Forensic psychiatry and malpractice.
H. C. Modlin,
Bull. Amer. Acad. Psychiatry & the Law
18(2): 153-62, 1990.
This paper concerning the last 87 malpractice cases referred to the Department of Psychiatry and
Law, Menninger Clinic, includes 57 suits against mental health practitioners and/or institutions, and
30 nonpsychiatric suits against general hospitals, surgeons, obstetricians, etc. A patient was available
for interview in only 12 percent of the psychiatric cases; in 88 percent we reviewed medical records
and consulted with attorneys. In the psychiatric cases the crucial question was whether a generally
accepted standard of care was breached. The inherent problems of applying appropriate criteria to
standards of care by practitioners and institutions are discussed. In half the psychiatric cases we
found no significant deviation from acceptable clinical performance; in half we concluded that
negligent practice had occurred. We did see a litigant for evaluation in 90 percent of the
nonpsychiatric cases. The main issue involving them concerned harm or disability related to
presumed negligence by medical personnel. How we evaluate such cases and apply disability criteria