Category: Medical

First Circuit Orders Multiple AMOs Without Audio or Video Recording

Defendants often request an AMO (“Additional Medical Opinion,” formerly called “IME”) under La. Code of Civil Procedure article 1464 which grants the courts power to order the examination of a plaintiff’s physical or mental condition when in controversy.   Increasingly, plaintiff’s counsel will object outright to such examinations or seek to impose onerous restrictions designed to limit or prevent the examination. In Sistrunk v. Florida Marine, LLC, et al, 20-0771 (La. App. 1 Cir. 9/28/20), 2020 WL 575645, the First Circuit rejected limitations sought by the plaintiff and imposed by the trial court.

In Sistrunk, the plaintiff alleged brain injury and psychological problems caused by a blow to the head.  In view of the seriousness of the alleged injuries, the defense requested examinations by a neurologist, neuropsychologist, neurosurgeon, and psychiatrist. In response, the plaintiff agreed to examinations but only in areas plaintiff planned to offer medical testimony and under restrictions to include the presence of a third-party and audio or video recording. Although the trial court ordered the AMOs to move forward, it allowed the presence of a third-party who could then audio or videotape the exams.   With respect to the neuropsychological examination, the trial court rejected observation by a third-party based upon industry standards which do not allow for such observation.

The defense in Sistrunk sought review from the First Circuit. Without comment, the First Circuit rejected the condition imposed by the trial court that the exams be captured through audio or videotaping.  Sistrunk joins similar decisions such as Henry v. Barlow, 06-283 (La. App. 3 Cir. 8/9/06), 937 So. 2d. 895 which likewise prevented audio or videotaping of AMOs. In Henry, the court reasoned that the recording of an AMO would restrict the number of physicians willing to participate.


Brian has been doing defense work for the last 28 years. He has handled all types of defense matters over his career, but in recent years his practice has been focused in serious injury or damage cases and has worked extensively with experts involving complex cases, fire cases, and forensic work. 

La. Supreme Court Determines Impact of Failure to Pay Filing Fee in Medical Review Panel

The Louisiana Supreme Court recently held that failure to pay filing fees necessary to add a defendant does not invalidate the proceeding as to other defendants. Prior to the ruling, Louisiana courts held that a failure to pay for one defendant invalidated the entire proceeding. 

In Kirt v. Metzinger 2019-C-1162 (La. 04/03/20), plaintiffs requested a medical review panel after the death of their mother due to complications after surgery.  Plaintiffs named three defendants—two doctors and the hospital.  A letter from the Patient’s Compensation Fund Oversight Board (PCF) was mailed to the plaintiffs, confirming that the defendants were qualified under the Louisiana Medical Malpractice Act, and informing the plaintiffs that they were required by La. R.S. 40:1231.8 to pay a filing fee of $100 per named defendant within forty-five days of the mailing of the letter.  Plaintiffs responded, requesting to add two additional defendants to the panel, one of whom was an unidentifiable nurse.  Plaintiffs also included payment of $500.

The PCF responded that it was unable to add the nurse without proper identification.  Three weeks later, plaintiffs notified the PCF they were also unable to identify the nurse. Upon request, Parish Anesthesia was added to the panel instead. Nearly five months later, plaintiffs provided the PCF with the identity of the nurse in question and requested she be added. The PCF sent confirmed the addition and requested another $100 filing fee which was never paid.  Nevertheless, the medical review panel thereafter determined that none of the defendants, including the nurse, breached their standard of care.  Suit followed against all defendants.

The defendants moved for summary judgment, arguing that the failure to pay the additional filing fee invalidated the proceeding as to all defendants. The trial court granted this motion, and the appellate court affirmed.   Reversing the lower courts, the Supreme Court found that the failure to pay the additional $100 filing fee did not invalidate the entire proceeding. The court observed that separate confirmation letters sent by the PCF provided a different forty-five day period during which to pay the filing fee tied to each individual defendant.

The Kirt court stated: “[t]he notion of ‘one filing fee’ for every panel proceeding cannot be reconciled with the different payment deadlines that arise when the PCF sends separate letters confirming defendants’ qualified status.  A single filing fee cannot be subject to different payment deadlines.”  The court dismissed only the nurse and remanded the remainder of case to the lower courts. 


Chad A. Sullivan is a partner with Keogh, Cox & Wilson, Ltd.  Prior to becoming an attorney, he worked as a licensed Registered Nurse.  He utilizes his background in nursing on a daily basis in his law practice that primarily focuses on automobile liability, medical malpractice, nursing home litigation, healthcare professional licensure and discipline, and products liability.

Medical Malpractice: Can failure to communicate test results be medical malpractice?

The Louisiana Fourth Circuit Court of Appeal recently considered a medical malpractice case with an unusual set of facts.  Rather than the standard medical malpractice case, where a patient argues that he was misdiagnosed and/or claims that the doctor made a mistake when administering medical treatment, in Dufreche v. Jeffery Wayne Coco, MD and Internal Medicine Specialists, Inc., 2020-CA-0030 (La. App. 4th Cir.), the patient alleged that his doctor committed malpractice by failing to communicate test results.

In Dufreche, the patient showed signs of an HIV infection.  He was tested twice before being treated by the infectious disease specialist.  Both tests were negative.  During his examination, the infectious disease doctor thought it was unlikely that the patient had HIV, but tested him anyway at the patient’s insistence.  According to the patient, he was notified by the doctor that he would be provided the results upon receipt.

Unfortunately, the test results showed that the patient was HIV positive; however, he was not contacted.    Fifteen months passed, during which the patient was unaware that he was HIV positive.  Because he was not contacted, he assumed he was negative. When testing by another physician showed he was positive, the patient/plaintiff filed suit to recover damages allegedly suffered through a delay in treatment and psychological shock, including a claim for “emotional distress.”

To recover, the patient was required to establish: 1) the standard of care; 2) breach of that standard of care; and 3) that the breach caused his emotional distress.   At trial, the doctor testified that he required his patients to follow up in person to receive test results, and expected the patients to contact his office to schedule an appointment.  The court found that expecting a patient to follow up in person to receive sensitive test results was not a breach of the standard of care.  However, the evidence established that the patient was not instructed that he must schedule an in-person appointment to obtain his test results. 

The Dufreche court agreed with the lower court in finding that a failure to notify the patient of the doctor’s policy was a breach of the standard of care.  Further, the court found that the infectious disease specialist, who admitted to a duty to the public to protect them from HIV, had also breached his duty for failing to notify an HIV positive patient of his diagnosis for over fifteen months.  The doctor’s failure to communicate the results caused the patient’s emotional distress – resulting in an award of $45,000 in damages.


Virginia “Jenny” McLin is a partner at Keogh Cox who practices in the fields of corporate litigation, insurance defense and workers compensation defense.  When she is not practicing law, Jenny can be found volunteering with the Junior League of Baton Rouge; cheering for the LSU Tigers with her husband Ryan; or shuffling her two kids to and from dance practice.

Coronavirus and Workers Compensation in Louisiana

In Louisiana, workers compensation benefits can be owed if an employee sustains an accident or develops an occupational disease arising out of and occurring during the course and scope of their employment.  The definitions and burdens of proof differ for each.

An accident is defined by La. R.S. 23:1021 as:

(1) “Accident” means an unexpected or unforeseen actual, identifiable, precipitous event happening suddenly or violently, with or without human fault, and directly producing at the time objective findings of an injury which is more than simply a gradual deterioration or progressive degeneration.

An occupational disease is defined by La. R.S. 23:1031.1 as:

B. An occupational disease means only that disease or illness which is due to causes and conditions characteristic of and peculiar to the particular trade, occupation, process, or employment in which the employee is exposed to such disease. Occupational disease shall include injuries due to work-related carpal tunnel syndrome. Degenerative disc disease, spinal stenosis, arthritis of any type, mental illness, and heart-related or perivascular disease are specifically excluded from the classification of an occupational disease for the purpose of this Section.

C. Notwithstanding the limitations of Subsection B hereof, every laboratory technician who is disabled because of the contraction of any disease, diseased condition, or poisoning which disease, diseased condition, or poisoning is a result, whether directly or indirectly, of the nature of the work performed, or the dependent of a laboratory technician whose death is the result of a disease, diseased condition, or poisoning, whether directly or indirectly, of the nature of the work performed shall be entitled to the compensation provided in this Chapter the same as if said laboratory technician received personal injury by accident arising out of and in the course of his employment.

As used herein, the phrase “laboratory technician” shall mean any person who, because of his skills in the technical details of his work, is employed in a place devoted to experimental study in any branch of the natural or applied sciences; to the application of scientific principles of examination, testing, or analysis by instruments, apparatus, chemical or biological reactions or other scientific processes for the purposes of the natural or applied sciences; to the preparation, usually on a small scale, of drugs, chemicals, explosives, or other products or substances for experimental or analytical purposes; or in any other similar place of employment.

Except as otherwise provided in this Subsection, any disability or death claim arising under the provisions of this Subsection shall be handled in the same manner and considered the same as disability or death claims arising due to occupational diseases.

In general, if an employee can prove that they were exposed to Coronavirus at work, and that the particular exposure caused them to contract Coronavirus disease, they may be able to prove a compensable accident.  The burden of proof is a tough one, of course, because it would seem to be nearly impossible for an employee who contracts the Coronavirus to prove the contraction resulted from work as opposed to exposure in some other environment.  However, it is important to note that one Louisiana court did find that a claimant was able to meet that burden when he contracted the West Nile Virus by proving to the satisfaction of the Workers Compensation Judge, rather incredibly, that a particular mosquito bite occurring at work was the cause.  Allen v. Graphic Packaging,   51,080 (La. App. 2nd Cir. 1/11/17), 211 So.3d 1219.   If a claimant is able to prove the occurrence of an accident, then the usual workers compensation medical and indemnity benefits would be payable depending on medical needs, disability status, or even death benefits if the employee expired as the result of such an accident.

For an employee to be able to prove that their contraction of Coronavirus disease fits within the definition of an occupational disease, they would have to prove that it was “due to causes and conditions characteristic of and peculiar to” their employment.  Some healthcare workers and others in related fields who become infected would seem to have an easier time proving their cases than others whose work would not customarily lead to such exposures.  The definition above includes laboratory technicians (which could be an expansive list as defined) who contract a disease as the result exposure to something that they are working on/with.  The statute also provides some timing elements for claim filing and causation presumption, most of which would not seem to apply because of novel nature of the current Coronavirus outbreak.  As with claims asserted as accidents, the usual medical and indemnity benefits would be payable depending on the circumstances of the individual worker.

For additional details on the Allen case, please review Keogh Cox blog “One Particular Mosquito: West Nile Virus Found to be a Compensable Workers’ Compensation Claim” by clicking here:  https://keoghcox.com/one-particular-mosquito-west-nile-virus-found-compensable-workers-compensation-claim/.

Torts: “Loss of Chance”: Claim Limited to Medical Malpractice

In Niang v. Dryades YMCA School of Commerce, Inc., 19-0425 (La. App. 4 Cir. 12/4/19), – – – So.3d – – -, the Fourth Circuit declined to expand the “loss of chance of survival” cause of action to non-medical defendants.  Despite a statute which arguably supported such a cause of action under case facts, the Fourth Circuit felt constrained to reject the claim.

On March 7, 2017, Mouhamadou Niang collapsed while playing basketball at a YMCA.  Mrs. Niang was certified in cardiac life support, and requested an automated external defibrillator (“AED”) to attempt to resuscitation.  Mrs. Niang was advised that an AED machine was not available.  Thereafter, Mr. Niang was transported to University Medical Center where he died on March 11, 2017 secondary to cardiac arrest.

Mrs. Niang sued the YMCA for failing to have an AED machine on premises and asserted multiple claims including a loss of chance of survival claim.  She contended that the lack of the defibrillator contributed to her husband’s death.  Under La. R. S. 40:1137.3, all “physical fitness facilities” such as the YMCA are required to have an AED available.

The YMCA filed a Motion for Partial Summary Judgment which was granted.  In its reasons, the trial court held that the “loss of chance” cause of action was limited to claims raised in a medical malpractice context.  The Fourth Circuit affirmed.

The Fourth Circuit found that, although styled as a Motion for Partial Summary Judgment, the YMCA had actually raised an Exception of No Cause of Action and therefore analyzed the issue as a pure question of law.  The Fourth Circuit reviewed prior Louisiana Supreme Court decisions providing a right to recover damages for a loss of chance of survival in the medical malpractice context including the decision in Hastings v.  Baton Rouge Gen. Hosp., 498 So.2d 713 (La. 1986). In Hastings, the Louisiana Supreme Court identified a cause of action where a stab wound victim with weak vital signs was transferred from the hospital after the patient lacked insurance. The Hastings court commented on the reduced burden of proof in such cases:

“The law does not require the plaintiff to prove to a certainty that the patient would have lived had he received more prompt diagnosis and treatment for the condition causing the death.”

The Fourth Circuit identified no cases directly “on point” when the defendant was not a medical practitioner.  Therefore, the Fourth Circuit gave consideration to a noted Oklahoma decision in Hardy v. Southwestern Bell Tel. Co., 910 P.2d 1024 (Okla. 1996) which addressed the issue.  The court in Hardy considered the public policy implications associated with expanding the loss of chance of survival claim to non-medical cases and reasoned that the policy concerns which justify a reduced burden of causation in medical malpractice claims do not transfer to ordinary negligence cases.  The cause of action against medical providers is supported by the “special relationship” of the physician and the patient.  No such relationship exists in a non-medical setting.

Citing to Hardy, the Niang court determined that allowing a loss of chance of survival claim with general negligence would allow for improper speculation as to a person’s chance of survival.  Identifying no controlling cases and the lack of any statute creating a cause of action in non-medical malpractice cases, the Niang court concluded that loss of chance of survival claims are not supported outside of the medical context.


Collin is a Keogh Cox partner who litigates injury, commercial, and legal malpractice disputes. He lives in nearby Zachary, Louisiana with his wife Melissa and three all too active children. He is an outdoorsman, a league tennis player, a cook, and a hobbyist writer.