Demonstrative evidence: Malpractice defense from Advanced Practice Strategies
Posted Jan 08 2009 2:57pm
In addition to my consulting work and writing the Health Business Blog, I’m chairman of the board of Advanced Practice Strategies, a medical risk management firm that provides litigation support for malpractice defense and an eLearning curriculum focused on enhancing patient safety. I’ve posted a case study below.
Illustrated Verdict by APS Every month APS’s Demonstrative Evidence Group will share case examples from our archives to show how a visual strategy can support the defense effort. We hope that it is of value in your practice as you develop your defense strategies on behalf of healthcare providers. Please feel free to forward it to colleagues or clients.
About Us APS is a leading provider of demonstrative evidence for the defense of medical malpractice claims. Our team of medical illustrators consults with defense teams to educate the lay jury audience about the complexities of medical care. We do this by developing a visual strategy with expert witnesses including high-quality case-specific medical illustrations, x-ray enhancements, and multimedia presentations. To learn more, e-mail us or call 877.APS.4500.
Judgment for the Defense Fetal Assessment and Response PLAINTIFF’S CLAIM: Delay in performing a Caesarean delivery, caused low APGAR scores and cerebral palsy. DEFENSE’S ARGUMENT: The clinical management of labor was reasonable. While decelerations were noted, they recovered with positioning of the mother and the strips returned to baseline with good variability — a sign of no ischemic event. At Phase 3 of labor the labor and delivery team encountered limited progress and prepped the mother for vacuum extraction. But, vacuum also resulted in limited progress. The team realized that the mother’s pelvic disproportion made vaginal delivery impossible. As soon as they realized this, a Caesarean was performed. VISUAL STRATEGY: Like many cases, the challenge here was to back the jury up to the beginning of the delivery and help them understand how temporal labor is. Despite the bad outcome, the healthcare provided along the way was appropriate, given the information the team had.A major portion of our visual strategy was to rely on the Fetal Monitoring Strips: