Negligence

Professional Conduct Casebook ◽

10.1093/oso/9780198817246.003.0058 ◽

2019 ◽

Author(s):

Kenneth Hamer

Keyword(s):

Electroconvulsive Therapy ◽

Manual Control ◽

Medical Evidence ◽

Hospital Medical

B, the plaintiff, claimed damages against the defendants in respect of injuries that he received while undergoing electroconvulsive therapy (ECT) on 23 August 1954 at Friern Hospital. Medical evidence was called by both sides. No one suggested that there was any negligence in the diagnosis or in the decision to use ECT. However, there were different variants as to the use of restraining sheets, relaxant drugs, and manual control of the patient’s body. The question was whether Dr A, following the practice that he had learned at Friern Hospital and following the technique that had been shown to him by Dr B, was negligent in failing to use relaxant drugs or, if he decided not to use relaxant drugs, that he was negligent in failing to exercise any manual control over the patient beyond merely arranging for his shoulders to be held, his chin supported, a gag used, and a pillow put under his back. McNair J, in summing up to the jury, said, at 586–7:

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Issues in California Workers' Compensation: Substantial Medical Evidence, Causation, and Apportionment

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2020.sepoct02 ◽

2020 ◽

Vol 25 (5) ◽

pp. 12-15

Author(s):

Steven D. Feinberg

Keyword(s):

Compensation System ◽

Workers Compensation ◽

Medical Evidence

Abstract This article describes special aspects of addressing and defining substantial medical evidence, causation, and apportionment in the California Workers' Compensation system. Substantial medical evidence is framed in terms of reasonable medical probability, and the opinion must be based on fact and not be speculative. The issue of whether the injury occurred in the course of employment is left to the Trier of Fact (WCAB judge). The issue of arising out of employment is a medical issue left to the physician. Apportionment applies to both the industrial and nonindustrial cause of the disability.

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Spine Impairment Evaluation: Sixth Edition Approaches

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2009.janfeb01 ◽

2009 ◽

Vol 14 (1) ◽

pp. 1-5

Author(s):

Craig Uejo ◽

Marjorie Eskay-Auerbach ◽

Christopher R. Brigham

Keyword(s):

Functional Status ◽

Spinal Injury ◽

Current Medical ◽

Clinical Testing ◽

Medical Evidence ◽

Sixth Edition ◽

Whole Person ◽

Rating Process ◽

Impairment Ratings ◽

Class Assignment

Abstract Evaluators who use the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, should understand the significant changes that have occurred (as well as the Clarifications and Corrections) in impairment ratings for disorders of the cervical spine, thoracic spine, lumbar spine, and pelvis. The new methodology is an expansion of the Diagnosis-related estimates (DRE) method used in the fifth edition, but the criteria for defining impairment are revised, and the impairment value within a class is refined by information related to functional status, physical examination findings, and the results of clinical testing. Because current medical evidence does not support range-of-motion (ROM) measurements of the spine as a reliable indicator of specific pathology or permanent functional status, ROM is no longer used as a basis for defining impairment. The DRE method should standardize and simplify the rating process, improve validity, and provide a more uniform methodology. Table 1 shows examples of spinal injury impairment rating (according to region of the spine and category, with comments about the diagnosis and the resulting class assignment); Table 2 shows examples of spine impairment by region of the spine, class, diagnosis, and associated whole person impairment ratings form the sixth and fifth editions of the AMA Guides.

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Clinical Update: Understanding Causation: An Example Using Carpal Tunnel Syndrome

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2007.novdec02 ◽

2007 ◽

Vol 12 (6) ◽

pp. 5-8 ◽

Cited By ~ 3

Author(s):

J. Mark Melhorn

Keyword(s):

Risk Factors ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Legal Responsibility ◽

Medical Evidence ◽

Anatomic Structure ◽

Legal Professionals ◽

Compensation Systems ◽

Tunnel Syndrome ◽

Four Levels

Abstract Medical evidence is drawn from observation, is multifactorial, and relies on the laws of probability rather than a single cause, but, in law, finding causation between a wrongful act and harm is essential to the attribution of legal responsibility. These different perspectives often result in dissatisfaction for litigants, uncertainty for judges, and friction between health care and legal professionals. Carpal tunnel syndrome (CTS) provides an example: Popular notions suggest that CTS results from occupational arm or hand use, but medical factors range from congenital or acquired anatomic structure, age, sex, and body mass index, and perhaps also involving hormonal disorders, diabetes, pregnancy, and others. The law separately considers two separate components of causation: cause in fact (a cause-and-effect relationship exists) and proximate or legal cause (two events are so closely related that liability can be attached to the first event). Workers’ compensation systems are a genuine, no-fault form of insurance, and evaluators should be aware of the relevant thresholds and legal definitions for the jurisdiction in which they provide an opinion. The AMA Guides to the Evaluation of Permanent Impairment contains a large number of specific references and outlines the methodology to evaluate CTS, including both occupational and nonoccupational risk factors and assigning one of four levels of evidence that supports the conclusion.

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A Case of Catatonia in a 14-Year-Old Girl with Schizophrenia Treated with Electroconvulsive Therapy

Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie ◽

10.1024/1422-4917/a000211 ◽

2013 ◽

Vol 41 (1) ◽

pp. 69-74 ◽

Cited By ~ 10

Author(s):

Frank Häßler ◽

Olaf Reis ◽

Steffen Weirich ◽

Jacqueline Höppner ◽

Birgit Pohl ◽

...

Keyword(s):

Case Report ◽

Treatment Response ◽

Electroconvulsive Therapy ◽

Rating Scale ◽

Combined Treatment ◽

Adolescent Patient

This article presents a case of a 14-year-old female twin with schizophrenia who developed severe catatonia following treatment with olanzapine. Under a combined treatment with amantadine, electroconvulsive therapy (ECT), and (currently) ziprasidone alone she improved markedly. Severity and course of catatonia including treatment response were evaluated with the Bush-Francis Catatonia Rating Scale (BFCRS). This case report emphasizes the benefit of ECT in the treatment of catatonic symptoms in an adolescent patient with schizophrenic illness.

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