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Call Stamford (203) 325-4491
Bridgeport (203) 386-9844
Danbury (203) 816-8476
Greenwich (203) 489-2952
Hartford (860) 785-6585

New Haven (203) 916-5796
New London (860) 785-6581
Waterbury (203) 916-5785
Westport (203) 349-8154
Out of State (866) 248-8744

Protect Yourself Against Connecticut Drivers with Little or No Insurance Coverage

Joaquin L. Madry

November 12, 2018 

In Connecticut, drivers are required to have a minimum amount of liability car insurance — $25,000 for bodily injury, per person per accident, and $50,000 for bodily injury, total per accident.  As such, there are many Connecticut drivers that choose this minimum amount of coverage over a much more comprehensive, but only slightly more expensive, policy.  The 25/50 policy is wholly inadequate to compensate an individual with a significant permanent injury or death from a motor vehicle accident.  It is even more problematic if there are multiple individuals injured in the same accident that need to share in this limited policy.  Importantly, there are people driving illegally in Connecticut without any insurance.

In order to protect against these underinsured or uninsured motorists, drivers can purchase uninsured/underinsured motorist (UM/UIM) insurance coverage.  As part of an automobile insurance policy, it provides some protection in the event of a catastrophic injury in a motor vehicle accident when the individual who caused the accident does not have insurance or has insufficient insurance to pay for the injuries and other losses. Most insurance carriers will allow drivers to purchase a maximum of $1 million dollars in UM/UIM insurance coverage on a primary automobile.

Two additional ways to protect against Connecticut’s uninsured/underinsured motorists are through:

  • An umbrella policy with UM/UIM coverage
  • Conversion insurance

Designed as secondary insurance, an umbrella policy provides excess coverage above and beyond homeowners and auto insurance policies.  It has underlying insurance requirements so that drivers must have a certain amount of auto insurance and homeowners insurance coverage as a condition of being approved for an umbrella policy.  However, an umbrella policy alone does not protect you from Connecticut drivers with little or no insurance coverage.  You must purchase UM/UIM coverage on the umbrella policy.  Not all umbrella insurance carriers will offer UM/UIM insurance coverage on an umbrella.  The insurance carriers that do offer it generally provide a maximum of $3 million dollars in additional insurance coverage as a purchase option.

Conversion coverage is an option that insurance companies must offer you by law.  With UM/UIM conversion coverage, the insurance company must pay the full amount of coverage and is not permitted to reduce this coverage by any amounts paid by the negligent driver’s auto policy.

The bottom line is that the safest course of action is to be fully insured in case of a serious automobile accident.

In Connecticut, persons injured in a serious auto accident have up to two years to file a lawsuit and also have two years to file a suit for property damage, such as compensation for vehicle repairs. Failure to bring a lawsuit within this time frame will prevent any recovery regardless of the merits of the case.

Joaquin L. Madry
Silver Golub & Teitell LLP

Decisions in the Neo-natal Intensive Care Unit

Richard A. Silver

November 9, 2018 

In this week’s New England Journal of Medicine, November 8, 2018, Vol. 379, No. 19, Page 1851, there is a detailed discussion of decision making for neo-natal babies in reference to hypoxic encephalopathy, degenerative neurologic diseases and even brain death. This article discusses ethical decisions in reference to when treatment is futile or should be withdrawn.

It further discusses disagreements between doctors and parents and family members as to the decision making. In this very sensitive issue, it discusses the information to be given to parents to make a final decision.  It also discusses focusing on shared decision making. While it is rare that attorneys become involved at this stage, it is a very important article discussing these very sensitive issues.

Richard A. Silver
Silver Golub & Teitell LLP

Private Foundations: A Guide To Organization and Administration

November 6, 2018 


FCBA Co-Chairs: Mark Chioffi & Michael Clear

At the office of Fairfield County Bar Association

970 Summer Street, Stamford, CT

WEDNESDAY, NOVEMBER 7, 2018                                  NOON to 2:00 PM


Stefania L. Bartlett, Esq. & Cara Howe Santoro, Esq.
Cummings & Lockwood LLC

Jennifer Pagnillo, Esq., Day Pitney LLP

Jay H. Sandak, Esq., Carmody Torrance Sandak & Hennessey LLP 

Ernie F. Teitell, Esq., Silver Golub &Teitell LLp

  • Have you ever considered starting a charitable foundation?  Don’t know where to start?
  • Talk with local lawyers who have started their own foundations for their insights.
  • Our panel will also include representatives from Foundation Source and Fairfield County Community Foundation to discuss other types of charitable vehicles


  • Statutory Framework
  • Characteristics of a Private Foundation and their alternatives
  • Considerations when forming a Private Foundation
  • Qualifying for and maintaining tax exemption
  • Administration of a Private Foundation (including compliance, grant-making and investment considerations)

Registration: 12:00 to 12:15 pm

Pricing, including lunch & materials: $50 (Members); $75 (Non-Members)

*Reduced Rate FCBA Members: $35 *(Legal Administrators, Paralegals, Law Students & Law Clerks)

  • Information on financial assistance is available upon request


The Enormous Cost of Cerebral Palsy Caused by Doctor Negligence

Richard A. Silver

November 6, 2018 

The cost of care for a brain-damaged child as the result of physician medical negligence is enormous.  Extensive, costly supportive care is required for cerebral palsy in children and often continues into adulthood.  The lifetime cost of caring for someone suffering from cerebral palsy at birth is projected into the millions of dollars (Centers for Disease Control and Prevention. MMWR 2004; 53-57-9).

The services that can be needed for Connecticut cerebral palsy care include:

  • Medical evaluations and medical care
    • Neurologic, orthopedic, gastroenterological, surgical
  • Hospitalizations
  • Home nursing and/or skilled nursing facility
  • Diagnostic tests and laboratory procedures
  • Therapeutic evaluations and treatments
    • Occupational, speech, physical, feeding/oral/communication
  • Rehabilitation, orthopedic, mobility equipment
    • Braces, walkers, wheelchairs, modified vans
  • Prescription medication
    • Tube feeding nutrition
    • Gastrostomy tube equipment
  • Support care for family (respite, family counseling, education)
  • Home modifications
  • Special education

The costs of medical care, psychologic and physical therapy continue to increase every year – and at rates greater than the inflation rate.  As a whole, consumer prices for medical care have increased 98% since January 1997 — compared with a 50% increase for all items over that same period.  Specifically, since January 1997, consumer prices for inpatient healthcare services have increased 195% and prices for outpatient healthcare services have increased 200%.  Over that same period, consumer prices for prescription drugs have doubled, as have prices for nursing homes and adult day services (Bureau of Labor Statistics. Spotlight on Statistics: A Look at Healthcare Spending, Employment, Pay, Benefits, And Prices. June 2016)

Unfortunately, public funding, support services and facilities for Connecticut brain-damaged children and adults are extremely limited and are often simply not available.  Parents of these children need to rely on their recoveries from medical malpractice cases to provide the required lifetime care for their children.  Without those funds, average parents do not have the resources they need and cannot provide adequate care for their children.

Richard A. Silver
Silver Golub & Teitell LLP

Medical Literature Resources for the Medical Malpractice Attorney

Richard A. Silver

November 2, 2018 

Medical malpractice attorneys conduct medical research on medical issues in the particular cases in which they are involved. It is my opinion that in addition to this case-specific research, it is helpful to keep up-to-date with current medical literature.

The New England Journal of Medicine is an excellent source to keep current with major medical breakthroughs. This periodical comes out weekly.  The articles are peer reviewed and are heavily relied on by experts in the field.

In addition, I have found the New England Journal Watch monthly publications are extremely helpful.  They contain summaries of important, peer reviewed articles that have been published throughout the U.S. and internationally.  These include, for example, Obstetrics and Gynecology, The Lancet (an English publication), Nature, JAMA and Journal of Urology.

I have found that the series that are helpful in my work are Women’s Health, Emergency Medicine, General Medicine and Hospital Medicine. Other Watch series include Cardiology, Gastroenterology, Infectious Disease, Neurology, Oncology, Hematology, Pediatrics, Adolescent Medicine and Psychiatry.  These publications can be ordered through the Massachusetts Medical Society —  The Journal Watch publications also include comments on recent medical news; for instance, the FDA approval of a new migraine drug.

In addition, I have found the The Medical Letter on Drugs and Therapeutics periodical to be helpful in evaluating drugs in cases that involve malpractice in prescribing pharmaceutical drugs.

Richard A. Silver
Silver Golub & Teitell LLP


Cerebral Palsy – Was It Caused by Doctor Negligence?

Richard A. Silver

April 11, 2017 

When complications arise during the birth of a baby, the result can be heartbreaking injuries to the infant or the mother.  Birth injuries are some of the most devastating personally and financially and are often complicated to prove.  These injuries can be extensive — impairment of motor function, muscle control, muscle coordination, muscle tone, reflex, posture and balance.

Cerebral palsy is actually caused by brain damage, such as a brain injury or by the abnormal development of the brain, and it can be caused by medical negligence at or around the time of birth.

Cases of cerebral palsy caused by medical negligence can occur when the physician fails to follow the proper procedures as defined by the mandated medical standard of care, which cause the baby to suffer from lack of oxygen, bleeding, head trauma or other injuries.  The most common reasons include:

  • Delay in delivering the infant, causing oxygen deprivation
  • Failure to appropriately monitor fetal heart rate before and during labor and birth
  • Failure to identify umbilical cord problems, such as a prolapsed cord
  • Failure to correctly use forceps or vacuum extraction during delivery
  • Failure to plan and schedule a cesarean section when a baby is too large to safely pass through the birth canal
  • Delay in performing (or failing to perform) a medically necessary cesarean section
  • Failure to detect and/or properly treat infections in the mother during pregnancy

In order for parents to consider filing a lawsuit in these cases, there must be proof that the doctor acted in a negligent manner and that this negligence caused the baby to develop cerebral palsy.

Sorry Isn’t Enough: Apology Laws Don’t Limit Doctor’s Risk of Medical Malpractice Lawsuit

Richard A. Silver

March 30, 2017 

Apology laws are designed to reduce medical malpractice lawsuits by allowing doctors to apologize to patients or their families, with those statements prohibited from being admissible in a lawsuit. However, a recent Vanderbilt University study found that these laws do not limit medical malpractice lawsuits.

After analyzing 3,517 malpractice claims, the researchers found that apology laws do not have a statistically significant effect on the probability that a surgeon will face a medical malpractice lawsuit. However, they increase the probability of a lawsuit being filed against other types of doctors because the apologies may alert patients to nonsurgical errors they would not have discovered otherwise, such as misdiagnosis or failure to refer, which can encourage them to file a lawsuit.

Wouldn’t it be better for patients if rather than “sorry isn’t enough,” doctors would never have to say they’re sorry because medical errors were eliminated from every type of hospital setting?

Thoughts Raised by the Article ‘Hospitalists and the Decline of Comprehensive Care’

Richard A. Silver

September 29, 2016 

According to a recent article in the New England Journal of Medicine (“Hospitalists and the Decline of Comprehensive Care,” September 15, 2016), the hospitalist model has provided such benefits as reductions in length of stay, cost of hospitalization and readmission rates – all hospital-defined metrics.  But what is its impact on overall health, total costs and, most critically, its benefit to patients?

I see several issues raised by this increased reliance on hospitalists.  Most importantly, it can be highly disconcerting for patients to discover that the physician who knows them best will not be able to see them at their moment of greatest need — when they are in the hospital, facing serious illness or injury.  Isn’t it much better for patients in these situations to be talking to someone they trust and who knows them and their medical history?

In addition, as the number of physicians caring for each patient increases, the depth of the relationship between patient and physician tends to diminish — a sad counterpoint to the patient–physician relationship as the core of good medical care.  This also creates greater opportunities for miscommunication and discoordination, particularly at admission and discharge, between community physicians and hospitalists as well as between hospitalists and other hospitalists. The result may be failures to follow up on test results and treatment recommendations.

Finally, as community physicians treat hospitalized patients less frequently, their skills in hospital care may decline, while hospitalists who never see outpatients may never understand patients’ lives outside the hospital.  This fragmented patient care model may cause physicians to find it more difficult to provide truly integrated care.

In my view, the key to comprehensive patient-centric care is communication between doctor and patient and knowledge of the patient’s condition and past treatment.  By their very definition, hospitalists are not in this position and their utilization does not assist in the necessary communication of patient information to ensure comprehensive, patient-centric care.


Medical Errors Found in Nearly 50% of Surgeries

Richard A. Silver

September 15, 2016 

Over the years, I have written much about the impact of medical errors in medical malpractice cases, and now a new study has found them to be a much larger problem than previously thought — medical errors or unintended drug side effects occur in nearly 50% of surgeries.

Researchers at Massachusetts General Hospital in Boston recently looked at 277 procedures that had a high prevalence of medical errors and found that the number of medical errors was higher than previously reported because those studies relied of self-reported medical errors.

The most commonly observed errors involved administering incorrect dosages of medications. Of those perioperative medication errors that might have led to patient harm, less than 2% percent were considered life-threatening, 69% were considered serious and 30% were considered significant.

Once again, as the healthcare profession continues to study medical errors more carefully to determine their cause, frequency and impact on patient care, strategies can be developed and procedures implemented that will reduce – and one day eliminate – this unnecessary cause of patient suffering. That day cannot come soon enough.

Mining for Gold in Medical Malpractice Data

Richard A. Silver

August 31, 2016 

Healthcare professionals and insurers have started mining recent medical malpractice lawsuits in order to learn how to make fewer mistakes and improve the quality of care.

They are looking at tried, settled and dismissed lawsuits to find out the reasons that doctors are sued and are then sharing these findings with doctors and hospitals in order to reduce mistakes and fix the issues that undermine patient safety.

Doctors Company, the largest physician-owned malpractice insurer, has conducted more than 40 studies of more than 10,000 recently closed claims.  While there are common themes in claims from almost every medical specialty, such as failure to properly diagnose or poor procedural technique, data from different specialties are helping to identify issues unique to different types of doctors — from primary care physicians and emergency room doctors to anesthesiologists to cardiologists.

The results of this data mining provide new insights into the types of errors doctors are making and when and where they are making them.  Now, healthcare professionals and facilities can put in place the steps necessary to prevent these errors and provide safer, higher quality of care for their patients.


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