Original research
Teaching malpractice litigation in a mock trial setting: a center for perinatal medicine and law

https://doi.org/10.1016/S0029-7844(02)03133-2Get rights and content

Abstract

Objective

To describe a novel center for perinatal medicine and law in a school of medicine and assess its inaugural presentation of the role of expert witnesses in a mock trial setting.

Methods

The center’s first program was an obstetrics and gynecology Grand Rounds that staged an abbreviated mock trial. The case summary was read. An attorney then conducted the direct examination of the plaintiff’s obstetrics and gynecology and neonatal expert witnesses. The audience acted as the jury and anonymously voted electronically after the direct examination. The plaintiff’s attorney then conducted the cross-examination of the defense experts on issues pertaining to possible bias and expert compensation with only a limited inquiry into substantive medical issues. A second vote was taken. A posttrial panel discussion and questionnaire evaluated the importance of this program to medical education.

Results

The first vote indicated 86% of the jury decided that negligent obstetric management contributed substantially to the infant’s injury, and 82% of the attendees felt that negligent neonatal care was a substantial factor in the infant’s injury. After the cross-examination, 63% of the jurors now felt that negligent obstetric management contributed to the brain damage; whereas only 39% of the participants concluded that negligent newborn care was responsible for the injury. During posttrial discussion, the audience suggested that cross-examination of defense experts on issues of bias rather than medical care negatively affected their perception of the examining attorney’s case.

Conclusion

Analysis of the questionnaire showed that the attendees strongly appreciated experiencing this abbreviated mock trial and indicated that the center was a welcome addition to medical education.

Section snippets

Materials and methods

The Center for Perinatal Medicine and Law gives four Grand Rounds lectures per year. The inaugural Grand Rounds presentation was an abbreviated mock trial staged with a presiding judge, a plaintiff’s attorney, a defense attorney, and expert witnesses. Time constraints limited the presentation to the plaintiff attorney’s direct examination of his obstetric and neonatal experts and cross-examination of the defense’s obstetric and neonatal expert witnesses (20 minutes for each). In this exercise,

Results

There were 43 attendees who participated as jurors. After the fact pattern was read and the plaintiff’s attorney conducted a direct examination of the obstetrics–gynecology and neonatal expert witnesses, the audience voted on the following issues:

  • 1.

    Was substandard (negligent) care during labor and delivery a substantial factor in causing this infant’s neurological injuries? Answers: yes, 86%; no, 14%.

  • 2.

    Was substandard (negligent) care during newborn resuscitation a substantial factor in causing

Discussion

A medical negligence trial often takes a severe toll on all parties.3 Families of the plaintiffs are required to relive the traumatic events over and over. Physician defendants may seriously consider no longer taking care of high-risk patients after the experience.8 Some physicians may consider giving up obstetrics altogether. If this were to happen, there would be fewer physicians to care for pregnant women, especially in rural areas.9

Because of the 2-hour Grand Rounds format, this mock trial

References (9)

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Cited by (0)

The authors express their sincere appreciation to Mr. Levin, who undertook the role of defense counsel in this demonstration. We also thank Drs. Lloyd Smith and Anthony Philipps, Professors and Chairs of Obstetrics and Gynecology and Pediatrics, respectively, who served as the plaintiff’s obstetric and neonatal experts. We are indebted to Jan Sherman, RN, PhD, for her critique of the statistical analyses. Lastly, we convey our sincere gratitude to Dean Joseph Silva, whose unwavering support helped establish the Center for Perinatal Medicine and Law.

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