Pediatric Medico-Legal

Delivering Expert Pediatric Opinions with Integrity Since 1993 ™

This Article Provides Some of the Specialized Language Used in Pediatric Medicine and Pediatric Litigation.

How Do You Determine a Qualified Medical Expert?

  • Adequate training in top rated medical schools and training programs across the United States.
  • Board Certification ensuring competence by their governing body.
  • Experience in practice.
  • Do they teach? Have they been published?
  • Do they think logically when being questioned?
  • Knowledge of medicine and how the medico-legal process works.
  • Careful listening skills.
  • Exemplary spoken and written communication skills.
  • An expert that is knowledgeable and humble, clear, and concise while explaining complicated and intricate diseases and injuries to jurors and jurists alike.


Pediatric Medical-Legal Terminology

These qualities ensure a thorough evaluation and objective assessment of material facts of your case as well as incorporating lay witness testimony to provide a comprehensive review of the issues: including strengths and weaknesses and an opinion to a reasonable degree of medical certainty that is commensurate with the current literature and standards of practice in the area of pediatrics.

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What Is a Pediatrician?

What is a Pediatrician
A pediatrician is a physician who has been specially trained after medical school to care for infants and children. They spend three years learning about normal development and growth in children as well as diseases, injuries, and infirmities that affect infants and children. During these three years, they spend time in a myriad of places in the hospital including:
  • Neonatal
  • ICU
  • Pediatric ICU
  • Cardiology clinic
  • Hematology/Oncology clinics
  • Gastroenterology clinic
  • The emergency department
  • Child abuse clinic
  • Time with other pediatric subspecialists such as pediatric surgeons, pediatric trauma surgeons, and pediatric cardiothoracic surgeons.
Their education is mixed between inpatient and outpatient experiences to allow for a balanced education and a myriad of experiences and exposure for those general pediatricians who may want to go on to train in a pediatric subspecialty.

What Is a Pediatric Critical Care Doctor?

A Pediatric Critical Care Doctor works in Pediatric Critical Care Management, and carries (PCCM) in their Medical title. These doctors are fully trained pediatricians who go on to train for three additional years, focusing on illness where children are critically ill and traumatic injuries in children. Our Medico-Legal White Papers contains articles and case studies on many of these critical diseases or injuries.

Pediatric Critical Care

Their expertise encompasses a wide spectrum of conditions, such as congenital heart disease, trauma, child abuse, childhood cancers, shock, and various other diseases. They will collaborate closely with fellow subspecialists to provide comprehensive care for critically ill or traumatically injured infants and children.


What Is the Standard of Care?

“Standard of care can be defined as “…not a guideline or list of options; instead, it is a duty determined by a given set of circumstances that present in a particular patient, with a specific condition, at a definite time and place.”

In other words, standard of care is sensitive to time, place, and person. This is a challenge to physicians who try to adhere strictly to clinical guidelines because the absence of absolute standards forces physicians to make judgments that may prove in hindsight to have been incorrect. (AMA Journal of Ethics: Virtual Mentor. 2005;7(11):756-758).

The standard of care can, in some cases, be determined by policy statements of the physicians governing body or national and international standards such as the “Surviving Sepsis Campaign” in the early 21st century which was adopted worldwide.

In other cases, the standard of care must be determined by an assessment of the medical literature surrounding the child’s disease process as well as the physician’s training, education, and experience.

In these cases, experts must assess if the actions of the physician were reasonable and in accordance with what another prudent physician in the same or similar circumstances might do.

If the expert determines that the standard of care in the care of a child has not been met there are 5 issues that need to be assessed to determine negligence:

  • Breach of duty to provide the care required by the standard of care.
  • An injury must have occurred from the breach of the standard of care.
  • There must be a preponderance of evidence linking that breach to the injury.
  • The breach must satisfy the legal requirement of “a reasonable degree of medical certainty”. This means that an expert can say that more likely than not the breach caused the injury to the patient. (The Journal of Legal Medicine, 26:207–231)

What Is Causation?

Causation refers to the reason or cause for an injury or death. There are two types of causation: factual and legal.

Factual causation is via medical records and investigative documents proving that the injury or death of the child was caused by a failure on the part of the care provider.

For example, a child comes to the hospital breathing fast and deep, says they have been drinking and urinating a lot in the last week and smell funny when they are being examined but that child is not diagnosed with diabetic ketoacidosis and is sent home and dies.

Factually the failure of the practitioner to diagnose diabetes and Diabetic Ketoacidosis is the cause of the child’s death.

What is Causation

Legal Causation is determined on a “but for” test. But for the negligence that occurred would the child’s death still have happened? In the example above the answer is “no”. Had the diagnosis been made correctly the child would not have died.

So, what is “proximate cause”? “Proximate cause is a cause which in a natural and continuous sequence produces a person’s illness or injury, and is a cause which a reasonable and prudent health care provider could have foreseen would probably produce such illness or injury or some similar injurious result.” (N.C.P.I.-Civil 809.00A).

Proximate cause simply means that there was foreseeability of the event that caused illness or injury. So, the practitioner had a duty to the plaintiff, they breached that duty and but for that breach the plaintiff had a more than 50% chance of having a better outcome.

Our Medico-Legal White Papers contains articles and case studies on many of these critical diseases or injuries.