Educational Objectives:

The aviation industry has long recognized risky situations and high-risk behavior. No pilot would venture takeoff and flight without a thorough run through of the check lists, which are then re-checked! Labor and delivery pose defined hazards, not all of which can be anticipated. The possible hazards, while easy to list, have not been translated into scientifically-based action checklists that would enable early recognition of complications and facilitate sound anticipatory decision-making prior to an avoidable crisis. Rather, there is an overdependence on “personal experience,” opinion, and the learned “art of medicine.” Simply witness the surfeit of birth injury litigation which continues unabated.

While diagnostic and laboratory medicine attracts a considerable burden of litigation, medication errors have ripened into fertile grounds for suits.

The Institute of Medicine conservatively estimated that 1.5 million preventable medication errors (adverse drug events) occur annually with significant mortality and morbidity. The IOM estimates that an inpatient can expect, on average, one medication error each day! Prescribing and administering drugs are two key areas where errors occur. Today patients are advised to have an advocate accompany them to hospital!

The focus of this conference is to teach physicians to better comprehend the machinations of negligence law, and to develop a more complete awareness of the need for anticipatory and safety practices. The objective is also to teach lawyers about the complex issues encountered in the practice of medicine, aiming to sharpen their understanding on behalf of their clients, both plaintiff and defense.

The major conference objective is to enhance the continuing education of obstetricians, gynecologists, midwives, and neonatologists with special attention to standards of expected care, coupled with a clearer comprehension of the role of law and lawyers as well as the complexities of the legal process. Only through a thorough understanding of the challenges physicians face and recognition of the critical role lawyers have in influencing medical practice, can we hope to deal effectively with the current pressures of medical practice.

Once again, an extraordinarily experienced and superb faculty has been assembled for this 25th Anniversary conference that will be important to obstetricians, gynecologists, midwives, neonatologists, nurse practitioners, trial attorneys, pediatricians, primary care physicians, insurers, risk managers and all providers of health care for women in pregnancy.

Major subjects include:

• Contemporary management of premature ruptured membranes
• Oxytocin and medicolegal risks
• Hazards of instrumental delivery
• Mothers who kill their babies
• Unintended consequences and the lessons they spawn
• Medication errors - who is culpable?
• Counseling and the limits of fetal viability
• Standards for neonatal resuscitation
• Suicide risk and malpractice avoidance
• Medications that kill or disable: who is liable?
• On the defense of medication errors
• Guidelines and standards of care for cancers of the ovary, cervix, and uterus
• Management of the short cervix
• Respiratory care of the very preterm infant
• New recommendations for fetal heart rate monitoring
• Shoulder dystocia - is there a SOP?
• Genetics, developmental delay, and problems in labor and delivery
• Psychiatric malpractice in the obstetrician's office
• Managing the twin-twin transfusion syndrome
• Post-maturity, birth and liability
• Hypothermia and hypoxic ischemic encephalopathy
• On the prevention of medication errors
• Wisdom (?) and admissibility of apologies
• Suing the physician's estate
• Vicarious liability for a resident or midwife
• Informed consent during labor?
  
  
  

Registration

Continental Breakfast

Welcome and Introduction
Aubrey Milunsky, M.D., D.Sc.

Operative Vaginal Delivery: Important Do's and Don'ts
Michael A. Belfort, M.D., Ph.D., F.A.C.O.G.

Use of Oxytocin: Reducing Medico-Legal Risks
John C. Hauth, M.D.

Contemporary Management of Preterm Premature Rupture of Membranes
Errol R. Norwitz, M.D., Ph.D.

Refreshment Break

Mothers Who Kill Their Babies: An Exploration of Postpartum Depression
Phillip J. Resnick, M.D.

Legal Commentary
W. Mark Lanier, J.D. and John A. Scully, J.D.

Unintended Consequences - Lessons from Decades of Experience
Aubrey Milunsky, M.D., D.Sc.

Legal Commentary
W. Mark Lanier, J.D. and John A. Scully, J.D.

Medication Errors: The Problem, the Consequences, and the Culpable
J. Lyle Bootman, Ph.D., Sc.D.

Legal Commentary
W. Mark Lanier, J.D. and John A. Scully, J.D.

Adjourn

25th Anniversary Dinner

Continental Breakfast

Intrapartum Counseling at the Limits of Fetal Viability
John C. Hauth, M.D.

Neonatal Resuscitation: Is There a Standard of Care? - The View from the Balcony!
Neil N. Finer, M.D.

Assessing Suicide Risk and Avoiding Malpractice
Phillip J. Resnick, M.D.

Refreshment Break

The Nature of Medication Errors
J. Lyle Bootman, Ph.D., Sc.D.

Death or Disability by Prescription
W. Mark Lanier, J.D.

On the Defense: Medication Errors with Serious Consequences
John A. Scully, J.D.

Ovarian Cancer: Standards of Expected Care
Larry J. Copeland, M.D.

Adjourn

Continental Breakfast

Management of the Short Cervix: The Shorter the Cervix, the Bigger the Problem
Errol R. Norwitz, M.D., Ph.D.

CPAP vs. Intubation for the Very Preterm Infant: Is it a COIN Toss?
Neil N. Finer, M.D.

Cancer of the Cervix: Diagnostic Guidelines and Potential Pitfalls
Larry J. Copeland, M.D.

Refreshment Break

2008 NIH Recommendations for Interpretation and Quantification of Fetal Heart Rate Monitoring
John C. Hauth, M.D.

Shoulder Dystocia: A Time for Calm and Process
Michael A. Belfort, M.D., Ph.D. F.A.C.O.G.

Developmental Delay After a "Stormy" Labor and Delivery: The Basic Genetic Evaluation
Jeff M. Milunsky, M.D., F.A.C.M.G.

Malpractice in Psychiatry
Phillip J. Resnick, M.D.

Adjourn

Continental Breakfast

Welcome and Introduction
Aubrey Milunsky, M.D., D.Sc.

Recognition and Management of Two Complications of Monochorionic Twins: Twin-Twin Transfusion Syndrome and TRAP Sequence
Michael A. Belfort, M.D., Ph.D., F.A.C.O.G.

Post-Term Pregnancy: Rescue by Birth (and From Liability)
Errol R. Norwitz, M.D., Ph.D.

Hypothermia for the Near-Term and Term Infant with Hypoxic Ischemia Encephalopathy: Ready for Prime Time?
Neil N. Finer, M.D.

Refreshment Break

Cancer of the Uterus
Larry J. Copeland, M.D.

Personal and Institutional Guidelines in the Prevention of Medication Errors
J. Lyle Bootman, Ph.D., Sc.D.

Medicolegal Forum
W. Mark Lanier, J.D. and John A. Scully, J.D.

• Wisdom (?) and Admissibility of Apologies
• Is it Ever Appropriate to Sue the Physician's Estate?
• Stillbirth: A Cause of Action for Wrongful Life?
• Focus Groups, Mock Juries, and Jury Consultants
• Vicarious Liability for the Resident and/or Midwife
• Informed Consent During Labor?
• Competence to Consent: Who Judges and How?
  
  

Adjourn