David M. Yousem MD, Moderator: Royalties, Oakstone Publishing, LLC Author with royalties, Reed Elsevier Research Grant, Bayer AG

1) To understand the implications of the four components of a medical negligence case: a) duty to the patient, b) breach in the standard of care, c) causation between breach and harm, and d) damages (economic, pain and suffering, punitive). 2) To reflect on the patient and physician experience in going through a malpractice trial. 3) To apply practice habits that reduce the chance that you will be the subject of a medical malpractice suit, enhance patient safety, increase the likelihood of good outcomes, and prevent frivolous lawsuits. 4) To learn dos and don'ts once sued. 5) To comprehend the role of medical experts in establishing the standard of care and ensuring an equitable and fair judicial process. 6) To discuss ethics of testifying as expert.

A medical malpractice case requires establishing four components of the case: 1) the duty of the physician to the patient, 2) a breach in the standard of care (what a reasonably prudent person would do in a similar situation), 3) the establishment that the breach caused the subsequent harm to the patient, and 4) damages to the patient. Most malpractice cases are won or lost in determining whether a deviation in the standard of care occurred and whether that deviation truly caused the patient's damages. Expert witnesses are commonly employed to help establish the standard of care for the setting in question, although some experts also provide guidance as to the expected economic costs that will be incurred by the damaged plaintiff. Because of the high cost of medicolegal litigation, most cases that have minor damages never come to court but may be dropped or settled out of court. because of the vagaries of a lay jury, many substantive cases are also settled out of court. One can reduce the chances that one will be sued by being cognizant of professional standards and guidelines that dictate certain behaviors such as timeliness of reporting, communication of important/relevant/critical/unexpected findings, and establishing good peer review systems that identify errors before they occur. Applying behaviors or work habits that enhance accuracy and efficiency and good practice patterns while also developing good physician-patient relationships are helpful for mitigation of litigation. Effective expert witnesses can help a lay jury understand the nuances of a case and establishing whether negligence has occurred. The credibility of expert witnesses is enhanced when they are impartial, do blinded unbiased reads, understand the specific practice patterns in which the defendant physicians are employed, and can explain complex issues to non-medical jury members.

Yousem, D, Mitigation of Litigation (Sponsored by the RSNA Professionalism Committee) .  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14002190.html