Justice And Arbitration Fairness

Arbitration. What role should it play in our justice system? What role does it currently play? These are important questions if you have an interest in seeing that those injured are able to access the courthouse for justice.

As Federal policy, arbitration began as a means for sophisticated businesses to resolve complicated commercial disputes privately. That is the proper role arbitration should still play today. However, it has become something very different.

Forced arbitration. That is what arbitration has become. It is no longer a matter of significant negotiation between companies entering complicated contracts. Forced arbitration has become a means for businesses to deny justice to individuals injured by their misconduct. Forced arbitration has closed the courthouse doors to you and your family.

Buried in the fine print of your basic documents -- related to all kinds of consumer items used daily, such as credit cards, television cable, car purchases, cell phones, retirement accounts -- are forced arbitration clauses that deny you the right to go to court. Do you have an elderly parent or relative in a nursing home? Most likely, there is an arbitration clause in the documents admitting them. That means any injuries due to negligence or abuse will be arbitrated before someone chosen by the nursing home. Does that sound fair?

Forced arbitration is unjust. As Public Citizen so clearly explains:

In arbitration, there is no judge, jury or right to an appeal. The arbitrators do not have to follow the law, and there is no public review of decisions to ensure the arbitrator got it right. Moreover, contracts typically name the arbitration firm that must be used – the one preferred by the company.

People who have been harmed by fraud, predatory lending, discrimination, negligence, defective products or scams should not be forced into arbitration: they should have a choice.

Think some private arbitration group chosen by the company will be fair? Think again. Several years ago, the Attorney General of Minnesota spotlighted one private arbitration group. It turns out the group was the chosen arbitrator in many collection actions. Yet, it was discovered that the arbitration group was largely owned by certain debt collection companies. Does it sound fair that consumers should be forced to submit their disputes to a private arbitrator tied by ownership to the very companies and industries at issue?

It is outrageous that we can be forced to give up our Constitutional right to a jury trial just to hold a job or purchase necessities for life. A few days ago, the Arbitration Fairness Act was introduced into Congress. What does the Arbitration Fairness Act seek to accomplish? Simply, it protects the rights of citizens to justice in our courts. A press release by one of the Congressmen sponsoring the bill, says that its purposes are:

What the Arbitration Fairness Act Does:

- Restores the original intent of the FAA by clarifying the scope of its application.

- Amends the FAA by adding a new chapter invalidating agreements that require the arbitration of employment, consumer, or civil rights disputes made before the dispute arises.

- Restores the rights of workers and consumers to seek justice in our courts.

- Ensures transparency in civil litigation.

- Protects the integrity of the Civil Rights Act, the Equal Pay Act, the Americans with Disabilities Act, and the Age Discrimination in Employment Act, among others. 

This is an important proposal. The courthouse doors should not be closed to families who have suffered personal injuries or damages because of corporate wrongdoing. 

Hospital Bills and Payments: Issues in Personal Injury Cases

The U.S. government recently released data detailing and comparing hospital charges. The clear fact revealed by the data -- Charges for specific procedures can vary greatly between hospitals. This comes as no surprise to me. I see hospital bills on a regular basis in my personal injury practice.

When asked about this data on hospital charges, Huntsville Hospital's CEO responded:

I'm not sure it's really relevant to what Huntsville, Crestwood, or UAB hospitals actually get paid.

He's right. The amount billed and the amount actually paid to the hospital can be very different. Blue Cross, Medicare, Medicaid, Tricare, and other plans, all pay differently. How does this issue impact personal injury claims? It creates many issues. Frankly, many lawyers who advertise for personal injury cases really don't take the time to understand these issues. As a result, their clients suffer. Here are a few of these issues:

  1. The Same Injury Can Result In Very Different Medical Damages -- Because of insurance issues, the amount accepted by a hospital for the same procedure to two different accident victims, can be very different. Under current Alabama law, the defendant in a personal injury case can introduce into evidence the lesser amount accepted by the hospital to satisfy a bill. Is this really fair to the injured person who paid huge health insurance premiums for many years?
  2. Some Hospitals Try To Collect Top Dollar From Accident Victims -- If you have health insurance or coverage through a program like Medicare, the hospital should collect payment directly from your health plan. Yet, some hospitals ignore this coverage and file a lien directly against the accident victim for the full amount of the bill. In these cases, it is important that you have legal counsel that understands how to deal with health insurance and hospital liens. The difference to you can be huge.
  3. Different Health Plans/Programs Have Different Subrogation Rights -- When a health program pays your bills and you later recover damages for the personal injury, that plan has certain rights to be paid back. A good understanding of subrogation is essential to helping your client with his personal injury claim. I have written about this topic previously. Too often, lawyers fail their client with these issues. Like the prior issue, the difference to you can be huge.
  4. People Without Insurance Have The Highest Charges -- Because health plans and programs pay a reduced rate, people without health insurance effectively have the highest charges. So, the people who can least afford a big bill get the biggest. This makes it difficult to get the treatment needed for recovery. It also creates a cycle that can impact the injured victim for years. A prior study indicated that a majority of personal bankruptcies had a medical cause.

The recent study on hospital charges is interesting. The payment issues related to hospital charges are very important to my practice as a trial lawyer. This is an area where effective legal counsel can really help a client.

 

UPDATE -- Takeda Faces First Trial Over Diabetes Drug Actos

April 27, 2013:

A few days ago, I wrote about the first case to go to trial against Takeda Pharmaceuticals over its diabetes drug Actos. Takeda faces a huge number of cases alleging that its drug Actos is defective.

As I wrote my last post, the jury was about to begin deliberating this first Actos trial. After several days of deliberation, the jury found in favor of the plaintiffs and assessed $6.5 million in damages.

In its initial statements after the verdict, Takeda stated that it would continue to fight the many claims for personal injury and death over its diabetes medication. Initial posturing by Takeda aside, the truth is that the company faces some significant decisions. Many people have suffered tremendously after taking this medication.

The main allegation related to Actos is that it caused bladder cancer in patients and that the company failed to disclose test results which revealed this relationship. However, additional questions related to other conditions, such as liver and heart problems, have also now been raised. Takeda's choices after losing this first trial and the developing research connecting Actos to many serious health issues will be closely watched.

May 3, 2013:

I am continuing to follow the first Actos trial. In the newest development, the trial judge has thrown out the jury's verdict. In his opinion, the judge found that the plaintiff's medical expert was "not reliable." The expert opinion at issue concerns the specific plaintiff in that case and his medical history. The ruling is especially interesting since the judge did not exclude the expert's testimony at trial or issue any ruling prior to the verdict. The injured plaintiff's attorney has vowed to appeal. So, this case is not yet concluded.

Takeda still faces some tough decisions. The jury found that Takeda failed to warn adequately about the risk of bladder cancer. This finding is important, considering the large number of cases presently pending.

 

Prior Posts Related To Diabetes Drug Actos:

Takeda Faces The First Trial Over Diabetes Drug Actos

Whistleblower Files Suit Against Takeda Over Actos

Actos Update -- MDL Panel Consolidates Cases

Takeda May Face Thousands Of Lawsuits Over Actos

Type 2 Diabetes, Actos, And Bladder Cancer

 

Takeda Faces The First Trial Over Diabetes Drug Actos

According to Bloomberg, the first trial against Takeda Pharmaceutical over the diabetes drug Actos could soon be in the hands of a jury. Takeda faces a huge number of lawsuits claiming that its drug Actos is defective and dangerous. The Bloomberg article says that over 3,000 product liability lawsuits have already been filed against Takeda.

This first trial involves a case filed against Takeda in California. While some cases have been filed in state courts, all the cases against Takeda filed in Federal Courts have been consolidated before a Judge in the Western District of Louisiana for pre-trial purposes. Our office in Alabama has been involved in that litigation.

I have written previously about the problems in our safety system related to the approval of drugs such as actos and the similar medication avandia. I have also written several times about medical devices, such as transvaginal mesh, that are marketed to innocent consumers without adequate testing.

This first actos trial revealed significant evidence of the manufacturer's efforts to persuade the Food and Drug Administration (FDA) not to increase the warning on the drug's label. Here is an internal email among Takeda executives concerning the FDA that was cited in the article:

Actos is the most important product for Takeda and therefore we need to manage this issue very carefully and successfully not to cause any damage for this product globally.

It appears that Takeda was much more concerned with the $1.6 billion in annual actos sales, than it was the devastating injuries being reported by patients prescribed the medication here in Alabama and throughout the United States. In closing argument, the plaintiff's attorney told the jury that Takeda possessed studies revealing links to bladder cancer as early as 2004 but did not disclose the information until 7 years later. This case will be followed closely.

The purpose of the FDA is to protect us from dangerous drugs, defective medical products, and unsafe food. However, the safety and approval process has lost its focus on protecting citizens. Instead, it has become a system where safety is often delayed or denied while dangerous products needlessly cause death or severe personal injury.

The Workers' Compensation System And Its Impact On Injured Workers

Each year, our workers' compensation system in Alabama faces new threats from the insurance industry. In some states, like Texas, the system has been dramatically altered leaving many injured workers unable to recover and return to gainful employment. In Alabama, injured workers with a partial disability that impacts their ability to work are often compensated at an amount below Federal poverty levels. Our state has not increased partial disability payments in over two decades! While benefits to workers are over two decades behind inflation, some of our legislators continue to propose new laws that would cut off other important benefits.

What is the purpose of our workers’ compensation laws? Why were they created? A recent article titled Workers’ Compensation: The System’s Devastating Economic Impact on Workers’ Lives provides an excellent answer:

Workers’ compensation was created for two primary purposes—to provide at least partial compensation for lost wages and to pay for medical treatment and rehabilitation services for workers injured or made ill on the job.

The problem is that our system often fails these purposes. Insurance carriers routinely refuse or delay needed medical care in an effort to save themselves money. Yet, the cost to society of leaving an injured worker unable to recover for an extended period of time is much greater. Constantly, I see denials of medical care that are simply wrong. Is it right for medical care to be refused because the insurance adjuster simply ignores the requests of the treating physician for weeks? Is it right for the insurance carrier to pick a surgeon and then subject all of their surgeon’s recommendations to some anonymous medical reviewer who may not even practice medicine? Or, to deny the requested care repeatedly because of some claim as to missing paperwork that nobody understands?

Because our system does not penalize or prevent insurance carriers from wrongfully or needlessly cutting care and benefits, the entire system is dysfunctional. The first question I am usually asked by injured workers is how quickly they can get back to regular work. Yet, needlessly delaying or denying care frustrates this. That costs the worker and his or her family tremendously. It also costs the rest of us in lost productivity. The article points out the results of allowing insurance carriers to disrupt the important goals of the system:

By compromising workers’ capacity to earn a living, injuries and illnesses unleash a cascade of destructive impacts affecting access to housing and food, stability of relationships, and poverty-related health problems.

It is unconscionable that workers’ compensation places much of the economic burden of occupational injuries and illnesses on workers and their families. This makes workers’ compensation all too often the accomplice, if not direct perpetrator, in pushing workers – especially low wage workers – into debilitating economic insecurity. Injured and ill workers report depleting their savings, sometimes taking out retirement funds or even declaring bankruptcy in their efforts to cope.

All of us need the system to work. Yet, it often does not. I have seen far too many clients who were forced into selling their possessions or declaring bankruptcy after months of begging for basic medical care so they could return to work. What’s more – the long-term trend does not look good:

 Because every state has its own workers’ compensation program, there’s a dangerous race to the bottom as states compete to attract businesses by reducing workers’ benefits. In addition, the largely privatized nature of the system guarantees ever-deepening power disparities between workers and employers. This skews the system to primarily represent the interests of employers and the insurance industry, ensuring that discussions on workers’ compensation and reform initiatives are focused on the cost of the system.

Costs are important. If we are going to focus on costs, we should not simply focus on the costs to insurance carriers paying claims. They collect premiums and make a nice profit. A focus on costs should focus on the larger costs to communities of having injured workers unable to return to productive employment, unable to support their families, and unable to get the medical recovery they need.

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This is an article I originally published on a separate site I created only to discuss workplace injuries. After writing the article, it was also copied (with permission) on an insurance industry site.

Families Can Take Action In Coping With Brain Injury

The March calendar means basketball to some and springtime for others. However, March also marks Brain Injury Awareness Month.  As this month draws to a close, I am focusing on this serious injury that deserves, from a broad perspective, increased national and state awareness. An estimated 10,000 Alabamians sustain a brain injury each year, with 2-3 males suffering for every one female.

From a personal standpoint, head injuries need greater attention within immediate families of sufferers. Family involvement is critical because the injured person may not even be aware of outward symptoms and changes resulting from an injury event such as a car crash, workplace accident or fall. While many brain injury symptoms like dizziness, unconsciousness, nausea, headache and vision changes may be immediately apparent,  as time passes, others become more evident---especially to family and friends close to the person. These symptoms include:

  • Difficulty concentrating and remembering new information
  • Sleeping more or less than usual
  • Acting irritable/grumpy
  • Exhibiting nervousness or anxiety
  • Displaying sensitivity to light or loud noise
  • Feeling sadness
  • Acting emotional
  • Difficulty communicating

Often in my practice, it is the wife who has noticed the changes in the husband's behavior and prompted him to seek further medical attention and compensation.

Another issue resulting from these injuries is the inability to perform everyday tasks at home or in the workplace. Memory problems, difficulty making decisions, coping with emotional issues at work,  and focusing on the steps to complete a task have left many brain injury sufferers unable to work. This problem is often compounded by mounting medical bills from the injury. Many men are reluctant to recognize and admit the severity of these issues and the hindrance they place on their ability to provide for their families. Yet, when these symptoms go unchecked and untreated, health can deteriorate. I always first advise my clients to seek good medical help from a physician with the training and understanding to help with brain injuries.

Finally, with family support and medical care in place, I encourage anyone who is facing brain injury from an accident to take the time to find a lawyer with the appropriate background and experience to handle these difficult cases. Testing for traumatic brain injury involves complicated neuropsychological assessment. Lawyers who do not understand the complex problems suffered by people with brain injuries and who are unfamiliar with the testing fail to present fully the client's story at trial. The good news is Alabama has many medical professionals dedicated to researching brain injuries  and rehabilitating those who suffer from them.

 

Injured by a Defective Product - Who are you Hiring?

With the recent verdicts in California and New Jersey against manufacturers of defective transvaginal mesh products, the flood of lawyer advertisements will begin. Many women have suffered severe personal injury and disability from these products. They have questions. They need good legal help.

Alabama is fortunate to have a number of attorneys who are very skilled in handling defective product claims. The same is true for other states as well. How do you tell the good from the bad? How do you tell which ones will actually represent you as a person and not as a number? How do you tell which ones actually know how to prepare a case for trial?

In the last week since the latest mesh verdict, I have received several mass emails from lawyers claiming they are "national law firms" and seeking these cases. One attorney from another state even called me. I looked him up to see his credentials. What I found was a solo attorney with a new law degree and a brand new firm. He did have experience in creating websites prior to law school. Was he really going to handle complicated defective product claims from places throughout the Untied States? Do you think he understood the specifics of Alabama law and how they differed from other states? Do you think he had ever tried a case or even examined an expert witness? I suspect his intentions were different - get the case and refer it to another lawyer.

This brings me back to my prior question - How can you tell the good from the bad? How can you tell which lawyer to hire? After all, you are entrusting a very serious matter to this person. You can do several things to help make this decision. Here are some questions to ask:

  1. Does the lawyer have real experience handling complex cases in your state? For me, that is Alabama. Each state has unique legal rules. Lawyers who don't understand these rules can quickly ruin a good claim.
  2. Does the lawyer prepare his or her cases? This may sound like a silly question. However, too many lawyers fail to prepare their cases. Consistently good results come with consistent preparation. If you have ever played sports, then you know that all the hard work in practice is what separates the championship teams from everyone else.
  3. Does the lawyer have the desire to go to trial if needed? Trial is like war. Reasonable clients do not want to go to trial. However, sometimes trial is needed. Will your lawyer go to trial? Does he or she even know what to do in trial?
  4. Does the lawyer care about you as a client? When I first graduated from law school (18 years ago), an old lawyer told me that all lawsuits are personal. He was right. They are about real people who are hurting. A good lawyer should not only be good at dealing with the legal issues, he or she should respect you as a client.

How do you get answers to these questions:

  1. Ask people that you trust in your community.
  2. Research the attorney. Any attorney can create a website that claims they are an expert. You should dig a little deeper than the attorney's own website. Many attorneys have profiles on LinkedIn or Avvo that contain information concerning their professional background. Avvo even rates lawyers as does Martindale-Hubbell. Many attorneys have also published information that can often be easily found on the internet.
  3. Talk to the attorney. I interview every potential client in detail before taking a case. That time is important. I find out about your case. I also get to know you in order to decide if we can work together on your case. I am shocked by the number of people who hire lawyers they have never even met. In many cases, the client meets only with a paralegal or, even worse, simply receives paperwork in the mail and returns it upon completion.

Clients who are hurt need an attorney with the ability and desire to really prepare their case. The insurance companies and drug companies have plenty of money to hire skilled lawyers for their defense. Before you hire a lawyer to pursue your claim, ask a few questions to make sure you get representation that is up to the task.

Mesh: Concerns and Questions

Transvaginal mesh and its complications made headlines this week as a jury reached a $3.35 million compensatory damages verdict in a New Jersey Court, with punitive damages to follow. This bold action ignites concern and questions for thousands of other women implanted with the same device.

What is transvaginal mesh?

Transvaginal mesh is a medical device used to repair weakened or stretched tissue caused by conditions such as pelvic organ prolapse (POP) and stress urinary incontinence(SUI). The mesh is made from relatively cheap synthetic materials such as polyester and polypropylene (developed from petroleum). Surgical mesh is inserted through the vagina during pelvic surgery. 79,500 of these profitable devices were sold in 2010 at $2,000 apiece in the United States. In one of our cases, the Alabama surgeon performing the procedure told a patient he implanted 3-5 devices a week.

What conditions are transvaginal mesh used to treat?

  • Pelvic organ prolapse (POP)
  • Stress Urinary Incontinence (SUI)

What are the complications of transvaginal mesh?

  • Pain
  • Infection
  • Bleeding
  • Scarring
  • Erosion of Tissue
  • Incontinence
  • Bladder Injury
  • Bowel Injury
  • Pain During Sexual Intercourse

According to an article in the July issue of Nursing 2009, Volume 39, Issue 7, "a patient, 67, had a transvaginal repair with synthetic mesh for pelvic organ prolapse. Four weeks later, she reported spotting, discomfort, and vaginal irritation. The surgeon found that the surgical mesh had eroded into her vagina and prescribed estrogen cream for a month, but it wasn't effective. The patient needed more surgery for resection of the exposed mesh and closure of eroded tissue." The injuries reported in this journal article are similar to those we have heard from many women while investigating these claims.

Has transvaginal mesh been tested and studied?

Available data on transvaginal mesh is limited, as testing of the device prior to placement on the market is inadequate. As a result, venerable organizations, such as the American Congress of Obstetricians and Gynecologists (ACOG),  recommend that clinicians be vigilant for possible adverse events from mesh.

A review by the Society of Obstetricians and Gynaecologists of Canada (SOGC) found that 5-19% of the surgeries using mesh had erosion and 18% of women developed pelvic muscle dysfunction and pain. Similarly, a recent study by Danderyd Hospital in Sweden concluded that surgeries using mesh resulted in higher rates of surgical complications and postoperative adverse events than the traditional colporrhaphy surgery.

Are there government warnings for the use of transvaginal mesh?

The FDA alerted the public in 2008 to the complications associated with transvaginal mesh and followed with an update in 2011 reporting that the complications were not rare. 

Has transvaginal mesh been recalled?

Johnson & Johnson recalled and removed vaginal mesh products associated with these complications from the market in June 2012.

Are the vaginal mesh manufacturers facing lawsuits?

Women across the country are taking action against the manufacturers of these surgical mesh products in an effort to battle the staggering medical costs, lost wages and other quality of life issues that have taken a beating due to this faulty product. The recent lawsuit involving $3.35 million in compensatory damages follows a a similar mesh lawsuit in California resulting in a jury decision of $5.5 million.

What companies manufacture transvaginal mesh?

  • Johnson & Johnson/Ethicon
  • American Medical Systems (AMS)
  • Boston Scientific Corporation
  • C.R. Bard
  • Coloplast

What to do if you have had complications with vaginal mesh:

I always stress to my clients that they should get the best medical care as quickly as possible.  If you choose to seek legal counsel, look for a lawyer who has actual trial experience helping people who have suffered severe injuries and disabilities. Too many television lawyers simply push paper. The women injured by these products deserve an attorney with the knowledge, skill and desire to pursue their case to the courtroom if needed. I would be happy to answer any of your questions at (256) 650-5500.

Related articles:

Mesh Problems and No Where to Turn: Will A New Jersey Jury Offer Hope?

The eyes of the medical community are on a courtroom in New Jersey as a second case involving transvaginal mesh injury is in the hands of a jury. The first trial, in California, resulted in a $5.5 million verdict against the mesh manufacturer.

My own North Alabama legal team counsels women with their own personal stories of anguish and suffering at the hands of companies like Johnson & Johnson's Ethicon who have manufactured vaginal mesh to treat pelvic organ prolapse (POP) and female stress urinary incontinence (SUI). In a rush for profits, the manufacturers pushed their products without proper testing. Patients, including my own clients, relate heart-wrenching accounts of bleeding, scarring and excruciating pain as the mesh erodes their flesh. Such complaints have led to an FDA warning on the failure of transvaginal mesh.

I recognize the bravery and sense of futility leading women to come forward, as these are personal issues that demand discretion and respect.

While the side effects are a threat to health, the problem is compounded by difficulty in securing follow-up care to remove the device. Some women are left unable to work or care for themselves. As my associates and I pursue multiple cases against these manufacturers, we have heard firsthand the burden on these women and their families. Failing health along with disability and loss of quality of life is difficult with no where to turn. My team's philosophy is a personal approach to alleviate this burden. We treat each case as unique, reviewing each document and record along with attempting to interview the physicians treating the patient.

Currently, there are over two thousand pending vaginal mesh lawsuits in the federal court system. While this is a large issue affecting many and involving a host of counsel, my eyes look toward New Jersey with my North Alabama clients in mind. I anxiously await the verdict in New Jersey--will the problems be recognized and addressed? Is there hope that my clients' burdens will be lightened?

Among the companies facing claims over their defective mesh:

  • Johnson & Johnson/Ethicon
  • American Medical Systems (AMS)
  • Boston Scientific Corporation
  • C.R. Bard 
  • Coloplast

If you have had an experience with mesh similar to what I have described, please feel free to contact me at (256) 650-5500 to have your case reviewed by my team.

 

Plaintiffs' Verdicts Routinely Rejected On Appeal In Alabama

The Alabama Supreme Court reversed verdicts for the plaintiff in 72% of the cases it decided during the last 10 years. A recent study of court decisions revealed this troubling fact. Really, were almost 3/4 of the plaintiff's verdicts wrong?

I have a problem with a percentage that huge. My problem is simple -- civil cases that lack merit rarely, if ever, make it that far. By the time a case reaches an appeal, the plaintiff has survived countless pre-trial motions testing the claim. After these, comes the trial. In Alabama, a plaintiff only wins a civil trial if the verdict is unanimous. All 12 jurors must agree. Then, you still aren't finished. If the plaintiff wins the trial, he will likely face numerous post-trial motions.

If the Alabama Supreme Court is correct and 3/4 of those verdicts were bad, then the problem lies with the trial courts and juries. But, I don't think it does. In North Alabama, we are fortunate to have many excellent trial judges. They work tirelessly to review the cases before them. In addition, the citizens who serve on our juries care deeply about getting to the truth and making the correct decision. I've sat in the courtroom after closing arguments and waited while jurors carefully considered and discussed every piece of evidence in order to make the right decision. I believe our jurors care deeply about making the right decision. And, I believe that most of the time the local judges and jurors get it right.

What does concern me are our appellate courts in Montgomery. The combination of huge election contributions from groups that may not be interested in fair justice, the partisanship of current elections, and a tendency to issue opinions without written decisions explaining them, all cast a shadow over our appellate courts. Whether their decisions were correct or not, it's time to address some of the issues that call our appellate courts into question.