Tort and lobbying issues make noise but little changes

first_img June 15, 2005 Senior Editor Regular News Tort and lobbying issues make noise but little changes Tort and lobbying issues make noise but little changes Expect bills on both topics to be introduced next year Gary Blankenship Senior Editor Two issues with potentially wide-ranging effects on many Florida Bar members were high profile battles in the legislature this year, but when the dust had settled, not much had changed.But those involved in the disputes over lobbying disclosure legislation and attempts to change tort laws say both are likely to be back before lawmakers in their 2006 Regular Session.The Florida Bar, which is restricted on the legislative actions it can take, did not take lobbying positions on either issue. But many lawyers closely watched the tort and lobbying conflicts as they could affect many practices around the state.Many observers also saw the issues as linked, with Senate President Tom Lee, R-Brandon, championing more disclosure for lobbyists and House Speaker Allan Bense, R-Panama City, favoring more protections for businesses in defending tort actions. And because of the failure of the upper and lower chambers to agree, the lobbying bill and the bills making the most serious tort changes died on the last day of the session.Rep. Dudley Goodlette, R-Naples, isn’t so sure there was such a solid connection.“The fact of the matter is the House in any event did pass a bill that dealt with the subject matter of lobbying reform, but did not go as far as the Senate president wanted to go [in the bill originally passed by the upper chamber and sent to the House],” he said. “Therefore, the Senate did not take it up and pass it.”Tort reform, on the other hand, was a hodge-podge of priorities of the House leadership and individual bills by House members.“I think that the speaker of the House is a businessman and the members of the House are free to file six bills,” Goodlette said. “Many of the members of the House had an interest in tort reform or litigation reform measures.”Bills requiring more medical proof of injury before filing, such as asbestos claims and giving electric utilities greater protection when streetlights fail, which were Bense’s priorities, did pass, he said, while another bill giving business owners greater protections from suits by victims of crimes committed on their property, also the speaker’s priority, failed, as did many other member-sponsored bills. Lobbying The lobbying bill proved to be a contest of the public’s right to know versus traditional privacy privileges. And it was particularly ticklish for lawyer/lobbyists.“I think it would have been important for the press and public to see what the real impact of money in that political process is,” said Ben Wilcox, head of the Florida Chapter of Common Cause, and a supporter of Lee’s lobbying proposals. “We’re not really getting an accurate picture with what is required now for lobbyist disclosure.”Wlicox noted there were some criticisms that the Senate bill could cause problems, including some claims that if one lawyer in a firm did lobbying, then every attorney in that firm could be forced to reveal what clients paid, even for lawyers who did no lobbying and for clients who hired the firm for nonlobbying work.“I realize that in the first draft of the bill, that scenario was raised as a potential problem,” Wilcox said. “I believe that problem could be dealt with; I saw it more as a red herring.“I’m hoping that Sen. Lee will come back and take another shot at it. Maybe we can have a dialogue with lobbyists who were open to the changes. Maybe we can come forward with some compromise legislation that will move the state forward and be comparable to what other states require.”Tallahassee attorney and lobbyist Wade Hopping said it wasn’t so much that he objected to having to report more information to the state on his lobbying activities, but that he thought much of the information that would have been required by the Senate was either confusing, impractical, or useless.“I wish there were more give-and-take on the mechanics,” he said. “I respect the right of the legislature to fix the policies, but many, many times, on many pieces of legislation, it’s not what the legislature wants to do, but how they do it. I would hope there would be more dialogue on how to do it.”Hopping said problems he saw included that reporting periods were changed, and the annual regular sessions would be split into two separate reporting periods. That would make it difficult to compile the information lawmakers said they were trying to make more available to the public, he said.There was also a lack of clarity about determining what was important information. Hopping said sometimes his and other firms are hired to do both legal and lobbying work for a client, and determining where the line falls can be done, but it might waste time and resources.Likewise there may not be a direct relationship between what a client pays and what a lawyer-lobbyist earns, Hopping said. At his firm, his compensation comes from a pool into which all of the firm’s fees go and from which are paid its expenses and overhead. Thus, a lobbying client paying a hefty fee to the firm for Hopping’s services might have little if any direct impact on Hopping’s final compensation. He noted that only five of the 37 attorneys at his firm do significant lobbying, although a few others are registered but primarily provide expert testimony at legislative hearings.“How much does the public have a right to know and what form should that be so it’s useful in making decision?,” Hopping asked. “The other part is what do they have a right to know about my compensation?”Among the differences between the House and Senate final versions of the lobbying bill were:• The Senate would require lobbyists to report individual expenditures for food and beverages and for whom the expenditure was made; the House deleted that provision.• The Senate would require reporting all contributions to a political party, which in turn could be forwarded to a legislator as an indirect gift. The House deleted that provision.• The House required reporting only categories of income by lobbyists unless the dollar compensation exceeded $150,000 per semiannual reporting period. The Senate required exact dollar reporting of a lobbyist’s compensation from an employer if the total compensation exceeded $45,000 in a quarterly reporting period.• The Senate would have the auditor general audit 3 percent of all lobbying firms annually, while the House version did away with the auditing requirement.• The House would require semiannual reporting, while the Senate would mandate quarterly reporting.• The Senate would require a lobbyist submitting a report to certify it is complete and accurate, while the House would require certification that it is complete and accurate to the best of the filer’s knowledge. Tort Bills Alexander Clem, president of the Academy of Florida Trial Lawyers, said the deluge of tort bills — most of which did not pass — came from both legislative leaders and a variety of business interests. He speculated those interest groups are rushing to push business-friendly tort bills before the 2006 elections, and while the House, Senate, and governor’s mansion are all controlled by Republicans. Clem argued that more laws aren’t needed.“The state of Florida and its citizens have been tort-reformed to death over the past 10 years,” he said. “There has not been any demonstrable need for any further restrictions or elimination of the people’s constitutional right to pursue redress when they’ve suffered catastrophic injuries.”But George Meros, who has lobbied on tort issues for years, said the legislature is slowly “making common sense reforms” and restoring fairness to the tort arena. He says more needs to be done.“There remains areas of inequity in Florida law that other states have reformed and it is high time we reformed,” Meros said. “Joint and several liability needs to be fully repealed, and the other areas that were at issue in this session I’m sure will be discussed and at issue next year.”Meros said “significant progress” was made this year in the areas of class actions, slip and fall, and product liability matters — all of which will be revisited next year.Of the bills that did pass, one gives power companies more protection from suits related to streetlight failures. Those companies will now have 60 days after they are notified to fix such a problem before they would be liable for damages, Clem said.Likewise, another bill gives asbestos companies greater protection, by requiring those exposed to asbestos show an injury before being allowed to file suit, Meros said.“What this bill will do is require a screening to show actual physical injury,” Meros said, adding those exposed to asbestos who do not show physical impairment now, but show physical impairment in the future, will still be able to sue and the statutes of limitations will be tolled until evidence of impairment is detected.Another bill that didn’t pass would have given business property owners greater protections from lawsuits from victims of crime committed on their properties. Clem said a major sticking point was business owners wanted the criminal listed as a defendant on the jury verdict form, but lawmakers failed to go along with that provision. Meros said the holdup was due to a misunderstanding that the bill would have immunized property owners or that it somehow would have a negative impact on crime prevention.Bills aimed at restricting lawsuits based on product liability and class actions claims also failed, in part, Clem said, because the agriculture industry and others realized they would have to pursue such claims in federal court, making those actions more expensive and time-consuming.Other failed bills would have given radiologists more protection from lawsuits, limited damages for teaching hospitals, and given nursing homes some protections if they guaranteed a certain minimum liability standard.Clem said the academy also saw as part of the tort battles legislation to implement amendments 7 and 8 approved by voters last November. The former gives patients and potential patients more access to adverse incident reports and other medical records, while the latter requires removing the license of any doctor found to have committed three acts of malpractice. The legislation to carry out those amendments “gutted” their intent, Clem said, adding, “Our expectation is we do go to court to reinstate amendments 7 and 8.”“Florida lawyers ought to look at the reality of it rather than the spin,” Meros said. “Look at it from the perspective of do the reforms make good common sense, are they fair. And, if so, we as lawyers should always advance the social interest of making our laws fairer and more predictable to the common person, regardless of whether we are financially impacted by it.”last_img read more

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Reports examine high H5N1 death rate in Indonesia

first_imgJul 17, 2008 (CIDRAP News) – Recent reports from Indonesian health officials tie the high fatality rate in human H5N1 influenza cases there to the difficulty of diagnosing the disease, late treatment with antiviral drugs, and a shortage of well-equipped hospitals.The case-fatality rate (CFR) in Indonesia, which leads the world in H5N1 cases, climbed from 63% in 2005 to 80% in 2006 and 85.7% in 2007, according to a report in the journal Annals Academy of Medicine Singapore. The CFR remains high so far this year, with 15 of 18 cases fatal, or 83.3%, according to World Health Organization (WHO) figures.By comparison, the CFR for the global total of 385 cases with 243 deaths is 63.1%. The fatality rate with Indonesian cases excluded is 53.2% (250 cases with 133 deaths, based on WHO figures).Two reports in the Singapore journal discuss H5N1 cases in Indonesia. One, written by Indonesian Ministry of Health (MOH) officials, looks at the 116 cases, including 94 fatal ones, the country recorded from 2005 through 2007 (the article also defends Indonesia’s refusal to share H5N1 virus isolates with the WHO). A second article, written by hospital physicians, profiles the 27 cases, including 21 fatal ones, treated at Sulianti Saroso Infectious Diseases Hospital in Jakarta during that period.Hospital deficit called major factorAccording to the second report, Indonesia, like most developing countries, has few primary or secondary care hospitals with the protocols, isolation rooms, or cardio-respiratory support equipment to treat patients critically ill with H5N1 influenza.”This is probably the largest single contributor to the high mortality recorded,” says the report, written by Sardikin Giriputro, MD, and colleagues.The MOH report cites the infection’s nonspecific early clinical features, medical providers’ unfamiliarity with the disease, and the late clinical stage of patients when hospitalized as potential causes of the high mortality. But with the increasing CFR over time, it adds, “the probability of an increase in the virulence of H5N1 viruses should also be considered.”Without a fast, convenient test for H5N1 infection, the disease is difficult to diagnose, the hospital article says. Because the early signs and symptoms are not specific, primary care physicians “would find it extremely hard to predict which of their dozens of patients with influenza-like illness is going to turn out to have highly pathogenic H5N1 influenza in a few days time,” it states.The MOH report says that 71% of H5N1 patients in Indonesia were treated with the antiviral drug oseltamivir (Tamiflu), but only two patients received it within the recommended time frame of 48 hours after the first symptoms. Those two patients survived. The survival rate decreased as the time to start treatment increased, the report says.Because early recognition is critical, the hospital report says, “The only conceivable solution is the development of cheap, effective point-of-care tests for H5N1 influenza that are as easy to use as a pregnancy test for example. These could be used by a rural primary healthcare clinic or district hospital in any developing country. This is clearly a challenge for the global scientific community.”Most H5N1 patients were severely ill by the time they were brought to the hospital, the report says. “The vast majority had evidence of the systemic inflammatory response syndrome (SIRS) with marked tachycardia and tachypnoea” (rapid heart and breathing rates).Gender gap in fatality rateIn other observations, the MOH report says the CFR was significantly higher among females than males—89% versus 73%; it offers no explanation for the difference. Adults had a higher CFR than children, 83% versus 76%, but the difference was not significant. The median age for all case-patients was 20 years.The MOH report also says that 24% of the 116 cases “occurred in 10 clusters of blood-related family members.” But the report offers no opinion on how many cases of person-to-person transmission occurred. As reported previously, person-to-person transmission was considered likely in a widely publicized cluster of eight cases (seven confirmed, one probable) in Sumatra in May 2006.WHO reports on the Indonesian cases so far this year show only one family case cluster, involving a 38-year-old woman from West Jakarta, who fell ill in late January, and her 15-year-old daughter, who got sick in early February.According to the MOH authors, less than half of all the Indonesian patients—46%—had an “unmistakable history of direct contact with sick or dead poultry.” Another 36% had been near sick or dead poultry without direct contact, and the possible sources for the other 18% were unclear, the report says.Among the Sulianti Saroso patients, 12 of 27 (44%) had indirect contact with poultry, mainly from visiting markets or areas where poultry outbreaks had occurred, the hospital report says. A smaller, unspecified number had direct contact with poultry, and the source was unclear for the rest. The authors speculate that some of the patients who had no direct contact with poultry might have caught the virus from fertilizers made of chicken manure.As for the epidemiologic curve, the MOH report says Indonesia averaged 5 cases per month from September 2005 through May 2007, but the rate dropped to 3 cases per month from June through December 2007. The WHO records indicate a similar pace so far this year, with 18 confirmed cases through June, but two thirds of those were in January and February.While 31 of 33 Indonesian provinces have had H5N1 outbreaks in birds, only 12 provinces have had human cases, the MOH report says.Giriputro S, Agus R, Sulastri S, et al. Clinical and epidemiological features of patients with confirmed avian influenza presenting to Sulianti Saroso Infectious Diseases Hospital, Indonesia, 2005-2007. Ann Acad Med Singapore 2008 Jun;37(6):454-7 [Full text]Sedyaningsih ER, Isfandari S, Soendoro T, et al. Towards mutual trust, transparency and equality in virus sharing mechanism: the avian influenza case of Indonesia. Ann Acad Med Singapore 2008 Jun;37(6):482-8 [Full text]last_img read more

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