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Taskforce on Medical Malpractice Report
DC Council Committee on Health
July 28, 2005




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Press release Taskforce Report


D.C. Council Committee on Health
1350 Pennsylvania Avenue, NW, Suite 115, Washington, D.C. 20004

For Immediate Release: July 28, 2005

Contact Information:
Ross Weber
(202) 724-7772
(202) 724-8087 fax


WASHINGTON, D.C. - Little more than two months after its first meeting, the D.C. Council Committee on Health Taskforce on Medical Malpractice released a report today calling for changes in three broad areas: civil justice, patient safety, and insurance regulation. Most of these recommendations will be included in legislation to be introduced in mid-September. 

Committee on Health Chairman David Catania praised the eight-member taskforce for finding consensus on this thorny issue.

"This report reflects common sense goals that the medical and legal communities can support. Relying on other proposals that have no chance of becoming law will ultimately leave patients and doctors in the same unenviable situation they find themselves in today," Catania said referring to Mayor Williams' plan to limit injury awards. A majority of the D.C. Council continues to raise objections to award caps. 

Since late May, representatives of the legal and medical professions as well as patient advocates have gathered at the behest of Chairman Catania to address pressing issues concerning medical malpractice in the District of Columbia. They were charged with creating a set of policy recommendations for the Committee on Health that address challenges surrounding medical malpractice in the District. 

In its 18-page report, the Taskforce calls for legislation requiring that patients inform doctors of their intent to bring legal action against them at least 90 days in advance. Once a suit has been filed, the group recommends that mediation be mandated. Finally, a doctor's benevolent gesture, such as expressing sympathy, should not be considered if a case makes it to court. 

The report goes on to suggest patient safety measures that include the creation of a database to track malpractice claims, a study of claims made against OB/GYNs, and the improved performance of the government agency that oversees the Board of Medicine.

To encourage greater transparency in the insurance industry, the Taskforce recommends making public average insurance rates and the data used to justify rate increases. The report also calls for the collection and publication of judgment and settlement information.

A copy of the report and a list of Taskforce members may be found by following the link to the Committee on Health at www.davidcatania.com

For more information, please contact the Office of Councilmember David Catania by calling 202-724-7772.

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Council of the District of Columbia Committee on Health
Taskforce on Medical Malpractice


To: David A. Catania, Chairperson, Committee on Health
From: William Lightfoot, Esq., and Robert Malson, Esq., Co-Chairmen 
Date: July 28, 2005
Subject: Report of the Taskforce on Medical Malpractice

In your letter, dated April 12, 2005, you requested, and we agreed, to co-chair a Taskforce on Medical Malpractice (Taskforce). The mission of the Taskforce was to “research and examine solutions to the challenges surrounding medical malpractice in the District of Columbia.” The goals included “creating a set of policy recommendations for the Committee on Health.” This report represents the recommendations of the Taskforce. The Taskforce will assist Council staff in crafting legislation based on the recommendations of this report.


I. Background of the Taskforce
II. Summary of Recommendations
III. Detailed Explanations of Recommendations
IV. Minutes of Taskforce Meetings
V. Biography of Taskforce Members

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The Taskforce on Medical Malpractice was created in the summer of 2005 by Councilmember David A. Catania, Chairperson of the Committee on Health, to address pressing issues concerning medical malpractice in the District of Columbia. The creation of this Taskforce was unique because it brought together individuals with widely varying viewpoints. They were charged with researching and examining solutions to the challenges surrounding medical malpractice in the District of Columbia and creating a set of policy recommendations for the Committee on Health. Ultimately, it is hoped that the recommendations will ensure that the citizens of the District of Columbia are provided with the highest quality of healthcare that is both accessible and safe.

The Taskforce, representing, broadly, those in the medical profession, the legal profession, the hospital field and those in patient advocacy, met and compiled a wish list of initiatives. The items of commonality became the main issues that the Taskforce examined. While there were many points of disagreement throughout the process and certain aspects of tort reform were not examined, it was decided that any agreement is a step in the direction of addressing the problem. Additionally, it is hoped that the discussion between the two sides will continue after this report is submitted.

The Taskforce met four times over the course of the summer and discussed many different topics, narrowing them down to three broad categories:

  1. Civil Justice Modifications

  2. Patient Safety Initiatives

  3. Insurance Regulation Initiatives

Within each category are three to four specific recommendations to the Council of the District of Columbia and its various committees, including the Committees on Health, Judiciary, and Consumer and Regulatory Affairs.

William Lightfoot and Robert Malson chaired the Taskforce and each selected three other members that provided different competencies to the Taskforce as a whole.

The members of the Taskforce selected by Mr. Lightfoot were:

Barry J. Nace, Esq. 
Frank Clemente 
Jay Angoff, Esq.

The members of the Taskforce selected by Mr. Malson were:

Charles H. Epps, Jr., M.D. 
Larry L. Smith, Esq. 
Peter E. Lavine, M.D.

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In the area of civil justice modification, the Council should enact legislation requiring a 90-day notice of intent to sue, early mandated mediation, and inadmissibility of benevolent gestures. In the area of patient safety initiatives, the Taskforce recommends the creation of a mandatory adverse event database and a closed claims project for OB/GYNs. The Taskforce also recommends improved performance by the Health Professional Licensing Administration. In the area of insurance regulation initiatives, the Taskforce recommends making the "street rates" for malpractice insurance carriers public; making the data used to justify rate increases public; and enabling the collection and publication of accurate judgment and settlement information for the District of Columbia.

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The Taskforce proposes three different changes to the civil justice system. Each modification is meant to encourage early settlement of cases and decrease costs for all parties.

Three modifications:

  1. 90-day Notice of Intent to Sue

  2. Early Mandated Mediation

  3. Inadmissibility of Benevolent Gestures

90-Day Notice of Intent to Sue


This modification requires the potential plaintiff to send to the potential defendant(s) a 90-day notice of intent to file suit in D.C. Superior Court.


No lawsuit or administrative action for medical malpractice may be commenced unless the defendant has been given at least 90 days notice of the intent to file a lawsuit. The notice must include sufficient information to put the defendant(s) on notice of the legal basis for the claim and the type and extent of the loss sustained, including information regarding the injuries suffered.

If the notice of intent to file suit is served within 90 days of the expiration of the applicable statute of limitations, the statute of limitations shall be tolled for a period of 90 days from the date of service of the notice.

The 90-day notice requirement does not apply when the defendant(s) are unknown to the plaintiffs and are, therefore, identified in the complaint by fictitious name(s).


The 90-day notice is intended to encourage early settlement or mediation of the claim. The 90-day period allows time for the defendant to evaluate the potential suit and talk with the plaintiff about settlement or mediation.

This modification will keep costs down by reducing the number of cases that go to trial and hopefully encourage productive mediation coupled with the mandatory mediation (described in the next section). Other states, such as New Jersey and Connecticut, have implemented this change.

Issues of Contention

All taskforce members agree to this modification.

Early Mandated Mediation


This modification requires that the parties engage in mandatory mediation early in the litigation process. Mediation encourages early settlement and avoids litigation which decreases costs.


Once a lawsuit is filed in D.C. Superior Court, the parties are required to mediate as the first step in the litigation process.

Retired judges or lawyers with at least 10 years experience in medical malpractice cases will conduct the mediation. All parties need to agree on the mediator and any costs associated with the mediation will be split between the plaintiff and the defendant(s).

The mediation will take place with little to no discovery and will be governed by rules established by the D.C. Superior Court. The lack of or reduced discovery and informality will help reduce costs.

A trial date will not be scheduled until a mediator's report of the mediation has been filed with the court.


Early mediation with an experienced mediator would greatly reduce the costs incurred by all parties. Mediation encourages settlement before extensive and expensive depositions occur.

The benefits of mediation include reductions in trial rates, case disposition time, and the court’s workload, increased litigant satisfaction with the court's services, and decreases in litigant costs in cases that are resolved at mediation in some or all of the participating courts.

Issues of Contention

All taskforce members agree to this modification.

Inadmissibility of Benevolent Gestures


This change allows doctors and other healthcare providers to make benevolent gestures without fear that the gesture would be used against them in a court proceeding.


For the purpose of any civil action or administrative proceeding against a healthcare provider, an expression of sympathy, regret or apology made in writing, orally, or by conduct made by or on behalf of the healthcare provider to a victim of alleged medical malpractice, any member of the victim's family, or any individual who claims damages by or through that victim is inadmissible as an admission of liability for any purpose.


An important concern for the medical community and the general public is the erosion of the doctor-patient relationship due to a fear of malpractice lawsuits. This modification enables doctors to make expressions of sympathy regarding a medical outcome without fear that such expression will provoke a lawsuit.

The ability of healthcare providers to communicate more freely with their patients following an adverse outcome could result in fewer lawsuits being filed. It is hoped that the result of this modification is one of creating an atmosphere free of animosity and ill will, one in which a positive and corrective outcome is sought.

In addition, if healthcare providers, after determining that an adverse event was caused by their actions, commence early settlement negotiations in an honest and open manner, patients would be less likely to use the costly and adversarial legal system. Taskforce members, while interested in this type of program, did not articulate a specific proposal for the District of Columbia. However, the Taskforce members will monitor Illinois’ similar pilot program.

Issues of Contention

One issue of contention is whether or not admissions of fault would be covered by this modification. Further, there is concern about the “gray” area between benevolent gestures expressing general sympathy versus admissions of fault.


One of the goals of the addressing medical malpractice through the civil justice system is to improve patient safety and ensure that best practices are identified and followed.

Three initiatives:

  1. Mandatory Adverse Event Reporting

  2. Closed Claims Project for OB/GYN specialty

  3. Improved performance by the Health Professional Licensing Administration

Mandatory Reporting of Adverse Events


This initiative creates a centralized system for the collection of de-identified and anonymous information for the analysis of adverse events in order to reduce medical errors and improve health care delivery.


All adverse events at any medical facility in the District of Columbia will be reported to a common database.

The administrator of the database will be responsible for:

  1. Tracking, assessing, and analyzing the incoming reports, findings and corrective action plans.

  2. Identifying common patterns of failure, if any, and recommending successful methods for correcting systemic problems.

  3. Providing technical assistance to facilities on the development and implementation of patient safety plans to address reported problems.

  4. Disseminating information among facilities and educating facilities across the District regarding best practices.

  5. Monitoring national efforts and those in other states to ensure consistency and adoption of best practices in the District and proposing modifications to District practices accordingly.

  6. Publishing an annual report of events and corrective actions and communicating with facilities and the public about lessons learned to improve health care quality.

This project will also require financial resources. The Taskforce proposes that the District government work with the federal government in creating such a system.


Adverse event reporting has the public policy goal of improving patient safety and medical service delivery through identifying problems, holding providers accountable for meeting the standard of care, sharing information among facilities and health care consumers, and facilitating corrective action. This is most effective where there is a centralized authority to collect, analyze, and share best practices across institutions and among all providers to facilitate action.

Issues of Contention

The main area of contention is the distinction between the treatment of “serious” adverse events and “near misses.” Serious adverse events are those that cause lasting injury and death; near misses do not result in harm because they are caught in time. The Institute of Medicine sets different reporting requirements for each category. For serious adverse events it recommends full disclosure and disciplinary action to hold negligent providers accountable, satisfy a patient’s right to know, and remediate grave safety hazards. For near misses it recommends confidential reporting that is used to develop patient safety improvements. The contention in the case of serious adverse events includes whether identifying information will be removed from reports, what information will be made available to patients and the public, and what actions will be taken in response to an incident report - such as disciplinary measures, reporting to licensing boards or the Department of Health.

States have addressed the provision of database information to the public in various ways. (See http://www.nashp.org/Files/Medical_Malpractice_and_Medical_Error_Disclosure.pdf for a report by the National Academy for State Health Policy on the creation of such systems and their scope.)

Closed Claims Project for OB/GYN


This initiative proposes to fund a closed claims project that examines all closed liability claims against OB/GYNs in the District in order to identify ways to improve healthcare delivery and share best practices.


The District government will fund a research project that will maintain a database of closed OB/GYN claims reports provided by participating insurance companies. The reports will be analyzed to identify trends and develop recommendations for preventive action. The project will ensure dissemination of recommendations and a sharing of best practices among OB/GYN practitioners and facilities and will include a follow-up mechanism to ensure that recommendations are implemented. Such a project will also analyze other studies of closed claims in other jurisdictions.


A closed claims project conducted by the American Association of Anesthesiologists is one of the reasons why the insurance premiums for that specialty have not increased nearly as much as they have for other medical fields and why serious injuries resulting from anesthesiology errors have been greatly reduced. OB/GYNs have particularly high malpractice premiums, on average, and would be well served by a project aimed at improving service delivery and controlling premium increases.

Issues of Contention

All Taskforce members agree to this initiative.

Improved Performance by the Health Professional Licensing Administration Overview

The Health Professional Licensing Administration (HPLA) within the Department of Health (DOH) evaluates each applicant’s qualifications, conducts investigations, and holds hearings in order to take appropriate action to ensure that the performance of healthcare professionals in the District is maintained at the highest level.


The HPLA needs to more sufficiently fulfill its mission. The problem may be related to insufficient and poor resource allocation, or lack of autonomy or independence. The Mayor and Council should ensure quality leadership and high performance of the HPLA. While the Taskforce does not have a specific proposal, the members encourage the District government to improve operations at the HPLA to better protect and serve the citizens of the District of Columbia.


It is the responsibility of the HLPA to maintain the highest standards of professional conduct of its licensees. Vigorous enforcement, coupled with high standards for licensees and applicants, will reduce the incidence of medical malpractice in the District of Columbia.

Issues of Contention

All Taskforce members agree to this initiative.


The Taskforce considered insurance industry regulation and proposes three initiatives to ensure that medical care providers and the public are better informed about malpractice insurance premium rates and claims.

Three initiatives:

  1. "Street Rates" from malpractice insurers published online

  2. Public disclosure of information that a malpractice insurer files with the Department of Insurance, Securities and Banking (DISB) for a rate change 

  3. Disclosure of claims information

Reporting of "Street Rates"


This initiative makes public the "street rates” charged by malpractice insurance carriers in the District of Columbia. “Street rates” are the current rates charged by insurers, excluding individual adjustments based on low, average, or high risk.


The Commissioner of DISB will make all rate information public. Any forum in which the information is available will contain a disclaimer saying that these are the base rates that do not take into account other actuarial factors.

The preferred forum for the posting is on a website administered by the DISB Commissioner that will be disseminated to health care providers.


Although competition in the District is limited, there are still multiple carriers of malpractice insurance. Making the rates public will better enable doctors to shop for insurance by comparing rates.

Taskforce members acknowledge the current lack of competition in the District. There are few insurance companies in the District and Taskforce members questioned the efficacy of this initiative. The Taskforce wants to study ways to encourage more insurers to come to the District.

Issues of Contention

All parties agree to this initiative.

Disclosure of Rate Change Information


This initiative makes public all required information filed with the DISB Commissioner regarding rate changes for malpractice policies written in the District of Columbia.


The DISB Commissioner will make public any and all required information filed with DISB regarding rate increases. This information will be made available in the offices of the DISB or published on the website of the DISB.

The Taskforce does not desire to compel the DISB Commissioner to release proprietary information to the public; it does, however, want to ensure that all information disclosed to the public is as comprehensive and informative as possible.


There is much confusion over the rationale for rate increases and an overall lack of data on claims made in the District on malpractice policies. Making these documents public will give organizations and individuals a better picture of the malpractice industry. The information will also allow consumers to determine whether or not to challenge the rate increase if they, based on the information, determine that the insurance company is charging an excessive amount.

As with other insurance reforms, it is unclear what effect, if any, it will have on the insurance industry. Taskforce members are generally supportive of this reform as long as it does not drive insurance companies out of the District.

Issues of Contention

All Taskforce members agree to this initiative.

Disclosure of Claims Information


This initiative makes it mandatory for all insurance companies and self-insurers, including pools, joint underwriting associations and trusts, to disclose on a quarterly basis certain information about claims, settlements, and judgments related to medical malpractice. All information will be de-identified and anonymous.


All insurance companies and self-insures will report quarterly the numbers of claims they settle, the amount of the settlement, and the number of judgments entered together with their dollar amounts. All information will be de-identified and anonymous. Reporting must be done on an individual claims basis and on a standardized form. The report should include information concerning the policy, injury, and claims process.

The information provided would have to be monitored and examined for accuracy and accountability. This system requires the allocation of financial resources.


According to the Taskforce, this reform has important ramifications for future examinations of the medical malpractice issue. There is a lack of data on the amount paid out by insurance companies and self-insurers compared to the amount paid in premiums. Once there is an accurate picture of the situation in the District, a real analysis of the causes of the raising costs of medical malpractice rates can be examined and solutions found. 

Issues of Contention

All Taskforce members agree to this initiative. 

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Minutes from the First Meeting

The Taskforce on Medical Malpractice held its first meeting on Wednesday, May 25th, 2005 at 10:15 a.m. in room 104 of the John A. Wilson Building located at 1350 Pennsylvania Avenue, NW, Washington, DC 20004. After introductions by both Councilmember David A. Catania and Taskforce Co-Chairs Robert A. Malson and William Lightfoot, the Taskforce members introduced themselves. Present at the meeting were Mr. Lightfoot, Mr. Malson, Dr. Lavine, Mr. Nace, Mr. Clemente, Mr. Smith, and Mr. Angoff. Absent was Dr. Epps due to a prior commitment.

The following ground rules were agreed to by the members:

  • Each Taskforce member will only represent themselves and not necessarily their organization.

  • Each member is free to advocate for any position outside of Taskforce meetings and being a member of the Taskforce does not preclude anyone from lobbying on any issue.

  • The Taskforce will not make any representations to the press, although individual members are free to comment in their personal capacity and all meetings of the Taskforce are open to the public.

  • All members and staff will pay special attention to their choice of words and acknowledge that sometimes a discussion about terminology is helpful.

  • Members and staff will refrain from making generalizations about other Taskforce members.

Mr. Lightfoot and Mr. Malson then described the process of how the Taskforce would work. Mr. Lightfoot then spoke about six topics of discussion:

  1. Elimination of unwarranted lawsuits (Dr. Lavine, Dr. Epps, and Mr. Nace)

  2. Inadmissibility of benevolent gestures (also known as "”SorryWorks”!") (Mr. Clemente, Mr. Smith, Mr. Malson)

  3. Early mandated mediation (Dr. Lavine, Dr. Epps, and Mr. Nace)

  4. A 90 day notice of plaintiff's intention to file a lawsuit (Dr. Lavine, Dr. Epps, Mr. Nace, and Mr. Smith)

  5. Patient safety initiatives (Mr. Malson, Mr. Smith, and Mr. Clemente)

  6. Insurance regulation reform (Mr. Angoff and Mr. Smith)

After discussion about the lack of certain items, asserted by Dr. Lavine and others, an agreement was reached that the Taskforce would start with the six items, work together to form a good working relationship, and possibly work together in the future on other issues.

The Taskforce co-chairs then assigned groups of members to focus on the six areas the Taskforce will be looking at. Each group will make a 10 minute presentation at the next meeting with further information to be discussed at a later date. It was decided that items five and six could have multiple sub-topics and members agreed to come back at the next meeting with further defined proposals.

The members' names in parenthesis after each topic (above) indicate who will be working on which topic. All members are free to contribute to any topic, but the indicated persons will be responsible for the presentation. Members will meet in the next two weeks.

It was also decided that the Taskforce will complete its work by July 31. Further meetings are scheduled for June 8th, June 29th, July 6th, and July 20th. Each meeting is on a Wednesday from 10 a.m. to 12noon.

The Taskforce adjourned at 11:30 a.m.

Minutes from the Second Meeting

The second Taskforce on Medical Malpractice meeting was called to order at 10:12 a.m on June 8, 2005.

Taskforce members present: 

Mr. Malson 
Mr. Lightfoot 
Mr. Nace 
Mr. Smith 
Dr. Lavine 
Dr. Epps 
Mr. Clemente 
Mr. Angoff

All members were present.

Because of his absence at the last meeting, Dr. Epps introduced himself to the group. He spoke about his thoughts on malpractice reform and expressed his disappointment that certain reforms would not be examined by the Taskforce. Mr. Malson then went through the ground rules and spoke about what he thought the benefits of the Taskforce were.

The co-chairs, Mr. Malson and Mr. Lightfoot, then began the business portion of the meeting. Taskforce members representing the six different areas of interest were allotted 10 minutes to update the group on their progress and talk about the next steps.

The first item discussed was the elimination of unwarranted lawsuits (#1). Members announced that this item was too vague and that members had problems with the term "unwarranted." The subcommittee decided that it needed to be further broken down into smaller, more concrete action items. Members will continue to work on this item in the next few weeks.

The second item was the inadmissibility of benevolent gestures (#2). Mr. Smith circulated a "summary of the patient safety initiatives subcommittee" detailing both #2 and #5 (patient safety initiatives). Mr. Clemente told the group about Sorry Works and its specifics. Mr. Smith talked about how MedStar liked the program but was wary of it being a mandatory program in the District of Columbia. Mr. Nace questioned the inadmissibility of the gestures and wanted more information on how this worked. Mr. Malson stated that society would benefit by having a physician have the capacity to say "I'm sorry for the outcome, diagnosis, or act that I did." Mr. Nace asked if that would extend to other professions. It was decided that the Taskforce would only work with the current situation and not look to other professions. Mr. Smith talked about the purpose of the tort system and how subsequent repairs are inadmissible in the tort system. Dr. Epps then made comments about his experiences.

It was decided that there was enough consensus on this item for the Taskforce to move forward with it. Further discussion and research would be needed. Eric Lashner, Taskforce assistant, was tasked with collecting and sending out copies of the laws relating to inadmissibility of benevolent gestures in other jurisdictions.

Mr. Clemente then talked about Patient Safety Initiatives (#5). He first talked about reforms to the D.C. Medical Board. There were two main areas, the first related to resources for the Board and the second related to the creation of a first class website with licensure information for the public. Dr. Lavine said he agreed the Board needed more resources and also noted that some reforms were already in the Mayor's bill. He stated that the DC Medical Society and the American Medical Association both thought there was a lot of work to be done in that area. It was decided that there was a sense of agreement on the reform issues for the D.C. Medical Board. Dr. Epps talked about the increase in fees and how it was originally supposed to go only to the Medical Board and not to other areas of the government. The website issues needed further discussion.

Mr. Clemente then introduced the idea of mandatory reporting of serious adverse events and voluntary reporting of near misses. The mandatory reports would be available to the public while the voluntary reports of near misses would not be made public. Mr. Smith said that Maryland has a very good system of mandatory reporting. It was also decided that any such a system would need resources, as it would be pointless for the reports to sit in a PO BOX for years. Mr. Clemente announced that he would like to partner with the federal government to find funding to make D.C. a national laboratory for such a system. Mr. Smith talked about the usefulness of these programs for fixing systems and not for blaming certain persons for adverse events.

Mr. Clemente and Mr. Smith then talked about a related issue in the creation of a closed claims project for specialties. A closed claim project looks at closed insurance claims over a period of time for a certain specialty and then decided what best practices could be used to improve patient safety. A similar project with anesthesiologists has kept their premiums down over the past few years. The question was raised about funding and if the government would be willing to fund a closed claims project for the OBGYN specialty.

The last item Mr. Clemente discussed was a method to analyze what the data says. It was suggested that the data collection piece be moved to action item #6 (insurance industry regulation reform) because there are already many items on this sub-committee's plate.

Items #3 and #4 were discussed together. It was suggested that a mandatory 90-day notice of intent to file be coupled with early mandated mediation. It was suggested that a retired or senior judge could serve as the early mediator. Everyone seemed to support the concept of mandated mediation and agreed in theory to a 180-day timetable for mediation in addition to a 90-day notice of intent to sue. Mr. Nace noted that mediation is available now in D.C. The question for him was how to balance the mandatory part and the rights of the plaintiff. He said that if a mediator recommends something and the parties did not agree then there should be no penalty for either side. He also said that he did not want mandatory mediation to become a procedural quagmire like it is in West Virginia. It was also noted that the statute of limitation should be extended to include the extra 90 days.

Eric was tasked with finding similar legislation and public policy papers for those two aspects. The subcommittee will continue to meet to hammer out details on how to assure meaningful reform and mandating mediation without penalties.

The final topic discussed was insurance regulation reform. Mr. Angoff spoke about his 15 proposals and Mr. Smith asked if they could be pared down to D.C. specific reforms.

The Taskforce then went into a long discussion about the different insurance companies and the philosophies of insurance regulation reform as well as debating different sorts of data available. Mr. Malson noted that D.C. is one market with three jurisdictions and thus any reform should be carefully looked at. Mr. Angoff countered by saying that both Maryland and Virginia are more regulated than D.C.

The issue then turned to how to encourage more insurers to come into the District. Mr. Catania then came in and was seated in the audience. Mr. Catania added that the government could assist with tax breaks or other financial incentives to get more insurers for medical malpractice in the District.

Dr. Epps told everyone how NCRIC was formed and about his experiences. Dr. Lavine noted that he thought there is no crisis of patient safety but there is a crisis of liability premiums that are unaffordable and out of line with other jurisdictions.

It was decided that the insurance subcommittee would meet to further discuss the issues.

All subcommittees will be sure to consult other stakeholders (such as Larry Mirel in DISB for insurance regulation reform issues)

Mr. Malson then moved for approval of the minutes, Dr. Lavine seconded the motion and the meeting was adjourned at 11:50 a.m.

The next Taskforce meeting will be June 29th at 10:00 a.m. at which each subcommittee will report on its progress. Dr. Epps will not be present due to his 50th wedding anniversary.

Minutes from the Third Meeting

The third Taskforce on Medical Malpractice meeting was called to order at 10:16 a.m on June 29, 2005.

Taskforce members present: 

Mr. Malson 
Mr. Lightfoot 
Mr. Nace 
Mr. Smith 
Dr. Lavine 
Mr. Clemente 
Mr. Angoff

Taskforce members absent: 

Dr. Epps

The minutes from the June 8th meeting were approved unanimously.

The co-chairs made announcements regarding the progress of the subcommittees and the need to have further discussions. The Taskforce decided to allocate time at the close of the public portion of the meeting for subcommittee meetings.

The co-chairs, Mr. Malson and Mr. Lightfoot then began the business portion of the meeting. The six original topics have been condensed to three broad topics, each with a few issues of reform. They are: Insurance Regulation Reform, Civil Justice Reform, and Patient Safety Initiatives.

Mr. Smith and Mr. Angoff then presented information from the insurance regulation reform subcommittee. They stated that they had narrowed reforms from 15 broad proposals to 9 DC-specific ones and then to 4 that the both of them thought worth looking into. Mr. Angoff noted that the DC/MD/VA comparison sheet was incorrect and that Mr. Smith correctly noted an error in who has standing to challenge a rate in the District. Mr. Angoff passed out a corrected chart.

The four areas were:

  1. Changing the persons with standing to Challenge Rates

  2. "Street Rates" from malpractice insurers published online

  3. Disclosing information that a malpractice insurer files to the DISB for rate change to the public

  4. Disclosure of Claim Information

The subcommittee members discussed the myriad of issues for the Disclosure of Claim Information, but agreed that it will be a goal of the Taskforce to come up with a way to collect accurate data. There is the challenge of the self-insurers who are not a regulated by the DISB. It was noted that the government regulated hospitals and that legislation could be passed that requires self-insurers to report their claims. Additionally, such language will have to mandate that records reported a breakdown of the settlements and judgments between non-economic and economic damages. Mr. Clemente thought this was a very good idea but wanted a way to audit and verify the information.

It was suggested that Eric look at the Texas statute dealing with reporting as an example.

The Civil Justice subcommittee decided to continue discussions and present a more formal proposal at the next meeting. All members said there were many e-mails back and forth and that in-person meetings were much more productive.

Next, the Patient Safety subcommittee presented their progress. The three sections of the Patient Safety Reforms are:

  1. Creating an adverse event reporting system in the District

  2. Funding a closed claim project for OBGYN Specialty in the District

  3. Reforming the DC Board of Medicine

Mr. Clemente talked about the creation of the adverse event system and the closed claim project. He and Mr. Smith noted their desire to work with the federal government for funding and/or advice for the first two projects. They suggested that some local dollars could be allocated for the project(s).

Finally, Mr. Clemente presented information on Sorry Works. After much debate on the specifics of the program, it was decided that while there was a sense of agreement on pursuing the topic, further off-line discussion is needed to come to a compromise. The main issues of discussion dealt with admissibility.

The Taskforce decided to cancel the July 6th meeting and to meet throughout the month as subcommittees in order to have concrete proposals by the July 20th meeting.

The meeting was adjourned at 11:15 for the Civil Justice subcommittee to meet. Minutes from the Fourth Meeting

The fourth Taskforce on Medical Malpractice meeting was called to order at 10:07 a.m on July 20, 2005.

Taskforce members present: 

Mr. Malson
Mr. Lightfoot 
Mr. Nace 
Mr. Smith 
Dr. Lavine 
Mr. Clemente 
Mr. Angoff 
Dr. Epps

The minutes from the June 29th meeting were approved unanimously.

Councilmember Catania first offered thanks to all Taskforce members and invited them all to a Taskforce dinner next Thursday. Councilmember Catania then stated that his staff would be creating legislation throughout the summer and would circulate the legislation to all Taskforce members for comments.

The Taskforce then moved onto revising the Draft Taskforce Report that was originally circulated on July 13, 2005. The Chairmen thanked all Taskforce members and Taskforce staff members Shaun Snyder and Eric Lashner for their work.

For the next three hours the Taskforce examined and reviewed various drafts and went line by line though the document and came up with a consensus of the report. Eric Lashner will work with Taskforce members to create the final Taskforce report.

The meeting was adjourned at 1:00 p.m.

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Robert A. Malson, Esq.
Robert A. Malson is President of the District of Columbia Hospital Association and former Chairman of the Board of Directors of the Children’s National Medical Center. A graduate of Howard University and the Harvard Law School, Mr. Malson served as Counsel to the United States Senate Judiciary Committee and as Associate Director of the White House Domestic Policy Staff under President Jimmy Carter.

The Honorable William Lightfoot, Esq.
William P. Lightfoot is managing partner at Koonz, McKenney, Johnson, DePaolis & Lightfoot, LLP. For eight years, Mr. Lightfoot served as an at-large member of the Council of the District of Columbia, where he chaired the Committee on the Judiciary. During his tenure on the Council, he continued to practice personal injury law. Mr. Lightfoot is a graduate of Howard University and Washington University School of Law. The National Board of Trial Advocacy certifies him in the field of civil trial advocacy, and he is a Diplomat of the National College of Advocacy.


Jay Angoff, Esq.
He is a lawyer from Jefferson City, Missouri. He served as insurance commissioner of Missouri between 1993 and 1998, and also served as deputy insurance commissioner of New Jersey and director of the Private Health Insurance Group at the U.S. Health Care Financing Administration (now the Centers for Medicare and Medicaid Services).

Frank Clemente
Frank Clemente has been Director of Public Citizen’s Congress Watch since 1996. Public Citizen’s Congress Watch conducts public education and advocacy efforts on campaign finance reform; better access to quality health care; legal "reform" issues; corporate accountability; and regulatory issues related to health, safety and the environment. He holds a B.S.W. from the State University of New York at Albany.

Charles H. Epps, Jr., MD
He is a retired orthopedic surgeon who has served as Executive Dean of the College of Medicine and Vice President for Health Affairs at Howard University. Dr. Epps is past President of the American Orthopedic Association and a current member of the District of Columbia Hospital Association’s Board of Directors.

Peter E. Lavine, MD
He is an orthopedic surgeon specializing in trauma, total joint, sports and performing arts medicine. In 2005 he is serving as the Chairman of the Medical Society of the District of Columbia and in 2004 served as the Medical Society’s President. Dr. Lavine received his undergraduate degree from Washington University in St. Louis, MO and his medical degree from Georgetown University Medical Center.

Barry J. Nace, Esq
Always active in Bar work, he was elected President of the Association of Trial Lawyers of America in 1993 and subsequently asked to chair its Political Action Committee for two years. He also served as President of the DC Trial Lawyers Association on two different occasions. He is certified as a trial lawyer (civil litigation) by the National Board of Trial Attorneys and also by the American Board of Professional Liability Attorneys (medical malpractice). He graduated from Dickinson College with a B.S. in chemistry and then from Dickinson School of Law with a J.D. degree in 1969.

Larry L. Smith, Esq.
He is Vice President, Corporate Risk Management, at MedStar Health. Mr. Smith is President of MedStar’s captive insurance company and in that capacity is responsible for MedStar’s comprehensive risk management, self-insurance and commercial insurance program for the seven hospitals in the system

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