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To the Editor:
The recent article by Glick1 and the accompanying cautionary editorial2 are quite interesting and provocative and are a timely reminder that the neurologist is not immune from lawsuits. Currently, there are a total of 18 million lawsuits per year in the United States and tort reform is just an illusion. Malpractice claims and settlements are indeed complex and thus, the information provided may be erroneous if used as a surveillance tool. For example, some of the largest awards in medical litigation have been made for neurologic impairment in children. Sympathetic awards seem to be based on the degree of plaintiff disability rather than evidence of negligence of culpable acts. Recent years have seen changes in our understanding of birth asphyxia and the epidemiology of cerebral palsy (CP) and most cases of CP are not due to birth asphyxia. In addition, no intervention including caesarean section has ever been shown to prevent CP.3 Thus, the presence of CP does not establish substandard medical care or that birth hypoxia occurred. Yet, undaunted by these facts, a handful of the same neurologic and obstetric experts are not deterred from testifying alleging negligence.
Glick …
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