title: Medico-legal consultation: an expanded role of the tertiary neonatologist.
abstract: Between January 1982 and December 1984, the neonatologists at the University of Michigan Medical Center were asked to render 115 consultations regarding potential medical litigation. Requests for consultation were made by attorneys representing plaintiffs in 36 per cent of cases and defendants in 64 per cent (hospitals, 32 per cent, physicians, 30 per cent, private industry, 2 per cent). A review of these cases indicates frequently recurring themes, especially fetal distress, postdate pregnancies, and birth trauma among obstetrical cases, and neurologic injury, birth asphyxia, meconium aspiration, and hypoglycemia among neonatal cases. In many instances, incomplete documentation in the medical record and poor physician-patient communications were the issues leading to litigation. In 49 per cent of plaintiff cases reviewed, outcomes were felt not be related to the medical care rendered. Sixty-one per cent of defendant cases were felt to be strongly defensible; in 30 per cent of cases significant doubt as to defensibility existed. The physician practicing perinatal or neonatal medicine must be aware of the areas of vulnerability to malpractice litigation and the need for adequate documentation and patient communication. The daily activities of the tertiary neonatologist support his credentials as an expert medical witness in his specialty.
mesh_terms: D000046:Academic Medical Centers; D005104:Expert Testimony; D005180:Faculty, Medical; D008318:Malpractice; D009359:Neonatology; D012017:Referral and Consultation