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OBJECTIVE: To obtain epidemiologic outcome information about pediatric lawsuits that originate in the emergency department and urgent care center. METHODS: This was an anonymous retrospective review of all closed pediatric claims in the Physician Insurers Association of America database during a 16-year period (1985-2000). This database, containing data from 20 major malpractice insurance firms, insuring 25% US physicians, was queried for epidemiologic outcome information about pediatric lawsuits originating in US emergency departments and urgent care centers. RESULTS: There were 2283 closed claims reviewed. Of these, 96% originated in the emergency department, and 4% originated in an urgent care center. Nonteaching hospitals were the sites for 79% of claims. Suits involved emergency department physicians in 29%, pediatricians in 19%, board-certified physicians in 46%, US graduates in 70%, and full-time physicians in 96% of cases. In 66% of cases, doctors had a previous claim. In 65% of cases, more than 1 defendant was involved. Patients were boys in 59% and were younger than 2 years in 47%. The most common diagnoses involved in the lawsuits were meningitis, appendicitis, arm fracture, and testicular torsion. Cases in which the child died were most often from meningitis or pneumonia. The most common misadventures were diagnostic error (39%), and no medical error identified in 18%. OUTCOME: Cases were settled in 93% (indemnity paid in 30%). There was a judgment for the doctor in 5.5% and for the patient in 1.4%. The average indemnity/claim was US66,000 dollars in 1985 versus US218,000 dollars (+330%) in 1997. The average indemnity ranged from US7000 dollars for emotional injury, US149,000 dollars for death of the patient, US300,000 dollars for major permanent injury, and US540,000 dollars for quadriplegic from injury. There was no significant difference between teaching versus nonteaching hospitals, between urgent care center versus emergency department, US graduate physician versus non-US graduate, or physician age. Indemnity paid/claim for full-time physicians was US161,000 dollars versus US91,000 dollars for part-time physicians. Total paid to plaintiffs was US116 million dollars. Legal cost of defending the cases was US36 million dollars (including defense attorney fees, US24 million dollars, and expert witness fees, US3.4 million dollars). CONCLUSIONS: Malpractice suits most often involved fractures, meningitis, and appendicitis. Most suits are settled; many are apparently frivolous. Paid indemnities have dramatically increased in recent years. Verdicts decided by juries favored the doctor in 80% of suits.

The impact of increasing numbers of lawsuits for access to medicines in Brazil is hotly debated. Government officials and scholars assert that the "judicialization of health" is driven by urban elites and private interests, and is used primarily to access high-cost drugs. Using a systematic sample of 1,262 lawsuits for access to medicines filed against the southern Brazilian state of Rio Grande do Sul, we assess these claims, offering empirical evidence that counters prevailing myths and affirms the heterogeneity of the judicialization phenomenon. Our findings show that the majority of patient-litigants are in fact poor and older individuals who do not live in major metropolitan areas and who depend on the state to provide their legal representation, and that the majority of medicines requested were already on governmental formularies. Our data challenge arguments that judicialization expands inequities and weakens the universal health care system. Our data also suggest that judicialization may serve as a grassroots instrument for the poor to hold the state accountable. Failing to acknowledge regional differences and attempting to fit all data into one singular narrative may be contributing to a biased interpretation of the nature of judicialization, and limiting the understanding of its drivers, consequences, and implications at local levels.

SYNOPSIS Positive accounting theory predicts that conservative financial reporting averts GAAP-based litigation. However, very little empirical evidence addresses whether and how accounting conservatism provides these benefits. Using a sample of lawsuits against public companies for alleged violations of U.S. GAAP, we examine the association of accounting conservatism with subsequent initiation of lawsuits and with four litigation outcomes: market reactions to lawsuits, duration of lawsuits, dismissals of lawsuits, and penalties approved by courts. We find that firms with greater degrees of conditional conservatism experience more favorable consequences on all five dimensions of litigation occurrence and outcomes. Several measures of unconditional conservatism are not associated with the litigation variables. Our study provides new empirical evidence supporting Watts's (2003a) litigation explanation for accounting conservatism. JEL Classifications: M41.

Of the 1.65 million lawsuits enforcing federal laws over the past decade, 3 percent were prosecuted by the federal government, while 97 percent were litigated by private parties. When and why did private plaintiff-driven litigation become a dominant model for enforcing federal regulation? The Litigation State shows how government legislation created the nation's reliance upon private litigation, and investigates why Congress would choose to mobilize, through statutory design, private lawsuits to implement federal statutes. Sean Farhang argues that Congress deliberately cultivates such private lawsuits partly as a means of enforcing its will over the resistance of opposing presidents. Farhang reveals that private lawsuits, functioning as an enforcement resource, are a profoundly important component of American state capacity. He demonstrates how the distinctive institutional structure of the American state--particularly conflict between Congress and the president over control of the bureaucracy--encourages Congress to incentivize private lawsuits. Congress thereby achieves regulatory aims through a decentralized army of private lawyers, rather than by well-staffed bureaucracies under the president's influence. The historical development of ideological polarization between Congress and the president since the late 1960s has been a powerful cause of the explosion of private lawsuits enforcing federal law over the same period. Using data from many policy areas spanning the twentieth century, and historical analysis focused on civil rights, The Litigation State investigates how American political institutions shape the strategic design of legislation to mobilize private lawsuits for policy implementation.

Abstract Legal rights of investors are recognized as an essential component of corporate governance. We assess the efficacy of these rights by examining board changes surrounding the filings of shareholder derivative lawsuits. We find that the incidence of derivative lawsuits is higher for firms with a greater likelihood of agency conflicts. We also find that derivative lawsuits are associated with significant improvements in the boards of directors. In particular, the proportion of outside representation on the board of directors increases. There is also some evidence that other board characteristics change favorably. These findings suggest that shareholder derivative lawsuits are not frivolous as is often claimed, but rather that they can serve as an effective corporate governance mechanism.

This article using the database of Taiwanese land property lawsuits studies the economic effects of rainfalls on land property lawsuits during the period of Japanese colonial rule (1920-1941). The results obtained from basic ordinary least squares indicate that it shows no significant influences. However, an interesting result is that, when we adopt the approach of two stage least squares and use the variables of temperature and evaporation as the instrument variables of rainfalls, we find that there are highly significant influences on the lawsuits of land property. If 1 year comes with low average rainfalls, it means that the costs of productive inputs increase, because the available natural resource will decrease, and brings the distorted using of land property.

Research summary: Tournament theory suggests that a large gap in pay between CEOs and top managers can provide incentives to perform, but we argue that it can also elicit negative effort and even motivate the kind of behavior that leads to lawsuits. We posit that this negative effort is greater when firms have high levels of unrelated diversification because there is less operational interdependency, so tournament effects are stronger. We also contend that the influence of tournament incentives on behavior leading to lawsuits is weaker when environmental uncertainty is high. We discuss the consequences of these findings for research on fraud and tournament theory as well as the practical repercussions for firms, investors, and policymakers. Managerial summary : Each year, the press has a field day when companies announce the outsized compensation packages laid out for CEOs . Economists use “tournament theory” to describe how high CEO pay motivates everyone else to work hard to get into the top job. The problem with this approach is that, yes, top managers work harder when the gap between their and the CEO 's pay increases, but as that gap widens, it also incentivizes top managers to cheat or cut corners. As a result, we find that the gap between CEO and top manager compensation predicts the likelihood that shareholders will file a securities class action lawsuit against the company. This gap in pay is an especially good predictor of lawsuits for highly unrelated diversified companies and companies facing a low level of external uncertainty . Copyright © 2015 John Wiley & Sons, Ltd.

BACKGROUND: Our objective was to identify the prevalence of recent malpractice litigation against American surgeons and evaluate associations with personal well-being. Although malpractice lawsuits are often filed against American surgeons, the personal consequences with respect to burnout, depression, and career satisfaction are poorly understood. STUDY DESIGN: Members of the American College of Surgeons were sent an anonymous, cross-sectional survey in October 2010. Surgeons were asked if they had been involved in a malpractice suit during 2 previous years. The survey also evaluated demographic variables, practice characteristics, career satisfaction, burnout, and quality of life. RESULTS: Of the approximately 25,073 surgeons sampled, 7,164 (29%) returned surveys. Involvement in a recent malpractice suit was reported by 1,764 of 7,164 (24.6%) responding surgeons. Surgeons involved in a recent malpractice suit were younger, worked longer hours, had more night call, and were more likely to be in private practice (all p <0.0001). Recent malpractice suits were strongly related to burnout (p < 0.0001), depression (p < 0.0001), and recent thoughts of suicide (p < 0.0001) among surgeons. In multivariable modeling, both depression (odds ratio = 1.273; p = 0.0003) and burnout (odds ratio = 1.168; p = 0.0306) were independently associated with a recent malpractice suit after controlling for all other personal and professional characteristics. Hours worked, nights on call, subspecialty, and practice setting were also independently associated with recent malpractice suits. Surgeons who had experienced a recent malpractice suit reported less career satisfaction and were less likely to recommend a surgical or medical career to their children (p < 0.0001). CONCLUSIONS: Malpractice lawsuits are common and have potentially profound personal consequences for US surgeons. Additional research is needed to identify individual, organizational, and societal interventions to support surgeons subjected to malpractice litigation.

Abstract This paper documents significantly negative stock price reactions to shareholder-initiated class action lawsuits. We find that shareholders partially anticipate these lawsuits based on lawsuit filings against other firms in the same industry and capitalize part of these losses prior to a lawsuit filing date. We show that the more likely a firm is to be sued, the larger the partial anticipation effect (shareholder losses capitalized prior to a lawsuit filing date) and the smaller the filing date effect (shareholder losses measured on the lawsuit filing date). Our evidence suggests that previous research that typically focuses on the filing date effect understates the magnitude of shareholder losses, and that such an understatement is greater for firms with a higher likelihood of being sued.

Lawsuits over coffee burns, playground injuries, even bad teaching: litigation "horror stories" create the impression that Americans are greedy, quarrelsome, and sue-happy. The truth, as this book makes clear, is quite different. What Thomas Burke describes in Lawyers, Lawsuits, and Legal Rights is a nation not of litigious citizens, but of litigious policies—laws that promote the use of litigation in resolving disputes and implementing public policies. This book is a cogent account of how such policies have come to shape public life and everyday practices in the United States. As litigious policies have proliferated, so have struggles to limit litigation—and these struggles offer insight into the nation's court-centered public policy style. Burke focuses on three cases: the effort to block the Americans with Disabilities Act; an attempt to reduce accident litigation by creating a no-fault auto insurance system in California; and the enactment of the Vaccine Injury Compensation Act. These cases suggest that litigious policies are deeply rooted in the American constitutional tradition. Burke shows how the diffuse, divided structure of American government, together with the anti-statist ethos of American political culture, creates incentives for political actors to use the courts to address their concerns. The first clear and comprehensive account of the national politics of litigation, his work provides a new way to understand and address the "litigiousness" of American society.

INTRODUCTION: New medical technology brings the potential of lawsuits related to the usage of that new technology. In recent years the use of point-of-care (POC) ultrasound has increased rapidly in the emergency department (ED). POC ultrasound creates potential legal risk to an emergency physician (EP) either using or not using this tool. The aim of this study was to quantify and characterize reported decisions in lawsuits related to EPs performing POC ultrasound. METHODS: We conducted a retrospective review of all United States reported state and federal cases in the Westlaw database. We assessed the full text of reported cases between January 2008 and December 2012. EPs with emergency ultrasound fellowship training reviewed the full text of each case. Cases were included if an EP was named, the patient encounter was in the emergency department, the interpretation or failure to perform an ultrasound was a central issue and the application was within the American College of Emergency Physician (ACEP) ultrasound core applications. In order to assess deferred risk, cases that involved ultrasound examinations that could have been performed by an EP but were deferred to radiology were included. RESULTS: We identified five cases. All reported decisions alleged a failure to perform an ultrasound study or a failure to perform it in a timely manner. All studies were within the scope of emergency medicine and were ACEP emergency ultrasound core applications. A majority of cases (n=4) resulted in a patient death. There were no reported cases of failure to interpret or misdiagnoses. CONCLUSION: In a five-year period from January 2008 through December 2012, five malpractice cases involving EPs and ultrasound examinations that are ACEP core emergency ultrasound applications were documented in the Westlaw database. All cases were related to failure to perform an ultrasound study or failure to perform a study in a timely manner and none involved failure to interpret or misdiagnosis when using of POC ultrasound.

Importance: Medical malpractice litigation against surgical residents is rarely discussed owing to assumed legal doctrine of respondeat superior, or "let the master answer." Objective: To better understand lawsuits targeting surgical trainees to prevent future litigation. Design, Setting, and Participants: Westlaw, an online legal research database containing legal records from across the United States, was retrospectively reviewed for malpractice cases involving surgical interns, residents, or fellows from January 1, 2005, to January 1, 2015. Infant-related obstetric and ophthalmologic procedures were excluded. Exposures: Involvement in a medical malpractice case. Main Outcomes and Measures: Data were collected on patient demographics, case characteristics, and outcomes and were analyzed using descriptive statistics. Results: During a 10-year period, 87 malpractice cases involving surgical trainees were identified. A total of 50 patients were female (57%), and 79 were 18 years of age or older (91%), with a median patient age of 44.5 years (interquartile range, 45-56 years). A total of 67 cases (77%) resulted in death or permanent disability. Most cases involved elective surgery (61 [70%]) and named a junior resident as a defendant (24 of 35 [69%]). Cases more often questioned the perioperative medical knowledge, decision making errors, and injuries (53 [61%]: preoperative, 19 of 53 [36%]) and postoperative, 34 of 53 [64%]) than intraoperative errors and injuries (43 [49%]). Junior residents were involved primarily with lawsuits related to medical decision making (21 of 24 [87%]). Residents' failure to evaluate the patient was cited in 10 cases (12%) and lack of direct supervision by attending physicians was cited in 48 cases (55%). A total of 42 cases (48%) resulted in a jury verdict or settlement in favor of the plaintiff, with a median payout of $900 000 (range, $1852 to $32 million). Conclusions and Relevance: This review of malpractice cases involving surgical residents highlights the importance of perioperative management, particularly among junior residents, and the importance of appropriate supervision by attending physicians as targets for education on litigation prevention.

ABSTRACT Using the staggered adoption of universal demand (UD) laws in the United States, we study the effect of shareholder litigation risk on corporate disclosure. We find that disclosure significantly increases after UD laws make it more difficult to file derivative lawsuits. Specifically, firms issue more earnings forecasts and voluntary 8‐K filings, and increase the length of management discussion and analysis (MD&amp;A) in their 10‐K filings. We further assess the direct and indirect channels through which UD laws affect firms' disclosure policies. We find that the effect of UD laws on corporate disclosure is driven by firms facing relatively higher ex ante derivative litigation risk and higher operating uncertainty, as well as firms for which shareholder litigation is a more important mechanism to discipline managers.

For the RCRA and Superfund Acts, the publicly announced desired effects are the protection of the public and natural resources from, and ultimate cleanup of, hazardous waste materials. If the regulations are working, firms are being deterred from illegal disposal of wastes. If not, the regulations are providing only illusions of improved safety, while the public actually faces a never ending process of site discovery and cleanup. While not addressed in previous empirical literature, the deterrent effects of the RCRA and Superfund Acts are the focus of this paper. The deterrent effects of the RCRA and Superfund Acts stem from the potential for suits against responsible parties seeking an end to violations, site cleanup, and reimbursement for expenditures and damages. This paper measures the impact of hazardous waste mismanagement lawsuits on stockholder returns. Specifically, the standard event-study method is used to directly measure the abnormal losses suffered by stockholders associated with lawsuit filings and settlements between 1977 and 1986.

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Using a qualitative design, we develop a model of discrimination lawsuit resolution identifying type of discrimination, firms' verbal and behavioral responses, and stakeholder mobilization as key. Data from media accounts of lawsuits reveal four paths to resolution, distinguishable largely by the type of discrimination they represent. Findings also highlight aspects of race discrimination and sexual harassment that invite different organizational responses than other forms of discrimination. In addition, analysis of the response paths suggests that external stakeholders with and without formal authority critically influence firms' responses. We discuss findings in the context of organizational responses to threat, and institutional theory.

Physicians contend that the threat of malpractice lawsuits forces them to practice defensive medicine, which in turn raises the cost of health care. This argument underlies efforts to change malpractice laws through legislative tort reform. We evaluated physicians' perceptions about malpractice claims in states where more objective indicators of malpractice risk, such as malpractice premiums, varied considerably. We found high levels of malpractice concern among both generalists and specialists in states where objective measures of malpractice risk were low. We also found relatively modest differences in physicians' concerns across states with and without common tort reforms. These results suggest that many policies aimed at controlling malpractice costs may have a limited effect on physicians' malpractice concerns.

Auditing, Auditor litigation, Audit failures, Lawsuits

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