relate to clinical claims. Almost two-thirds of those involve obstetrics. The State Claims Agency has also established a specialist unit to contest MRSA compensation claims of which it had 40 on its books.



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