The Abuse of Medical Diagnostic Practices in Mass Litigation

The Case of Silica

by Stephen J. Carroll, Lloyd Dixon, James M. Anderson, Thor Hogan, Elizabeth M. Sloss

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Abstract

Litigation over injuries due to the inhalation of respirable silica dust in the workplace skyrocketed beginning in 2001, raising concerns that silica litigation would become a mass tort with similarities to the asbestos litigation that had occurred in the previous 30 years. However, the litigation collapsed soon after the discovery of numerous abuses in the procedures used to diagnose the injuries. The uncovering of grossly inadequate diagnosing practices was a significant success for the tort system in handling a mass tort. However, there is no guarantee that similar practices would be uncovered should they be used in the future. This report reviews the court proceedings that led to the uncovering of abusive diagnostic practices in silica litigation. It then identifies several areas in which changes in litigation practices and procedures could increase the likelihood that similar diagnosing practices would be uncovered in the future or prevented from occurring in the first place.

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Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    The Exposure of Diagnostic Abuses in Silica Litigation

  • Chapter Three

    Factors That Facilitated or Hindered the Exposure of Diagnostic Abuses in Silica Litigation

  • Chapter Four

    Changes That Could Help Prevent or Expose Diagnostic Abuses in Mass Personal-Injury Litigation

  • Appendix A

    Epidemiology of the Health Effects Associated with Silica Exposure

  • Appendix B

    Evolution of Silica Litigation Prior to MDL 1553

The research described in this report was conducted by the RAND Institute for Civil Justice, a unit of the RAND Corporation. This research was supported by the National Industrial Sand Association, the U.S. Chamber of Commerce Institute for Legal Reform, and the Coalition for Litigation Justice.

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