The Charted Defense

The Lawsuit

Michael Season 4 Episode 2

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From bedside to courtroom. The complaint, discovery battles, expert testimony, and the hospital's defense that care met the standard — how a patient's death becomes a legal case.

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SPEAKER_01

This podcast is for educational and informational purposes only. It is not medical advice, legal advice, or professional advice of any kind. And it does not create an attorney client, physician patient, or other professional relationship. Any discussion of cases, outcomes, standards of care, statutes, or regulations is general in nature, may be incomplete, and may vary by jurisdiction and over time. Listeners should consult their own attorney, malpractice carrier, risk manager, or qualified clinician for advice on any specific matter. Any case discussions are based on public records, de-identified information, or educational reconstruction. The views expressed are those of the speakers, and do not necessarily reflect the views of any employer, hospital, health system, insurer, or affiliated organization.

SPEAKER_03

Welcome back to On the Record. Last episode, we told you the story of a patient we called Daniel, a real man experiencing a real medical crisis at a real hospital. He called 911 with chest pain. He made it to an emergency room. He received rapid care from a team that recognized his condition within minutes. And despite that, he passed away. Today we're shifting our lens entirely. This is the lawsuit that followed. Over the next three episodes, we're going to walk you through the legal machinery of a major medical malpractice verdict. The complaint, the discovery battles, the expert armies, the depositions, the pretrial motions, and finally the trial itself. But today, episode two, is about the foundation. How does a patient's death become a legal case? What happens when the family retains lawyers and files a complaint? And what happens when the hospital says we met the standard of care?

SPEAKER_01

Roughly 16 months after the patient's death, a complaint was filed in the State Circuit Court. The plaintiff, the patient's surviving wife, acting as personal representative of his estate, named two defendants, the hospital system and the interventional cardiologist who had been on call for the catheterization. The original complaint focused primarily on what happened in the catheterization lab, the airway emergency, the intubation and extubation, and the code blue response that followed. It alleged that the care team failed to have a supervising physician present at the patient's arrival, that the intubation was mishandled, that the breathing tube was removed without confirming placement, and that the code blue was chaotic and inadequate. The complaint also identified the treating physicians individually and named them alongside the hospital system.

SPEAKER_00

Let me break down what those early counts alleged because the structure of the complaint tells you what the plaintiff's initial case theory was. Count 1 alleged negligence against the hospital system itself. Count 2 alleged active negligence against the interventional cardiologist individually. At this stage, the focus was on phase three, the CATH lab crisis. The complaint alleged that there was no supervising physician present at the patient's arrival, the breathing tube was placed, but was unable to be confirmed by N-title CO2 monitoring, so it was removed. And the code blue response that followed involved multiple failed reintubation attempts over roughly 20 minutes without an anesthesiologist present and without activating the difficult airway response team. The arrest record was only partially completed and failed to document key participants and timing.

SPEAKER_03

It was alleging that the airway management and resuscitation were negligent. It wasn't yet making the broader argument about the hospital system's transfer protocols or the decision to accept a STEMI patient at a facility without catheterization capability. That broader theory, the system level failure, would come later after discovery opened up and the plaintiff's experts had a chance to review the full record. We'll get to that expansion in a few minutes.

SPEAKER_01

The defendants had a statutory window to respond to the complaint. Weeks later, the hospital system and the interventional cardiologist filed their answer. They denied the allegations, but they also raised affirmative defenses. Legal arguments that even if the facts alleged were true, the law would shield them from liability. The most significant defense was the state's Good Samaritan Statute.

SPEAKER_00

The Good Samaritan Act creates a legal shield for healthcare providers who render emergency care. Under the statute, the standard of liability is not ordinary medical negligence, it's reckless disregard. Reckless disregard is a substantially higher legal bar. It means the defendant consciously disregarded a known substantial risk to the patient's life. It's more than a mistake. It's more than a deviation from the standard of care. It's indifference. The defense invoked this statute, arguing that even if the hospital system's conduct fell short of the standard of care, it didn't rise to the level of reckless disregard. The plaintiff had to prove not just that the hospital deviated from accepted practice. They had to prove that the hospital knew a patient could die if they acted as they did, and they acted anyway. That's a significantly higher burden of proof.

SPEAKER_03

The Good Samaritan Act was one, the other was EMTALA, the Federal Emergency Medical Treatment and Labor Act. Both sides would use EMTALA to support their positions, and it would become crucial to how the plaintiff's expert framed the case. We'll get into the specifics of EMTALA when we discuss that expert's deposition testimony, but flag it now. It matters.

SPEAKER_01

After the complaint is filed and answered, both sides enter discovery. The phase where they exchange evidence. Medical records are produced. Expert reports are exchanged. Interrogatories. Written questions requiring written answers are filed. And both sides begin deposing the other side's witnesses. In this case, discovery was contentious. Over several years, the plaintiff filed multiple motions to compel. Legal filings demanding that the defendant produce information the plaintiff believed hadn't been fully provided. The court granted some of those motions. The defendant filed motions for protective order, seeking to shield certain discovery from the plaintiff on grounds of privilege or scope.

SPEAKER_00

Discovery disputes are common in complex medical malpractice litigation. Both sides have legitimate reasons to push back. The plaintiff wants everything that could support their theory of the case. Courts sort these disputes out, and in this case, the court ruled on several of them over time. What matters for our purposes is that contested discovery, regardless of why it happens, can shape how the evidence is perceived once it reaches the jury. Jurors don't typically hear about the motions to compel themselves, but the dynamics of a hard-fought discovery process can affect the completeness and presentation of the evidence they do see. And if a judge issues an adverse inference instruction, telling the jury they can draw negative conclusions from missing evidence, that's powerful.

SPEAKER_01

Times in the air cruise documentation didn't align with the hospital's records. The arrest record was only partially completed.

SPEAKER_03

I want to talk about this from a clinical perspective because this is something every physician and nurse listening has dealt with. We've all been in a chaotic emergency where resources and staff are limited, and there may not be any one person keeping a log and tracking times. If you have two providers and a patient in cardiac arrest, your focus is on the patient, not on documentation. That's normal, that's expected. But here's what matters. Once the chaos has resolved and the team has assembled, once everybody has a role, make sure someone is keeping time. And after the event, while things are fresh in everyone's mind, sit down together and document. Not to coordinate stories, to get the facts right. Because if you don't, five years later a plaintiff's attorney will point to the gaps between your note and the nurse's note and the flight crew's note, and they'll tell a jury that the care was chaotic and uncoordinated and didn't meet the standard of care. In reality, the care probably did meet the standard of care. But at trial, the documentation tells the story, and the jury will likely listen to that version. I'm supportive of providers in these scenarios. I've been there myself, but I want you to protect yourselves. Document while things are fresh, make sure everyone's part of the documentation process is complete before leaving the case. Otherwise, it can and will be used against you.

SPEAKER_01

As discovery unfolded and expert reports came in, the plaintiff's case theory evolved. The original complaint had focused primarily on the Cath lab crisis. The intubation, the extubation, the code blue. But as the plaintiff's experts reviewed the hospital records, the transport timeline, and the system's protocols, they began to suggest something bigger. They saw what they alleged were multiple opportunities to get the patient to a catheterization lab faster. And at each decision point, the system followed a path that kept the patient at a facility without that capability. More than two years after filing the original complaint, the plaintiff filed a second amended complaint. And it was much broader. It added allegations about the decision to accept a STEMI patient at a facility without a catheterization lab. It added allegations about the delay caused by the helicopter needing to burn fuel before transport. It added allegations about the failure to use ground transport as a backup. The complaint now articulated a three-phase alleged system failure, not just a single clinical disaster in the CATH lab.

SPEAKER_00

This expansion is strategic. By amending the complaint to alleged system level failures, the plaintiff widened the aperture. The original case was about what the interventional cardiologist and the CATH lab team did or didn't do. The amended case was about the hospital system's protocols, the hospital system's decisions, and the hospital system's alleged indifference to getting a STEMI patient to definitive care by the fastest possible means. It's the difference between blaming a physician and blaming the institution.

SPEAKER_03

And this is where the plaintiff's expert team reshaped the narrative. The amended complaint didn't happen in a vacuum. It happened because the plaintiff's experts, particularly an emergency medicine physician from a major academic medical center, were offering opinions that the case was bigger than the Cath lab. They alleged that the hospital system's transfer protocols failed the patient at three different phases of care. Those are allegations, opinions offered by retained experts, and not established facts. But they were compelling enough for the court to allow the amended complaint to proceed. The defense opposed the amendment, but the court permitted it.

SPEAKER_01

By the time the amended complaint was filed, both sides had assembled expert teams. The plaintiff's expert lineup included an interventional cardiologist to testify that the CATH lab care breached the standard and caused the death. They brought in an anesthesiologist and critical care physician to testify about airway management, the decision to extubate without confirmed placement, and the absence of an anesthesiologist at the arrest. And they hired nursing experts to testify about nursing care failures, scope of practice concerns, and record keeping. The defense brought their own team, an interventional cardiologist from a VA medical center to support the CATH lab care, an emergency and flight medicine physician to defend the community hospital and transport decisions, a critical care physician to defend the resuscitation, and the hospital system's own chief medical officer, as a corporate representative, to defend the system's policies and practices.

SPEAKER_03

The defense assembled experienced clinicians who practice medicine and could speak to the standard of care from the bedside perspective. That's how litigation works. Both sides bring their strongest voices to make their case.

SPEAKER_01

Some documents were produced, some weren't. The plaintiff alleged that the hospital system operated a model where its community hospitals funneled patients into its central regional medical center for higher level care rather than redirecting to the nearest capable facility, regardless of affiliation. This model, the plaintiff alleged, created a preference for keeping patients within the system's network. It should be noted that this is an allegation. The plaintiff did not present direct evidence of a financial incentive.

SPEAKER_00

The defense acknowledged that they operated through a centralized transfer center that coordinated flow from their community hospitals to their tertiary center. They argued this was actually more efficient. The transferring within the system was faster than the alternative, which would require the community hospital to contact a non-affiliated hospital's transfer center, then formally request physician acceptance, then arrange a separate ambulance. The defense presented evidence that interhospital transfers between unaffiliated hospitals take time. Their argument, we got this patient to the cath lab as fast as the system could. And from a pure timing perspective, the defense had a point. Even with the helicopter delay, the patient arrived at the cath lab within approximately 100 minutes of first medical contact inside the ACC slash AHA's 120-minute benchmark for transfer, S T E M I cases. The system identified the STEMI, accepted the patient for transfer within minutes, and got him to the catheterization lab. The question isn't whether the system was slow, it's whether there was a faster alternative that should have been pursued.

SPEAKER_01

The plaintiff countered with expert testimony that inter-hospital transfers, affiliated or not, happen routinely without significant delay. That's the expert's opinion, and it may not generalize to every region or every clinical scenario in the way he alleged. But he was allowed to offer it. The plaintiff also alleged that if the patient had been transferred by ground ambulance or diverted from the emergency department to a closer PCI capable facility, he would have been in the CATH lab sooner.

SPEAKER_03

I want to step back and give you my clinical perspective on this because I think it's important. Guidelines are just that, a guide. They don't replace our judgment. We can override the guideline or transfer protocol in place when clinical circumstances demand it. But in this case, the transfer system actually worked efficiently. The patient was accepted for transfer quickly. If it hadn't been for the helicopter needing to burn fuel, he would have arrived within an appropriate time. I don't think the physician at the community hospital played a role in any alleged system failure. The system is in place to offload the transfer logistics from the ED physician so she can continue focusing on all her emergency patients. That's how it's supposed to work. But this is clearly what the plaintiff is focusing in on, so we need to be aware of the policies and guidelines in place. And I want to be clear about something. There is no evidence in the record that the hospital system had a financial incentive to keep this patient in network. We don't know this patient's insurance status. The teaching point here is simpler. Know your transfer options. Know which facilities around you have catheterization capability. Know how long ground transport takes versus air. And if your protocol doesn't get a STEMI patient to a cath lab fast enough, you have the clinical authority to override it. That's the lesson.

SPEAKER_01

As the case broadened, a critical legal question emerged. The plaintiff was now alleging that the hospital system should have redirected EMS to a PCI-capable hospital. The defense countered with a statutory argument. MTA, the Federal Emergency Medical Treatment and Labor Act.

SPEAKER_00

MTALA is a federal statute that imposes obligations on hospitals with emergency departments. It has three core requirements. First, when a patient comes to the emergency department, and the regulations define that as presenting on hospital property, the hospital must provide a medical screening exam. Second, if that screening exam reveals an emergency medical condition, the hospital must provide stabilizing treatment within its capability. Third, if the hospital can't provide definitive treatment, it must arrange an appropriate transfer, meaning the receiving facility has agreed to accept, the patient is stabilized to the extent possible, and appropriate transport is arranged. The entire purpose of EM Tala is to prevent patient dumping, hospitals turning away emergency patients or transferring them without stabilization. The defense's argument was straightforward. Once the ambulance arrived at the community hospital, once the patient was on hospital property, EMTALA was triggered. The hospital was legally required to provide a medical screening exam. Once that exam revealed a STEMI, an emergency medical condition, the hospital was required to stabilize the patient. And this patient was hypotensive, his blood pressure was dropping, making stabilization all the more critical before any transfer. The hospital then arranged an appropriate transfer to a PCI-capable facility. The fact that they chose their own regional medical center rather than a non-affiliated hospital didn't violate EMTALA. The statute doesn't require transfer to the closest facility. It requires transfer to an appropriate facility that has agreed to accept.

SPEAKER_01

But here's what's important to understand about the reality of this situation. The STEME was identified two minutes before arrival. Two minutes. Whether the ambulance was technically on hospital property or approaching it, the window was extraordinarily narrow. This disagreement shows just how close the call was either way. And just how difficult a scenario everyone involved was placed in. And here's what's important to understand clinically. It's difficult to imagine a scenario where the ED physician or anyone else would divert an ambulance that is arriving imminently at your hospital. And there's a reasonable concern that diverting a hemodynamically unstable patient without performing a screening exam and stabilizing first could itself be an EMTALA violation. That is exactly the kind of patient dumping the statute was designed to prevent.

SPEAKER_00

He stated that the emergency physician could have performed a medical screening exam from the ambulance bay, confirmed STEMI, and then diverted the ambulance to the PCI capable hospital without formally accepting the patient for evaluation. Essentially, a screen and redirect at the door. Under his interpretation, you could satisfy the screening exam requirement and still send the patient elsewhere without going through the full stabilization and transfer process. This is a legally contested interpretation. Under the statute, once you perform a medical screening exam and identify an emergency medical condition, which a STEMI is, the hospital is obligated to either stabilize the patient within its capability or arrange an appropriate transfer. And an appropriate transfer under MTA has specific requirements. A physician must certify that the medical benefits of transfer outweigh the risks. The receiving facility must agree to accept. An appropriate transport must be arranged. What the expert described, screening at the ambulance bay and redirecting the ambulance without going through the formal stabilization and appropriate transfer process, bypasses those requirements entirely. That's closer to the kind of patient dumping Mtala was enacted to prevent. The defense would argue that what the expert described is not something the law allows, and that their transfer protocols were specifically designed to comply with their EMTala obligations.

SPEAKER_03

Here's what matters practically. Once you perform that screening exam and you identify an emergency condition, you are obligated to stabilize and transfer. You can't just see the patient at the ambulance bay and send them on their way. The law doesn't work that way. Now, reasonable people can disagree about the edges, about what constitutes coming to the emergency department, about whether a two-minute window of STEMI knowledge is enough time to redirect an arriving ambulance. But the core statute is clear, screen, stabilize, transfer appropriately. The hospital in this case did all three. Whether they should have done it faster or to a closer facility, that's the legal question. But the claim that the ED physician could have examined the patient and diverted the ambulance without accepting him for care is at minimum a contested interpretation that most emergency physicians I know would view skeptically.

SPEAKER_00

Let me take a step back and summarize where each side had positioned themselves as the case approached trial. Because the case had evolved considerably from where it started. Rather than immediately redirecting EMS to a closer, PCI-capable facility, or initiating ground ambulance transport as a backup, the system waited for a helicopter that needed to burn fuel, a delay of roughly 23 minutes. The patient spent over an hour at a facility that couldn't treat his condition. Then, when the patient finally reached the cath lab at the regional medical center, there was no supervising physician present, the airway was mishandled, the breathing tube was removed without confirmation of placement, the code blue response was delayed and poorly coordinated, and the patient died. The plaintiff alleged this was a system-wide failure, not just a cath lab error.

SPEAKER_01

The defense's theory was different. They argued that once the patient was arriving by ambulance, EMTALA was triggered. They were then obligated to arrange an appropriate transfer, which they did quickly and efficiently. They argued their transfer center coordinated the process, the interventional cardiologist accepted the patient within minutes, and the patient was transported to the PCI-capable facility. The policies in place were designed to comply with EMTALA and to effectuate a quick and smooth transfer process. The care, including the airway management decisions, represented medical judgment under emergency circumstances. And the patient's death was the result of the disease process, an acute STEMI affecting a large area of the heart, not the care provided. And they invoked the Good Samaritan Act. This was an emergency. The patient could arrest at any moment given the STEM he was experiencing. The state statute exists to protect emergency care providers given the critical nature of these patients and the split-second decisions they have to make. Even if there were deviations from ideal practice, those deviations didn't rise to the level of reckless disregard.

SPEAKER_00

So the jury would have to decide: is this a case of a hospital system that made reasonable emergency decisions under EMTALA constraints and the pressures of an acute STEMI? Or is this a case of a system that, despite having options, followed a path that delayed definitive care for a patient who was running out of time?

SPEAKER_01

Before trial, both sides filed motions requesting that the judge rule on evidence and legal issues in advance. The hospital system filed seven motions in Lemen. Legal requests to exclude certain evidence from being presented to the jury. The plaintiff filed motions of their own.

SPEAKER_00

But in his deposition, he went well beyond resuscitation. He criticized the ED physician's care. He opined on whether the patient should have been diverted from the ambulance bay, a question that implicates EMTALA, hospital logistics, and transport system design. He drove a rental car between hospitals and timed the drives with an app, then testified that ambulances could go faster. The defense argued that some of these opinions, particularly his statements about what the ED physician should have done with respect to diversion, were inflammatory and did not accurately represent what the law allows. The core issue for the defense was this. The expert's deposition contained statements suggesting that the ED physician could have performed a screening exam from the ambulance bay and diverted the ambulance without accepting the patient for care. The defense argued that this testimony misrepresented Mtala and would mislead the jury into believing the hospital had a legal option that it actually did not have.

SPEAKER_01

Essentially, to establish that the hospital's acceptance and transfer of the patient complied with federal law.

SPEAKER_03

Even if physicians listening to his testimony might disagree with some of his specific opinions, particularly around Imtala and diversion. The defense had a strong argument that some of his statements weren't grounded in what a reasonable physician would agree with. But whether the judge would agree, that's what episode three is about. The defense would say his statements were not grounded in what a reasonable physician would agree with, that he misrepresented the legal framework, and that his testimony was inflammatory. Whether you agree with the defense or the plaintiff on that, we'll walk through the actual deposition excerpts in episode three, and you can judge for yourself.

SPEAKER_01

His deposition was the most contentious in the case. The defense filed multiple scope objections, disputes over whether certain questions were appropriate. Dozens of pages of his transcript were designated for trial use by both sides. Meaning both the plaintiff and the defense wanted his testimony heard. But they were fighting over which excerpts the jury would see and in what context.

SPEAKER_00

The fact that the deposition was so contentious, multiple scope objections, extensive designation battles, tells you his testimony was important to both sides.

SPEAKER_01

His testimony about what happened during the handoff, who was in the room, what was said, why the decision was made to remove the breathing tube was critical. And the nursing staff present at the arrival and during the code blue provided testimony about the sequence of events and the coordination of care. By late fall of the fourth year of litigation, discovery was largely complete. The motions in Laimini had been briefed, and the interventional cardiologist, who had been named as an individual defendant in the original complaint, was voluntarily dismissed from the case. That left the hospital system as the sole remaining defendant. Jury selection was scheduled for the spring of the fifth year after the patient's death. The case would go to trial before the State Circuit Court judge who had presided over the case from the beginning.

SPEAKER_03

Experts are retained, deposed, and fight about their scope. Motions in Lemine are briefed, and not until nearly five years later does a jury of lay people sit down to hear the case. This is the reality of modern malpractice litigation. It takes years. The memory of what happened fades. The defending physicians have moved on. The depositions become the story the jury hears, not the live witnesses' recollection. In our next episode, episode three, we focus on the expert testimony. We'll walk through the deposition that the judge had to rule on before the jury heard it. We'll look at the Imtala arguments in detail. We'll examine the plaintiff's trial strategy, the reptile theory framing, the safety rules language, and we'll get into whether the experts' opinions hold up under scrutiny. First, your medical records will be used. In this case, conflicting timestamps between the air crew and the hospital, a partially completed arrest record, and narrative notes written hours after the event by providers who couldn't remember exactly what happened. All of those became evidence that something was disorganized or forgotten. I want to be sympathetic here because I've been in these situations when you're in a code with limited resources, you're focused on the patient, not on the clock. That's the right priority. But once the team assembles and roles are assigned, once you have enough people, make sure someone is recording. And after the event, while things are fresh in everyone's mind, document together. Not to coordinate stories, to get the facts right while you still remember them. I'm supportive of the nurses and physicians who provide emergency care in these critical moments. I want to keep them from having to defend the care they provided because of documentation gaps. Second, we all have structured code blue teams with dedicated roles for a reason. It's for this exact situation. So once you have a team at the bedside during a code, make sure everybody has a role. If you only have one or two providers, focus on the patient first, that's always the priority. But as resources arrive, assign the recorder, assign the medication nurse, assign the team leader. These structures exist because a jury will evaluate your code response based on whether it looked organized. An organized code that's documented in real time is defensible. A code where five providers each wrote their own note from memory hours later. That's what creates the timeline conflicts that plaintiffs use at trial. Third, expert evolution is normal, but it shapes the case theory. The plaintiff's original complaint focused on the cath lab. The amended complaint expanded to include the community hospital phase and the transport decisions. That expansion happened because the plaintiff's experts said there's more to this story. The defense opposed the amendment, but the court allowed it. And once it was allowed, the case became about the entire system. System, not just the individual physician. For defense counsel, that's a strategic turning point. Fourth, Imtala is invoked a lot, but understood by few. Both sides used Mtala in this case to support their position. The defense said Mtala required acceptance. The plaintiff said EMTALA didn't prevent diversion. The reality is that EMTALA is primarily an administrative statute. It exists to prevent patient dumping, and its core requirements are screen, stabilize, and transfer appropriately. Mtala compliance doesn't insulate you from malpractice liability, but Mtala violations carry serious consequences. Civil monetary penalties and potential Medicare exclusion. Good medicine, good documentation, and good clinical judgment, those are what protect you. Mtala provides a framework, but it's not a shield, and it's not a sword. One more thing before we move to trial. The defense invoked the Good Samaritan Act as their primary legal shield. Under that statute, the standard isn't ordinary negligence, it's reckless disregard. That's a high bar. The statute exists because emergency medicine is inherently high risk. These are critically ill patients. Decisions happen in seconds, and the legislature recognized that holding emergency care providers to the lower standard of ordinary negligence would discourage physicians from taking emergency calls. That's the purpose of the statute. In episode three, we'll examine the expert testimony in detail and see how the judge ruled on what the jury could and couldn't hear. Those rulings shape the trial in ways that matter.

SPEAKER_00

The Good Samaritan Act protects emergency care providers, but protection has limits. The statute raises the bar, it doesn't eliminate it. If a jury concludes that conduct crossed the line from negligence into conscious disregard of a known risk, the statute doesn't help. It just changes the question the jury has to answer.

SPEAKER_03

That's what we'll see in episode three. How the expert framed the case, how the judge ruled on what the jury could hear, and where this case goes from there.

SPEAKER_01

So here we are. The complaint alleged failures at three phases of care. Discovery revealed gaps in the medical records. Experts lined up on both sides. Depositions were taken and fought over. Motions in Lamine were briefed. And a jury was impaneled to decide a question that no physician wants to face.

SPEAKER_03

Next episode, we enter the courtroom. We'll walk through the expert testimony, the testimony that was allowed, and the testimony that was excluded. We'll look at the trial strategy that the plaintiff used to frame the case. We'll examine the judge's rulings on the expert's deposition and talk about what was allowed, what was excluded, and why it matters. And we'll reach the conclusion of this case. That's ahead in episode three. The expert testimony, the judge's pretrial rulings, the Amtala argument that both sides invoked, and the verdict that followed.

SPEAKER_01

This is on the record. We'll see you in episode three. This podcast is for educational and informational purposes only. It is not medical advice, legal advice, or professional advice of any kind. And it does not create an attorney-client, physician, patient, or other professional relationship. Any discussion of cases, outcomes, standards of care, statutes, or regulations is general in nature, may be incomplete, and may vary by jurisdiction and over time. Listeners should consult their own attorney, malpractice carrier, risk manager, or qualified clinician for advice on any specific matter. Any case discussions are based on public records, de-identified information, or educational reconstruction. The views expressed are those of the speakers and do not necessarily reflect the views of any employer, hospital, health system, insurer, or affiliated organization.