Any scenario where you need medical assistance is usually fraught with some amount of fear or uncertainty. There are so many concepts and terms that are beyond our understanding. As such, we rely on medical professionals to conduct thorough assessments, appropriately diagnose the issue, and provide the necessary treatments. In those moments, you are wholly dependent on the care and expertise of another person. That’s why it can be so devastating to discover when that person had acted negligently. This is what we call medical malpractice.

Within a legal context, medical malpractice is more succinctly defined as an act or omission by a healthcare professional that deviates from accepted medical practices and results in an injury to the patient that is being attended to. This includes cases where the harm to the patient is so severe it results in wrongful death. It is important to note that the label of medical malpractice can be applied to more than just one individual. In some cases, it is possible for multiple specialists working together to have committed malpractice, or even for institutions, such as a medical facility, to be named as the party at fault.

What Qualifies for a Malpractice Suit in San Diego, CA?

A medical malpractice suit is a claim filed by the patient, or in some cases, the patient’s family, against those responsible. A San Diego HMO malpractice attorney can help walk you through the process. The purpose of filing such a claim is generally twofold. Firstly, the person who was injured in the incident can receive compensation for any medical costs, losses of income, reduced quality of life, and mental or emotional trauma, amongst other things. This can go a long way towards helping the patient heal.

The secondary purpose of filing a medical malpractice suit is to ensure that those that have committed a crime are held responsible. Depending on the situation, the court may opt to award punitive damages to demonstrate the consequences of negligent behavior and reduce the possibility of such an incident occurring in the future.

If you or someone you love has been the victim of medical malpractice, act swiftly and contact the professionals at Kenneth M. Sigelman & Associates for legal guidance. Within the state of California, there are two deadlines to file such a claim. Medical malpractice claims have a three-year statute of limitations. This means that if they delay for too long while deciding whether to move forward with their claim, they can no longer do so. However, there is one caveat. A patient who was injured by a negligent healthcare provider has up to one year from the moment of discovery to file. This means that even if the statute of limitations has passed, the patient may still present their case to court as long as they do so within a year. This is most often the case when foreign objects are left inside the patient’s body during surgery.

Even with all that in mind, it can be difficult to decide whether to begin the process if you’re not sure what you experienced can be categorized as medical malpractice. While many scenarios qualify, here are some of the most common claims:

  • Lack of treatment

When a medical healthcare provider fails to treat a patient, for instance, by releasing them from the hospital without a proper examination or running applicable tests, omitting important follow-up information, or disregarding the patient’s medical history. Having limited time to interact with the patient is not a valid excuse to justify the lack of appropriate treatment. If the care provider is unable to treat the patient, they should refer the patient to another provider.

  • Incorrect or delayed diagnosis

A substantial amount of medical malpractice claims reference instances of incorrect or delayed diagnoses. Depending on the situation, the patient may take too long to get the treatment they need or end up having to experience unnecessary treatments that could potentially worsen their health. This can occur due to an oversight from the medical provider or due to inaccurate data from errors made during the testing process.

  • Errors involving prescription drugs

Somewhat related, issues involving errors with prescription drugs can also cause a patient to either fail to receive much-needed medication or end up taking something that could put their health at risk. Patients trust their doctors to screen for all sorts of drug-related complications, such as allergies or interactions with other medications, and failing to consult a patient’s chart fully could put them in danger. Providing the patient with the wrong prescription or the wrong dosage would also fall under this category.

  • Errors committed during surgery

Surgical procedures are extremely nerve-wracking procedures, given that they often require you to be placed in a state of complete unconsciousness. While asleep, you are unable to advocate for yourself or question the medical professionals in any way. This requires absolute trust in your medical provider. Unfortunately, that trust is sometimes broken. Some examples of malpractice claims related to surgery include procedures performed on the wrong area of the body, foreign items left inside the body, or even procedures performed on the wrong person altogether. Failure to follow required practices such as properly sterilizing equipment would also fall under this category, as would any errors related to the administration of anesthesia.

  • Errors committed during childbirth care

Finally, some errors are sometimes committed during the process of providing childbirth services. These can have lasting effects on the future life of the mother and child, and as such, are regarded as very serious. Mistakes made during the actual birth of the child, such as using excessive force, ignoring any signs that the baby is in distress, or physically mishandling the baby in any way, are all examples of childbirth-related medical malpractice. However, this form of malpractice is not limited to individual, specific acts. Generally, providing substandard prenatal care that fails to consider important information about the health of the mother and child would also fall under this category.

Note that there are plenty of other scenarios not covered by the above list. Generally speaking, as long as you sustained harm as the result of errors made by a medical provider, the case can be considered medical malpractice. More details on the qualifiers of medical malpractice can be found further below.

Is Negligence a Type of Malpractice?

Generally speaking, negligence is a term often used to describe behavior in personal injury claims. California law defines negligence as the failure to behave in a reasonable manner resulting in harm to oneself or others. Negligence can be applied to both actions and inactions depending on the situation. In the event of a car accident, choosing to text while driving is considered negligent behavior; however, so is failing to stop at a red light.

Because of how this definition is constructed, the most common attempted defense of negligence-related charges is that the behavior in question was not negligent, as the defendant did not owe any level of care to the victim, and as such, did not behave unreasonably. However, it is important to note that just because a person doesn’t feel individually responsible for the health and safety of others doesn’t mean they can behave in any way they wish.

Within most modern societies, there are a variety of laws that assign them that responsibility, whether they want it or not. For instance, when given a license to drive a vehicle, the driver is entering into a contract that legally requires them to drive a certain way. Failing to do so is inherently an act of negligence, and if they injure someone while behaving in that manner, they can be charged.

So how does this relate to medical malpractice? Negligence denotes general carelessness, while medical malpractice refers to negligence in a strictly medical sense. So, while the term negligence may be used to describe the behavior of a healthcare provider, all acts of negligence are not considered acts of medical malpractice. In short, malpractice is a type of legal negligence, not the other way around.

It’s important to keep in mind that both with claims of general negligence and medical malpractice, the mere presence of negligent or careless behavior is not enough to substantiate said claim. The act of carelessness must result in an actual injury. The injury does not necessarily have to be of a physical nature. Near-death experiences can be extremely traumatic, resulting in mental illness and emotional anguish, and a claim could be made based on that trauma. However, some form of injury must be sustained.

This is the key difference between terms like negligence and medical malpractice in a legal sense, versus negligence as it is more commonly used in everyday conversation. Outside of the legal definition, negligence is described as merely a failure to take proper care in doing something. For instance, if you are in an area with many dangers present and leave a child there, unsupervised, that could be described as negligent behavior, even if the child was not injured or harmed in any way. Someone could then use the term medical negligence to describe a situation where their doctor behaved in a way that could have potentially caused an injury but ultimately did them no harm. However, in that instance, they would be unable to file a legal claim for medical malpractice.

What Are the 4 Elements of Malpractice?

As alluded to earlier, there are a few qualifiers that must be present for an incident to be labeled as an act of malpractice. These consist of four key elements. Essentially these provide a more specific framework that allows legal teams to build a successful case, even when certain aspects seem to be matters of common sense. The four elements are as follows:

    1. There must be some professional, legal duty owed to the patient on behalf of their care provider.


    1. The provider must have breached that duty in some capacity by deviating from standards of care.


    1. The patient must have sustained an injury as a result of that breach.


    1. There must be quantifiable damages related to the said injury for which the patient can demand compensation.


In practical terms, the earlier explanations of medical malpractice fall into this framework neatly. As previously discussed, medical malpractice cases involve negligent behavior conducted by medical professionals, which resulted in an injury, which usually requires treatment and puts the patient in a situation where they can file for damages. However, by breaking the situation down into these four elements, the courts can ensure that the scenario is truly relevant and something worth pursuing in a court of law. It also offers clarification for any grey areas or confusion.

For instance, if you were to get medical advice from a friend who happens to be attending medical school and end up becoming injured, that would not be a case of medical malpractice. That friend does not have any professional relationship with you, and as such, has no legal duty to provide you with medical care. In this instance, the responsibility falls squarely on the patient for choosing to seek out a friend’s opinion instead of a doctor’s professional one. In fact, meeting a fully qualified medical professional in a nonprofessional setting and getting injured from their advice wouldn’t qualify as medical malpractice either. There must be a very specific relationship established between the two parties as attending healthcare professionals and patients for the first element of medical malpractice to be met.

The second element is in reference to the actual incident that took place. It is critical to note here that breaches of duty must involve some deviation from the standards of care. If you received treatment that is considered standard and appropriate and ended up sustaining an injury, that would not be considered malpractice. To be more precise, the act of accidentally leaving a foreign object inside your body during surgery is not standard practice and is a clear example of medical malpractice. However, prescribing a common medication to a patient with no previous history of allergies that later results in an allergic reaction would not be considered malpractice, given the context and information available at the time; the prescription would have been considered standard care.

The third element is the one that has been most discussed thus far, and that is the presence of an injury resulting from the negligent act. Deviating from the standards of care, while unprofessional and perhaps grounds for a rebuke from supervising staff members, is not enough for a medical malpractice claim to be filed. That doesn’t mean you can’t still voice your concerns to the relevant parties at the institution where the behavior took place. But you would be unable to present a case of malpractice in court.

The fourth element of malpractice ties directly into the third, and that is that the injury must result in quantifiable damages. While punitive damages are sometimes awarded depending on the case, the main purpose of submitting a claim is for the victim of the negligent behavior to receive compensation for their pain and suffering. If they are unable to quantify those damages in any capacity, then the court would be unable to direct the accused to provide them with said compensation, and there would be no point in going to court at all.

While your San Diego HMO malpractice attorney can provide all sorts of assistance and legal service throughout the entirety of the process, they can be especially helpful in ensuring that these elements are present. With extensive experience handling malpractice cases, your attorney would be familiar with the various types of damages that can be awarded in a malpractice case and can ensure that you receive enough to cover all of the losses you’ve incurred since becoming injured.

It is rare for there to be an injury without damages. When there are no damages to claim, this is usually because, despite the negligent behavior, there was no unusual injury sustained. As such, there are no losses to claim.

Are Medical Malpractice Cases Hard to Win?

Medical malpractice cases are certainly very challenging to pursue. In fact, most cases result in a defense verdict, meaning that the defense, or the medical providers named in the claim, were declared innocent of the charges brought to the court. For a patient to be successful with their case, they must be able to prove beyond any reasonable doubt that all four elements of medical malpractice are present. And while each case’s specifics are different, most of the challenges lie in proving the second of those elements.

The medical provider is not likely to admit any breach of duty, placing all burden of proof onto the patient. It often becomes a matter of whether the jury believes the doctor’s side of the story over the patient’s, and since the provider is the one with the most relevant knowledge and professional background, they are often perceived as an authority on the subject. Juries are often more likely to be lenient with medical professionals because of their presumed value to society.

To clarify, as the patient, you must prove that your provider deviated from standards of care. To do so, you must first be fully familiar with the standard of care for your situation and able to demonstrate how the provider’s behavior violated said standard. This is information that most patients don’t have access to.

Consider that most medical professionals must spend long years of study to learn about all the acceptable treatment options available, of which there are several for any given condition. It is much easier for a doctor to explain away their behavior as a more unusual but still acceptable course of action than it is for a patient to determine that the behavior was negligent in the first place. Any erroneous assumptions made by the patient will just further hurt their credibility in court.

What Are the Chances of Winning a Malpractice Lawsuit?

We live in a very data-driven society, and when it comes to malpractice cases, there is much data to draw from. A long-term, 20-year study of medical malpractice court cases resulted in concrete evidence of what most legal professionals already knew. In the majority of cases, the medical providers win. In fact, on average, the data showed that the defendants won the cases about 70% of the time. What’s interesting is that there was one key variable that had the power to sway that success rate: the presence of evidence.

In cases where there was little evidence to support the claims made, medical professionals won their cases up to 80-90% of the time — a higher than average rate. However, in cases where there was strong evidence present, that rate went down to 50%, despite the jury biases still present. So, what does this mean?

It means that despite the challenges involved with medical malpractice claims, it is still very possible to be successful with your case. The key is working with an experienced legal team that can help you gather evidence. Skilled attorneys have all sorts of contacts and resources that can help increase your likelihood of success, including medical experts that can successfully counter the authority of the medical providers on trial. In addition to compiling everything you need to build a strong case, your legal team will also be able to go through your records, job history, tax information, and more to clearly quantify any damages you’ve sustained, ensuring you are awarded the funds you deserve.

At Kenneth M. Sigelman & Associates, we have extensive experience handling medical malpractice cases and are familiar with every defense strategy likely to be attempted by the accused. We also know how best to navigate the system to ensure the court is afforded no technical grounds that would allow them to dismiss the case. We are so confident in our ability to get you the desired result in court that no attorney’s fees will be charged unless we are successful. If you or someone you love has been injured due to medical negligence, contact us online or call (866) 244-9285 to schedule a free review of your situation.