Maryland Injury Law Center

March 28, 2008

Does Singulair Cause Suicide?

The FDA said yesterday it is looking into an association between Merck’s allergy and asthma drug Singulair and suicide. The FDA has received reports of mood changes, suicidal ideation, and suicide in patients who have taken Singulair. Trying to get out on the front of the curve with its package insert, Merck has previously updated Singular’s drug labeling four times to include potential risks of tremors, anxiousness, depression, and suicidal behavior reported in some users of Singulair.

To call Singulair a popular drug is an understatement. Singulair is Merck’s biggest selling drug and one of the world’s top-selling medicines with $4.3 billion in sales. Singulair is also a leukotriene receptor antagonist. These types of drugs have been linked to suicidal ideation and suicide. Two similar drugs, AstraZeneca’s Accolate and Critical Therapeutics’s Zyflo, will also be reviewed by the FDA. Neither of these drugs’ labels include suicide warnings.

Singulair/suicide litigation just might be the next big mass tort. But I doubt it. Unfortunately, 40,000 people a year commit suicide and when you have a drug like Singulair that millions use, some of those people will take Singulair and commit suicide. Some will even take Singulair and commit suicide in a close temporal relationship with the initiation of the drug which really leads people to assume that it must be the drug. But it does not automatically follow that Singulair causes suicide. That remains to be seen and my guess is that Singulair does not cause suicidal behavior. Either way, it is nice to see the FDA is trying to get out in front of potential risk (for once). This is probably a byproduct of the errors that the FDA made with Chantix, where the FDA rushed Chantix – a drug that alters mood – onto the market without fully assessing the suicide risk.

March 27, 2008

Financial Information on Hired Gun Experts

by Ronald V. Miller, Jr.

Our lawyers have long believed that professional expert witnesses’ financial information, including their tax returns, may be discoverable and admissible for the purpose of showing potential bias. Yesterday, the Alaska Supreme Court joined the list of jurisdictions, including now Maryland, that agree with us.

Noffke v. Perez

Noffke v. Perez is a car accident case. An Anchorage, Alaska jury awarded the wife and husband $54,000 and $24,000 respectively. On appeal to the Alaska Supreme Court, the defendant claimed that it was an error for the trial judge to require her expert witness to produce income tax records. Reading between the lines, after a motion to compel the records was sought and granted, the defendant’s expert did what many hired medical experts do after an order to produce their records: they refuse to testify.

March 21, 2008

Legal Malpractice Settlement and Verdicts in Maryland, Virginia and Washington D.C.

by Ronald V. Miller, Jr.

Metro Verdicts Monthly recently provided data on legal malpractice settlements and verdicts in Virginia, D.C., and Maryland.

The median legal malpractice settlement/verdict in Washington D.C. was a whopping $262,500.00. In Virginia and Maryland, the median legal malpractice settlement/verdict was $212,500.00 and $140,211.00 respectively.

What explains the incredible disparity between Washington, D.C., and Maryland and why is Maryland’s median so low? I really have no idea. As always, I find this data very interesting yet useless.

March 7, 2008

Valuing Pain and Suffering Injuries: Per Diem Arguments

by Ronald V. Miller, Jr.

The biggest intangible dealt with by personal injury lawyers in settling or trying a personal injury case is noneconomic pain and suffering damages. These damages defy ready conceptualization and the law provides little in the way of help to jurors who make the final call.

Talking to Juries About Valuing Cases

In many of our personal injury cases we have used per diem reasoning to juries to articulate pain and suffering damages. Per diem arguments give some tangible basis for a pain and suffering award. In psychobabble speak, per diem arguments are a form of anchoring — the cognitive phenomenon of the tendency of people to make estimates with a value in mind. After an anchor is established, there is a bias toward that value to the exclusion of other evidence.

February 13, 2008

New Maryland Court of Appeals Opinion

by Ronald V. Miller, Jr.

The Maryland Court of Special Appeals decided the Titan v. Advance case yesterday. Titan is a case where the Plaintiff alleged negligent repair of a roof that led to the clogging of a roof drain, which then resulted in the Plaintiff’s premises to flood. It is located on Eastern Avenue in Baltimore, Maryland, at Crown Industrial Park. After a three-day trial, the jury found in favor of the Defendants.

As you might have expected, the amount of rain after the job was completed was relevant. Defendants introduced, over objection, a certified copy of the U.S. Department of Commerce’s weather reports from Baltimore-Washington Airport, which reported rain patterns at the airport between the day the roofing work was completed and the date of the flooding off the roof. Plaintiff objected that the weather at Baltimore Washington Airport on that day was not relevant because it was 10 miles from the site.

The Maryland Court of Special Appeals, in an opinion by Judge Arrie W. Davis, found that the documents were relevant because the parties disputed the amount of rainfall. The court further found that despite the length of the documents, the jury could reasonably interpret the recorded rainfall amounts and the court needed no expert opinion to explain the documents. As to the 10 miles between the Baltimore-Washington Airport and the site of the property, the court concluded this went to the weight of the evidence as opposed to admissibility.

February 7, 2008

Voir Dire in Maryland: Follow-up to Judge Sweeney’s Article on Voir Dire in the Daily Record

by Ronald V. Miller, Jr.

Last month, retired Howard County Judge Dennis M. Sweeney wrote an article in a series of articles he is writing for the Daily Record. The latest article discusses voir dire. One point Judge Sweeney makes is that judges have an aversion to proposed voir dire questions that seem to be uniform in every case the lawyer tries. In my last trial, the defense lawyer did not change the names of the parties from the voir dire that they had apparently cut and pasted from the last case. Judge Sweeney writes that they may poison the trial judge to ignore specific voir dire questions—usually put at the end of voir dire consistent with cut-and-paste practices—that may have more merit.

The article also points to dicta in Landon v. Zorn, 389 Md. 206 (2005), a failure-to -diagnose medical malpractice case in which the Plaintiffs appealed a defense verdict. The basis for the appeal was the trial judge’s refusal to ask whether the jury panel had any “preconceived opinion or bias or prejudice in favor of, or against Plaintiffs in personal injury cases in general and medical malpractice cases in particular?” The Maryland Court of Appeals affirmed in a unanimous opinion written by Judge Clayton Greene, Jr. that it is the responsibility of the attorneys to “propound voir dire questions designed to elicit potential bias from jurors, and not to bootstrap a tort reform argument on appeal to a general question inquiring into any potential ‘bias or prejudice’ against plaintiffs in personal injury or medical malpractice cases.” But as Judge Sweeney notes, the court indicated that the lower court may have had an obligation to include a question more tailored to the plaintiff in that case if requested by the attorneys. Judge Sweeney then said that this “places counsel in the position of having to ask the question in many different formulations to hit on the one that may be correct and specific enough.”

But Maryland trial judges love to rush through voir dire as it is, so I shuttered to imagine giving multiple formulations to these judges. I wrote to Judge Sweeney and asked if he had any solution to the Landon v. Zorn problem of having to ask in many formulations to find the most appropriate, noting my concern about how multiple formulations of the same question might risk annoying the court. Judge Sweeney offered this practical response:

February 5, 2008

Contingency Fees

by Ronald V. Miller, Jr.

Point of Law has an interesting blog post on a recent study regarding contingency fees. I found two conclusions of interest.

First, the study found that people who had the financial means to pay attorneys’ fees upfront still preferred a contingency fee arrangement, even if that arrangement meant they were ultimately likely to pay more in fees. Apparently, the experiment included affluent trial lawyers as imaginary plaintiffs, and they too chose the contingency fee agreement over the hourly billing rate. The authors explain that our instinct to be “loss adverse” is the principal reason people prefer a contingency fee arrangement, even if they expect it will cause higher legal fees. This theory may also explain why people are far more unhappy when they lose $100 than happy when they find $100.

I suspect another reason for this preference that the authors do not point to is that it is less stressful to have some level of cost certainty. I know I dislike paying anyone by the hour, especially when I do not know how many hours attorneys will expend. I would rather they give me an all-inclusive price to solve the problem.

January 8, 2008

New Maryland Court of Special Appeals Ruling on Wrongful Death Medical Malpractice Case

by Ronald V. Miller, Jr.

The Maryland Court of Special Appeals found in a 2-1 decision last month that a reduction of 30 percent in the survival chances of a woman with uterine cancer as the result of medical malpractice is not actionable as a matter of Maryland law.

Marcantonio v. Moen is a case about the delay in diagnosing cancer. Plaintiff claimed that his wife died as the result of her doctors misinterpreting a sonogram and failing to order sufficient tests to follow up on the woman’s symptoms. Because of this failure to diagnose, the Plaintiff claims that his wife’s chances of survival went down from 80% to 50%-60%. So while she was statistically likely to beat cancer even with the malpractice, she died.

The Maryland Court of Special Appeals found that the “major issue to be decided is whether proof that a health care provider was responsible for a twenty to thirty percent reduction in the decedent’s chance of survival suffices to prove that the malpractice caused the death. We shall hold that it is not,” wrote Judge James P. Salmon.

December 26, 2007

Videotaping Independent Medical Exams

by Ronald V. Miller, Jr.

In March, I wrote a blog post discussing whether it makes sense for to videotape medical exams by the defendant’s lawyer’s doctor. Last week, the Oklahoma Supreme Court ruled that a plaintiff who is required to submit to an “independent medical examination” (hereinafter the more honest “defense medical exam”) may videotape the exam.

Here, the doctor had refused a plaintiff’s request to videotape the DME because (1) it would invade the privacy of others in the office; (2) it would be “annoying and distracting” to the DME doctor and his staff; and (3) it would interfere with the doctor’s examination.

Actually, these are not the doctor’s objections. These are the defense lawyer’s objections. The doctor was more than happy to allow the recording of the DME as long as the defendant’s lawyer did not object. These objections are silly. First, obviously, the video should only consist of doctor’s examination of the plaintiff. Second, for $500 an hour, or whatever the doctor is charging, he should be able to bear a minor annoyance and distraction. Finally, there is no reason to believe that videotaping at the DME would interfere with the examination.

December 12, 2007

Medical Malpractice Liability to Third Parties

by Ronald V. Miller, Jr.

On Monday, the Supreme Judicial Court of Massachusetts overturned the dismissal of a lawsuit filed by a woman against a physician who had failed to warn his patient of the side effects of a medication. These side effects had caused the patient to lose consciousness at the wheel and kill the woman’s 10 year-old pedestrian son. The driver had recently had treatment for cancer and had been told by his doctor that he could safely resume driving while on his medication. (He had stopped driving for a period of time.) The mother sued, alleging that the doctor failed to warn his patient, the driver, of the possible side effects of drowsiness, dizziness, and altered consciousness.

The lower court had dismissed the lawsuit, claiming that the physician had a duty to his patient only, not to third parties. The Supreme Judicial Court disagreed and found that the doctor’s duty extended to anyone who could be harmed by his failure to warn his patient about the drug’s side effects. This ruling greatly widens the scope of duty of physicians when choosing treatment options for their patients and perhaps necessitates a wider discussion of possible side effects when prescribing medications. The case will now return to the lower court and be tried on the issue of the doctor’s negligence (the dismissal was on the basis of standing to bring the lawsuit in the first place).

This is a very sad case. The driver was 75 years old and suffered from lung cancer, chronic bronchitis, high blood pressure and emphysema. At the time of the crash, he had finished his cancer treatment but was still on many medications. He died of cancer shortly after the accident. A ten-year old boy lost his life when he was in the wrong place at the wrong time. It does not get much more awful than that.