HCM 3080 Module 2 Litigation Written Assignment Example

From Incident to Verdict: Following a Missed Hip Fracture Claim Through New Jersey Litigation and the Administrator's Role at Each Stage

Student Name

B.S. in Healthcare Management, Thomas Edison State University

HCM-3080: Healthcare Legal and Ethical Considerations

Mentor Name

Month Day, Year

From Incident to Verdict: Following a Missed Hip Fracture Claim Through New Jersey Litigation and the Administrator's Role at Each Stage

In March, an 84-year-old woman was seen in the emergency department at Riverbend Community Hospital (a composite South Jersey hospital used throughout these samples), after a fall at home. She was discharged with a diagnosis of a hip contusion. Nine days later, an orthopedic clinic found a displaced femoral neck fracture that required a hip replacement, and her recovery was longer and harder than it might have been. Fourteen months later, the hospital received a complaint naming the hospital, the emergency physician and the radiologist. This paper follows the claim through the stages of civil litigation and explains what the health care administrator does at each one.

Before the Complaint

Litigation often begins long before a lawsuit is filed. The hospital's risk manager first learned of the case when the patient's daughter requested the medical records and filed a complaint with patient relations. At that point, the administrator's tasks are to preserve the record, including imaging and audit logs, notify the hospital's insurer or self-insurance program, and ensure that any internal review is conducted in a way that protects privileged patient safety work. In New Jersey, most personal injury claims must be filed within two years, so the hospital can expect a decision about a lawsuit well within that window.

Pleadings and the Affidavit of Merit

The lawsuit formally begins when the plaintiff files a complaint stating the facts and the legal claims, here negligence by the physicians and vicarious and corporate liability for the hospital. The defendants respond with an answer. New Jersey adds a step that shapes many malpractice cases: within sixty days after a defendant's answer, the plaintiff must provide an affidavit from an appropriately licensed person stating that there is a reasonable probability that the care fell outside acceptable professional standards, with one extension of up to sixty days allowed (N.J. Stat. Ann. § 2A:53A-27). Claims without a timely affidavit can be dismissed. The administrator's role at this stage is to work with defense counsel to identify the right internal contacts and to confirm which staff were involved.

Discovery

Discovery is the longest stage. Each side exchanges documents, answers written questions called interrogatories, and takes depositions, sworn testimony recorded outside court. The emergency physician, the triage nurse and the radiologist will be deposed, along with the patient. The administrator coordinates document production, makes sure staff have counsel and support before depositions, and protects documents that are privileged. Expert witnesses on both sides will review the X-ray, which in this case showed a subtle fracture line, and testify about whether a reasonable emergency physician and radiologist would have detected it or ordered further imaging given the patient's inability to bear weight.

Resolution

Most malpractice claims never reach a verdict. Jena et al. (2011) found that about 7.4% of physicians faced a claim each year but that 78% of claims did not result in payment. Studdert et al. (2006), reviewing closed claims from several insurers, found that claims involving injuries caused by error were usually compensated while most claims without error were not, but also that the system was costly: for every dollar paid in compensation, 54 cents was consumed by overhead, from lawyers' fees experts and courts. In this case, defense counsel and the insurer weighed the subtle imaging, the patient's documented pain on weight bearing and the length of her recovery, and recommended mediation. The case settled before trial. Had it gone to trial, the jury would have decided whether each defendant breached the standard of care and caused the harm, and damages would have been determined.

Settlement does not end the administrator's work. The hospital's review found that the emergency department lacked a protocol for older patients with hip pain and negative X-rays. The administrator sponsored a new pathway calling for further imaging or orthopedic consultation when an older patient cannot bear weight, which addresses the safety lesson regardless of the legal outcome.

Conclusion

Litigation is a long, structured process, and each stage gives the administrator responsibilities: preserving evidence, coordinating with counsel and insurers, supporting staff and, finally, turning the claim into an improvement in care.

References

Jena, A. B., Seabury, S., Lakdawalla, D., & Chandra, A. (2011). Malpractice risk according to physician specialty. New England Journal of Medicine, 365(7), 629-636. https://doi.org/10.1056/NEJMsa1012370

N.J. Stat. Ann. § 2A:53A-27 (2024). Affidavit required in certain actions against licensed persons. https://law.justia.com/codes/new-jersey/title-2a/section-2a-53a-27/

Studdert, D. M., Mello, M. M., Gawande, A. A., Gandhi, T. K., Kachalia, A., Yoon, C., Puopolo, A. L., & Brennan, T. A. (2006). Claims, errors, and compensation payments in medical malpractice litigation. New England Journal of Medicine, 354(19), 2024-2033. https://doi.org/10.1056/NEJMsa054479