1. Medical Legal/CQI
Jim Simonson, Professor
Branches of Government and Lawsuits

2.  Branches of Government
 Executive
 FDA
 OSHA
 FEMA
 DEA
 DHHS
 CDC
 Public Health
 EMS Boards

3.  Legislative
 Senate and House
 Creates and Enacts Laws
 Direct regulation
 4765.114 Certificate automatically suspended for certain offenses.
 (A) A certificate to practice emergency medical services issued under this chapter is
automatically suspended on the certificate holder’s conviction of, plea of guilty to, or
judicial finding of guilt of any of the following: aggravated murder, murder, voluntary
manslaughter, felonious assault, kidnapping, rape, sexual battery, gross sexual
imposition, aggravated arson, aggravated burglary, aggravated robbery, or a
substantially equivalent offense committed in this or another jurisdiction. Continued
practice after the suspension is practicing without a certificate.
 (B) If the state board of emergency medical services has knowledge that an automatic
suspension has occurred, it shall notify, in accordance with section 119.07 of the Revised
Code, the certificate holder of the suspension and of the opportunity for a hearing. If
timely requested by the certificate holder, a hearing shall be conducted in accordance
with section 4765.115 of the Revised Code.
 Effective Date: 01-18-2007

4.  Legislative
 Some laws ‘delegated’ to EMS Board
 4765.15 Continuing education - approval and accreditation.
 A person seeking to operate an emergency medical services training program shall submit a completed
application for accreditation to the state board of emergency medical services on a form the board shall
prescribe and furnish. The application shall be accompanied by the appropriate application fee
established in rules adopted under section 4765.11 of the Revised Code.
 A person seeking to operate an emergency medical services continuing education program shall
submit a completed application for approval to the board on a form the board shall prescribe and
furnish. The application shall be accompanied by the appropriate application fee established in rules
adopted under section 4765.11 of the Revised Code.
 The board shall administer the accreditation and approval processes pursuant to rules adopted under
section 4765.11 of the Revised Code. In administering these processes, the board may authorize other
persons to evaluate applications for accreditation or approval and may accept the recommendations
made by those persons.
 The board may cause an investigation to be made into the accuracy of the information submitted in
any application for accreditation or approval. If an investigation indicates that false, misleading, or
incomplete information has been submitted to the board in connection with any application for
accreditation or approval, the board shall conduct a hearing on the matter in accordance with Chapter
119. of the Revised Code.
 Effective Date: 11-03-2000

5.  Judicial
 Interpret and enforce the policies and procedures of
the legislative and executive branches
 Provide a safe and efficient forum to enforce laws
and resolve disputes

6.  Criminal
 Violation of a law
 Beyond a reasonable doubt
 Unanimous
 Punitive damages including incarceration

7.  Civil
 Plaintiff suffered harm
 Preponderance of the evidence
 More than half for verdict
 Actual damages
 Punitive damages
 Requires Gross Negligence
 Injunctions
 Cease and Desist

8.  Cause of Action
 Gathering Data
 Medical Records
 Protocols
 Interviews
 Standard of Care

9.  Statute of Limitations
 2305.113 Medical malpractice actions.
 (A) Except as otherwise provided in this section, an action upon a medical, dental, optometric, or
chiropractic claim shall be commenced within one year after the cause of action accrued.
 (B)(1) If prior to the expiration of the one-year period specified in division (A) of this section, a
claimant who allegedly possesses a medical, dental, optometric, or chiropractic claim gives to the
person who is the subject of that claim written notice that the claimant is considering bringing an
action upon that claim, that action may be commenced against the person notified at any time within
one hundred eighty days after the notice is so given.
 (2) An insurance company shall not consider the existence or nonexistence of a written notice
described in division (B)(1) of this section in setting the liability insurance premium rates that the
company may charge the company’s insured person who is notified by that written notice.
 (C) Except as to persons within the age of minority or of unsound mind as provided by section 2305.16
of the Revised Code, and except as provided in division (D) of this section, both of the following apply:
 (1) No action upon a medical, dental, optometric, or chiropractic claim shall be commenced more than
four years after the occurrence of the act or omission constituting the alleged basis of the medical,
dental, optometric, or chiropractic claim.
 (2) If an action upon a medical, dental, optometric, or chiropractic claim is not commenced within four
years after the occurrence of the act or omission constituting the alleged basis of the medical, dental,
optometric, or chiropractic claim, then, any action upon that claim is barred.

10.  Filing of the Complaint
 Answer
 Within 28 days
 Soverign Immunity (can’t sue the King)
 Not for private companies
 Dismissal request

11.  Initial Interviews
 With YOUR attorney
 Discovery
 All information shared between sides
 Interrogatories
 Depositions

12.  Resolutions
 Mediation
 Working together
 Arbitration
 Person or Panel decides
 Settlement
 Makes it ‘go away’
 Trial
 Judicial Oversight
 Summary Judgment
 Only one reasonable option

13.  Trial Procedure
 Stipulations
 Dismissal without prejudice
 Can re-file
 Dismissal with prejudice
 Party’s over
 Settlement at any phase prior to reading of verdict

14.  Trial Procedure
 Voir dire
 Opening Statements
 Plaintiff’s Case
 Witnesses
 Direct Examination
 Cross Examination
 Re-Direct Examination
 Re-Cross Examination

15.  Trial Procedure
 Directed Verdict
 Not enough to prove Plaintiff’s side
 Defendant’s Case
 Same process as for Plaintiff
 Closing Arguments

16.  Trial Procedure
 Jury Instructions
 Deliberations
 Verdict
 Judgment Notwithstanding the Verdict (JNOV)
 Decreases excessive damage awards
 Appeals process

17.  Tell the truth
 Look Professional
 Understand the question
 Do not volunteer information
 Do not ‘fudge’ details

18.  Read documents before answering
 Avoid ‘never’ or ‘always’
 Do not express anger or argue
 Minimize conversations with attorney during
the procedures