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Emory Law: Advanced Legal Research: Final Project
Professor Elizabeth Christian


You are a new associate at a large general practice firm in Atlanta. Your firm has talked about developing a Medical Malpractice branch, but so far it's only been talk. Your boss comes into your office first thing Monday morning. Something has happened to the daughter of his top client, and the firm will be handling the case. He sits down and tells you hurriedly what happened to Abby Ingram over the weekend. You are horrified because you know her. She sat next to you last year in one of your classes at Emory Law. Here are the facts . . .
 
Abby is a 24-year-old third-year law student at Emory Law. She is healthy and a sweet and funny student who makes pretty good grades,but does have to work at it. She has recently gotten engaged and is excited about getting married next fall, hopefully after she passes the Bar and gets a job. Abby has a lot going on and has been feeling anxious and stressed out lately. She generally does not like to take medicine, but her doctor recently gave her an antidepressant, and it does make her feel somewhat better. 
 
Abby has two main friends in law school, Susan and Brooke. Susan's parents own a small mountain house near Clayton, Georgia, and the three law students decide to spend the weekend of February 16 studying and hiking in the mountains away from it all. It is peaceful and relaxing and they have been having a great time, but Abby starts feeling sick Saturday evening. She feels like she is getting the flu. She calls her dad several times that day, and he tells her to go to the emergency room in the neighboring town, just to be safe. Brooke and Susan have been drinking and the roads are bad, so Abby drives herself and tells them she will be back in a couple of hours, hopefully with a prescription for Tamiflu.
 
When Abby arrives at the Rabun County Hospital (RCH) she has the chills pretty bad and is shaking. It is a Saturday night and there is no doctor working in the emergency room that night, only a nurse practitioner named Kim who has been left in charge. Kim has just graduated from school this past December. She got a job in January working for a family practitioner during the day and works the emergency room night shift alone at RCH on the weekends. She has a month and half worth of experience. 
 
Abby tells the nurse practitioner that she thinks she is getting the flu and cannot stop shivering. She tells her that she has recently started taking an antidepressant and tells her the name of it. The NP then tells Abby that she will give her an injection for the chills. 
 
Abby just wanted the Tamiflu and to get back to the cabin. She doesn't like the sound of an injection, but the NP assures her repeatedly that it is safe, will not interact with her antidepressant, and that there is nothing to worry about. Abby calls her dad and tells him all of this. She also leaves this all on a voicemail to Susan, which Susan listens to and then deletes.
 
The NP gives Abby a Demerol injection and begins looking after other patients. Later, an orderly comes to find the NP because something is happening with one of the patients. Abby has begun crying uncontrollably. She is agitated, terrified, and wailing that something is wrong. She is crying for help, begging for her father, and saying over and over that she doesn't want to die. The NP does not examine Abby but instructs an orderly to keep her for observation and to put her in restraints. Abby is placed in a room, and the door is closed. At 6:30 a.m., when the NP checks on Abby, she realizes that she is dead.

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The antidepressant Abby was taking was an MAOI inhibiter, which interacts with the drug Demerol. Despite what she said, the NP never checked to make sure that it was safe with what Abby was taking. Abby's father has lost his only child and is devastated. Abby's mother died in childbirth years before. Mr. Ingram is a powerful and well-known person in Atlanta. Many people have given him advice on what to consider in this case. He has multiple questions, and your boss wants you to do the initial research and meet with Mr. Ingram later in the week with your findings. 

Directions: Write up your answers in a quick Memo format addressed to the Partner from you: (To, From, Regarding, Date). To answer his questions, tell what you found and where you found it. On a second page, for each question tell me how you found the answer. If you performed electronic searches, tell me what database and search terms you used, etc. If you used a print resource, how did you find the answer? Write clearly so that I can retrace your steps if necessary.  

Google can be your friend, but it cannot be your only friend. Please attach any copies of cases you cite in your memo with the pertinent language highlighted. You do not need to attach copies of any statutes. Please do not forget to Shepardize everything. I am also not interested in any in-depth research pertaining to legislative history. Lastly, please consider your writing style. Your memo should be to the point, easy and interesting to read, as well as well organized. Your Final Project is to be turned into the Circulation Desk in print format on March 4 by 5 p.m. 

1. Mr. Ingram has been told to brace himself by his friends, that his case will be affected by various tort reform measures that have been passed in Georgia. He’s heard the phrase over and over but never really understood what it was. What is tort reform, and what were the arguments for putting it in place?

2. Someone has told Mr. Ingram that there is now no such thing as a frivolous Med-Mal case in Georgia due to a requirement to have an expert affidavit first. What is this all about? What will your firm have to do before you can file a complaint?

3. Is there a cap on the amount of damages that Mr. Ingram can get on his medical malpractice claim? Are there any statutes or cases that discuss this?

4. Your boss has also told you that emergency rooms in Georgia now have the lower “standard of care” of “gross negligence.” Find some cases in Georgia pertaining to gross negligence in hospital emergency rooms that will both help and hurt your case.  

Your boss also tells you that some attorneys think that this means that doctors and nurses working in emergency rooms in Georgia are immune from suit. After your research, do you agree or disagree with this statement and why? In a brief, quick search, do you find any cases in neighboring states that might help? (Do not just cite the cases you find. Refer, at least briefly, to the facts of them that you deem important.)

5. Do you think a Georgia judge would find it important that a nurse practitioner with so little experience was left alone in charge of an emergency room with no supervision? Does a search turn up any cases or other legal authority that might help your client’s case in this regard?

6. You have found your research disturbing, and tell your boss this. He takes you aside and tells you that he has something else that makes him feel sick when he thinks of Abby Ingram and others like her who get hurt. He has heard that the real reason why doctors' malpractice premiums are so high is not because of frivolous lawsuits, but rather because malpractice insurance carriers are not subject to the same antitrust laws as every other business in the U.S. He’s heard this means these carriers can charge whatever they want and can price fix and price gouge with impunity.  

You have never heard this. Could it possibly be true? Have some members of Congress tried to draw attention to this loophole and fix it? What happened to their efforts? Use Google and www.Thomas.gov or any other resource you deem helpful to shed some light on your boss’ proposition.    

7. Your boss brings you two articles recommended by a member of Georgia’s Med-Mal Plaintiff’s Bar to get you acclimated to recent developments in medical malpractice in the U.S. He wants you to read them before you meet with Mr. Ingram. One of the articles appeared in The Wall Street Journal in September 2012, and the other was on MSNBC. The case will most likely be filed in the small town of Clayton, Georgia. Will these articles help you in presenting your case to a small town jury during your opening and closing arguments? How?

Note: The generic term for Demerol is meperidine. This fact pattern is based on an actual case. It has been altered somewhat for this exercise. There really was an Abby, only her name was something else.