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These are from a book called 'Disorder in the American Courts' and are things people actually said in court, word for word, taken down and now published by court reporters that had the torment of staying calm while these exchanges were actually taking place.
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ATTORNEY: This myasthenia gravis, does it affect your memory at all?
WITNESS: Yes.
ATTORNEY: And in what ways does it affect your memory?
WITNESS: I forget.
ATTORNEY: You forget? Can you give us an example of something you forgot?
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ATTORNEY: Now doctor, isn't it true that when a person dies in his sleep, he doesn't know about it
until the next morning?
WITNESS: Did you actually pass the bar exam?
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ATTORNEY: The youngest son, the twenty-year-old, how old is he?
WITNESS: He's twenty, much like your IQ
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ATTORNEY: She had three children, right?
WITNESS: Yes.
ATTORNEY: How many were boys?
WITNESS: None.
ATTORNEY: Were there any girls?
WITNESS : Your Honor, I think I need a different attorney Can I get a new attorney?
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ATTORNEY: How was your first marriage terminated?
WITNESS: By death.
ATTORNEY: And by whose death was it terminated?
WITNESS: Take a guess.
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ATTORNEY: Can you describe the individual?
WITNESS: He was about medium height and had a beard.
ATTORNEY: Was this a male or a female?
WITNESS: Unless the Circus was in town, I'm going with male
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ATTORNEY: Is your appearance here this morning pursuant to a deposition notice which I sent to your attorney?
WITNESS: No, this is how I dress when I go to work.
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ATTORNEY: Doctor, how many of your autopsies have you performed on dead people?
WITNESS: All of them. The live ones put up too much of a fight.
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ATTORNEY: ALL your responses MUST be oral, OK? What school did you go to?
WITNESS: Oral.
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ATTORNEY: Do you recall the time that you examined the body?
WITNESS: The autopsy started around 8:30 pm.
ATTORNEY: And Mr. Denton was dead at the time?
WITNESS: If not, he was by the time I finished
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ATTORNEY: Are you qualified to give a urine sample?
WITNESS: Are you qualified to ask that question?
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ATTORNEY: Doctor, before you performed the autopsy, did you check for a pulse?
WITNESS: No.
ATTORNEY: Did you check for blood pressure?
WITNESS: No.
ATTORNEY: Did you check for breathing?
WITNESS: No.
ATTORNEY: So, then it is possible that the patient was alive when you began the autopsy?
WITNESS: No.
ATTORNEY: How can you be so sure, Doctor?
WITNESS: Because his brain was sitting on my desk in a jar.
ATTORNEY: I see, but could the patient have still been alive, nevertheless?
WITNESS: Yes, it is possible that he could have been alive and practicing law
Are Contingency Fees An Integral Part to the American Judicial Process ?
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Are Contingency Fees An Integral Part to the American Judicial Process?
There has been a lot of talk about tort reform and the high price of justice in our country and in particular, our state. Legal costs have been historically skyrocketing across the country as disputes and differences have been difficult or impossible to resolve between business interests and the consumers.
As a practicing physician, I am also aware of the concern of frivilous lawsuits filed against physicians and hospitals, that can raise the cost of malpractice premiums and cost to practice medicine.
As a result, some groups have advocated the elimination of contingency fees for law firms that represent large entities such as class action plaintiffs or governmental agencies as they seek to collect damages from business concerns that may have harmed individuals or financially defrauded other businesses or state agencies. Some have advocated that legal firms that are chosen by government or state agencies to represent them in court be selected by bid process and that they are paid strictly by the hours worked on a particular case.
While this may seem to be a reasonable course to take, there are a number of considerations that need to be entertained before such a blanket application be applied to all legal contracts with the state, or individuals as well. Contingency fees were first introduced in order to allow those with limited resources to address their grievances in court with competent and qualified legal counsel, without consideration of their ability to pay. If the case appeared to have merit , then a legal team could be contracted by the plaintiffs and their reimbursement would be paid only if they prevailed in the case. This allowed for only cases that have merit to be considered by most legal firms, since they wouldn’t get paid for their time and expertise if they failed to win the case but also, plaintiffs would not have to produce a large retainer in order to have competent counsel. In addition, the legal teams that accepted this payment arrangement would be highly motivated to commit time and effort to the case at hand, since they could likely get a much higher payout if they ultimately prevailed. That in and of itself is not untoward, and should be embraced by those of us in the faith community such that everyone has equal access to justice in our legal system.
Secondly, contingency fees should be part of the legal strategy for our state as well. Yes, law firms have the potential to reap large returns if they prevail on behalf of the state, but it also allows the state and the taxpayers to obtain the best legal talent to represent them against some of the largest business concerns in the world. If the state of Alabama is taking on Exxon Mobile for example, the largest corporate entity in the world, with their vast legal team, wouldn’t make sense for the state to have equivalent legal counsel, not something that was put out to bid to any law firm in the state. While it would seem reasonable to also account for the hours logged on a particular case or possibly some type of maximal cap on attorney fees by the state, at the end of the day, the only thing important is whether the state prevails in its case.
Finally, the payment of legal fees by the state or any other entity within Alabama by an hourly rate rather than contingency is also ripe for abuse. There are numerous law firms, at present, contracted by the state to represent them on a number of issues, that are paid by hourly rates. State and local governemental agencies use hundreds of legal firms to represent them by hourly rates that may have political ties to the local and state government, that may or may not be providing adequate representation. Many of them are paid regardless of whether they go to court or not, should they be curtailed from payment as well ?
These firms are under no legal guideline regarding case filings, results, or producing a body of work that encompasses the payment that they are receiving. As suggested by the Alabamians Against Lawsuit Abuse, changing from contingency fees to hourly wages would do little to curb the abuse of legal fees charged to the state, and in fact, could actually worsen the abusive practice. More importantly should be regulation and scrutiny of those that are advertising for plantiffs that may have been harmed by a particular drug or substance, and to make sure that the claims by the plantiffs are accurate and confirmed by independent testing that has no financial ties to the plaintiffs or their legal representatives.
In closing, the legal profession in Alabama provides a valuable service to the state and local governments they serve. Changing contingency fees to a hourly wage or placing governmental legal services out to bid runs an even greater risk of fraud and abuse and limits the ability of governmental officials from obtaining the best legal counsel. While political spoils usually falls to those legal firms with ties to the prevailing administration, contingency fees are still the best method to make sure the taxpayers are not saddled with needless hourly bills on cases they may not even win or get settled out of court.
Randy Brinson, MD
Chair, Christian Coalition of Alabama
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In Settlement, A Warning To Drugmakers Pfizer to Pay Record Penalty In Improper-Marketing Case
Washington Post Staff Writer
Thursday, September 3, 2009
The Obama administration intensified its public campaign against health-care fraud Wednesday, putting drugmakers on notice that they will be forced to atone for improper marketing practices as prosecutors unveiled a record $2.3 billion settlement with Pfizer.
The Obama administration intensified its public campaign against health-care fraud Wednesday, putting drugmakers on notice that they will be forced to atone for improper marketing practices as prosecutors unveiled a record $2.3 billion settlement with Pfizer.
Officials at the departments of Justice and Health and Human Services called the agreement with Pfizer and one of its subsidiaries a cautionary example of their strategy to team up with states to police errant health-care businesses.
The Pfizer unit Pharmacia & Upjohn pleaded guilty to a single felony charge that accused the company of marketing its anti-inflammatory drug Bextra for broader uses and higher dosages than those approved by the Food and Drug Administration.
The company allegedly enticed doctors to prescribe the drug for pain relief by taking them on lavish trips, created sham requests for medical information as an excuse to send unsolicited advertising materials to physicians, and drafted articles promoting the pills without disclosing its role in preparing the stories.
In connection with the settlement, Pharmacia & Upjohn consented to pay $1.3 billion in fines and forfeiture, the biggest criminal penalty ever imposed in the United States, prosecutors said. Pfizer paid an additional $1 billion to state and federal authorities to resolve civil allegations of improper marketing over Bextra and three more drugs: Geodon, an antipsychotic medicine; Zyvox, an antibiotic; and Lyrica, an epilepsy medicine. In the bulk of the civil allegations, the company did not admit wrongdoing.
The settlement comes as federal agencies pursue a wider strategy to target wrongdoing in the deep-pocketed health-care industry.
Earlier this year, Justice and HHS deployed a task force of prosecutors and federal agents to bring criminal charges against the ringleaders of small groups that had bilked Medicare and Medicaid out of hundreds of millions of dollars through schemes involving wheelchairs, medical equipment and costly HIV/AIDS treatments. Authorities have rolled out dozens of indictments over the past several months in Miami, Houston, Detroit and Los Angeles.
The Justice Department's civil division, led by Tony West, also has pledged to devote more attention to whistleblowers at drug companies and insurance firms who flag improper payments and marketing schemes. The department is on track this fiscal year to collect more than $3 billion in False Claims Act cases; most of the money will go back to the U.S. Treasury.
The announcement yesterday came amid the escalating political debate on health-care reform, which hinges in part on concerns over the ballooning costs of medical care and prescription drugs.
Associate Attorney General Tom Perrelli called the Pfizer case "an example of the department's ongoing and intensive efforts to protect the American public" from fraud and abuse, which costs the Treasury billions of dollars a year. The bulk of the investigation was conducted under the Bush administration, which also began negotiating with the company on a settlement.
Mike Loucks, the acting U.S. attorney in Massachusetts, said that, in negotiating the financial penalties, authorities considered Pfizer's "recidivist" history. The world's largest drugmaker, he said, has entered into four settlements with the Justice Department over the past decade. Pfizer voluntarily withdrew Bextra from the market in 2005 amid concerns about its link to such health problems as strokes, heart attacks and blood clots in the lungs.
Health and Human Services Secretary Kathleen Sebelius said her department's inspector general will heighten scrutiny of the company to make sure it does not run afoul of the law.
The four-year investigation of Pfizer was ignited by whistleblowers inside the company who quietly sounded alarms about questionable marketing practices, said Kevin Perkins, assistant director of the FBI's criminal investigative division.
Under the False Claims Act, which dates to the Civil War, the corporate insiders who helped expose the fraudulent schemes -- which were costly to Medicare and Medicaid -- will receive a portion of the financial recovery. John Kopchinski, a West Point graduate and Gulf War veteran who joined Pfizer as a salesman in Florida, is set to collect more than $51 million.
"In the Army, I was expected to protect people at all costs," Kopchinski said in a statement distributed by his attorneys at the Washington firm Phillips & Cohen. "At Pfizer I was expected to increase profits at all costs, even when sales meant endangering lives. I couldn't do that."
Pfizer officials said they already had reserved funds in the 2008 books for the settlement, the broad outlines of which were known to the company.
"These agreements bring final closure to significant legal matters and help to enhance our focus on what we do best," said Amy W. Schulman, Pfizer senior vice president and general counsel.
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Sidney Wolfe, director of Public Citizen's Health Research Group, said the Pfizer settlement "may sound large, but it's not enough to ensure drug companies will curb their bad behavior." Wolfe pointed out that the Pfizer agreement topped a landmark settlement set by Eli Lilly in January, when that company paid more than $500 million in criminal penalties for improper marketing of the antipsychotic drug Zyprexa. Five other major drug manufacturers logged smaller settlements over the past decade.
"The U.S. pharmaceutical industry, long one of the most profitable in the country, with profits last year of close to $50 billion, has engaged in an unprecedented amount of criminal activity in the past decade," Wolfe said. "Unfortunately, the ever-escalating fines are unlikely to stop drug companies from continuing to bribe doctors because they represent just a fraction of drug company profits and no one has gone to jail."
http://www.washingtonpost.com/wp-dyn/content/article/2009/09/02/AR2009090201449.html?wprss=rss_nation
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Pfizer agrees to plead guilty in painkiller case
By Andrew Jack in London
Published: September 2 2009
Pfizer, the world’s largest pharmaceutical group, on Wednesday agreed to plead guilty to illegally promoting its painkiller Bextra, as part of a record-breaking $2.3bn final settlement reached with federal and state authorities across the US.
The company signed a “corporate integrity agreement” with the Department of Health and Human Services requiring regular and independently audited reports over five years designed to ensure improved marketing practices.
Kathleen Sebelius, US secretary of health and human services, announcing Pfizer's settlement in a press conference
Kathleen Sebelius, US secretary of health and human services, announces Pfizer will pay a $2.3bn settlement
It also acknowledged “certain improper actions” in promoting its antibiotic Zyvox and agreed to pay $33m to end compensation claims on its schizophrenia treatment Geodon, in addition to $2.3bn in fines on 13 drugs agreed in principle at the start of this year.
The action follows long-running investigations into aggressive marketing by Pfizer on medicines, which included efforts to encourage doctors to prescribe Bextra – a drug withdrawn in 2005 – for uses that the US Food & Drug Administration had specifically refused to authorise.
It comes at a time when the practices adopted by pharmaceutical companies to sell their drugs have been increasingly criticised by regulators, doctors and healthcare providers for potentially jeopardising patient safety and imposing excessive costs.
“This historic settlement will return nearly $1bn to Medicare, Medicaid and other government insurance programmes...[My] department will continue to seek opportunities to work with its government partners to prosecute fraud wherever we can find it ...Healthcare is too important to let a single dollar go to waste,” said Kathleen Sebelius, secretary of the Department of Health and Human Services.
Amy Schulman, general counsel of Pfizer, said: “We regret certain actions taken in the past but are proud of the action we’ve taken to strengthen our internal controls and pioneer new procedures so that we not only comply with state and federal laws, but also meet the high standards that patients, physicians and the public expect.”
Pfizer said it was already committed to capping and disclosing financial payments to doctors, medical organisations and patient advocacy groups, and has appointed a chief compliance officer as well as introducing training, compliance committees and a hotline to improve standards.
Its $2.3bn settlement with the Department of Justice includes a $1.3bn criminal penalty on Bextra and $1bn in civil payments, some to be distributed to 49 states and the District of Columbia, which brought actions related to its practices with other drugs including Zyvox, Geodon and the epilepsy treatment Lyrica.
The group said it denied civil allegations brought by states in relation to marketing these medicines except for Zyvox, while pleading guilty to one criminal count of violating the Food, Drug and Cosmetic Act in relation to promotion of Bextra.
http://www.ft.com/cms/s/0/452bc2a0-97f5-11de-8d3d-00144feabdc0.html
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