# Does this bother you as much as it does me? (John Edwards) **URL:** \ **Category:** The BBQ Pit\ **Created:** [July 7, 2004, 8:30pm UTC](https://boards.straightdope.com/t/does-this-bother-you-as-much-as-it-does-me-john-edwards/254001 "2004-07-07T20:30:27Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![Marley23](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Marley23](https://boards.straightdope.com/u/Marley23)\ **Post date:** [July 8, 2004, 6:00am UTC](https://boards.straightdope.com/t/does-this-bother-you-as-much-as-it-does-me-john-edwards/254001/41 "2004-07-08T06:00:21Z")
> [@Lamar Mundane](#): > > _The annual number of settlements greater than $1 million for medical liability cases has more than tripled between 1993 and 2002 from 6 to 19. (N.C. Lawyer’s Weekly)_ Of course, Edwards was in the Senate for about half of that period. The point I see here is not that there are no sleazy ambulance-chasers out there, it’s that your generalized reaction to bad lawyers is not necessary John Edwards _wasn’t one of them_. From what I’ve seen here, he has not made a career out of victimizing doctors and earning big paydays with junk science, and he has represented at least a few legitimate victims with real grievances. ---
**Author:** ![pepperlandgirl](https://avatars.discourse-cdn.com/v4/letter/p/f17d59/32.png) [@pepperlandgirl](https://boards.straightdope.com/u/pepperlandgirl)\ **Post date:** [July 8, 2004, 6:26am UTC](https://boards.straightdope.com/t/does-this-bother-you-as-much-as-it-does-me-john-edwards/254001/42 "2004-07-08T06:26:21Z")
> [@Lamar Mundane](#): > > Reread what I said. I did not say anything misleading, at all, and I have voted Democratic in every race for national office since I was old enough to vote. You can look at a thread from yesterday morning where I celebrated Edwards’ selection. That was before I found out about his history. I’m still going to vote for him. > > I am one of that odd breed that you don’t see around much, a conservative Democrat. I believe in a strong social safety net and equal opportunity for all. Other than that, I’m pretty conservative, especially fiscally. I don’t hold ambulance chasers in high regard, I don’t see them as adding much value to the economy, just siphoning off large ammounts of dollars from it, like a lot of people on Wall Street. I am in favor of tort reform. It bothers me greatly that doctors are dropping their OB pactices because they can’t pay the premiums. North Carolina is one of the states that are in crisis because doctors are leaving. > > If you really believe that lawyers like this are fighting the good fight, rather than looking for deep pockets to go after, then fine. You may be right. I don’t think so. > > Try googling “c section cerebral palsy” and see how many links are to research versus to law firms. > > Oh, I almost forgot. > > Poopydrawers. **Lamar** , I don’t have a dog in this fight because I simply do not know enough about these sort of cases or plaintiff attorneys in general to form an opinion yet. I see **minty green** , **Shayna** , **Squink** and others all countering your arguments and cites with good arguments and reputable cites of their own. So far, to me, it looks like your loony. For my own education, can you please respond to the points brought up? For example, if one of the merits of the case in question _is_ “preventable oxygen deprivation brain damage suffered during delivery” and Edwards handpicked the clients that suffered because of this, and the percentage of clients were well below the percentage of children who actually were harmed by doctors, what is your response? How do _you_ dismiss that case and why should I believe you? > [@](#): > > It it doesn’t bother you guys, thats fine, but suing doctors because a kid is born damaged is not a praiseworthy way to make a living, IMO. Well, this intriques me. I don’t know anything about Cerebral Palsy, so I did a bit of research to see what people think the causes are. I searched Ebscohost and LexisNexis, so I can’t provide links, though I can tell you where I found the info. > [@](#): > > A realistic estimate may be that around 10% of cases of cerebral palsy stem from adverse intrapartum events.(n2) The consensus statement published in this issue underlines this new insight into the origin of cerebral palsy. It points to events before labour or the newborn period as the main cause of cerebral palsy. This message is important because of the common opinion among the public, and also among some physicians, that cerebral palsy stems from intrapartum events. **ONLY A MINOR PART OF CEREBRAL PALSY CASES BEGIN IN LABOUR** BMJ: British Medical Journal, 10/16/99, Vol. 319 Issue 7216, p1016, 2p So it’s a rare event, but it _does happen_. Does that mean that the families of thie children who suffer from cerebral palsy because of “adverse intrapartum events” should just suck it up? They should receive no compensation for future medical procedures and a life-time of disabilities? > [@](#): > > Intrapartum hypoxia complicates about 1% of labours and results in death in about 0.5 in 1000 pregnancies and cerebral palsy in 1 in 1000 pregnancies. [1] When it is diagnosed clinically as “fetal distress” swift delivery is the aim, and the standard has become delivery within 30 minutes of diagnosing fetal distress. As two papers in this week’s BMJ illustrate, however, this standard is hard to achieve. Is it actually necessary? > \snip\ > Thus a decision to delivery interval of 30 minutes is a useful audit standard, though it is difficult to achieve in practice. There is no evidence, however, that 30 minutes is a critical threshold in intrapartum hypoxia. For most cases delivery after 30 minutes is not associated with adverse fetal outcome, yet for a few cases delivery has to be achieved much faster to avoid disability or death. In practice emergency caesarean section for fetal distress should be undertaken as quickly as possible and ideally within 30 minutes [11] but we shouldn’t consider it poor care if it takes a few minutes longer. > **CAESAREAN SECTION FOR FETAL DISTRESS** Source: BMJ: British Medical Journal, 06/02/2001, Vol. 322 Issue 7298, p1316, 2p > Author(s): James, David What if the doctors in question didn’t deliver the fetus until 45 minutes? 35 minutes? What if they were the rare cases where it had to happen under 30? I don’t know. None of the links give any details of the case, and I’m not a doctor. Still, it seems to me there is some room for error. > [@](#): > > Box 2-Criteria to define an acute intrapartum hypoxic event > > 1. Evidence of a metabolic acidosis in inwaparmm fetal, umbilical arterial cord, or very early neonatal blood samples (pH \< 7.00 and base deficit \>/= 12 mmol/1) > 2. Early onset of severe or moderate neonatal encephalopathy in infants of \>/= 34 weeks’ gestation > 3. Cerebral palsy of the spastic quadriplegic or dyskinetic type > > Criteria that together suggest an intrapartum timing but by themselves are non-specific > > ``` > * 4 A sentinel (signal) hypoxic event occurring immediately before or during labour > * 5 A sudden, rapid, and sustained deterioration of the fetal heart rate pattern usually after the hypoxic sentinel event where the pattern was previously normal > * 6 Apgar scores of 0-6 for longer than 5 minutes > * 7 Early evidence of multisystem involvement > * 8 Early imaging evidence of acute cerebral abnormality > > ``` > > Source: BMJ: British Medical Journal, 10/16/99, Vol. 319 Issue 7216, p1054, 6p > Author(s): MacLennan, Alastair If he was able to prove all 8 of those points in the trial using expert witnesses, would that be ok? Would you get off his back then? Or would he still be reprehensible? Is it still junk science if actual scientists establish the criteria? > [@](#): > > Current available data indicate that perinatal hypoxic-ischemic brain injury accounts for approximately 10% to 20% of all cases of CP.[3-6] The most distinctive and often discussed immediate sequelae in newborns is intrapartum asphyxia. The magnitude of the changes in the blood gas measurements obtained from the cord umbilical artery that warrants the term birth asphyxia remains unclear. Precision in the use of the changes in the blood gas parameters with regard to birth injury would necessitate knowledge about fetal CBF and cerebral metabolism. Although interference in placental gas exchange is fairly common, residual neurologic sequelae is infrequent and is more likely to occur when the asphyxial event is severe. Thus, a major priority in perinatal medicine is the early and accurate identification of the asphyxiated term infant at greatest risk for subsequent cerebral injury. This is a highly relevant clinical issue because newer therapies aimed at reducing subsequent hypoxic-ischemic cerebral injury and long-term neurologic deficits from asphyxia are being investigated.[2,16] These exciting therapies, which may shortly be available in clinical trials in the asphyxiated term infant, carry with them a large risk for side effects. > > Currently, specific measures to identify the term infant at risk for asphyxia and subsequent hypoxic-ischemic cerebral injury are taken during labor, in the delivery room, and in the initial neonatal period. Some of these measures and the correlation with neurologic outcome are briefly reviewed next. > **Source: Pediatrics, Jun97, Vol. 99 Issue 6, p851, 9p, 3 charts > Author(s): Perlman, Jeffrey M.** So if doctors know that there can be a possible problem, and if they don’t take the proper measurements for whatever reason, should the affected families just what? Ignore it? Shrug it off? In fact, even articles entitled **Birth asphyxia not usual cause of cerebral palsy Bob Babinski. Medical Post. Toronto: May 25, 2004. Vol. 40, Iss. 21; pg. 19, 1 pgs**state > [@](#): > > In fact, one study that was drawn on heavily in the task force report found that 69% of cases of neonatal encephalopathy and cerebral palsy were linked to antepartum risk factors alone, 4% were linked to intrapartum hypoxia and 25% were linked to a combination of antepartum risk factors and intrapartum hypoxia, with the rest of cases having unknown causes > \Snip\ > Criteria for definition > > The task force document outlines criteria for the precise definition of an acute intrapartum event sufficient to cause cerebral palsy, and focuses on how to pinpoint the timing of a brain injury-the central question in determining the cause. > > The criteria are: > > - evidence of metabolic acidosis in fetal umbilical cord arterial blood obtained at delivery (pH less than seven and a base deficit of 12 mmol/L); > > - early onset of severe or moderate neonatal encephalopathy in infants born at 34 or more weeks’ gestation; > > - cerebral palsy of the spastic quadriplegic or dyskinetic type; > > - exclusion of other identifiable etiologies, such as trauma, coagulation disorders, infectious conditions or genetic disorders. > [@](#): > > The National Center for Health Statistics reported that in 1997 frontline clinicians-obstetricians, family practice physicians, residents, fellows, midwives, and nurses-used electronic fetal monitoring (EFM) to assess the fetus in about 3.2 million pregnant women,1 an increase from 68 percent of pregnant women in 1989 to 83 percent in 1997. That is a staggering rate for frontline clinicians to use a tool that some critics claim is potentially harmful and lacks any real benefit.2 > > The goal of EFM is to detect fetal hypoxia at its earliest stage and attempt to prevent asphyxia resulting from prolonged and severe hypoxia.3 > > One of the reasons EFM does not prevent more cases of cerebral palsy is that clinicians continue to make too many mistakes when they interpret electronic-fetal-monitoring patterns. Too often, they fail to respond to warning signs of hypoxia and ischemia, worsening hypoxia with developing acidosis, and fetal asphyxia," thereby missing a window of opportunity to prevent conditions that can lead to brain damage and cerebral palsy.5 Many of their mistakes result from inexperience, inadequate training, reliance on biased literature, inadequate hospital protocols, ambiguous professional guidelines, and reluctance to communicate and exchange views with other members of the health care team. > > **Fetal monitoring mistakes and their catastrophic consequences > Dov Apfel. Trial. Washington: Aug 2003. Vol. 39, Iss. 8; pg. 54** So…where’s the junk science? Am I just misinterpretting all the articles and journals? It’s possible. I’m an English major, not a med student. ---
**Author:** ![cmason32](https://avatars.discourse-cdn.com/v4/letter/c/51bf81/32.png) [@cmason32](https://boards.straightdope.com/u/cmason32)\ **Post date:** [July 8, 2004, 6:33am UTC](https://boards.straightdope.com/t/does-this-bother-you-as-much-as-it-does-me-john-edwards/254001/43 "2004-07-08T06:33:13Z")
I never understand why the AMA goes after the victims of doctors’ negligence rather than the insurance companies. Insurance companies are raking in record profits, but somehow the rates are the fault of the little boy born with some deformity because of a gross error by the doctor. There are also other reasons the insurance companies have recently risen: > [@](#): > > In the early 1980s, when interest rates were very high, the industry set insurance rates below the expected level of losses to attract more business. Premium $$ could be immediately invested; claims would be paid years later. Investment earnings more than offset underwriting losses. When interest rates declined, insurers lost money, but the plaintiffs’ bar said that was the natural consequence of the insurance market’s relation to interest rates. On this view of the facts, big premium increases were also the result of declining interest rates. Insureds got an unusually large return from their insurers’ investment income when interest rates were high; now that interest rates are low, their premiums have to cover nearly the full value of their expected claims. further: > [@](#): > > The annual number of settlements greater than $1 million for medical liability cases has more than tripled between 1993 and 2002 from 6 to 19. (N.C. Lawyer’s Weekly) Whenever I see statistics like this I am always suspicious. How many awards over $1 million were there in 1992? If the answer was 15 then the “tripled” is certainly presenting of statistics in a deceptive manner to make a point. What if in 2001 there were only 5 awards over $1 million. Rather than picking two years out of a hat, I’d rather see the numbers over a period of years. Finally, the _Medical Liability Monitor_ did a study that found that premiums did not decline in states that had caps on awards. That’s probably because a DOJ study found that _only 4% of successful medical malpractice lawsuits returned punitive damage awards_. ---
**Author:** ![Typo\_Negative](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/typo_negative/32/484_2.png) [@Typo\_Negative](https://boards.straightdope.com/u/Typo_Negative)\ **Post date:** [July 8, 2004, 6:38am UTC](https://boards.straightdope.com/t/does-this-bother-you-as-much-as-it-does-me-john-edwards/254001/44 "2004-07-08T06:38:56Z")
> [@cmason32](#): > > Finally, the _Medical Liability Monitor_ did a study that found that premiums did not decline in states that had caps on awards. That’s probably because a DOJ study found that _only 4% of successful medical malpractice lawsuits returned punitive damage awards_. Can you give us a link to that? 'Cause\* that \* sounds very important indeed. ---
**Author:** ![cmason32](https://avatars.discourse-cdn.com/v4/letter/c/51bf81/32.png) [@cmason32](https://boards.straightdope.com/u/cmason32)\ **Post date:** [July 8, 2004, 7:26am UTC](https://boards.straightdope.com/t/does-this-bother-you-as-much-as-it-does-me-john-edwards/254001/45 "2004-07-08T07:26:11Z")
> [@spooje](#): > > Can you give us a link to that? 'Cause\* that \* sounds very important indeed. I don’t have any internet links because I got the information from materials for my Remedies class. The first sentence is from a NY Times article on Feb 2, 2003 entitled “Walkout by New Jersey Doctors Illuminates a Battle Between Specialists and Insurers.” The second sentence is from a study entitled, “Civil Justice Survey of State Courts, 1992” by the U.S. Justice Department and the National Center for State Courts. (Actually, google found [this](http://webapp.icpsr.umich.edu/cocoon/ICPSR-STUDY/06587.xml), but I’ll let others sort through that.) Another google search brought this up - a similar study done in 2001. [http://www.ojp.usdoj.gov/bjs/civil.htm](http://www.ojp.usdoj.gov/bjs/civil.htm) > [@](#): > > During January and December 2001, juries decided 74% (8,859) of the nearly 12,000 civil trial cases disposed of by State courts of general jurisdiction in the Nation’s 75 most populous counties. > > – Tort cases (93%) were more likely than contract cases (43%) or real property cases (27%) to be decided by jury trial. > – In 53% of jury trial cases, the jury found in favor of the plaintiff and awarded in the 12 month period an estimated $3.9 billion in compensatory and punitive damages. > – The median total award for a plaintiff winner was $37,000. > – Juries awarded punitive damage in **6%** of civil cases with a plaintiff winner. > – The median punitive damage award to plaintiff winners was $50,000. > During 2001, judges decided 24% (2,828) of the nearly 12,000 civil trial cases disposed of by State courts of general jurisdiction in the Nation’s 75 most populous counties. > > – The majority of contract cases (56%) and real property cases (69%) were disposed by bench trial. > – Plaintiffs won in 65% of bench trials and received an estimated $369 million in compensatory and punitive damages. > – The median total award for a plaintiff winner was $28,000. > – Judges awarded punitive damages in **4%** of civil cases with a plaintiff winner. > – The median punitive damage award to plaintiff winners in bench trials was $46,000. The above study includes torts, real property, and contract suits. ---
**Author:** ![Earthworm\_Jim](https://avatars.discourse-cdn.com/v4/letter/e/f07891/32.png) [@Earthworm\_Jim](https://boards.straightdope.com/u/Earthworm_Jim)\ **Post date:** [July 8, 2004, 11:39am UTC](https://boards.straightdope.com/t/does-this-bother-you-as-much-as-it-does-me-john-edwards/254001/46 "2004-07-08T11:39:58Z")
> [@spooje](#): > > It is if the doctors fucked up. If your kid was damaged by the malpractice of a bad doctor and needed care for the rest of his/her life, would _you_ want to sue? And wouldn’t you want someone like Edwards on _your_ side? If it happened to one of my kids? I don’t know. But I do know that I have no desire to file a suit that’s going to line some one elses pockets. Yeah, maybe my kid does need expensive care for the rest of his life - but my lawyer doesn’t. But if my kid needs it - I’m probably going to bite the bullet and pay up. [In Florida](http://www.floridamalpractice.com/med4.htm), you’re looking at paying the lawyer huge, huge sums of money: > [@](#): > > The Florida Supreme Court and the Florida Bar have adopted a maximum fee schedule that attorneys are permitted to charge in contingency fee cases. Generally speaking, contingency fees may not exceed 40% of the first $1 million, 30% of the amounts recovered between $1 million and $2 million, and 20% of all amounts over $2 million. If an appeal is filed the fee may rise 5% more. There are other limitations, exceptions, and special circumstances where this may vary. The Florida Bar has also adopted a Statement of Client’s Rights, which must be followed by any attorney handling a case on a contingency fee. The primary Florida Bar Rule on contingent fees is Rule 4-1.5, Florida Rules of Professional Conduct. So a $1M or $2M suit nets $400,000 for the attorney?? In what way is this justified?? (If our resident legal experts care to comment, I’m interested.) I’m all for making a living, but in other industries this type of payout is regarded as extortion. A company which loans you money at 40% interest is a loan-shark. [These guys](http://www.housingrights.com/ahap/section8.htm) feel that 40% of your income is too high to consider “affordable” for housing. But a lawyer is right to charge you 40% of 1 MILLION dollars for a single suit? That’s OK?? A: Medicine is imperfect. B: People, some of whom are doctors, are imperfect. Mistakes will be made. Sometimes, deadly mistakes will be made. Suing because “the doctors fucked up” is not a praiseworthy way to make a living. Especially considering the amount of money you’re charging the person who may genuinely be in need of coverage due to malpractice. I have to sue for half-again as much as I needed just to pay for the attorney. These payouts keep the ‘malpractice suit industry’ lucrative, and drive up the cost of healthcare by driving up the cost of malpractice insurance. Surely you realize it isn’t just the practitioners who are paying for this insurance - they’re passing the cost along to the consumer. You don’t think the high cost of health care in this country is solely the results of doctors greed, do you? Note that I’m not saying all malpractice suits or bad, nor that Edwards is a bad guy himself. I’m saying that I see a fundamental conflict of interest in getting rich by filing malpractice suits on behalf of those in need. ---
**Author:** ![Typo\_Negative](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/typo_negative/32/484_2.png) [@Typo\_Negative](https://boards.straightdope.com/u/Typo_Negative)\ **Post date:** [July 8, 2004, 12:06pm UTC](https://boards.straightdope.com/t/does-this-bother-you-as-much-as-it-does-me-john-edwards/254001/47 "2004-07-08T12:06:33Z")
> [@Beelzebubba](#): > > So a $1M or $2M suit nets $400,000 for the attorney?? In what way is this justified?? (If our resident legal experts care to comment, I’m interested.) I’m all for making a living, but in other industries this type of payout is regarded as extortion. He only gets paid if he wins. He get bupkas if he loses. The defense lawyer gets paid either way. And nobody wins every time. Maybe one winner could pay for the 2 losers he had previously? ---
**Author:** ![Earthworm\_Jim](https://avatars.discourse-cdn.com/v4/letter/e/f07891/32.png) [@Earthworm\_Jim](https://boards.straightdope.com/u/Earthworm_Jim)\ **Post date:** [July 8, 2004, 12:13pm UTC](https://boards.straightdope.com/t/does-this-bother-you-as-much-as-it-does-me-john-edwards/254001/48 "2004-07-08T12:13:11Z")
> [@spooje](#): > > He only gets paid if he wins. He get bupkas if he loses. The defense lawyer gets paid either way. And nobody wins every time. Maybe one winner could pay for the 2 losers he had previously? This is supposed to answer the question you quoted? 40% is justified because he only gets paid if he wins? Do elaborate… ---
**Author:** ![Typo\_Negative](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/typo_negative/32/484_2.png) [@Typo\_Negative](https://boards.straightdope.com/u/Typo_Negative)\ **Post date:** [July 8, 2004, 12:22pm UTC](https://boards.straightdope.com/t/does-this-bother-you-as-much-as-it-does-me-john-edwards/254001/49 "2004-07-08T12:22:57Z")
Did you also read **cmason32** ’s post? The one where he cites that punaitive damages are only awarded in 4 to 6 percent of cases. Punative damages are punishment. You don’t punish good faith mistakes, you punish negligence and wrongdoing. And as **cmason32** has already pointed out, it’s not nearly as common as widely believed. Perhaps one of the lawyers can answer a question. If a lawyer loses a contingency case, can he bill for expenses such as investigators and what not? And if he wins, do those charges come out of his end of the award? ---
**Author:** ![Frank](https://avatars.discourse-cdn.com/v4/letter/f/3d9bf3/32.png) [@Frank](https://boards.straightdope.com/u/Frank)\ **Post date:** [July 8, 2004, 12:49pm UTC](https://boards.straightdope.com/t/does-this-bother-you-as-much-as-it-does-me-john-edwards/254001/50 "2004-07-08T12:49:37Z")
> [@minty green](#): > > Given the context, I assume that by “corporate lawyer,” you mean a defense attorney who represents corporations in lawsuits. (For us lawyer types, “corporate law” means a bunch of boring crap about wannabe business majors who negotiate mergers and fill out government paperwork.) Yes, that’s what I meant. Thank you. ---
**Author:** ![EddyTeddyFreddy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/eddyteddyfreddy/32/18796_2.png) [@EddyTeddyFreddy](https://boards.straightdope.com/u/EddyTeddyFreddy)\ **Post date:** [July 8, 2004, 12:59pm UTC](https://boards.straightdope.com/t/does-this-bother-you-as-much-as-it-does-me-john-edwards/254001/51 "2004-07-08T12:59:15Z")
What’s it cost to take a case to trial? Short answer: Hundres of thousands of dollars, that’s what. I’ve typed out long, thoughtful answers twice, and my computer ate them. I gotta run, so will just note that between litigation support, expert witness fees, deposition expenses, and other good stuff like that, it’s the rare case that doesn’t cost several hundred thousand dollars to take through a jury verdict. With no recovery if the plaintiff loses. I’ll leave it to the real lawyers here to provide the details, if they wish. ---
**Author:** ![Left\_Hand\_of\_Dorkness](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/left_hand_of_dorkness/32/7156_2.png) [@Left\_Hand\_of\_Dorkness](https://boards.straightdope.com/u/Left_Hand_of_Dorkness)\ **Post date:** [July 8, 2004, 1:05pm UTC](https://boards.straightdope.com/t/does-this-bother-you-as-much-as-it-does-me-john-edwards/254001/52 "2004-07-08T13:05:48Z")
> [@Beelzebubba](#): > > This is supposed to answer the question you quoted? 40% is justified because he only gets paid if he wins? Do elaborate… Often a trial lawyer receives nothing: they do hundreds of hours of work for no remuneration at all. In other professions, this would be considered a violation of the minimum wage act; why do we let clients get away with this? You’re comparing apples to oranges. Daniel ---
**Author:** ![Earthworm\_Jim](https://avatars.discourse-cdn.com/v4/letter/e/f07891/32.png) [@Earthworm\_Jim](https://boards.straightdope.com/u/Earthworm_Jim)\ **Post date:** [July 8, 2004, 1:07pm UTC](https://boards.straightdope.com/t/does-this-bother-you-as-much-as-it-does-me-john-edwards/254001/53 "2004-07-08T13:07:48Z")
If you’re punishing negligence and wrong-doing, I would expect punitive damages to be awared in almost **ALL** cases, as negligence and wrongdoing are the core of genuine malpractice cases - are they not? Regardless, I’ll be the first to admit that I don’t know much about the civil court system. But all of the information I’ve looked at so far reviews expected attorneys fees based on “recovery”, not on “damages”. Are the two synonymous? If not, this seems to indicate a line item on the bill to the insurance company, regarless of punitive damages, will be **Attorneys Fees: $400,000**. Especially in light of [this cite](http://www.uoworks.com/crisis.html), which paints more of a grim picture than **cmason32**. > [@](#): > > Between 1986 and 1996 there was nearly a 100% increase in mean awards from $1,216,195 to $2,293,064 (Current Award Trends in Personal Injury, 1997 edition. Jury Verdict Research Series) > The average paid claim has risen almost three times as fast as the level of inflation over the last 10 years (source: Statement by the Physician Insurers Association of America, January 29, 2003). > The percentage of claims paid at $1 million or greater doubled from 1997 to 2001. (source: same as previous) > The size of median medical malpractice jury awards rose to $1 million in 2000, a 110.7 percent jump from $474,536 in 1996, according to Jury Verdict Research (source: Insurance Information Institute, January 2003). This means that HALF of all jury awards are over $1 million. > In California, two lawsuits threaten to undermine the Medical Injury Compensation Reform Act of 1975 (MICRA) that caps non-economic damages in medical malpractice lawsuits at $250,000. The two suits were both won by plaintiffs against Health Care Partners Medical Group (HPMG) and, in both cases, pain and suffering verdicts that far exceed the cap imposed by MICRA were awarded (source: same as previous). > One award in December 2002 against an OB/GYN in the Brooklyn was over $90 million – 1 of 3 medical malpractice verdicts over $80 million in 2002 (Lawyers Weekly USA, January 2003). > In 2002, there were 3 medical malpractice verdicts over $80 million (source: same as previous) > > In reaction to this: > > Malpractice insurers have been losing money > Despite high rate increases (16.8% from 1996 to 2001), losses and expenses have grown four times as fast (68.9%) (Source: A.M. Best’s) > With these terrible results, one can only expect the premium increases to continue. Interestingly enough, for full disclosure, [this article from Sep 2001](http://www.irmi.com/Expert/Articles/2001/Kolodkin09.aspx) indicates rising insurance costs were expected, as insurance had been priced too low all along: > [@](#): > > The chaos in the medical malpractice insurance marketplace has been created by a historically underpriced product. Premiums, along with investment income, have been inadequate to cover the claims costs and expenses insurance companies have incurred. > > Insurance 101: If premiums are too low or if losses are too high, then insurers lose money. The end result is premiums must increase, losses must decrease, or the insurer will eventually cease operating. Interesting stuff, to be sure. On preview, I see **EddyTeddyFreddy** has posted: > [@](#): > > What’s it cost to take a case to trial? Short answer: Hundres of thousands of dollars, that’s what. Really? Can some one provide a cite for the breakdown of court costs? What is the cost to the plaintiffs attorney? And, a common statement has been “The defense attorney always gets paid.” - I’m curious, at the end of the day (case) in general how much each has paid out and taken home? ---
**Author:** ![minty\_green](https://avatars.discourse-cdn.com/v4/letter/m/f6c823/32.png) [@minty\_green](https://boards.straightdope.com/u/minty_green)\ **Post date:** [July 8, 2004, 1:21pm UTC](https://boards.straightdope.com/t/does-this-bother-you-as-much-as-it-does-me-john-edwards/254001/54 "2004-07-08T13:21:18Z")
A very simple trial, with very simple facts and basic questions of law, can be taken through a jury trial for roughly the price of a new car. Medical malpractice cases are in no way simple. They require large numbers of witnesses, much consultation with medical experts, huge amounts of discovery to to see what the health care providers are hiding (if anything), and just oodles and oodles of preparation.We’re talking many hundreds or even thousands of hours to prepare for such a trial. $400,000 / 1000 hrs. = $400 per hour. The defense guy–who gets paid regardless–may be billing anywhere from $175-$400 an hour himself. The plaintiff’s guy gets nothing at all if he doesn’t win. He even has to swallow the costs of all those experts, office staff, etc., and that ain’t cheap either. ---
**Author:** ![Earthworm\_Jim](https://avatars.discourse-cdn.com/v4/letter/e/f07891/32.png) [@Earthworm\_Jim](https://boards.straightdope.com/u/Earthworm_Jim)\ **Post date:** [July 8, 2004, 1:21pm UTC](https://boards.straightdope.com/t/does-this-bother-you-as-much-as-it-does-me-john-edwards/254001/55 "2004-07-08T13:21:34Z")
> [@Left Hand of Dorkness](#): > > Often a trial lawyer receives nothing: they do hundreds of hours of work for no remuneration at all. In other professions, this would be considered a violation of the minimum wage act; why do we let clients get away with this? The key difference, in my mind, being that they volunteered. It **seems** almost like a bait-and-switch, or a lottery: “You’re free chance at making money!!Some restrictions may apply.” > [@](#): > > You’re comparing apples to oranges. > > Daniel You’re probably right, but heck - that’s why I post - to find out if I am 😉 ---
**Author:** ![Earthworm\_Jim](https://avatars.discourse-cdn.com/v4/letter/e/f07891/32.png) [@Earthworm\_Jim](https://boards.straightdope.com/u/Earthworm_Jim)\ **Post date:** [July 8, 2004, 1:26pm UTC](https://boards.straightdope.com/t/does-this-bother-you-as-much-as-it-does-me-john-edwards/254001/56 "2004-07-08T13:26:23Z")
> [@minty green](#): > > A very simple trial, with very simple facts and basic questions of law, can be taken through a jury trial for roughly the price of a new car. > > Medical malpractice cases are in no way simple. They require large numbers of witnesses, much consultation with medical experts, huge amounts of discovery to to see what the health care providers are hiding (if anything), and just oodles and oodles of preparation.We’re talking many hundreds or even thousands of hours to prepare for such a trial. > > $400,000 / 1000 hrs. = $400 per hour. > > The defense guy–who gets paid regardless–may be billing anywhere from $175-$400 an hour himself. > > The plaintiff’s guy gets nothing at all if he doesn’t win. He even has to swallow the costs of all those experts, office staff, etc., and that ain’t cheap either. Dammit, **minty** , you weren’t there when I previewed the last one. I’m curious then - if greedy lawyers, greedy doctors, greedy corporations, and greedy plaintiffs **aren’t** the cause of rising health care costs - what are?? All the sources seem to agree that all the dollar amounts are rising - health insurance, malpractice insurance, jury payouts. Where (oh where?) is the money going? ---
**Author:** ![Left\_Hand\_of\_Dorkness](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/left_hand_of_dorkness/32/7156_2.png) [@Left\_Hand\_of\_Dorkness](https://boards.straightdope.com/u/Left_Hand_of_Dorkness)\ **Post date:** [July 8, 2004, 1:34pm UTC](https://boards.straightdope.com/t/does-this-bother-you-as-much-as-it-does-me-john-edwards/254001/57 "2004-07-08T13:34:17Z")
> [@Beelzebubba](#): > > The key difference, in my mind, being that they volunteered. If they didn’t volunteer, the clients would be in violation of [the thirteenth amendment](http://www.law.cornell.edu/constitution/constitution.amendmentxiii.html). All workers are voluntary, or else the employer is violating the constitution. Apples to oranges, still :). Daniel ---
**Author:** ![Dewey\_Cheatem\_Undhow](https://avatars.discourse-cdn.com/v4/letter/d/13edae/32.png) [@Dewey\_Cheatem\_Undhow](https://boards.straightdope.com/u/Dewey_Cheatem_Undhow)\ **Post date:** [July 8, 2004, 2:08pm UTC](https://boards.straightdope.com/t/does-this-bother-you-as-much-as-it-does-me-john-edwards/254001/58 "2004-07-08T14:08:41Z")
> [@minty green](#): > > Given the context, I assume that by “corporate lawyer,” you mean a defense attorney who represents corporations in lawsuits. (For us lawyer types, “corporate law” means a bunch of boring crap about wannabe business majors who negotiate mergers and fill out government paperwork.) _Ahem._ I’m sure you meant to say that corporate law is a dynamic area of practice that is vital to Our Capitalist Way of Life, requiring creative thinking and the ability to find unique solutions to conflicting business visions. Truly, a practice area attractive to the best and brightest of the legal profession. I will, however, grant you that SEC compliance is a bunch of boring crap. At least my line of work doesn’t carry the risk of being squirted with a water pistol. (Note to SDMB’ers: inside joke at work) ---
**Author:** ![Excalibre](https://avatars.discourse-cdn.com/v4/letter/e/898d66/32.png) [@Excalibre](https://boards.straightdope.com/u/Excalibre)\ **Post date:** [July 8, 2004, 2:18pm UTC](https://boards.straightdope.com/t/does-this-bother-you-as-much-as-it-does-me-john-edwards/254001/59 "2004-07-08T14:18:21Z")
> [@Beelzebubba](#): > > Dammit, **minty** , you weren’t there when I previewed the last one. > > I’m curious then - if greedy lawyers, greedy doctors, greedy corporations, and greedy plaintiffs **aren’t** the cause of rising health care costs - what are?? All the sources seem to agree that all the dollar amounts are rising - health insurance, malpractice insurance, jury payouts. Where (oh where?) is the money going? Who said it’s not greedy corporations? The insurance companies are raking it in, even as they lower the standard of care. And basic tests and so forth are shockingly expensive as well - medical procedures themselves cost far more than they should. Look at the ridiculous price of prescription drugs. Corporations are making tons of money off of health care, and the lawsuits, justified or not, are a sliver compared to what the drug companies and insurance companies are making. ---
**Author:** ![Left\_Hand\_of\_Dorkness](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/left_hand_of_dorkness/32/7156_2.png) [@Left\_Hand\_of\_Dorkness](https://boards.straightdope.com/u/Left_Hand_of_Dorkness)\ **Post date:** [July 8, 2004, 2:30pm UTC](https://boards.straightdope.com/t/does-this-bother-you-as-much-as-it-does-me-john-edwards/254001/60 "2004-07-08T14:30:28Z")
> [@Dewey Cheatem Undhow](#): > > (Note to SDMB’ers: inside joke at work) Huh? Do you write “Hi, Opal!” in your office memos? Daniel [Previous page](https://boards.straightdope.com/t/does-this-bother-you-as-much-as-it-does-me-john-edwards/254001.md?page=2) [Next page](https://boards.straightdope.com/t/does-this-bother-you-as-much-as-it-does-me-john-edwards/254001.md?page=4)