OBSTETRIC MALPRACTICE CLAIMS

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American Conference Institute’s 14th Annual Advanced Forum on

OBSTETRIC

MALPRACTICE CLAIMS

June 23–24, 2015 | The Union League | Philadelphia, PA

Gain key strategies and updates from top in-house counsel, outside counsel, claim specialists, risk managers and medical experts on:

• Genetic and Epigenetic Disorders: Emerging Trends and Strategies • Neonatal Encephalopathy and Neurologic Outcomes: The ACOG Reports

• Resolving the Tension Between Nurses, Midwives and Obstetricians

• The Anatomy of an Obstetric Malpractice Case: An Examination of Every Stage and Trial Techniques

• Neonatal Brain Injury: Assessing the Standard of Care and Determining the Timing and Causation of an Injury

• New Trends in Hypothermia Treatment for Newborns Suffering from Acute Hypoxic Encephalopathy

• The Affordable Care Act Subsidies: Addressing/Defining/Defending Damages and Life Care Plans • Neonatal Brachial Plexus Palsy Cases

• Catastrophic Verdicts, Reinsurance and The Patient Safety Movement

• The Reptile Theory: Implementing Effective Litigation Strategies Between Client and Counsel to Counter Reptilian Tactics

Joseph S. Picchi

Galloway, Lucchese, Everson & Picchi

Norman D. Tucker

Sommers Schwartz

Hear from and network with: Richard P. Kidwell

UPMC

Richard T. Henderson

Transatlantic Reinsurance

Robert Shavelle, PhD, FAACPDM

Life Expectancy Project

John S. Moore

CNA

James L. McGarity

R&D Strategic Solutions

David C. Zielinski

MedPro Group

Michael D. Anderson

Medical Insurance Exchange of California

Richard A. Farlow

BerkleyMed

Jennifer L. Green

AIG Claims, Inc. Property Casualty

Brian S. Kern

Gallagher Bollinger Distinguished Co-Chairs:

Thomas F. Halpin, MD

University of Massachusetts Medical School

Michael G. Ross, MD, MPH

Harbor-UCLA Medical Center

Harry F. Farb, MD

Obstetrician and Maternal Fetal Medicine Specialist

Robert H. Allen, PhD, PE

Johns Hopkins University

Michele J. Grimm, Ph.D.

Wayne State University

David A. Clark, MD

Albany Medical College

Max Wiznitzer, MD

CWRU School of Medicine

and others Featuring unparalleled medical insights from:

Obtain insight as to the perspectives from the Bench. Hear from:

Earn

CLE

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Obstetric malpractice cases continue to result in massive verdicts

, reaching amounts in excess of $100 million.

Claims are evolving

in response to advances in medical technology, which can increase the potential for errors in the

delivery room. Further,

new standards of care are emerging

and with these new standards come

new malpractice

claims

. Given the state of obstetric malpractice, it is essential that all those along the obstetric malpractice continuum,

including medical professionals, risk managers, insurance professionals, plaintiffs’ attorneys, and defense counsel, be

current on the latest claims and defense strategies and how they are impacting the practice.

American Conference Institute’s

14

th

Annual Advanced Forum on Obstetric Malpractice Claims

will bring together

an

unparalleled faculty of medical experts, risk managers, insurance professionals, and leading plaintiffs’ and defense

attorneys

, who will provide you with

the most up-to-date information on complex medical issues and litigation

hurdles

, including:

•

Genetic and Epigenetic Disorders

: Emerging Trends and Strategies

• Neonatal Encephalopathy and Neurologic Outcomes:

The

ACOG

Reports

• The Tension Between Nurses, Midwives and Obstetricians

• The Anatomy of an Obstetric Malpractice Case:

An Examination of Every Stage and Trial Techniques

•

Neonatal Brain Injury

: Assessing the Standard of Care and Determining the Timing and Causation of an Injury

• New Trends in

Hypothermia Treatment

for Newborns Suffering from

Acute Hypoxic Encephalopathy

•

The Affordable Care Act Subsidies

: Addressing, Defining, Defending Damages and Life Care Plans

•

Neonatal Brachial Plexus Palsy Cases

Register now by calling

1-888-224-2480

or by faxing your registration form to

1-877-927-1563

. You can also

register online at

www.AmericanConference.com/ObMal

WHO SHOULD ATTEND

� Lawyers, both plaintiff and defense, who litigate medical malpractice cases attend in order to get a solid grounding on the latest medical issues upon which cases are based. Our faculty of medical and legal experts from around the nation will provide you with the information and strategies that are essential to achieve the best outcomes for your clients

� Doctors, nurses and hospital risk/quality assurance managers attend in order to benchmark their current practices and procedures and develop a deeper understanding of the current state of obstetric malpractice litigation

� Insurance professionals attend in order to obtain valuable insights and strategies for assessing professional negligence claims and to better understand litigation strategies and hospital risk management techniques

Be a part of the nation’s premier obstetric malpractice conference and ensure that you keep

abreast of the evolving standards of care, emerging theories of liability, and new plaintiff and

defense strategies.

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7:15

Registration and Continental Breakfast

8:00

Co-Chairs’ Opening Remarks

Joseph S. Picchi

Partner

Norman D. Tucker

Of Counsel Sommers Schwartz

8:05

In-House Claims and Risk Management

Professionals Speak Out on Obstetric Malpractice

Financial & Legal Decisions, Evaluation and

Settlement of Cases, Insurance Coverage, and More

Richard P. Kidwell

Senior Associate Counsel/Vice President of Risk Management

UPMC

Robert Shavelle, PhD, FAACPDM

Technical Director Life Expectancy Project

David C. Zielinski

MedPro Group

Michael D. Anderson

Senior Claims Representative

Medical Insurance Exchange of California

Jennifer L. Green

Senior Claims Analyst

Healthcare Malpractice Claims Department AIG Claims, Inc. Property Casualty

Brian S. Kern

Area Executive Vice President Gallagher Bollinger

Courtney Koch

Complex Claims Examiner

Berkshire Hathaway Specialty Insurance

Kenneth Appleby

Director Healthcare Insurance Services ProMac Specialty Insurance

Moderator:

Joseph S. Picchi

Partner

10:00

Genetic and Epigenetic Disorders:

Emerging Trends and Strategies

David A. Clark, MD

Chair, Dept. of Pediatrics Albany Medical College

Victoria L. Vance

Chair of HealthCare Practice Group Tucker Ellis LLP

Andrew S. Kaufman

Partner

Kaufman Borgeest & Ryan LLP

• Assessing new and emerging research regarding genetics and the impact of epigenetic factors on development • ACOG and AAP recommended screening and testing

for appropriate patients

• Specific conditions with genetic and epigenetic

contributions – diabetes, ADHD, autism, asthma, motor difficulties (cerebral palsy)

11:40

Neonatal Encephalopathy and Neurologic

Outcomes: The ACOG Reports

Thomas F. Halpin, MD

Professor of Obstetrics and Gynecology University of Massachusetts Medical School

Max Wiznitzer, MD

Pediatric Neurology

CWRU School of Medicine

The impact of the reports that presented the findings and recommendations of a task force of obstetricians and gynecologists who represented key areas of expertise. Learn key takeaways and how you should be adapting your practice.

1:00

Networking Luncheon for Speakers and Delegates

2:00

Resolving Tension Between Nurses, Midwives and

Obstetricians

Eric J. Stockman

Principal

Neubert, Pepe & Monteith, P.C.

Angelo A. Ziotas

Partner

Silver Golub & Teitell LLP

Kristi McClure

Clinical Educator, Perinatal Services Mount Carmel West Hospital

Day One: Tuesday, June 23, 2015

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3:00

Preparing and Presenting Your Witnesses

Joseph S. Picchi

Partner

Roger E. Harris

Partner

Swift, Currie, McGhee & Hiers, LLP

John A. Scully

Partner

Cooper & Scully, P.C.

Norman D. Tucker

• Ensuring that the witness is adequately prepared for deposition

• Anticipating where a deposition is heading • Key considerations for video depositions • Pitfalls to avoid

• How minor physical and verbal cues can have a major effect on the impact of a deposition

• Watching videotaped depositions to improve your ability to conduct or participate in a deposition

• What to look for

• Incorporating the lessons learned into future deposition

4:05

Afternoon Break

4:15

The Reptile Theory: Implementing Effective

Litigation Strategies Between Client and Counsel

to Counter Reptilian Tactics

Richard A. Farlow

Assistant Vice President BerkleyMed

John E. Hall, Jr., Esq.

Partner

Hall Booth Smith, P.C.

Tammy L. Wade

Partner

Ruff, Freud, Breems & Nelson, Ltd.

James L. McGarity

Specialized Professional Competence R&D Strategic Solutions

Jury Selection

• Applying the lessons learned from jury focus groups to your jury selection process

• Making sure of the critical insights provided by jury consultants to obtain a more favorable jury

Using Demonstrative Evidence and Themes

• Conveying your message and effectively explaining complex theories to jurors

• Using aids to explain data, provide accurate representations, and debunk opposing theories

• Using a clear and concise presentation which conveys credibility while staying within legal limits

Narrating a Comprehensive Story

• Using themes to explain the details to the jury • Simplifying the critical issues to the jury • Demystifying complicated technical issues • Persuasively detailing what is a reasonable risk

The Reptile Theory: How to Counteract the Inherent Instinct to Punish Your Client

• Overcoming sympathy for injured plaintiffs • Overcoming juror bias against doctors

- intolerance of virtually any risk of harm

- the assumption that given advancements in medical technology, any death or serious injury means that there must have been some form of obstetric malpractice - explaining hard evidence in a way that lay people can

internalize

- minimizing juror anxiety about injuries to baby and mother

5:25

Electronic Medical Records, Patient Portals

and Audit Trails: The Benefits and Dangers

of a Paperless System

Kirsten Ullman

Partner

Lewis Brisbois Bisgaard & Smith LLP

• The increased malpractice risks associated with Health Information Exchanges

• Overcoming the challenges of implementing an electronic platform

• Providing assurance of the integrity of the electronic record and the associated raw data

• How to train users and the risks involved • Form v. narrative notes

• The use of electronic medical records in documenting labor and delivery and how that impacts the defensibility and expert opinion of the case

• Cloning records and the retroactive manipulation of electronic records

• Implementing enhanced documentation tools to capture relevant information in the electronic record

6:10

Conference Adjourns

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7:30

Continental Breakfast

8:00

View From the Bench: Renowned Federal and

State Judges Will Tell You What Works and

What Doesn’t in Their Courtrooms, Why Parties

Succeed and Don’t Succeed in Med Mal Cases,

Novel Trial and Case Management Strategies,

Examples of Bad Lawyering and More

Hon. Ruben Castillo

U.S. Dist. Ct., N.D. Ill.

Hon. Lorenzo F. Garcia

U.S. Dist. Ct., D.N.M.

Hon. Victor J. DiNubile, Jr.

Philadelphia Ct. C.P.

Hon. Robert B. Collings

U.S. Dist. Ct., D. Mass. Moderator:

Norman D. Tucker

9:25

Morning Break

9:35

The Anatomy of an Obstetric Malpractice

Case: An Examination of Every Stage and Trial

Techniques

Eric J. Frisch

Partner

Carlock, Copeland & Stair LLP

Lisa S. Dagostino

Partner

Kline & Specter

Timothy L. Barnes

Partner

Porzio, Bromberg & Newman, P.C

Mark J. Brice

Of Counsel

Decof, Decof & Barry, P.C.

• Investigating the facts concerning liability, causation, and damages: what is relevant?

• Ensuring that your client is prepared for trial • Trial briefs and motions in limine

• Overcoming the challenges of representing the institutional client

• Giving an effective opening statement

10:40

Neonatal Brain Injury: Assessing the Standard of

Care and Determining the Timing and Causation

of an Injury

Michael G. Ross, MD, MPH

Chairman, Dept. of Ob/Gyn Harbor-UCLA Medical Center

Bruce G. Habian

Partner

Martin Clearwater & Bell LLP • Neuroimaging and radiology

• Pediatric Neurology : determining when the injury occurred • The impact of intrauterine infections and genetic disorders

on the placenta and fetus

• Assessing the role of cytokines in the development of long-term neurological defects

• Ascertaining if cytokines were created by HIE injury or infection

• Detecting signs or symptoms of infection prior to delivery • Infection as a causal element of cerebral palsy

11:40

New Trends in Hypothermia Treatment

for Newborns Suffering from Acute Hypoxic

Encephalopathy

Joseph A. Farchione

Partner

Wheeler Trigg O’Donnell LLP

Jim Puga

Partner

Leventhal & Puga, P.C.

• Update of hospital hypothermia protocols, clinical trial guidelines, and their use as evidence in HIE claims • Update on hypothermia clinical trials for HIE, use for

neonatal injury other than HIE, and the use and results of hypothermia for adult cardiac arrest in birth injury cases • Effect of hypothermia use on NEACP definition of HIE

and proofs of negligence and proximate cause

• Treatment’s results on motor and/or intellectual function and its effect on claims filed and damages evaluations • Has hypothermia created a new standard of care for treating

newborns with HIE

12:30

Networking Luncheon for Speakers and Attendees

1:25

The Affordable Care Act Subsidies: Addressing,

Defining, Defending Damages and Life Care Plans

Brant E. Poling

Partner

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Ralph F. Valitutti

Principal

Kitch, Drutchas, Wagner, Valitutti & Sherbrook, P.C. • Case studies and the future of the collateral source rule • Mitigation of Damages

• Burden of proof and the affirmative defense • Expert testimony

• Billed rates and negotiated rates • Life expectancy

• The surge of applicants entering an already stressed system as a result of Obamacare

2:20

Catastrophic Verdicts, Reinsurance

and The Patient Safety Movement

Richard T. Henderson

Vice President

Transatlantic Reinsurance

John S. Moore

Director – Specialty Strategic Claims CNA

Maggie M. Finklestein

Shareholder Stevens & Lee

• Reasons for the ever increasing amounts of obstetric malpractice verdicts

• Malpractice reinsurance pools

• The Patient Safety Movement: Born out of the fear induced by monster verdicts, physicians are more likely to offer the cesarean section option, even in the absence of any actual medical purpose

• Defensive medicine and the decision to offer the cesarean section

3:20

Neonatal Brachial Plexus Palsy Cases

Michele J. Grimm, Ph.D.

Associate Professor, Biomedical Engineering Wayne State University

Robert H. Allen, PhD, PE

Undergraduate Program Director Department of Biomedical Engineering Department of Gynecology and Obstetrics Johns Hopkins University

William F. Cunningham

Partner

Cunningham Meyer & Vedrine, P.C.

• Brachial plexus: injury with and without shoulder dystocia • Fundal pressure, expulsive forces and clinician applied

forces

• Failure to detect macrosomia

• Understanding the key risk factors for shoulder dystocia, how they should be managed, and the delivery note

• The Expulsion Defense and it’s impact on juror’s perception of defense credibility & verdicts

• Daubert – Davis Frye Motions: the trial before the trial in these cases

4:40

Category Two Fetal Monitoring Strips:

Safeguarding Against Incorrect Readings

and Responses

Harry F. Farb, MD

Obstetrician and Maternal Fetal Medicine Specialist

Luke M. Pittoni

Senior Partner

Heidell, Pittoni, Murhpy & Bach, LLP • An update on fetal strip categorization

• Ensuring accurate readings and interpretations of fetal strips • Assessing emerging technologies that can assist with

evaluations and interpretations of fetal heart rate patterns • Common claims of negligence involving Fetal Monitoring

Strips

• Degree of sophistication of training of OB nurses regarding fetal monitoring and the disputes between doctors and nurses when a strip is misread

• Potential liability resulting from a lack of FM scrutiny by a physician

• Avoiding the pitfalls of overreliance on fetal heart rate algorithms

5:45

Conference Ends

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CLE Credits

Continuing Legal Education Credits

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The Union League, which occupies an entire city block in the center of Philadelphia’s commercial and cultural district, is a shining jewel of history in a city defined by such treasure. Founded in 1862 as a patriotic society to support the policies of President Abraham Lincoln, The Union League has hosted U.S. presidents, heads of state, industrialists, entertainers and visiting dignitaries from around the globe. The classic French Renaissance-styled League House, with its brick and brownstone façade and dramatic twin circular staircases leading to the main entrance, is listed in the National Historic Register, and dates back to 1865, when the Broad Street building was completed. Adorning the walls and hallways is the League’s distinguished art collection, artifacts imbued with the heritage and culture of its membership. The collection is a rich, historical chronicle of Philadelphia’s unique imprint upon the American landscape from the nineteenth century to today.

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American Conference Institute’s 14th Annual Advanced Forum on

OBSTETRIC

MALPRACTICE CLAIMS

June 23–24, 2015 | The Union League | Philadelphia, PA