Legal Negligence: When Medical Malpractice is the Case within the Case

Presented By:William F. McMurry
WILLIAM F. MCMURRY & ASSOCIATES

The practice of law, as with most professions, has become increasingly specialized—in tandem with the growing complexity of society and commerce.1

I. INTRODUCTION

We all learn in law school that the necessary elements for an actionable legal malpractice claim are: (1) the duty of the attorney to use such skill, prudence and diligence as members of the profession commonly possess; (2) a breach of that duty; (3) a proximate causal connection between the breach and the resulting injury; and (4) actual loss or damage.2 Often the most challenging element is proving damages in the legal malpractice case. That challenge is twofold when the underlying case involves allegations of medical malpractice.

This work will address some of the common issues in the legal malpractice setting and examine just what is the case within a case method of proving damages and how courts apply the rule. This work will also look at what consequential and other damages are available in a legal malpractice case. Next, this work will look at common ethical pitfalls that arise in the legal malpractice setting, particularly when the underlying case is specialized in nature such as medical malpractice. Finally, this work will address a common procedural maneuver, a motion to bifurcate, and how it affects your legal malpractice case.

II. PROVING DAMAGES AND THE CASE WITHIN THE CASE

In a legal malpractice action, compensatory damages can be classified as either direct or consequential.3 Direct damages are compensation for the loss of the expected benefits from the attorney’s services and any expenses incurred due to the attorney’s failure to achieve those benefits. The direct damage usually is the value of the lost benefit or of the detriment. The value of that benefit is based on the circumstances existing at the time of the wrongful act or omission. If the injury occurred because of negligence in handling litigation, the measure of direct damages is the difference between the amount actually recovered or paid and the amount that should have been recovered or paid. The legal interest that was, or that should have been, awarded on the judgment also may be part of the direct damages. The measure of direct damages can be exemplary damages that were not recovered or awarded. The direct damages may be the value of a lost settlement opportunity or the cost of a disadvantageous settlement. Additional elements of direct damages can be the legal fees paid to the defendant attorney and expenses incurred to mitigate the loss of the intended benefit.4

As a New Jersey Court summarized, “damages are generally shown by introducing evidence establishing the viability and worth of the claim that was irredeemably lost. This procedure has been termed a ‘suit within a suit.’”5 Proving damages in the case within a case arena is often challenging, and logically, any proof or other difficulties in the underlying case are not to be escaped in the legal malpractice case. Depending on the nature of the attorney’s negligent act, proving the underlying case can become next to impossible.

Courts apply the case within a case rule with varying degrees of rigidity. For example, as the New Jersey Court points out, some courts require the plaintiff to prove by a preponderance of the evidence that “(1) he would have recovered a judgment in the action against the main defendant, (2) the amount of that judgment, and (3) the degree of collectability of that judgment.”6 However, this approach fails to take into consideration the possibility of settlement. Also, it can be difficult to present an accurate evidential picture of the original action and the passage of time works against the case within a case approach.7 New Jersey has adopted a more flexible rule than the rigid case within a case rule finding that “it should be within the discretion of the trial judge as to the manner in which the plaintiff may proceed to prove his claim for damages....”8

A recent decision out of the Court of Appeals in Ohio has also rejected the case within a case approach. The Court stated that Ohio precedent rejected a “blanket requirement that plaintiffs in a legal malpractice case always had to prove their ‘case within a case,’ the court favored a case-by-case analysis of the causation and damages element of the claim.” 9 The Court analyzed the shortcomings of the case within a case method approach of proving damages in a legal malpractice case:

[W]e reject any finding that the element of causation in the context of a legal malpractice action can be replaced or supplemented with a rule of thumb requiring that a plaintiff, in order to establish damage or loss, prove in every instance that he or she would have been successful in the underlying matter(s) giving rise to the complaint. This should be true regardless of the type of representation involved.

A standard of proof that requires a plaintiff to prove to a virtual certainty that, but for the defendant's negligence, the plaintiff would have prevailed in the underlying action, in effect immunizes most negligent attorneys from liability. No matter how outrageous and morally reprehensible the attorney's behavior may have been, if minimal doubt exists as to the outcome in the original action, the plaintiff may not recover in the malpractice action. Except in those rare instances where the initial action was a ‘sure thing,’ the certainty requirement protects attorneys from liability for their negligence.

A strict ‘but for’ test also ignores settlement opportunities lost due to the attorney's negligence. The test focuses on whether the client would have won in the original action. A high standard of proof of causation encourages courts' tendencies to exclude evidence about settlement as too remote and speculative. The standard therefore excludes consideration of the most common form of client recovery.

In addition, stringent standards of proving ‘but for’ require the plaintiff to conduct a ‘trial within a trial’ to show the validity of his underlying claim. A full, theoretically complete reconstruction of the original trial would require evidence about such matters as the size of jury verdicts in the original jurisdiction. For example, an experienced attorney could testify that juries in that jurisdiction typically award verdicts of x dollars in similar cases. But such evidence is too remote and speculative; the new fact finder must try the merits of both the malpractice suit and the underlying claim to make an independent determination of the damage award. The cost and complexity of such a proceeding may well discourage the few plaintiffs otherwise willing to pursue the slim chance of success.

Other problems await those who do proceed with the ‘trial within a trial.’ For example, the attorney in the original action may have negligently failed to pursue the discovery that would have insured success. If the results of that same discovery are now necessary to prove the merit of the underlying claim-and the passage of time has precluded obtaining that information-the attorney by his own negligence will have protected himself from liability. In such a case, the more negligent the attorney, the more difficult is the plaintiff's task of proving causation.10

The other component of damages in legal malpractice cases are consequential damages. “Consequential damages are compensation for those additional injuries that are a proximate result of the attorney’s negligence, which do not flow directly from or concern the objective of the intended benefit of the attorney’s services but damages that occurred because the benefit was lost. Such injuries may include damages for mental distress and related personal injuries, injuries to reputation, economic losses, and expenses incurred in suing the attorney for legal malpractice.”11

Looking at the issue of emotional damages, courts across the country have fallen on both sides of the fence on whether or not emotional damages are recoverable, with an increasing number of courts allowing plaintiffs to recover for emotional damages in a legal malpractice case, separately from the underlying claim.12

Within your state, there may be statutory remedies that would allow recovery for emotional damages. In Kentucky, the legislature has defined the damages allowable for legal malpractice in K.R.S § 411.165(1) as follows: “If any attorney employed to attend to professional business neglects to attend to the business, after being paid anything for his services, or attends to the business negligently, he shall be liable to the client for all damages and costs sustained by reason thereof.”13 (emphasis supplied). The defense bar has argued that in a legal malpractice case since plaintiff’s claims of emotional distress do not derive from any “affirmative or intentional wrongdoing” on the part of the defendant that such damages should not be recoverable. The Kentucky Supreme Court has never reached the issue of whether emotional damages are recoverable, however for the words “all damages” to be given any meaning at all, the statute must mean that a negligent or grossly negligent attorney is liable for the derivative damages stemming from the underlying case and all resultant damages that have a direct causal link to the misconduct, such as those recoverable for emotional distress. Both types of damages are inarguably “sustained by reason” of the attorney’s wrongful conduct.

As mentioned above, in pursuing claims for damages, be mindful of specific state statutory remedies for additional damages such as trebled awards, specific penalties, punitive damages, etc. Finally, the defendant attorney can make a variety of arguments for a reduction in the ultimate award. For example, “the attorney usually can set off the fees that would have been received for the services necessary to secure the intended benefit for the client. An attorney also can reduce damages by sums recovered by the client from a tortfeasor in an underlying action. If the client was a defendant in the underlying action, the attorney may claim the benefit of payments made by a joint tortfeasor or the client’s liability insurer. Finally, an attorney can diminish the award by those damages that are attributable to the plaintiff or which the plaintiff should have mitigated or avoided. The amount of a lien that would have attached to the client’s recovery also may be subtracted.”14

III. ETHICAL PITFALLS A. COMPETENCE, DILIGENCE AND THE STANDARD OF CARE

“With few exceptions, the courts agree that the violation of an ethics rule alone does not create a cause of action, constitute legal malpractice per se or necessarily create a duty.”15 In the 2002 Amendments to the Model Rules, the ABA clarified their position on the scope of the ethic rules and how they related to civil liability:

Violation of a Rule should not itself give rise to a cause of action against a lawyer nor should it create any presumption in such a case that a legal duty has been breached…Nevertheless, since the Rules do establish standards of conduct by lawyers, a lawyer’s violation of a Rule may be evidence of breach of the applicable standard of conduct.16

Furthermore, ethics rules do not necessarily set legal standards, but they do have relevance.17 “The issue, however, is not whether the lawyer was “unethical,” but whether the lawyer deviated from the governing standard.”18 Two ethical rules that are clearly intertwined with the standard of care in a legal malpractice case are the rules regarding competence and diligence.

The very first Model Rule of Professional Conduct by the American Bar Association is Rule 1.1 regarding Competence. Rule 1.1 states:

A lawyer shall provide competent representation to a client. Competent representation requires the legal knowledge, skill, thoroughness and preparation reasonably necessary for the representation.19

As the Comments to the rule above suggest, “a lawyer can provide adequate representation in a wholly novel field through necessary study. Competent representation can also be provided through the association of a lawyer of established competence in the field in question.”20 Where lawyers run into problems, is attempting to handle a mater in a novel field without the association of a lawyer who has established competence in the field or by failing to thoroughly commit the time to becoming competent themselves in the novel field.

Another familiar rule of professional conduct, Rule 1.3 (Diligence) states: “A lawyer shall act with reasonable diligence and promptness in representing a client.”21 As the comments state, diligence requires an attorney to “pursue a matter on behalf of a client despite opposition, obstruction or personal inconvenience to the lawyer, and take whatever lawful and ethical measures are required to vindicate a client's cause or endeavor. A lawyer must also act with commitment and dedication to the interests of the client and with zeal in advocacy upon the client's behalf.”22

Courts and commentators long have recognized that lawyers’ dilatory tactics impede the administration of justice and that such delay is a burden upon opposing parties and a waste of public resources.23 Rule 3.2 (Expediting Litigation), as well as Rule 1.3 (Diligence), attempt to address this issue. While Rule 1.3 sets forth the general requirement that lawyers “act with reasonable diligence and promptness in representing a client,” Rule 3.2 specifically requires lawyers to attempt to “expedite litigation.” Lawyers who fail to make “reasonable efforts” to do so are subject to discipline. The comments to the rule point out that “dilatory practices bring the administration of justice into disrepute.”24

The landmark legal malpractice case in Kentucky, Daugherty v. Runner, 581 S.W.2d 12 (Ky. App. 1978), is a prime example of how an attorney’s violation of the above ethics rules can lead to a malpractice suit. As the Court stated, “the standard of care is generally composed of two elements care and skill. The first has to do with care and diligence which the attorney must exercise. The second is concerned with the minimum degree of skill and knowledge which the attorney must display.”25 In Daugherty, “the basis for the legal malpractice claim is that appellee Runner, while representing the deceased Roach for injuries sustained in an automobile accident, failed to pursue a medical malpractice claim by the estate of Roach against the hospital where Roach was treated for her injuries after her accident and against the doctors who treated her, until her claim was barred by the statute of limitations.”26 A jury found Runner not liable for malpracticing the medical malpractice case. While affirming the lower court’s jury instructions, the Court refused to hold that simply because Mr. Runner did not have competence, as he alleged, in handling medical malpractice suits, this did not remove his duty to his client. The Court reasoned: “An attorney cannot completely disregard matters coming to his attention which should reasonably put him on notice that his client may have legal problems or remedies that are not precisely or totally within the scope of the task being performed by the attorney.”27

A lack of diligence can hurt any case, as well as a lack of competence. “Concern about the competence of attorneys has resulted in certification of legal specialists.”28 According to Mallen in his treatise, Legal Malpractice, “[s]pecialization raises the question whether the standard of care devised for the “ordinary” attorney suffices for the practice of law today. The answer, with increasing frequency, is that an attorney undertaking a task in a specialized area of the law must exercise the degree of skill and knowledge possessed by those attorneys, who practice in that specialty.”29

B. CLIENT COMMUNICATIONS
In legal malpractice cases, common ethical pitfalls often involve the malpracticing attorney’s failure to communicate properly with their client. Below are some of the ethical rules concerning a lawyer’s communications with their clients:

Rule 1.4 (Communication):
(a) A lawyer shall:
(1) promptly inform the client of any decision or circumstance with respect to which the client's informed consent, as defined in Rule 1.0(e), is required by these Rules;
(2) reasonably consult with the client about the means by which the client's objectives are to be accomplished;
(3) keep the client reasonably informed about the status of the matter;
(4) promptly comply with reasonable requests for information; and
(5) consult with the client about any relevant limitation on the lawyer's conduct when the lawyer knows that the client expects assistance not permitted by the Rules of Professional Conduct or other law.
(b) A lawyer should explain a matter to the extent reasonably necessary to permit the client to make informed decisions regarding the representation.30

Rule 1.16 (Declining or Terminating Representation):

(d) Upon termination of representation, a lawyer shall take steps to the extent reasonably practicable to protect a client's interests, such as giving reasonable notice to the client, allowing time for employment of other counsel, surrendering papers and property to which the client is entitled and refunding any advance payment of fee or expense that has not been earned or incurred. The lawyer may retain papers relating to the client to the extent permitted by other law.31

Rule 1.2 (Scope of Representation and Allocation of Authority Between Client and Lawyer):

(c) A lawyer may limit the scope of the representation if the limitation is reasonable under the circumstances and the client gives informed consent.32

Rule 7.1 (Communications Concerning a Lawyer’s Service):

A lawyer shall not make a false, deceptive or misleading communication about the lawyer or the lawyer’s service. A communication is false or misleading if it contains a material misrepresentation of fact or law, or omits a fact necessary to make the statement considered as a whole not materially misleading.33

Rule 1.4 is the general rule regarding communications, while the remaining rules deal with specific problem areas that arise in communicating with clients. For example, Rule 1.16 would include advising a client of any applicable statute of limitations and also would include as in the above Daugherty case, advising of any other potential claims a client may have regardless of what the attorney has agreed to litigate. The Daugherty dilemma also involves Rule 1.2, which allows a lawyer to limit the objectives of representation, but such limitation must be done properly. Finally, of course, a lawyer should not make a false, deceptive or misleading communication to a client. For example, an attorney who has never handled a medical
malpractice case should not represent that he has any special knowledge in such matters.

IV. CASE WITHIN A CASE: MOTIONS TO BIFURCATE

It is common in legal malpractice cases for the defense to move to bifurcate the underlying action from the legal malpractice claims. Under Federal Rule of Civil Procedure Rule 42, courts have the discretion to order separate trials. FRCP Rule 42 states:

For convenience, to avoid prejudice, or to expedite and economize, the court may order a separate trial of one or more separate issues, claims, crossclaims, counterclaims, or third party claims. When ordering a separate trial, the court must preserve any federal right to a jury trial.

However, bifurcation is the exception, not the rule.34 Imagine using the defendant’s logic in every case. Using the common defense approach, every negligence case should be bifurcated and tried piecemeal. Such practice would create havoc in the judicial system and cases would become extremely difficult to manage in the best of circumstance. Potentially, every negligence case would result in multiple trials and possibly multiple appeals. Discovery would become disjointed, and prosecution of any negligence case would become nearly impossible. The court’s docket would become extremely backlogged and the need for additional jurors would increase substantially. It is the party making the motion for bifurcation’s burden to establish that bifurcation of the issues will promote judicial economy and expedition and avoid prejudice to any party. In exercising its discretion, federal courts look at such relevant factors as "(1) whether separation of the issues for trial will expedite disposition of the actions; (2) whether such separation will conserve trial time and other judicial resources; (3) whether such separation will avoid prejudice; (4) and whether the issues are essentially independent of each other so that there will be no need to duplicate the presentation of significant areas of the evidence in the separated proceedings."35 The controlling factor in determining whether an action should be bifurcated is "the interest of efficient judicial administration."36 As such, the party requesting bifurcation must specifically show that “bifurcation will promote judicial economy, and avoid inconvenience or prejudice to the parties.”37

“Because bifurcation works an infringement on such an important aspect of the judicial process, courts are ‘cautioned that [it] is not the usual course that should be followed.’”38 Furthermore, “A trial may be bifurcated only when the issues are clearly distinct and the bifurcation will not work a hardship against either party. Although bifurcation may result in judicial economy in some cases, it often works an injustice and does not achieve judicial economy when trials must be conducted again.... A fair trial is often thwarted when interwoven issues are tried separately.”39 Furthermore, “when issues are ‘so interwoven’ that their independent trial would cause ‘confusion and uncertainty, which would amount to a denial of a fair trial,’ they must be tried together.”40

In Mallen’s treatise, Legal Malpractice (2007), the authors take the position that such bifurcation can “provide a cogent and clear evidentiary process, reducing the risk of confusing a jury.”41 However from the plaintiff’s point of view this is not always the best approach. If bifurcation is ordered, procedurally it is favored to try the issue of the attorney’s negligence before the issue of causation and damage in the underlying action.42 Obviously, every defendant would love to have bifurcation of every single issue. By presenting issues separately, it becomes more difficult for the jury to understand the entire picture. In theory, a defendant could ask for
bifurcation of duty, causation, damages, and so on.

There is a danger that bifurcation may deprive plaintiffs of their legitimate right to place before the jury the circumstances and atmosphere of the entire cause of action which they have brought into the court, replacing it with a sterile or laboratory atmosphere in which causation is parted from the reality of injury.

Other courts have rejected the bifurcation method finding that the issues of liability were too closely intertwined with the other issues.43 Courts have also rejected bifurcation where the attorney’s negligent actions have impaired the plaintiff’s evidence of damages in the underlying case. In National Union Fire Insurance Co. v. Dowd & Dowd, P.C., 191 F.R.D. 566 (N.D.Ill.1999), the Court refused to bifurcate the underlying case from the legal malpractice claims because the attorney’s actions were “alleged to have directly affected the strength and strategy of the personal outcome of the personal injury trial.”44

Bifurcation should not create a vehicle by which the defendant attorney can disguise their true identity. Consider a claims against the UIM carrier in an automobile accident case. In Kentucky, the case law is clear that the UIM carrier is the real party in interest and must be named.45 In the UIM setting, Kentucky has found:

There is no more reason to create a legal fiction by substituting the name of the tortfeasor for the UIM carrier, when the carrier alone is the real party in interest in UIM cases, than there is a reason to do so when dealing with UM coverage. The issue of permitting a “legal fiction” to be employed has been laid to rest in an uninsured motorist claim which involves a direct action against the UM carrier.46

There is little difference between the role of an underinsured or uninsured motorist carrier who is represented by counsel in the bifurcated automobile accident case and the role of the former lawyer in a legal malpractice suit. The defendant attorney likewise should not be allowed to use bifurcation to create a fiction in an attempt to prove to the jury that their prior client is undeserving of damages in the underlying case. The jury should be told that it is the plaintiff’s former attorney, who now, as a result of allegations of malpractice, is attempting to prove to the jury that his or her own client was not worthy of representation from the outset.

IV. CONCLUSION

In statistics released by the American Bar Association in 2003, plaintiff personal injury work is listed as the area with the highest claims rate responsible for almost 20% of all legal malpractice claims.47 Medical malpractice cases are certainly a part of this group and present unique challenges to the attorney handling any legal malpractice claims arising out of an underlying medical malpractice case. However, with the complexity involved in handling medical malpractice claims and a legal malpractice combined, novices be warned.


1 Duffey Law Office, S.C. v. Tank Transport, Inc., 194 Wis.2d 674, 682 (Wis. App. 1995).
2 Schultz v. Harney, 33 Cal.Rptr.2d 276, 281 (Cal. App. 2nd Dist. 1994).
3 Ronald E. Mallen & Jeffrey M. Smith, Legal Malpractice, vol. 3, § 20:1, 3, (2007 ed., West).
4 Id. at 4.
5 Gautam v. DeLuca, 521 A.2d 1343, 1348 (N.J. Super. App. Div. 1987)
6 Id. at 1348. See also, Wilkins v. Safran, 649 S.E.2d 658, 673 (N.C. App. 2007)
7 Id. at 1348.
8 Id. at 1348 (quoting Lieberman v. Employers Ins. of Wasau, 419 A.2d 417 (N.J. 1980).
9 Young-Hatten v. Taylor, 2009 WL 690165 at *5 (Ohio App. 10 Dist.).
10 Id. at 4, quoting Vahila v. Hall, 77 Ohio St.3d 421 (Ohio 1997)(quoting Note, The Standard of
Proof of Causation in Legal Malpractice Case, 63 Cornell L.Rev. 666, 670-71 (1978)).
11 Mallen, supra n. 3, at 4.
12 See Gautam v. DeLuca, 521 A.2d 1343, 1348 (N.J. Super. App. Div. 1987).
13 K.R.S § 411.165 (2008).
14 Mallen, supra n. 3, at 4-5.
15 Ronald E. Mallen & Jeffrey M. Smith, Legal Malpractice, vol. 2, § 19:7, 1208, (2007 ed., West).
16 Id. at 1213-1214, (quoting ABA Model Rules of Professional Conduct, Scope (2002)).
17 Mallen, supra n. 15, at 1218.
18 Id. at 1218-1219.
19 A.B.A. Model R. Prof. Conduct 1.1.
20 Id. See Comment 2.
21 A.B.A. Model R. Prof. Conduct 1.3.
22 Id. See Comment 1.
23 See Roadway Express v. Piper, 447 U.S. 752, 757 n. 4 (1980) (“The glacial pace of much
litigation breeds frustration with the federal courts and, ultimately, disrespect for the law.”)
24 A.B.A. Model R. Prof. Conduct 3.2. See Comment 1.
25 Daugherty, 581 S.W.2d at 14 (quoting Wade, The Attorney’s Liability for Negligence, 12 Vand.L.Rev.
755, 762 (1959)).
26 Id.
27 Id. at 17.
28 Mallen, supra n. 15, at 1185.
29 Id.
30 A.B.A. Model R. Prof. Conduct 1.4.
31 A.B.A. Model R. Prof. Conduct 1.16.
32 A.B.A. Model R. Prof. Conduct 1.2.
33 A.B.A Model R. Prof. Conduct 7.15.
34 See J2 Global Communications, Inc. v. Protus IP Solutions, 2009 WL 910701 (C.D.Cal. March 31,
2009) at p. 3 (“all claims in a case-even if founded on different causes of action-are tried together, as such
an approach is generally considered to be the most efficient for the court and parties); Hamm v. American
Home Products Corp., 888 F.Supp. 1037, 1039 (E.D. Cal. 1995) (“absent some experience demonstrating
the worth of bifurcation, ‘separation’ of issues for trial is not to be routinely ordered.”); Hangarter v. Paul
Revere Life Ins. Co., 236 F.Supp.2d 1069, 1094 (N.D. Cal. 2002) (“piecemeal trial of separate issues in a
single suit is not to be the usual course [and] should be resorted to only in the exercise of informed
discretion when the court believes that separation will achieve the purposes of the rule”).
35 Tuey v. Mammoth Mountain Ski Area, 2009 WL 928328 at *4 (E.D. Cal.).
36 J2 Global Communications, Inc., 2009 WL 910701 at *3 (C.D. Cal.) (citing Charles Alan Wright &
Arthur R. Miller, Fed. Prac. & Proc. Civ. 3d §2388).
37 Spectra-Physics Lasers, Inc. v. Uniphase, Corp., 144 F.R.D. 99, 101 (N.D. Cal. 1992).
38 Kimberly-Clark Corp. v. James River Corp. of Virginia, 131 F.R.D. 607 (N.D. Ga., 1989).
39 Beavis ex rel. Beavis v. Campbell County Memorial Hosp., 20 P.3d 508 (Wyo. 2001).
40 Id.
41 Ronald E. Mallen & Jeffrey M. Smith, Legal Malpractice, vol. 4, § 33:26, 1198-1199, (2007 ed., West).
42 Id. at 1199.
43 Id. at 1200 (citing National Union Fire Insurance Co. v. Dowd & Dowd, P.C., 191 F.R.D. 566
(N.D.Ill.1999)).
44 National Union, 191 F.R.D. at 567.
45 Kentucky Rule of Civil Procedure 17.01 provides in part: “Every action shall be prosecuted in the name
of the real party in interest...nothing herein, however shall abrogate or take away an individuals right to
sue.”
46 Earl v. Cobb, 156 S.W. 3d 257, 261 (Ky. 2005).
47 See http://www.kybar.org/documents/benchbar/bb_0107_2.pdf

courtroomlaw.com