To the surprise of many, most of the doctors who work in Florida’s hospital emergency rooms are not hospital employees. Instead, they are independent contractors. (It is quite rare for Florida hospitals to employ their ER physicians.) Equally surprising is that Florida law does not hold a hospital liable for a doctor’s negligence simply because the hospital grants privileges or credentials to the doctor, unless there was negligence in the credentialing. These matters become important when emergency room malpractice causes serious personal injuries and death.

With the reality of arbitrary statutory damage caps limiting the monetary exposure of medical negligence defendants, it is often necessary [for the victim or the victim’s family] to recover from multiple parties to be justly compensated for serious injuries or death. For such damages resulting from negligent emergency room services, the hospital would seem to be a natural target. Not so.

Today’s hospitals typically take the position that the doctors working in their emergency rooms are independent contractors, individuals for whom they have no legal liability when things go wrong. Strictly speaking, they may be right. Independent contracts are not employees, whose negligence subjects the employer to liability under the principle of respondeat superior (the Latin meaning is ‘let the master answer’).

Thankfully, Florida law does not accept the strict view of this consequential subject.

The main legal principles being used to hold hospitals accountable are:

  • Non-delegable duty
  • Actual agency
  • Apparent agency
  • Negligent credentialing

Non-delegable duty. This theory, which is not limited in its application to medical negligence cases, is most often utilized for activities involving the risk of serious injury or loss. In the context of emergency rooms, the risk is addressed by statutes and rules which set forth strict guidelines for modes of operation. Recent court decisions have relied on these rules and regulations to find that hospitals have a non-delegable duty to provide various non-negligent services in its emergency rooms.

Actual agency. The elements necessary to establish an actual agency relationship are: acknowledgment by the principal that the agent will act for him, the agent’s acceptance of the undertaking, and control by the principal over the actions of the agent.

Apparent agency.The main element of this principle is the impression through words and actions a hospital conveys to the public about its ER. Through advertising and appearance (e.g., uniforms; logos; paperwork; etc.), the general public can reasonably believe that an ER’s physicians are hospital employees. This is usually a fact question requiring a decision by the trier of fact, typically a jury.

Negligent credentialing. Involves granting privileges to an unqualified physician to practice medicine in the hospital. The mechanism for allowing a doctor to ply his trade in a hospital setting is supposed to be more than a rubber-stamp process. Thoughtful consideration based on rigorous standards should be followed.
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There is a distinct lack of unanimity throughout the country regarding the appropriate duty, if any, of a landowner for dangers presented by natural hazards on the landowner’s property. One camp applies the so-called “agrarian rule,” which provides that a landowner owes no duty to persons harmed by natural conditions on the land. The other camp applies the principle that a landowner may owe a duty of care for dangers posed by natural conditions when an invitee uses the property in a reasonable manner. (See this blog for the meaning of the legal term “invitee.”)

(Examples of such natural hazards include: tree roots obscured by leaves; view of sidewalk blocked by foliage; hole in ground covered by tall grass; traffic control device – e.g., stop sign, yield sign – obstructed by tree branches.)

Thankfully, Florida falls into the latter camp.
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Florida insurance adjusters often argue that vehicles sustaining damage costing in excess of 80% of fair market value (or replacement cost) to repair, must be declared a total loss. The argument is made with such conviction that most people, including many attorneys, believe it is true. It is not true. It is an urban myth.

The truth is that insurance companies must pay for repairs costing up to 100% of fair market value. (Florida Statute 319.30(3)(a)2.)

For many owners, repairing makes more sense than replacing. This is especially true for owners who owe little or no money on their vehicle.

Replacement usually requires owners to lay out more money than they receive as fair market value from the insurance companies. The main reason why is because insurance companies use databases that understate fair market value. Thus, the carriers try to pay less than the actual replacement cost.
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Surprisingly, most of the clothing sold and manufactured in the United States today is regulated by a law enacted in 1953, the Flammable Fabrics Act. The law was enacted to remove only the most flammable garments, leaving unregulated countless other dangerous fabrics. As a result, every year thousands of people are injured and nearly two hundred die due to clothing-related burns. The Act provides minimal protection and is sorely outdated. More can and should be done.

An example of what can be done is the Children’s Sleepwear Standards Act, enacted by Congress in the 1970s. The goal of this Act was to protect children up to the age of 12 years from the unreasonable risk of burns caused by burning sleapwear. It has worked. The standards have resulted in a drastic reduction in clothing-related burn injuries and death to children.

Adults should not be mislead by labeling announcing the burn resistance or safety characteristics of their clothing. Language such as “Class one normal flammability” or “does not ignite,” terms commonly used in the industry, do not necessarily mean that a fabric will not ignite under real world conditions. Consider this: ordinary newsprint passes the standard of “Normal flammability.”
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“Umbrella” insurance is a relatively inexpensive way to obtain significant increases in important insurance policy coverage limits.

Consumers are familiar with motor vehicle and homeowners insurance policies. They are separate policies covering separate and distinct risks. Each has its own policy limits and premium charge.

Umbrella insurance is a distinct coverage that is purchased as a stand alone package to supplement other, separate policies, such as the the motor vehicle and homeowners examples mentioned above.

Example: A motor vehicle policy may provide bodily injury coverage of $10,000 or even $100,000. Separately, the homeowners policy (similar renters insurance is also available) may provide the same coverage limit.

Bodily injury coverage pays for personal injuries and death caused by the insured’s negligence. Although $100,000 in coverage is enough in most cases, in some cases it is not nearly enough. Some serious injuries command $1,000,000 and more in damages, while wrongful death damages can reach into the multiple millions. In these cases, the protection afforded by the primary policy is insufficient. This is where umbrella coverage comes into play.
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The remedies available under Florida’s workers’ compensation system and its personal injury laws are significantly different in many ways. The most important difference may be that workers’ compensation does not compensate for pain and suffering (non-economic damages). For this reason, many people wish to pursue their remedy under the personal injury system.

Easier said than done….

The workers’ compensation system is essentially a no-fault system. Once eligibility is established, the benefits are supposed to begin. Establishing eligibility is usually as simple as showing that the accident occurred in the course and scope of employment. Fault is rarely an issue.

It is because of this important element that injured workers have lost the right to be compensated for pain and suffering. This element also accounts for the employer having almost absolute immunity from lawsuits seeking damages under the personal injury system.

The language granting the immunity is contained in Florida Statute 440.11(1). The exceptions [to the immunity] are contained in Sections 440.11(1)(a) & (b).

Exception (1)(a) applies to employers who have failed to secure workers’ compensation insurance or its statutory equivalent. This employer can be sued for workers’ compensation benefits or personal injury damages under traditional theories of negligence. The successful negligence litigant may be awarded compensation for pain and suffering. (Most employers are properly covered. Unfortunately, the ones who are not, commonly do not have enough money to provide workers’ compensation benefits or pay personal injury damages.)
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Personal Injury Protection (PIP) (also known as No-Fault Insurance) is one of the few coverages in Florida that is mandatory in most motor vehicle insurance policies. (See this blog about “Full Coverage.”) Its primary function is to pay the medical expenses and lost wages of those individuals injured in motor vehicle accidents. (Which individuals are covered is another subject and beyond the scope of this blog.) However, unbeknownst to many lawyers and lay people alike, the PIP statute also provides for the payment of “Death Benefits.” (See Florida Statute Section 627.736(1)(c) (2008).)

The maximum dollar amount of coverage available under PIP is $10,000. Of this $10,000, only $5,000 is available for death benefits under Section 627.736(1)(c).
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The anterior cruciate ligament (ACL) is one of the most frequently injured ligaments in the human body. The typical mechanism of the injury is a non-contact twisting movement, usually due to abrupt deceleration and change of direction. Side-stepping (cutting), pivoting and landing from a jump are examples of events that may cause an ACL tear.

ACL tears can be partial or complete. A complete tear of the ACL has minimal ability to heal and often requires surgical reconstruction, as most patients suffer from functional problems, like giving way and instability, and significant pain. To a lesser extent, partial tears also produce pain and instability. There is serious debate within the medical and workers’ compensation communities about the need for surgical intervention for partial tears.

ACL reconstruction involves replacing the torn ligament, usually with the middle third patellar tendon or hamstring tendon graft. Although most people benefit from ACL reconstruction in functional terms, approximately 10% of patients require a second operation, mainly because of the loss of motion, further meniscal injury and graft failure. ACL reconstructions are not very successful in the long-run in people with chronic meniscal and chondral deficiency.

As ACL injuries typically occur in the context of physical activity, it is a common injury among manual laborers, individuals whose job duties include signficant amounts of climbing, lifting, squatting, and carrying.

Due to instability and pain associated with complete tears, manual laborers with any hope of returning to the work force will almost always require surgery and comprehensive post-surgical rehabilitation. Even then, a successful return to long-term gainful employment is not assured. Repetitive trauma associated with hours of manual labor on a daily basis can lead to pain and hasten the need for additional surgery.
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Disabled commercial vehicles are hazardous to motorists.

Rightfully, much blame for traffic accidents is placed on trailing/approaching vehicle drivers. However, commercials vehicles disabled in lanes of traffic often contribute to serious and fatal accidents through little to no fault of approaching drivers. Surprisingly, many of these accidents occur in broad daylight on straight roadways. (More obvious contributing factors include nightime and foggy conditions, and curves in the road.)

The U.S. Department of Transportation Federal Motor Carrier Safety Administration has created rules and regulations designed to reduce the danger. For commercial vehicles (buses and trucks that have a gross vehicle weight rating (GVWR) greater than 10,000 pounds. U.S. DOT Rule 571.125 S3) stopped upon the traveled portion of the highway for any cause other than a necessary traffic stop, Rule 392.22 requires the following:

  • The driver shall immediately activate the vehicular hazard warning signal flashers and contiune the flashing until the driver places the warning devices required by other parts of 392.22. (Hazard warning signals are [L]amps that flash simultaneously to the front and rear, on both the right and left sides of a commercial motor vehicle, to indicate to an approaching driver the presence of a vehicular hazard.” Rule 393.5. The hazard warning signals “shall operate independently of the ignition or equivalent switch….” Rule 393.19.)
  • The driver shall, as soon as possible, but in any event within 10 minutes, place the following warning devices beside and behind the vehicle in the manner outlined in Rule 392.22(b)(1)(i-iii), (b((2), (b)(2)(iv), and (b)(2)(v): Three bidirectional emergency reflective triangles or at least 6 fusees or 3 liquid-burning flares. See Rule 393.95. (In Section 571.125 S2, the U.S. Department of Transportation advises that the purpose of these standardized warning devices “is to reduce deaths and injuries due to rear end collisions between moving traffic and disabled vehicles.)

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Anyone who lives in South Florida knows that the population of road bikers has exploded in recent years. With Lance Armstrong’s exploits and the availability of relatively inexpensive high performance bicycles, it is not uncommon, especially on weekend mornings, to see a countless number of road bikers of all shapes and sizes challenging themselves in their spandex shorts and colorful helmets on the streets and highways.

Even without having to contend with cars and trucks, road biking is a dangerous activity. Potholes, debris, and other bicycles can send a rider to the unforgiving cement in the blink of an eye. Eyes on the road and hands on the handlebars is Rule #1.

South Florida has experienced a rash of highly publicized serious and sometimes fatal motor vehicle vs. bicycle accidents in recent years. With the volume of traffic, motor vehicles and bicycles, on the roadways, one can safely assume that the frequency of such accidents far exceeds the publicized accounts.

This blog will address the points of Florida law dealing with the rights and obligations of road bikers on our roads.

The primary Florida Statute dealing with these issues is 316.2065. Section 316.2065 addresses everything from helmet requirements to carrying children, much of which is beyond the scope of this blog, making it important reading for all bike enthusiasts.

Section (1) of 316.2065 contains the sweeping pronouncement that bicyclists and motor vehicle operators have the same rights and duties. One might conclude this means that bicycle riders can take up entire lanes of traffic without regard to the conditions. This conclusion would be far from correct.

Further in Section (1) is language that qualifies the broad pronouncement, while Section (5)(a) provides the simple details of the limitations. (5)(a) instructs that bicycle riders who are unable to to travel at the normal speed under the conditions at the time “shall” ride as close as practicable to the right-hand curb or edge of the roadway. As the typical lone rider travels at an average of 14-18 mph, and a pack (or pelaton) of strong riders around 5 mph faster than that, most road bikers will always be traveling slower than the speed limit. This means that most of the time, most riders should be riding at the edge of the roadway.

There are exceptions to this rule, also contained within Section (5)(a). Under the following circumstances, riders may leave the right-hand curb of the roadway:

  • When overtaking another bicycle or vehicle proceeding in the same direction
  • when preparing to make a left turn (see, also, 316.151(c))
  • To avoid any condition, such as parked cars, debris in the roadway, and a pedestrian.

Also included as an exception within section (5)(a) is one relating to roads of “substandard-width,” meaning roads not wide enough to safely accomodate a bicycle and a vehicle traveling side by side. For bikers, motorists, law enforcement officers, and the courts, this provision may be the most controversial within Florida Statute 316.2065.

What is a road of “substandard-width?” Arguably, the answer is any road that is less than 14 feet wide.

The Florida Department of Transportation’s Manual of Uniform Minimum Standards recommends an outside lane width of 14 feet as the “minimum width that will allow passenger cars to safely pass bicyclists within a single lane,” i.e., without the need for passing motorists to use part of the next lane. A typical passenger vehicle is from 5.5 feet (car) to 7 feet (SUV) wide. This means that you need at least 8 feet of lane width for a car. (That’s the narrowest parking lane width allowed).

Florida Statute 316.083 states that motorists must pass bicycles at least 3 feet away. Add another 3 feet for the width of a bicycle and its rider, and 14 feet (8 + 3 + 3) is the narrowist width a road should be for bicyclists and automobiles to safely travel side by side. (This minimum does not account for commercial vehicles and utility trailers which are 8.5 ft wide and can have mirrors extending to 10 feet. Those vehicles MUST use part of another lane to pass safely.)
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