About William R. Settles

Bill Settles has been defending physicians, hospitals, and other health care providers in Nebraska for 30 years. He chose this career path because his father was a physician and his mother was a nurse. A graduate of Notre Dame Law School, Mr. Settles is a Fellow of the American College of Trial Lawyers, a two-time selection as Best Lawyers Medical Malpractice "Lawyer of the Year" in Omaha, and an Associate of the American Board of Trial Advocates. He has been rated AV Preeminent by Martindale Hubbell over 20 consecutive years.
5 Jul, 2023

Amendments to Rule 702 Aim to Tighten Standards for Expert Testimony

2023-07-05T11:48:16-05:00July 5th, 2023|Latest News, LDM MedMal Forum|

In the thirty years since the Supreme Court decided Daubert v. Merrill Dow Pharmaceuticals, the use of scientific evidence in the courtroom has produced much confusion. Although the scientific literacy of the judiciary has advanced considerably, the proper application of Daubert principles to expert testimony remains inconsistent. Federal Rule of Evidence 702 establishes the criteria for the admissibility of expert testimony. The Rule, however, has not been amended since [...]

17 May, 2022

When DHHS Comes Calling

2022-05-17T13:21:05-05:00May 17th, 2022|Disciplinary Actions, LDM MedMal Forum, Litigation Tips, Risk Management|

Every licensed health care provider dreads receiving that certified letter with the return address, “Nebraska Department of Health and Human Services, Investigations Division.”  Opening the letter doesn’t help matters:  “Dear sir or madam, we are gathering information regarding a complaint that has been made against you.  The complaint alleges that you blah, blah, blah.  Please provide your written response to this office no later than 14 days after receipt of [...]

4 May, 2022

Five Do’s and Don’ts of Deposition Preparation

2022-05-04T10:56:42-05:00May 4th, 2022|LDM MedMal Forum, Litigation Tips, Medical Malpractice, Midwest Medical Legal Advisor|

Giving a deposition is a form of communication that is usually completely foreign to health care providers.  The surgeon who is in complete control of her operating suite may find herself utterly lost in a conference room surrounded by attorneys.  Some physicians become old hands at giving depositions, but for newcomers to the arena, emphasizing a few do’s and don’ts can make the process easier: DO Spend the time it [...]

25 Apr, 2022

Nebraska Supreme Court Puts the Brakes on the Continuous Treatment Doctrine

2022-04-25T08:56:19-05:00April 25th, 2022|LDM MedMal Forum|

The statute of limitations is a frequent defense in medical malpractice cases. Patients are often reluctant to sue a physician with whom they have an ongoing relationship. This has led to many cases being filed after the statute of limitations has expired. In the past, patients have relied upon the vague and confusing “continuous treatment doctrine” to avoid the statute of limitations. That will now be much more difficult to [...]

16 Feb, 2022

Is the Legislature Dictating the Standard of Care for Opioid Prescribing?

2022-02-24T16:11:40-06:00February 16th, 2022|LDM MedMal Forum|

Opioid abuse has grown into a crisis that has occupied the headlines in recent years. The Centers for Disease Control and Prevention estimates that the total "economic burden" of prescription opioid misuse alone in the United States is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement. The root of the problem is misuse of opioids prescribed for chronic pain. It is estimated [...]

13 Aug, 2013

Risks of Social Media in Medicine

2018-04-24T00:10:06-05:00August 13th, 2013|Disciplinary Actions, Health Care Law, HIPAA, Midwest Medical Legal Advisor, Risk Management|

A twenty-year-old nursing student had finally realized her dream and was caring for patients on her pediatric oncology rotation.  She fell in love with the courage of her young patients.  One patient, in particular, captured her heart.  She took a picture of the three-year-old boy grinning from ear-to-ear despite his chemotherapy.  When she posted the picture to her Facebook page, she put the following caption: "This is my 3-year-old leukemia [...]

13 Jul, 2013

Oregon Experiment May Reduce ER Frequent Flyers

2018-04-24T00:10:06-05:00July 13th, 2013|Health Care Law, Midwest Medical Legal Advisor|

One of the little discussed features of the Affordable Care Act (better known in some circles, for better or worse, as Obamacare) is the authorization of federal funds to be given to states so that they can set up test programs that experiment with ways to reduce Medicaid costs.  One such program is underway in Oregon and is receiving positive preliminary reviews. The program establishes "coordinated care organizations" to care [...]

29 Mar, 2013

Missouri Moves to Reinstate Cap on Malpractice Damages

2018-04-24T00:10:06-05:00March 29th, 2013|Health Care Law, Midwest Medical Legal Advisor, Tort Reform|

On a 93-62 vote, the Missouri House passed a measure yesterday to reinstate that state's cap on non-economic damages in medical malpractice cases.  The cap had been declared unconstitutional by the Missouri Supreme Court last summer.  In that decision, the Missouri Supreme Court held that the cap violated the right to trial by jury found in the Missouri Consititution.  The Court found that, because there was a common law right [...]

26 Feb, 2013

Hospital Employed Physicians May Face Conflicts of Interest

2018-04-24T00:10:06-05:00February 26th, 2013|Health Care Law, Medical Malpractice, Midwest Medical Legal Advisor|

Between 2000 and 2010, the number of doctors employed by hospitals grew by 32 percent, to 212,000.  This unmistakeable trend raises serious questions about potential conflicts of interest that such employment arrangements may create.  For example, some physicians have reported that their hospital employer requires them to use in house lab facilities when the physicians have received better results or better service from an outside lab.  Others have reported that [...]

18 Feb, 2013

Don’t Let Your Medical Record Invite Litigation

2018-04-24T00:10:06-05:00February 18th, 2013|Litigation Tips, Medical Malpractice, Midwest Medical Legal Advisor, Risk Management|

The medical record can be your best friend or your worst enemy in litigation.  More than that, a well documented record can prevent a lawsuit altogether.  In order to see how, one must understand the process of how a lawsuit comes to pass.  Whenever there is an unexpected or untoward outcome, the patient or the patient's family will have many questions.  The first and best source to answer those questions [...]

7 Feb, 2013

Would Streamlining the Malpractice System Reduce Defensive Medicine?

2018-04-24T00:10:06-05:00February 7th, 2013|Health Care Law, Medical Malpractice, Midwest Medical Legal Advisor, Tort Reform|

Dr. Robert Glattner posted a very interesting article on Forbes.com yesterday that discusses the need for malpractice reform.  It is well worth the read.  I do have a couple of criticisms of his thesis, however. First, Dr. Glattner cites a recent RAND Corporation study for the proposition that "waiting for the resolution of [malpractice] claims can take up more than 10 percent of the average medical career."  While the study [...]

5 Feb, 2013

Stolen Laptop Costs Idaho Hospice $50,000

2018-04-24T00:10:06-05:00February 5th, 2013|Health Care Law, HIPAA, Midwest Medical Legal Advisor|

Last month the U.S. Department of Health and Human Services announced a first-of-its-kind settlement involving a breach of unsecured electronic protected health information.  The Hospice of North Idaho agreed to pay HHS $50,000 to settle potential violations of the HIPAA security rule.  The case arose when the hospice reported to HHS that an unencrypted laptop computer containing the electronic protected health information of 441 patients had been stolen.  During its investigation, [...]

2 Feb, 2013

Falling on Your Scalpel: Admitting Fault in Medical Malpractice

2018-04-24T00:10:06-05:00February 2nd, 2013|Litigation Tips, Medical Malpractice, Midwest Medical Legal Advisor, Risk Management|

In a previous post, I discussed the potential use of an apology to head off medical malpractice litigation.  In this post, I will discuss situations where a complete admission of fault may help bring about a more favorable outcome in such litigation.  Before I do so, however, I want to direct you to a superb article on the subject of physician apologies that was published last week by the Boston [...]

25 Jan, 2013

Surcharge Under Nebraska Hospital-Medical Liability Act Continues to Decline

2018-04-24T00:10:07-05:00January 25th, 2013|Health Care Law, Midwest Medical Legal Advisor, Nebraska Hospital-Medical Liability Act|

The Nebraska Excess Liability Fund provides excess coverage for medical malpractice claims against qualified health care providers in Nebraska.  The provider is responsible for the first $500,000 in coverage, and the Excess Fund provides coverage from $500,000 up to the maximum amount recoverable of $1,750,000.  The Excess Fund is paid for by a surcharge levied on qualified health care providers.  The surcharge is expressed as a percentage of the premium charged for [...]

18 Jan, 2013

HHS Releases Final HIPAA Omnibus Rule

2018-04-24T00:10:07-05:00January 18th, 2013|Health Care Law, HIPAA, HITECH, Midwest Medical Legal Advisor|

The U.S. Department of Health and Human Services yesterday unveiled long awaited changes to the Health Insurance Portability and Accountability Act of 1996 ("HIPAA").  The release is comprised of four final rules combined into a single omnibus rule designed to reduce the impact and number of times certain compliance activities need to be undertaken by regulated entities.  Important provisions include: An expansion of HIPAA's scope to apply many HIPAA provisions [...]

15 Jan, 2013

Does It Pay To Say You’re Sorry?

2018-04-24T00:10:07-05:00January 15th, 2013|Midwest Medical Legal Advisor, Risk Management|

In the third hour of her deposition, and after over a year of litigation, a plaintiff who was suing over the death of her daughter said, “Nobody ever came to talk to us about what happened.  Nobody ever explained it to us.  It’s like they didn’t care.  We had to file this case to learn the truth.”  We hear these words, or words like them, over and over again in [...]

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