Books


New Jersey Medical Malpractice Law

Abbott S. Brown

Add To Cart


 

New 2015 Edition


New Jersey Medical Malpractice Law addresses issues as they commonly arise through the litigation process—from considering the elements of a malpractice cause of action, through investigating and preparing a case, to managing trial issues.


NEW For 2015:


1) Expanded discussion of Duty to Maintain Insurance and discussion of 2014 decision in DeMarco v. Stoddard

2) Revised discussion of increased risk/substantial factor test with regard to proximate causation

3) Discussion of new case, Graham v. Twedell, 432 N.J. Super. 592, 597 (Law Div. 2013),  addressing prior independent tort and effect on jury verdict of settlement with other defendants.

4) New sections expanding discussion of qualification of expert witnesses and recognized medical specialties and sub-specialties.

5) Discussion of 2014 Supreme Court decision in L.A. v. New Jersey Division of Youth and Family Services concerning use of a statute to establish the standard of 

6) Coverage of relevant new court decisions through Spring 2014. 



Included with your print edition is an eBook, containing hyperlinks to the full text of cases, statutes and other authoritative content and can be read using a variety of devices and readers including: Apple iPad or iPhone, SONY Reader, Barnes & Noble NOOK and Adobe Digital Editions.

In its sixth edition, now published by ALM, New Jersey Medical Malpractice Law provides the bench and bar with a comprehensive review and analysis of New Jersey medical malpractice law in a portable and reader-friendly format.

Chapters Include:

 

Chapter 1: Duties of Health Care Providers

Chapter 2: Doctrines of Informed Consent and Refusal

Chapter 3: Other Causes of Action

Chapter 4: Proximate Causation

Chapter 5: Damages in Medical Malpractice Cases

Chapter 6: Pre-Suit Investigation of Medical Malpractice Claim

Chapter 7: Expert Testimony and Learned Treatises

Chapter 8: Pleadings, Defenses and Voir Dire in Medical

Malpractice Cases

Chapter 9: Pretrial Discovery in Medical Malpractice Cases

Appendix

Table of Cases

Index


    Your purchase today includes this title in EPUB format. The e-book is viewable on Apple iPad or iPhone, SONY Reader, Barnes & Noble NOOK

NOTE: Credit card will be charged at time of order. Product cannot be returned if eBook has been downloaded. For further information please call 1-877-256-2472 or email regionaltitles@alm.com


    Subscriptions to books are auto-renewed to avoid disruptions in service. Print editions must be returned within 30 days in resalable condition for refund. For downloadable eBook products, a refund will be granted if the eBook has not been downloaded.


 

.

  • Availability: Available
  • Brand: New Jersey Law Journal
  • Product Type: Books
  • Edition: 6
  • Page Count: 1000
  • ISBN: 978-1-57625-808-8
  • Pub#/SKU#: MedMal15
  • Pub Date: 07/17/2014
  • Volume(s): 1
  • Frequency: Annually

Author Image
  • Abbott S. Brown
  • 80 Main Street
  • 973736-9800

Abbott S. Brown is a Certified Civil Trial Attorney whose practice focuses on medical and legal malpractice, products liability and insurance litigation. A partner with Lomurro, Davison, Eastman & Muñoz, P. A., in Freehold, New Jersey, Mr. Brown received his J.D. in 1978 from Rutgers University School of Law, Newark. He is admitted to practice in New Jersey and before the U.S. District Court for the Districts of New Jersey and the Eastern and Southern Districts of New York, and the Second and Third Circuit Courts of Appeal. Mr. Brown has been counsel for one or more bar associations as amicus curiae in 12 published malpractice decisions, including Cornblatt v. Barow, 153 N.J. 218 (1998), Ferreira v. Rancocas Orthopedic Associates, 178 N.J. 144 (2003), and Nicholas v. Mynster, 213 N.J. 463 (2013). 


Mr. Brown served on the Supreme Court Committee on Jury Selection and Voir Dire from 2004-2010, the Supreme Court Committee on Model Civil Jury Charges from 1998-2009, where he served on the medical malpractice sub-committee, and the Board of Governors of the New Jersey Association for Justice (formerly the Association of Trial Lawyers of America - New Jersey) from 1996 to 2011. He has also served on the District V-B Ethics Committee, as Chair of the Medical Malpractice Committee of the New Jersey State Bar Association and on the Special Committee on Implementation of a Pilot Medical Malpractice Mediation project. Mr. Brown was an Adjunct Professor at Seton Hall University School of Law in the Health Law and Policy Program, teaching medical malpractice law between 1998 and 2012. He has also lectured at the New Jersey Judicial College and delivered more than 70 lectures for N.J.I.C.L.E., the Association of Trial Lawyers of America, the New Jersey Association for Justice, the New  Jersey State Bar Association, and other organizations.


Mr. Brown is also the author of New Jersey Medical Malpractice Cases, 3rd Ed. (NJICLE 2009) and a chapter titled “Medical Experts” in New Jersey Trial and Evidence Law (NJICLE 2003).

He has written more than 35 articles for numerous professional publications, and had opinion or editorials published in the New York Times, The Star-Ledger, and the New Jersey Law Journal. Mr. Brown was awarded the Gold Medal for Distinguished Service by the Association of Trial Lawyers of America – New Jersey in April 2001. He was named as one of New Jersey’s “Top Ten Lawyers” in 2006 and named one of New Jersey’s “Top 100 Lawyers” in 2005 and every year since 2007. In April 2012, Mr. Brown was recognized by NJBIZ as one of the 50 Most Powerful People in New Jersey Healthcare.



Chapter 1: Duties of Health Care Providers……………………. 1

I DUTY OF CARE ………………………………………………………….. 1

1-1 The Generally Accepted Standard of Care …………………….. 1

1-1:1 Introduction ……………………………………………………… 1

1-1:2 “Generally Accepted” and “Reasonably Prudent”

Standards Distinguished …………………………………………….. 3

1-1:3 Not All Deviations From the Standard of Care

Constitute Malpractice ………………………………………………… 5

1-2 The Role of the Physician’s Judgment …………………………… 8

1-2:1 Physician’s Exercise of Reasonable Judgment

Is Not Malpractice ……………………………………………………….. 8

1-2:2 Evolution of the Judgment Charge ……………………………. 11

1-2:3 Limitations on Applicability

of the Judgment Charge ………………………………………………….16

1-2:4 Specific Cases Addressing the Judgment Charge ……………. 21

1-2:5 Need for Informed Consent Charge

When Judgment Charge Is Given …………………………………….. 30

1-3 Personal Standards Do Not Establish the Standard of Care… 30

1-4 Duties of Specific Medical Providers …………………………. 34

1-4:1 Duty of Examining or Consulting Physician

Acting for Third Party ……………………………………………… 34

1-4:1.1 General Duty of Care ………………………………………. 34

1-4:1.2 Duty to Report Findings to Patient ……………………. 39

1-4:1.2a Duty of Examining Physician ………………….………… 39

1-4:1.2b Duty of Consulting Physician

Not Examining Patient ………………………………………………….. 43

1-4:1.2c Duty of Third Party to Disclose Test Results ………..…. 45

1-4:1.3 Duty to Persons Other Than Patient …………………………46

1-4:2 Duty of a Specialist ………………………………………………. 46

1-4:3 Standard of Care for Hospital Resident Physician …………. 50

1-4:4 Duty of a Supervisor ……………………………………………… 52

1-4:5 Duty of a Supervisor of Nurses …………………………………. 56

1-4:6 The Scope of Chiropractic Care ………………………………… 58

1-4:7 Duty of Emergency Department ……………………………….. 62

1-4:8 Duty of Nursing Home …………………………………………… 62

1-4:9 Non-Delegable Duty of Jail or Prison …………………………. 66

1-5 Duties in Specific Circumstances …………………………………. 68

1-5:1 Duty Regarding Treatment of Body/Deceased …………….. 68

1-5:2 Duty to Elderly and Infirm Patient …………………………….69

1-5:3 Duty to Suicidal Patient …………………………………………. 70

1-6 Liability of Third Parties for Physician’s Breach

of Duty of Care …………………………………………………………….. 75

1-6:1 Duty of a Credentialer …………………………………………… 75

1-6:2 Duty of Employer/Respondeat Superior ……………………. 79

1-6:2.1 Employment Relationship Required ………………………79

1-6:2.2 Employee Need Not Be Party ……………………………….. 79

1-6:2.3 Employer Not Liable for Employee

Conduct Outside Scope of Employment …………………………….81

1-6:2.4 Limitation of Liability ……………………………………………83

1-6:3 Apparent Employment of Medical Professionals …………. 84

1-6:4 Liability of Referring Physician ………………………………… 89

1-6:5 Liability of Workers’ Compensation Carrier

for Examining Physician’s Negligence ……………………………….. 90

1-7 Termination of the Duty of Care ………………………………… 93

II OTHER RELATED DUTIES …………………………………………….. 94

1-8 The Duty of Confidentiality ……………………………………….. 94

1-8:1 Generally ………………………………………………………….. 94

1-8:2 Exceptions to/Waiver of Confidentiality ……………………. 96

1-8:2.1 Personal Injury Claim Waives Confidentiality …………..96

1-8:2.2 Use and Misuse of a Subpoena ……………………………. 99

1-8:3 Duty to Keep AIDS Diagnosis Confidential ………………….. 102

1-8:4 Duty to Keep Psychiatric Records Confidential …………….. 104

1-8:4.1 Privilege Akin to Attorney-ClientPrivilege ……………..… 104

1-8:4.2 Exceptions to Confidentiality

of Psychiatric Records …………………………………………….. 108

1-8:4.2a Defense to Crime/Mental

State at Issue/Best Interests of Children …………………………… 108

1-8:4.2b Persons at Risk of Harm ……………………………….. 109

1-8:4.3 Improper Use of Subpoena

for Psychiatric Records ………………………………………………. 111

1-9 The Duty to Provide Genetic Counseling …………………… 112

1-10 The Duty to Terminate Care …………………………………… 114

1-11 The Duty of Treating Physician to Testify or Provide

Litigation Support ……………………………………………………… 115

1-12 The Duty to Maintain Insurance …………………………….. 119

Chapter 2: Doctrines of Informed Consent and Refusal ………. 123

I Duty to obtain INFORMED

CONSENT or REFUSAL..................................................................123

2-1 The Fully Informed Patient …………………………………….123

2-1:1 Physician’s Common Law Duty to Provide

Information ………………………………………………………………. 123

2-1:2 Code Provisions Require Written

Informed Consent …………………………………………………………. 127

2-2 Actions for Breach of Duty to Obtain Informed

Consent or Refusal ………………………………………………………… 127

2-2:1 Elements of Cause of Action for Breach

of Duty to Obtain Informed Consent ………………………………… 127

2-2:2 Standard for Duty to Disclose ………………………………….. 128

2-2:2.1 Professional Standard Abandoned ……………………………128

2-2:2.2 Reasonable Patient Standard …………………………….. 129

2-2:2.3 Informed Consent Regarding Prescription Drugs ………..133

2-2:2.4 Only Material Risks Need Be Disclosed ………………………. 134

2-2:3 Duty to Disclose Applicable to Non-Invasive

Procedures or Non-Treatment ……………………………………………..142

2-2:4 Duty Regarding Informed Refusal …………………………………. 144

2-2:5 Duty to Inform of Available Diagnostic Testing ………………..145

2-2:6 The Relationship Between Medical

Judgment and Informed Consent ……………………………………….. 148

2-2:7 No Duty to Disclose Unavailable Options …………………….. 154

2-2:8 Distinguishing Negligent Treatment/Failure

to Diagnose from Failure to Disclose ……………………………….. 155

2-2:8.1 Negligent Treatment/Diagnosis ………………………… 155

2-2:8.2 Failure to Disclose Distinguished ………………………….. 160

2-2:9 Immunity/No Duty to Obtain Informed

Consent in Emergencies ………………………………………………. 163

2-2:10 Disclosure Regarding FDA Approvals ……………………. 166

2-2:11 Disclosures Regarding Physicians ………………………. 168

2-2:11.1 Duty to Disclose Physician’s HIV/AIDS …………………… 168

2-2:11.2 Duty Regarding Disclosure of Credentials …………..170

2-2:11.3 Duty to Identify Specific Physician

Performing Service ………………………………………………… 174

2-2:11.4 No Duty to Disclose Risks

of Treatment by Other Physicians ……………………………….. 175

2-2:12 Liability to Third Parties for Breach

of Duty to Obtain Informed Consent ……………………………… 177

2-2:12.1 Child’s Cause of Action for Breach

of Duty to Disclose Risks to Mother ……………………………….177

2-2:12.2 Duty to Advise of Test Results

Affecting Patient and Third Parties ……………………………. 182

II PROCEDURAL ISSUES........................................................187

2-3 Pleading Informed Consent …………………………………….. 187

2-4 A Directed Verdict May be Warranted Where

Defendant Concedes a Material Risk Was Not Disclosed …….. 189

2-5 Routine Disclosure As Evidence of Information

Disclosed to Patient …………………………………………………..191

2-6 Whether Patient Would Decline Treatment Is Issue

for the Jury …………………………………………………………… 192

2-7 Jury Interrogatories in Informed Consent Case …………. 194

III ASSAULT AND BATTERY DISTINGUISHED...................194

2-8 Introduction ………………………………………………………… 194

2-9 “Ghost Surgeries”: Patient Not Informed Who

Will Perform Services …………………………………………………… 194

2-10 Performing Different Surgery Than Described ……………… 196

2-11 No Proof of a Deviation from the Standard

of Care Required for Battery ………………………………………. 202

2-12 Exceeding Conditions of Consent Constitutes Battery ….. 203

Chapter 3: Other Causes of Action …………………………….. 207

I TORT CLAIMS......................................................................207

3-1 Strict Liability in Tort …………………………………………….. 207

3-2 Abandonment ……………………………………………………. 207

II FRAUD CLAIMS...................................................................210

3-3 Fraud ……………………………………………………………….. 210

3-3:1 Elements of Cause of Action …………………………………… 210

3-3:2 Benefits/Burdens of Pleading Fraudulent

Concealment …………………………………………………………….. 210

3-3:3 Consumer Fraud ……………………………………………….. 212

3-3:4 Misrepresentation of Credentials …………………………… 213

3-3:5 Misrepresentations Concerning Treatment …………….. 216

III CONTRACT AND OTHER CLAIMS ………………………………… 220

3-4 Breach of Contract ……………………………………………….. 220

3-5 False Imprisonment …………………………………………………222

3-6 The Mishandling of a Corpse …………………………………….. 223

3-7 Unauthorized Autopsy …………………………………………. 224

3-8 False Diagnosis of Disease ………………………………………… 225

3-9 Alteration or Destruction of Medical Records …………….. 225

3-10 Sexual Misconduct ………………………………………………230

Chapter 4: Proximate Causation ……………………………………. 233

I INTRODUCTION .................................................................233

4-1 Overview…………………………………………………………..233

4-2 Reasonable Degree of Medical Probability ………………………. 234

II PRE-EXISTING CONDITIONS......................................................240

4-3 Causation Issues Raised by Pre-Existing Conditions ……………… 240

4-3:1 Introduction ………………………………………………………….….. 240

4-3:2 Defining What Constitutes a Pre-Existing Condition ………………… 242

4-3:2.1 Condition That Could Evolve into

Ultimate Condition Absent Negligence …………………………….…… 242

4-3:2.2 Condition Being Treated to Delay Outcome ……………….. 242

4-3:2.3 Addiction as Pre-Existing Condition …………………………… 245

4-3:3 Defendant’s Burden to Apportion Damages

Caused by Pre-Existing Condition …………………………………………… 249

4-3:4 Evers, Scafidi and the “Increased

Risk/Substantial Factor” Test ……………………………………………….. 252

4-3:4.1 Development of “Increased Risk/Substantial Factor” Test ............ 252

4-3:4.2 Defining “Substantial Factor” ……………………………………….283

4-3:4.3 Retroactive Application of Scafidi ………………………………….. 285

4-3:4.4 Application of Scafidi to Specific Cases ………………………... 287

4-3:4.5 Explaining Limitation of Scafidi Charge ………………………….. 299

4-3:4.6 Issuing Ultimate Outcome Jury Charge with Scafidi Charge ….. 299

4-3:5 Failure to Perform Diagnostic Test Which

Would Have Disclosed Pre-Existing Condition ……………………….300

4-3:6 Apportionment of Pain and Suffering …………………………. 306

4-4 Loss of a Chance …………………………………………………….. 307

4-5 Aggravation of a Prior Independent Tort …………………….. 312

4-6 Pain and Suffering .……………………………………………….. 322

III AVOIDABLE CONSEQUENCES/COMPARATIVE

NEGLIGENCE......................................................................325

4-7 Effect of Avoidable Consequences/Comparative

Negligence on Proof of Causation ………………………………….. 325

4-7:1 Introduction ……………………………………………………….325

4-7:2 Distinction Between Patient’s Pre-Treatment

and Post-Treatment Conduct ………………………………………. 325

4-7:3 Distinguishing Avoidable Consequence

and Superseding Cause ………………………………………………….. 331

4-7:4 Cases Limiting Application of Avoidable

Consequence/Comparative Negligence …………………………….. 334

4-7:5 Applicability to Informed Consent Cases ………….335

IV CAUSATION IN INFORMED CONSENT CASES.............336

4-8 Proof of Proximate Causation in the Informed

Consent Case...........................................................................336

4-9 Failure to Warn Regarding Prescription Drug Risks................338

4-10 Failure to Fully Inform Patient Regarding

Procedure and Alternatives......................................................343

Chapter 5: Damages in Medical Malpractice Cases …………. 351

I TYPES OF DAMAGES..........................................................351

5-1 Introduction ………………………………………………………………….. 351

5-2 Damages for Delay in Treatment ………………………………………. 352

5-3 Pain and Suffering ……………………………………………………….. 356

5-4 Hedonic Damages ………………………………………………………….. 363

5-5 Disability ………………………………………………………………………. 366

5-6 Economic Loss ……………………………………………………………………. 367

5-7 Medical Bills …………………………………………………………………….. 373

5-8 Emotional Distress Damages ………………………………………………….379

5-8:1 Generally …………………………………………………………………….. 379

5-8:2 Emotional Distress of Relatives ……………………………………….. 383

5-8:2.1 Portee and Elements of Claim ………………………………………….. 383

5-8:2.2 Application of Portee in Malpractice Cases …………………………384

5-8:2.3 Claims for Mistreatment of Body/Corpse ……………………………… 389

5-8:2.4 Misdiagnosis Generally Does Not Satisfy Portee Factors ……………. 390

5-8:2.5 Emotional Distress of Parents for Loss of a Child ………….……..393

5-8:2.6 Relatives Must Connect Malpractice

to Injury to Recover Emotional Distress Damages …………………..….. 402

II DAMAGES IN CASES INVOLVING A FETUS OR CHILD......................406

5-9 Damages Involving a Fetus ……………………………………………….. 406

5-9:1 Injuries to a Fetus/Preconception Injuries ……………………………. 406

5-9:2 Loss of a Fetus ……………………………………………………………. 412

5-10 Injuries to a Child …………………………………………………………… 414

5-11 Effect of Settlement with Infant Without Judicial Approval ……….. 417

III WRONGFUL BIRTH/LIFE CLAIMS............................................................419

5-12 Wrongful Birth ……………………………………………………………. 419

5-12:1 Introduction …………………………………………………………….. 419

5-12:2 Distinguishing Wrongful Life Claims

in New Jersey …………………………………………………………….. 419

5-12:3 Development of Wrongful Birth Claim ……………………. 422

5-12:4 Measure of Damages for Wrongful Birth …………………….425

5-12:4.1 Emotional Distress of Parents ………………………….. 425

5-12:4.2 Damages for Extraordinary Costs of Care ……………….425

5-12:5 Distinguishing Wrongful Birth and Informed

Consent Claims: Medical Causation Not Required ………………… 428

5-12:6 Preconception Negligence ………………………………………….432

5-12:7 Superceding Cause/Avoidable Consequences

in Wrongful Birth Cases ……………………………………………………. 434

5-12:8 Emotional Distress Damages for Wrongful Birth …………... 438

5-12:9 Damages Not Reduced by Joy

of Raising Child …………………………………………………………….. 441

5-12:10 No Claim for Grandparents, Siblings ………………………………. 443

IV DAMAGES IN WRONGFUL DEATH CASES........................................445

5-13 Wrongful Death Claims...........................................................445

5-13:1 Generally …………………………………………………… 445

5-13:2 Wrongful Death of a Child ………………………………… 448

5-13:3 Wrongful Death After a Prior Medical 

Malpractice Suit ……………………………………………… 453

V OTHER DAMAGES ISSUES................................................457

5-14 Punitive Damages....................................................................457

5-15 Per Quod …………………………………………………………. 462

5-16 Additur/Remittitur of Damages..............................................464

Chapter 6: Pre-Suit Investigation of Medical

Malpractice Claim …………………………………………………………471

I MEDICAL RECORDS ……………………………………………………… 471

6-1 The Duty to Maintain Accurate

and True Medical Records ……………………………………………….. 471

6-2 Statutory and Administrative Code Regulations

Regarding Medical Records ……………………………………………… 472

6-3 Legibility Requirements for Medical Records ……………….. 475

II INCIDENT, INVESTIGATION AND OTHER REPORTS ....…………476

6-4 Incident Reports ……………………………………………………. 476

6-5 The Patient Safety Act, N.J.S.A. 26:2H-12.23 ………………….. 476

6-6 Investigation of Serious Preventable Adverse Events …………. 488

6-7 Peer Review/Committee Reports …………………………………. 492

6-8 Sentinel Event Reports ………………………………………………..502

6-9 Interviews of Health Care Professionals ………………………….. 503

III DECLINING A MEDICAL MALPRACTICE CASE ………………….. 505

6-10 Advising the Client …………………………………………………… 505

Chapter 7: Expert Testimony and Learned Treatises ………………509

I EXPERT TESTIMONY IN MALPRACTICE CASES …………………….. 509

7-1 Introduction …………………………………………………………….509

7-2 Requirements for Expert Testimony ………………………………. 511

7-2:1 Expert Establishes Standard of Care

and Deviation Therefrom ……………………………………………….. 511

7-2:2 Content of Expert Testimony/Report ……………………….. 516

7-2:2.1 Introduction ……………………………………………………….. 516

7-2:2.2 Clear, Specific Opinions ………………………………………… 517

7-2:2.3 Reasonable Medical Probability ………………………………. 518

7-2:3 Importance of Expert Testimony ………………………………….. 521

II QUALIFICATION OF EXPERTS

AND THE PATIENTS FIRST ACT ………………………………………………………522

7-3 Qualification of Expert Witnesses ……………………………………… 522

7-3:1 Introduction …………………………………………………………… 522

7-3:2 Qualification of Expert Witnesses Prior to New

Jersey Medical Care Access and Responsibility and 

Patients First Act …………………………………………………………………….. 523

7-3:2.1 Continuing Applicability of Pre-Act

Common Law for Cases Arising Prior to 2004 …………………….….. 523

7-3:2.2 Expert in Different Specialty May

Qualify in Pre-2004 Cases …………………………………………………….. 523

7-3:2.3 Examples of Qualified Experts in Pre-2004 Cases ……………………. 525

7-3:2.4 Examples of Experts Not Qualified in Pre-2004 Cases ...........…. 531

7-3:3 Qualification of Expert Witnesses After the 

New Jersey Medical Care Access and Responsibility 

and Patients First Act ……………………………………………………….…….. 534

7-3:3.1 Same Specialty Required for Expert …………………………………. 534

7-3:3.2 Applicability of Same Specialty Requirement ……………………. 535

7-3:3.3 The Specialties and Sub-specialties Recognized by the 

American Board of Medical Specialties or the American 

Osteopathic Association ………………………………………………..………. 537

7-3:3.3a Recognized Specialties ……………………………………………….. 537

7-3:3.3b ABMS Recognized Specialties …………………………………537

7-3:3.3c AOA Recognized Specialties ………………………………………… 542

7-3:3.3d Scope of Practice for Specialties …………………………..…… 545

7-3:3.3e Overlap Between Specialties ………………………………………. 546

7-3:3.4 Constitutionality Challenged ………………………………………….. 546

7-3:3.5 Amendment to Affidavit of Merit ………………………………………. 548

7-3:3.6 Equivalently Qualified ……………………………………………………. 549

7-3:3.7 Determining the Qualifications of Medical

Malpractice Liability Experts ………………………………………………………. 550

7-4 The Patients First Act’s Impact on Other Medical Malpractice Issues ………… 561

7-4:1 Introduction ……………………………………………………………………… 561

7-4:2 Statute of Limitations Amended ……………………………………………561

7-4:3 Affidavit of Noninvolvement …………………………………………………………… 562

7-4:4 Malpractice Premium Increases Barred

if Case Dismissed Within 180 Days ………………………………………………….. 562

7-4:5 Remittitur and Additur ……………………………………………………. 563

7-4:6 Good Samaritan Immunity …………………………………………………….. 563

7-4:7 Reimbursement of Non-Economic Damages ……………………………….. 563

7-4:8 Malpractice Insurance Policies ……………………………………………………..564

7-4:9 Applicability and Effective Date of The Patients First Act ……………….. 565

7-4:10 NJ Health Care Consumer Information Act …………………………………… 565

III THE AFFIDAVIT OF MERIT …………………………………………………………… 566

7-5 Overview ……………………………………………………………………………….. 566

7-5:1 Professions Covered…………………………………………………………………. 566

7-5:2 Statutory Requirements …………………………………………………………… 569

7-5:2.1 Time for Service …………………………………………………………………….. 569

7-5:2.2 Failure to Produce Necessary Records or Other Information ………… 569

7-5:2.3 Minimum Requirements ………………………………………………………….. 570

7-5:2.4 Qualifications of the Affiant ……………………………………………………. 570

7-6 Judicial Interpretation of Affidavit of Merit Statute ……………………………… 571

7-6:1 Constitutionality ………………………………………………………. 571

7-6:2 Supreme Court’s Initial Construction:

Hall and Cornblatt …………………………………………………………………573

7-6:2.1 In re Hall: Purpose of Affidavit of Merit Statute ……………………….. 573

7-6:2.2 Cornblatt v. Barow: Affidavit of Merit Not 

Required for Malpractice Occurring Pre-Statute …………………….. 575

7-7 Application of the Affidavit of Merit Requirements ………………. 577

7-7:1 Introduction ………………………………………………………………… 577

7-7:2 Who is Entitled to an Affidavit of Merit? …………………………………. 579

7-7:2.1 Which Licensed Professionals are

Entitled to Affidavit of Merit? ………………………………………………… 579

7-7:2.2 Is an Affidavit of Merit Needed for

Professional Corporations? …………………………………………………….581

7-7:3 Who is Qualified to Render the Affidavit of Merit? …………….. 583

7-7:3.1 Same Specialty Requirement ……………………………………….. 583

7-7:3.2 Waiver of Same Specialty Requirement ……………………………… 586

7-7:4 What Information Must be Contained

in the Affidavit of Merit? ………………………………………………… 589

7-7:5 Does the Affidavit of Merit Statute Require Identification 

of the Defendants Who Deviated from the Standard of Care? …….. 590

7-7:6 When Must the Affidavit of Merit be Filed? ………………………… 592

7-7:7 What Constitutes Substantial Compliance

with the Affidavit of Merit Statute? …………………………………… 596

7-7:7.1 Substantial Compliance Concept Explained ………….. 596

7-7:7.2 Applying the Substantial Compliance Concept ………………… 598

7-7:7.3 The Affidavit of Merit Statute Should

Not Be Mechanically Applied ……………………………………………….600

7-7:7.4 Dismissal with Prejudice Absent

Extraordinary Circumstances …………………………………………………. 603

7-7:7.5 Failure to Put Expert Under Oath

Renders Affidavit Non-Compliant …………………………………………. 606

7-7:8 Does the Doctrine of Waiver or Estoppel

Apply to the Affidavit of Merit Statute? ……………………………….. 607

7-7:8.1 Failure to Promptly Seek Dismissal

Estops Defendant……………………………………………………………. 607

7-7:8.2 The Ferreira Conference …………………………………….. 609

7-7:9 Does the Failure to Hold a Ferreira

Conference Extend the Time to Serve an Affidavit of Merit? ………….. 609

7-7:10 Can the Ferreira/Affidavit of Merit

Conference be Waived? …………………………………………………….. 610

7-7:11 Is the Affidavit of Merit Waived

if the Defendant Withholds Medical Records

Needed to Prepare the Affidavit? ……………………………………………. 610

7-7:11.1 Records Having Substantial Bearing

on Preparation of Affidavit of Merit ………………………………………… 610

7-7:11.2 Records Not Needed for Affidavit ……………………………… 614

7-7:12 Once Suit Is Filed, Is the Affidavit of Merit Statute Tolled 

Due to the Minority of an Infant Plaintiff ? ……………………..…. 616

7-7:13 Is an Affidavit of Merit Required in Common

Knowledge or Res Ipsa Cases? ……………………………………………… 617

7-7:14 Is an Affidavit of Merit Required for

Informed Consent Cases? ……………………………………………………..620

7-7:15 Does the Affidavit of Merit Statute Apply

to Cross-claims or Counterclaims? ………………………………………. 621

7-7:15.1 Applicability to Cross-claims ……………………………………… 621

7-7:15.2 Applicability to Third-Party Malpractice Complaint ………………….. 622

7-7:15.3 Applicability to Counterclaim ……………………………. 624

7-7:16 Does the Affidavit of Merit Statute Apply to Non- Malpractice 

Claims, Such as Contract or Assault and Battery Claims? …………………… 625

7-7:17 Is an Affidavit of Merit Needed to Establish Causation

 or Damages? ……………………………………….. 627

7-7:18 Should the Affidavit of Merit Statute Ever

be Permitted to be Used to Defeat Meritorious Claims? ………………….. 628

IV PRESENTING EXPERT TESTIMONY AND REPORTS ……………….. 630

7-8 The Foundation for Expert Testimony ………………………… 630

7-8:1 Testimony Based on Knowledge, Training,

Experience or Education ……………………………………………..630

7-8:2 Theories Not Yet Generally Accepted …………………………. 633

7-8:3 Rule 104 Hearing on Admissibility …………………………….. 637

7-8:4 Use of Multiple Experts ……………………………………… 637

7-9 The Requirements of the Expert Report …………………….. 640

7-10 The Net Opinion Rule …………………………………………646

7-11 The Common Knowledge Doctrine ………………………….. 660

7-11:1 Doctrine Established in Cases of Foreign

Objects Left Behind in Surgery ……………………………………… 660

7-11:2 Cases in Which Common Knowledge Found ………………. 662

7-11:2.1 Generally ………………………………………………………………..662

7-11:2.2 An Extreme Application

of the Common Knowledge Doctrine ………………………………….. 670

7-11:2.3 Common Knowledge Regarding

Communication of Test Results ……………………………………………….672

7-11:3 Cases in Which Common Knowledge Doctrine Was Rejected …..…674

7-12 Res Ipsa Loquitur …………………………………………………….. 676

7-12:1 Required Elements ………………………………………………………. 676

7-12:2 Expert Testimony Still Required for Res Ipsa Loquitur ……………….. 678

7-12:3 Examples Where Res Ipsa Loquitur Applied ………………………… 681

7-12:4 Examples Where Res Ipsa Loquitur Not Applied …………………….. 684

7-12:5 Conditional Application of Res Ipsa Doctrine ………………………..687

7-13 Anderson v. Somberg and Collective Joint Responsibility………… 696

7-14 Expert Testimony in Informed Consent Cases …………………… 705

7-15 Compelling Expert Testimony ………………………………………… 716

V LEARNED TREATISES AND OTHER SOURCES …………………………….. 727

7-16 The Jacober Rule/Learned Treatises ……………………………………. 727

7-16:1 Treatises …………………………………………………………………. 727

7-16:2 Manufacturers’ Technical Guides and Package Inserts …………. 735

7-17 The Physicians’ Desk Reference and Package Inserts …………. 738

7-18 Hospital Protocols and Procedure Manuals …………………… 741

7-19 Recommendations of Professional Medical

Boards or Organizations ……………………………………………… 743

7-20 Recommendations of the American

Medical Association ……………………………………………………… 746

7-21 Statutes and Administrative Codes ……………………………….. 749

7-21:1 Generally ………………………………………………………….. 749

7-21:2 Statute as Evidence of Standard of ………………………………………. 750

7-21:3 Examples of Statute Held Not

Evidence of Standard ……………………………………………………….. 757

7-22 Discovery of Treatises to be Utilized as Evidence

of the Standard of Care …………………………………………………………758

VI REFUSAL OR INABILITY OF EXPERT TO TESTIFY …………………….….. 759

7-23 Remedies for Failure of Expert Witness to Testify ……………………….759

Chapter 8: Pleadings, Defenses and Voir Dire in Medical Malpractice

Cases …………………………………………………………………………………………763

I INTRODUCTION ………………………………………………………………763

8-1 Overview …………………………………………………………………….. 763

II PARTIES …………………………………………………………………………….. 763

8-2 Identifying All Claims as to All Parties …………………………………. 763

8-2:1 The Entire Controversy Doctrine ………………………………….. 763

8-2:2 Fictitious Defendant Rule …………………………………………….. 766

8-3 Service on Absent Defendants ………………………………………… 769

III DEFENSES ………………………………………………………………………… 770

8-4 Comparative Negligence and Avoidable Consequences …………. 770

8-5 Affidavit of Noninvolvement ……………………………………….777

8-6 Statute of Limitations ……………………………………………..779

8-6:1 Generally ……………………………………………………………. 779

8-6:2 The Discovery Rule ……………………………………………………..782

8-6:2.1 Development of the Discovery Rule ………………….….. 782

8-6:2.2 Filing within Two Years from the Date of Discovery ………………. 788

8-6:2.3 Discovery Rule Triggered by

Knowledge of Fault ……………………………………………………………………791

8-6:2.4 Fact of Injury, Not Injury’s Extent,

Triggers Statute of Limitations ………………………………………………………….. 799

8-6:2.5 Increased Risk of Harm, Latent Disease, Cancer Recurrence: Statute

of Limitations Begins to Run Only After Harm Occurs …………………………….…. 801

8-6:2.6 Discovery of Proper Defendant …………….………………… 804

8-6:2.6a Amended Complaint

Relates Back …………………………………………………………….. 804

8-6:2.6b Due Diligence Required …………………….…………………. 811

8-6:2.7 Application of Discovery Rule to Cases, Generally ……..…. 813

8-6:3 Statute of Limitations in Informed

Consent Cases ………………………………………………………….……831

8-6:4 Failure to Advise, Concealment of Malpractice

and the Statute of Limitations ………………………………………………… 834

8-6:5 Continuing Treatment and the Statute of Limitations .....……. 840

8-6:6 Incompetency/Insanity and the Statute of Limitations ……......841

8-6:7 Infancy/Parents’ Claim for Injuries to a

Child and the Statute of Limitations ……………………………..……… 842

8-6:8 Statute of Limitations for Wrongful Death……………………….. 846

8-7 Charitable and Other Immunities ……………………………….…. 857

8-7:1 Introduction …………………………………………………..………. 857

8-7:2 Hospitals and Charitable Immunity ……………………………. 857

8-7:2.1 Limitations on Hospital Liability ……………………………….. 857

8-7:2.2 Limitations on Hospital Liability Not

Applicable to Hospital Employees ………………………………………..859

8-7:2.3 Determining Whether Defendant is a

Charity Subject to Immunity …………………………………….. 860

8-7:2.4 Charitable Immunity Inapplicable

in Products Liability ……………………………………………………………862

8-7:2.5 Jury Charges on Charitable Immunity …………………….. 862

8-7:3 Immunity for Emergency Squads and Personnel …………. 865

8-7:4 Good Samaritan Act Immunity ………………………………..…… 870

8-8 Tort Claims Act and Public Entity Immunity ……………………… 872

8-8:1 Introduction …………………………………………………….. 872

8-8:2 The Notice of Tort Claim …………………………………… 872

8-8:3 Requirement of Notice of Tort Claim

for Public Employees …………………………………………….…….. 874

8-8:4 Time to Serve Notice of Claim in Malpractice Cases …….... 874

8-8:4.1 Eagan and Lowe Opinions ……………………………………. 874

8-8:4.1a Eagan v. Boyarsky: Public

Employee Status Unclear …………………………………………….…. 874

8-8:4.1b Lowe v. Zarghami:

Extraordinary Circumstances ………………………………………………. 877

8-8:4.2 Cases Applying Eagan and Lowe …………………………………….. 879

8-8:4.2a Ventola and Confusion about

Federal or State Status of Institution …………………………………….. 879

8-8:4.2b D.D. v. UMDNJ and Emotional

Distress as Extraordinary

Circumstances ……………………………………………….. 881

8-8:5 Application of Tort Claim Act Immunity ………………. 884

8-9 Workers’ Compensation Defenses …………………….. 886

8-10 Lack of Jurisdiction ……………………………………………. 891

IV MULTIPLE DEFENDANTS, DEFENSE

CLAIMS AGAINST OTHER PARTIES …………………………………. 893

8-11 Cross-claims ……………………………………………………… 893

8-12 Representation of Multiple Defendants ………………………902

8-13 Counterclaims by Defendants ………………………………… 912

V VOIR DIRE …………………………………………………………… 913

8-14 Voir Dire in Medical Malpractice Cases …………………. 913

8-14:1 Supreme Court Directive #4-07 ………………………. 913

8-14:2 Requirements of Voir Dire …………………………………..915

8-14:3 Use of Standard and Open-Ended Voir Dire……………….. 920

8-14:4 Peremptory Challenges ………………………………… 921

VI ARBITRATION ……………………………………………………… 926

8-15 Contractual Limitations Upon and Compelled

Arbitration of Malpractice Claims ………………………………….. 926

Chapter 9: Pretrial Discovery in Medical

Malpractice Cases ……………………………………………………. 935

I INTRODUCTION …………………………………………………………… 935

9-1 Overview ……………………………………………………………… 935

9-2 Priority of Discovery ……………………………………………………. 936

II MEDICAL RECORDS …………………………………………………………. 937

9-3 Obtaining Plaintiff’s Medical Records,

Interviewing Plaintiff’s Treating Physicians …………………………….. 937

9-4 Use of a Subpoena to Obtain Medical Records ………………. 942

III INTERROGATORIES ……………………………………………..944

9-5 Form Interrogatories ……………………………………………… 944

9-6 The Scope of Inquiry by Interrogatories ………………………………. 945

9-7 Discovery of Communications Between Plaintiff,

Counsel and Experts ……………………………………………………… 951

9-8 Penalty for Failure to Answer Interrogatories ……………………….. 952

9-9 Production of Expert Reports ………………………………………….953

IV USE OF ADVERSARY’S EXPERT …………………………………………. 958

9-10 Use of an Adversary’s Expert Generally Prohibited ………….958

V DEPOSITIONS …………………………………………………………….. 963

9-11 Depositions of Parties ………………………………………………963

9-11:1 Raising Objections During Depositions ………………………… 963

9-11:2 Scope of Deposition Questions …………………………………..964

9-11:3 Deposition Questions Concerning Opinions ……………………. 968

9-11:4 Deposition Testimony Supporting Learned Treatises ……. 972

9-12 Depositions of Experts ……………………………………………….. 973

9-13 Material Change in Testimony by a Witness …………………. 978

VI TREATING PHYSICIANS’ OPINIONS, REPORTS AND TESTIMONY ………… 983

9-14 Use of Treating Physicians’ Opinions …………………………….. 983

9-14:1 Value of Treating Physicians’ Testimony ……………………. 983

9-14:2 Discovery of Treating Physician’s Opinion ………………… 984

9-14:3 Use of Subsequent Treating Physician as Witness …… 985

9-14:3.1 Subsequent Treating Physician as

Witness Concerning Liability Issues …………………………….. 985

9-14:3.2 Subsequent Treating Physician as

Witness Regarding Causation …………………………………………… 989

9-14:4 Admissibility of Subsequent Treating Physician’s Reports ……. 995

9-14:5 Other Issues Concerning Treating

Physician’s Testimony …………………………………………………………… 997

9-15 Opinions of Psychiatrists or Mental Health Care Professionals …… 998

VII OTHER DISCOVERY ISSUES ……………………………………………………….. 1002

9-16 Opinions in Medical Records ……………………………………….. 1002

9-17 Medical Examiner’s/Autopsy Reports ……………………………………….. 1007

9-18 Records and Reports of Board of Health, Board of Medical Examiners ……… 1010

VIII CROSS-EXAMINATION OF EXPERTS ………………………………………. 1012

9-19 Scope of Cross-Examination of Expert Witnesses …………………….. 1012

9-19:1 Cross-Examination of Collateral Issues ……………………………….. 1012

9-19:2 Cross-Examination Regarding Prior Service as Expert Witness ……..1015

9-19:3 Use of Hypothetical Questions in Cross-Examination……………………… 1017

9-19:4 Questions Concerning Experts’ Financial

Arrangements …………………………………………………………………….1018

Appendix........................................................................................... 1021

Table of Cases …………………………………………………………………… 1023

Index …………………………………………………………………………….. 1049