doctor.jpgIs the loss of a loved one by medical malpractice less painful and catastrophic than such a loss by some other form of negligence? Either the Florida Legislature thinks so, or else it purposely created an arbitrary and capricious law to insulate medical providers from being held fully accountable for their negligence. The law in question is Section 768.21, of Florida’s Wrongful Death Act.

768.21 says who can make a civil damage claim arising from the death of a loved one through the negligent act of another party. Subsection (3) provides that “[M]inor children of the decedent and all children of the decedent if there is no surviving spouse, may also recover for lost parental companionship, instruction, and guidance and for mental pain and suffering from the date of injury.” Subsection (4) declares that “[E]ach parent of an adult child may also recover for mental pain and suffering if there are no other survivors.”

(Florida Statute 768.18 defines “minor children” as children under 25 years of age, notwithstanding the age of majority.)
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In our experience of representing individuals with practically every type of injury, we have learned that few injuries are more common — second to back pain — painful, and debilitating than rotator cuff tears.

The rotator cuff is made up of 4 tendons that cover the top of the humerus. A rotator cuff injury involves a tear to one or more of these tendons. Tears can be full or partial thickness.

Tears can be acute, when a sudden force (blunt or overstrain) is applied to the shoulder, or chronic, which is deterioration over a long period of time. Common symptoms of acute tears include a tearing sensation, sudden pain, and sudden weakness. The symptoms of chronic tearing include gradual progression of shoulder pain and weakness, and difficulty sleeping on the affected side.

Rotator cuff tears are diagnosed clinically, by the orthopedist through examination, and by MRI. The best type of MRI to accurately diagnose the presence of a rotator cuff tear is the MRI arthrogram.
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cemetery1.jpgAny cause of action, or lawsuit, arising in Florida from the death of an individual caused by the wrongful act or negligence of any person or entity is controlled by the “Florida Wrongful Death Act” (Sections 768.16-768.26). This blog describes some key wrongful death claim considerations.

  • Statute of Limitations: Florida Statute Section 95.11(4)(d) instructs that an action for wrongful death must commence within two years of death. Section 95.11(4)(b) describes when the SOL can be extended beyond 2 years where the WD resulted from medical negligence. (Read this blog: The Statute of Limitations (SOL) Under Florida’s Wrongful Death Act.)
  • Court of Competent Jurisdiction: Typically, WD claims are brought in state circuit courts. Regarding venue, Florida Statue, 47.011 provides that “Actions shall be brought only in the county where the defendant resides, where the cause of action accrued…. This section shall not apply to actions against nonresidents.” If none of the defendants reside in or have a principal place of business in Florida, the action must be brought in federal court.
  • Parties to the Lawsuit (Plaintiff): Florida WD actions are prosecuted by court appointed personal representative(s) on behalf of the decedent’s statutorily defined “survivors.” Link to this blog (for an outline of the “survivors” list.) The court appointed PR is often a survivor, like an adult child or a parent. The court may also appoint a guardian ad-litem for minors and incompetent adults.
  • Parties to the Lawsuit (Defendant): Defendants in WD actions are the individuals and entities who are alleged to be at-fault.
  • Damages: Making defendants pay monetary compensation to the survivors for their loss is how defendants are punished under our civil justice system. The amount of compensation, or damages, is determined by examining such elements as mental pain & suffering, loss of the decedent’s companionship and protection, past and future loss of support and services, and medical and funeral expenses. (Read this blog to see an outline of the damages available under the Act.)
  • Pretrial Procedure: Florida Wrongful Death Act claims can be settled by the parties at any time, even pre-suit. Some are settled after the lawsuit has been filed, but before or during trial. Some are dismiised by the court. The remainder go to final verdict.
  • Trial: Wrongful death cases are typically tried to juries, although judges can be chosen to act as the finder of fact. Judges make legal rulings, juries make factual determinations.
  • Post-trial: All rulings by judges and juries can be challenged on appeal. The threat of appeal sometimes precipitates settlement.

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law books.jpgWhen a person dies from an accident in Florida, who, if anyone, can be compensated for the loss is prescribed by statute in Florida’s Wrongful Death Act, Sections 768.16-768.26. The Act refers to those who are eligible as “survivors.”

The survivors list can be inequitable. For example, under some circumstances parents and children are barred from recovering for the painful loss of a loved one caused by the negligence of a wrongdoer. (See this blog for the survivors list broken down into chart form: Outline of Compensation for “Survivors” Under Florida’s Wrongful Death Act.)

Odd as it sounds, Florida wrongful death claims are not brought by statutory survivors. Rather, they are brought by Personal Representatives on behalf of survivors. WD actions are filed in the PR’s name, and the PR chooses the lawyer to handle the case. (While individual survivors can hire separate counsel to protect their interests, it is the PR and the PR’s chosen attorney who essentially control the course of the action.)

The PR can be a survivor. This may seem like an unworkable conflict, however, Florida laws and judges do an excellent job of policing cases to avoid problems. PRs have a serious fiduciary duty to apportion the proceeds of any recovery in a reasonable and equitable manner to each survivor. Section 733.602 Florida Statutes ; In re Estate of Wiggins, 729 So.2d 523 (Fla. 4th DCA 1999); Continental National Bank v. Brill, 636 So.2d 782 (Fla. 3rd DCA 1994); University Medical Center v. Ziegler, 625 So.2d 125 (Fla. 5th DCA 1993); Guadalupe v. Peterson, 779 So.2d 494 (Fla. 2nd DCA 2000); and Thompson v. Godson, 825 So.2d 941 (Fla. 1st DCA 2002) review denied 835 So.2d 266 (Fla. 2002). Failing to do so properly is messing with fire.
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worker2.jpgFlorida once treated its injured workers with dignity and respect. This is no longer the case. Current workers’ compensation laws treat injured workers as expendable commodities. Little regard is given to their health and well-being.

Rather than being a non-adversarial system for the provision of needed and deserved benefits, as it was originally designed to be when adopted in Florida nearly 80 years ago, Florida’s workers’ compensation system has become a gauntlet of detours and obstructions with little reward at the end for those few who somehow manage to find their way through.

Complicating matters greatly for injured workers is that their lawyers are prohibited from being compensated fairly for their services. This was a clever scheme formulated by former Governor Jeb Bush and his Republican colleagues in 2002 to keep injured workers from being represented adequately. Here’s proof in the pudding: In Jennifer Kaufman v. Community Inclusions, Inc./Guarantee Insurance Company, the claimant’s attorney successfully prosecuted claims against the employer/insurance carrier. For his services, which consumed 100.3 hours, he received a whopping court awarded a fee of $648.41, or $6.48 per hour. (The fee was awarded by Judge E. Douglas Spangler, Jr. To Judge Spangler’s credit, he wrote in his Final Compensation Order that the attorney deserved a fee in excess of $25,000, but that his hands were tied by the workers’ compensation attorney’s fee statute, 440.34. Judge Spangler also expressed dismay that the employer/carrier were allowed to pay their own defense attorney $14,720.) The First District Court of Appeal upheld the small award.

Here’s a sampling of other ways in which Florida’s workers’ compensation system has moved away from being for the people:

In 1990, amendments to Chapter 440, Florida’s body of workers’ compensation laws, reduced the duration of temporary monetary benefits from 350 weeks to 260 weeks. Temporary benefits are payable to injured workers during the recovery process prior to maximum medical improvement — (440.02(10). (In 1993, the legislature further reduced temporary benefits to a maximum of 104 weeks. However, in a recent 1st DCA decision, Westphal v. City of St. Petersburg/Risk Management & State of Florida, the 104 week limit was struck down and replaced by the 260 week limit.)

The 1990 amendments also cut dramatically the benefits available under the wage loss system. Consider the case of a person left with a 6% permanent impairment — this is the current rating for a single level spinal disc herniation. Pre-1990, the injured worker was eligible for 520 weeks of benefits. This person would have to perform weekly good faith job searches and prove a connection between his injury and wage loss to receive benefits. The 1990 changes reduced eligibility for a 6% impairment to 78 weeks. If this reduction were not drastic enough, in 2003 the wage loss system was eliminated altogether, replaced by one in which an injured worker left with a 6% permanent impairment would receive 12 weeks of impairment benefits. Period. So, in little more than 21 years, wage loss benefits have been reduced by 98%.

Before 1993, Chapter 440 contained explicit language calling for workers’ compensation laws to be liberally construed in favor of injured workers. When in doubt, rule in favor of the worker. This worker friendly mentality was adopted in 1935, when the Florida Legislature first enacted the “Workman’s Compensation Act.” The 1993 Legislature had no use for this attitude and cut it out of the statute.
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law books.jpgA statute of limitation is an enactment in a common law legal system which sets forth the maximum time after an event that legal proceedings based on that event may be initiated. Most people are familiar with the concept.

Less known, but equally potent as a time bar to bringing claims, is the statute of repose. It is sometimes called a non claim statute.

A products liability case is a legal action for injuries founded on the defective design, manufacture, distribution, or sale of personal property. Examples of the types of products sometimes found to be defective are tires, motor vehicles, drugs, and surgical hardware.

In Florida, defective products cases are subject to both a statute of limitation and a statute of repose.

A lawsuit for injuries caused by a defective product must be filed in Florida within four years of the event or within four years of when it is known or should have reasonably been known that the product is to blame. Florida Statute 95.11(3)(e). When death results from a defective product, Florida’s Wrongful Death Act imposes a two year time limit on bringing a claim.
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From time-to-time we publish in our blog letters and articles written by others on subjects of interest to us. Here are two excellent letters published in the March 1, 2013 issue of The Florida Bar News. Each addresses medical malpractice issues.
_____________________
Med Mal

This is a response to Robert William Patton’s defense-oriented letter on med mal experts. I have done complex medical malpractice cases for plaintiffs for the past 40 years and never filed a “frivolous med mal case.”

The sole cause of medical malpractice is bad doctors and health care providers. Nothing has ever been done to attack and remedy that root cause. Over 100,000 patients a year are killed by medical malpractice. It is so bad now that every patient should have a “patient advocate” with him/her when entering a hospital. The “Public Citizen Health Letter” has rated Florida one of the 10 worst states for pursuing disciplinary actions against physicians four times since 2001. The Florida Agency for Health Care Administration is a joke. The only thing that keeps healthcare providers accountable is med mal suits.

The defense bar and other conservative elements have put up every obstacle possible to prevent plaintiffs from filing these suits. The biggest obstacle is the presuit requirements, which are designed for doctors to investigate the case and, hopefully, settle them before suit is filed. After filing hundreds of medical malpractice cases, I have never had a plaintiff make a settlement offer during the presuit stage, before the complaint is filed. The defense always comes up with some “expert” to file an affidavit to refute the plaintiffs claims in pre-suit.
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people.jpgFlorida’s Wrongful Death Act, located in sections 768.16 through 768.26 of Florida’s statutes, controls legal actions arising from the loss of life on account of a tortfeasor’s negligence. The Act refers to those who may recover damages for the loss as “survivors.”

Survivors can be spouses, children and parents. The Act allows survivors to recover the decedent’s medical expenses and future lost earnings and accumulations, and to be compensated for their own mental anguish.

Needless to say, the loss of a parent or child causes substantial mental anguish. Inexplicably, Florida’s Legislature has carved out an exception for mental anguish damages caused by medical negligence. Specifically, the Act bars

  • compensating adult children for mental anguish caused by the death of a parent
  • compensating parents for mental anguish caused by the death of an adult child

Since section 768.18(2) of the Florida Statutes defines minor children as being children under 25 years of age, notwithstanding the age of majority, the Wrongful Death Act’s exceptions apply in the case of children 25 years of age and older.

These exceptions are arbitrary and capricious. Unfortunately, they have been upheld by the Florida Supreme Court. See Mizrahi v. North Miami Medical Center, Ltd., 761 So. 2d 1040 – Fla: Supreme Court 2000.

In addition to depriving survivors of their rightful due, these outrageous exceptions create a dangerous environment for many people who receive medical care in Florida. Strong and fair medical negligence laws demand accountability from providers and facilities. This promotes quality care. Weak laws allow the opposite. Making matters worse, the exceptions create a financial incentive for death as the prefered outcome following a serious malpractice event. Under Florida’s civil justice system, those who survive their medical malpractice injuries can be far costlier than those who do not. Because money has a way of making people do rotten things, this is a troubling scenario.
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people.jpgI discuss settlement with our workers’ compensation clients every day of the week. Even people we don’t represent call on a regular basis to pick my brain about settlement. Each case has its own unique set of variables. No blueprint is available to provide answers.

Some basic principles do apply in every Florida workers’ compensation case. It is important for them to be understood.

  1. Neither the employer/carrier (e/c) nor the injured worker/claimant can be forced to settle a Florida workers’ compensation case. If there is going to be a settlement, it must come by agreement of the parties.
  2. No judge or jury can order the e/c to pay a lump sum amount for future benefits. While workers’ compensation judges can order the e/c to provide some future benefits, the payout only comes as the benefit accrues. For example, the judge can make an e/c responsible for attendant care, but the e/c only pays as the service is provided. Lump sum verdicts are the remedy in civil cases, not in workers’ compensation cases.
  3. There are no juries in workers’ compensation cases, only workers’ compensation judges appointed by the Governor of the state. Juries render verdicts in civil cases.
  4. Injured workers never receive compensation for pain and suffering in Florida workers’ compensation cases. Compensation for pain and suffering is exclusive to civil liability cases. While an employer can sometimes be sued for civil damages, it is a rare exception. It is not uncommon, however, for a third party to be sued in civil court for causing the employee’s job-related accident. For example, our office is currently prosecuting a civil action for a woman who slipped in wet paint as she was leaving work. The case is against her employer’s landlord. We settled the workers’ compensation case against her employer (and its insurance company) six months ago.

Settlement value is based on exposure. How much a case is worth at any given moment in time depends on how much the case can reasonably be expected to cost e/c in the future if it does not settle. Since the e/c is not in the business of giving gifts to injured workers, it will never settle a case for more than what it projects as its long term exposure. In fact, the e/c won’t even settle for an amount equal to its projected exposure. If a deal is to be made, it will have to be for a fraction of e/c’s worst case scenario analysis. The main reason for this is because the e/c earns money on its money. Rather than pay the full amount today, the e/c is better off investing the money and paying it off over time. Another reason why less than full exposure is paid today is because workers’ compensation claims die with the claimant. The e/c’s obligation to pay benefits ends when the claimant dies. Whatever money e/c has in reserve to meet is future obligations becomes its money with the passing of the claimant.
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hospital.jpgIn every serious personal injury case in Florida, the issue of who will pay the medical providers and how much always arises. Needless to say, providers want to recover as much as they can. Patients, of course, want to pay as little as possible out-of-pocket. How this plays out often depends on who pays the bills.

The different pay sources include health insurance, PIP (motor vehicle insurance), workers’ compensation, the patient (self-pay), the tortfeasor (out-of-pocket), bodily injury liability coverage, UM/UIM (motor vehicle insurance), Medicare and Medicaid.

Various laws dictate who pays what and when. In some instances, the only available sources are Medicare or Medicaid (M/M) and bodily injury liability and/or UM/UIM. Since M/M provide some of the lowest reimbursement rates and providers accepting M/M payments are not allowed to balance bill their patients, in terms of raw numbers it is often to the victim’s advantage for M/M to pay the providers. While victims will ultimately have to reimburse M/M from their recovery in the personal injury case, the amount of the reimbursement is almost always less than what must be paid to the provider directly from the third party recovery (1st party if from UM/UIM).
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