Members of Danaher Lagnese's litigation department.
Members of Danaher Lagnese’s litigation department. ()

Danaher Lagnese has medical malpractice defense down to a science.

The Hartford firm’s 26 lawyers are divided up into teams based on areas of expertise. If a doctor who treats cancer patients gets sued, certain lawyers handle those malpractice cases involving cancer. Other teams focus on cardiology, birth injuries, nursing home and rehabilitation cases, orthopedics, anesthesiology and radiology.

“We’ve defended thousands of cases at this point,” said partner Joyce Lagnese. “Once you’ve been doing this for as long as you have a lot of the medicine is similar over similar types of cases. Just using birth injuries for example, the medicine involved in those cases is extremely complex. It is so much more efficient from a client’s perspective if teams of attorneys become acquainted with medicine in that area.”

Because of Danaher Lagnese’s approach to med-mal defense, and its success in the field, the firm has won the Connecticut Law Tribune’s Litigation Departments of the Year Award in the medical malpractice category.

Lagnese said the teams evolved naturally based on the types of cases certain lawyers were getting and the medical professionals they were used to working with as clients.

“Then it occurred to us we should formalize it in a more structured way,” she said.

“It also becomes in part client preference,” said partner Neil Danaher. “Attorneys establish relationships with specific clients, and the groups [of clients] sort of tend to gravitate to sometimes one attorney or a couple of attorneys as opposed to others. You certainly want to meet those wishes whenever you can.”

The firm has also worked to build its expertise through hiring. Former nurses have been brought on as paralegals and, in the past, former doctors joined the firm after earning law degrees.

“I’ve had two clients I’ve represented as doctors who went on to become lawyers,” Lagnese said.

The firm’s successful defense work in the past year included a claim brought by the estate of a woman who died of breast cancer against the woman’s doctor. The plaintiffs claimed doctors did not read earlier mammogram images correctly, leading to her death 14 months after her diagnosis in 2005.

The defense argued that the tumor in the woman’s breast did not follow the usual pattern for cancer. Rather, it was a “lobular carcinoma” which is less discernible from normal tissue and more difficult to detect with mammograms.

In another case, the estate of a man who died of a drug overdose sued MidState Medical Center in Meriden. The man had been taken to the hospital following a heroin overdose. Before his arrival, he had been given Narcan, a drug that counteracts the potentially fatal effects of such an overdose. The plaintiffs claimed the hospital was negligent because it released the man before the effects of the Narcan wore off and that the man died afterward.

But the defense proved the drug had worn off, the discharge was proper and the man later died from the ingestion of other drugs after his discharge.

Lagnese said what’s often lost in news reports of a medical malpractice case is the emotional toll it takes on the health care provider.

“We’ve had many doctors who have said, ‘I’m just leaving the practice, I cannot be put through this,’” she said.

“We work hard at making sure that the welfare of the defendant client is recognized,” said Danaher. “It’s a focus of support staff too. They work hard to help the clients through, which is an emotional and stressful dynamic. There’s an extraordinary amount of emotion that these caregivers go through. Bad outcomes for patients impact care providers profoundly. Sometimes people don’t appreciate that.”

As such, the firm partners said that the team approach goes beyond lawyers handling the cases.

“That support starts right at the front reception desk and continues through the firm,” said Danaher. “Our model of practice is very, very team oriented, which has been very helpful from a clients’ perspective. At any given time they know they can access any person and get their questions answered.”

Besides their courtroom work, the Danaher Lagnese partners represent their clients’ interests with lawmakers. The partners note that the plaintiffs bar, typically through the Connecticut Trial Lawyers Association, frequently asks lawmakers to resist lobbying efforts aimed at capping damage awards in medical malpractice cases.

In turn, Danaher and other med-mal lawyers argue that high damage awards drive up medical malpractice insurance premiums, and those escalating costs could drive doctors out of Connecticut.

“No one has ever suggested on the defense side that doctors shouldn’t be held accountable if they commit quote-unquote medical negligence. But to the extent we’re going to compensate for medical harm is where the debate is focused,” said Lagnese.

Lagnese has been active in providing lawmakers with a doctor’s point of view on these issues, though she said the argument is more effective when physicians make it directly.

“I’ve tried to play a behind-the-scenes role,” said Lagnese. “I do believe the future of health care in Connecticut will depend in large part on striking an appropriate balance so doctors feel Connecticut is welcoming to them and not punishing them.”•