OBSTETRIC MALPRACTICE CLAIMS

American Conference Institute s 13th Annual Advanced Forum on OBSTETRIC MALPRACTICE CLAIMS June 25-26, 2014 The Union League Philadelphia, PA Distinguished Co-Chairs: Joseph S. Picchi Galloway, Lucchese, Everson & Picchi Norman D. Tucker Of Counsel Sommers Schwartz Learn from and network with: John S. Moore CNA Richard T. Henderson Transatlantic Reinsurance Cheryl M. DeKleine Coverys Robert Shavelle, PhD, FAACPDM Life Expectancy Project Brian S. Kern Bollinger Insurance Services Molly L. Farrell MGIS Underwriting Managers, Inc. Sessions include: New trends in shoulder dystocia cases and the expulsion defense, and hypothermia treatment for newborns suffering from acute hypoxic encephalopathy The use and limitations of placental pathology in untoward pregnancy outcome The new tort reform : Early recognition of injury, disclosure, investigation, settlement negotiations and ADR The use of Oxytocin, hyperstimulation and oxygen deprivation Determining when an injury occurred: Infections, metabolic disorders, labor & delivery, genetic defects and beyond Affordable Care Act nuances and the collateral source rule Electronic records and audit trails, and preparing and presenting your witness for deposition Proven jury selection and communication methods, and harnessing social media when gearing up for trial Featuring unparalleled medical insights from: David A. Clark, MD Albany Medical College Robert H. Allen, PhD, PE Johns Hopkins University Michael G. Ross, MD, MPH Harbor-UCLA Medical Center Robert H. Debbs, DO, FACOOG, Dist. University of Pennsylvania John Rodis, MD St. Francis Hospital Theonia K. Boyd, M.D. Boston Children s Hospital Harvard University Harry F. Farb, M.D. Obstetrician and Maternal Fetal Medicine Crystal Strader, AIC, CPHRM Mount Carmel Health System Keith Rospond MHA Insurance Company Kenneth Appleby ProMac Specialty Insurance Michael D. Anderson Medical Insurance Exchange of California NEW THIS YEAR! Obtain insight as to the perspectives from the Bench: Hon. Lorenzo F. Garcia U.S. Dist. Ct., D.N.M. Hon. Alan C. Torgerson U.S. Dist. Ct., D.N.M. Hon. Jeanne E. Scott (ret.) U.S. Dist. Ct., C.D. Ill. Hon. Robert B. Collings U.S. Dist. Ct., D. Mass. Hon. Sandra Mazer Moss Philadelphia Ct. C.P. Hon. Lisa M. Rau Philadelphia Ct. C.P. Hon. John M. Younge Philadelphia Ct. C.P. Earn CLE ETHICS Credits Register Now 888-224-2480 www.americanconference.com/obmal

Now in its 13th installment, ACI s lauded Obstetric Malpractice Claims is the highest level event that provides maximum opportunities to learn from and network with leading medical experts, risk managers and insurance professionals, and helps you keep pace with the hot jurisdictions, case law, new and emerging claims and parties, and advancements in science. New twists on obstetric malpractice claims are here and it s more critical than ever to stay on top of all the current theories and prepare a sophisticated litigation strategy when defending and managing claims. ACI s 13th National Forum on Obstetric Malpractice Claims is the only event where law, science, and medicine intersect and that provides practitioners with clarity and certainty with respect to the industry s most pressing issues. No other event allows for unparalleled learning and networking with the nation s leading hospitals and insurers, top outside counsel, and renowned doctors and jurists. Register today to ensure your place by calling 888-224-2480, faxing your registration form to 877-927-1563 or registering online at www.americanconference.com/obmal WHO SHOULD ATTEND Lawyers, both plaintiff and defense, who litigate medical malpractice cases attend in order to get a solid grounding on the latest medical issues upon which cases are based. Our faculty of medical and legal experts from around the nation will provide you with the information and strategies that are essential to achieve the best outcomes for your clients Doctors, nurses and hospital risk/quality assurance managers attend in order to benchmark their current practices and procedures and develop a deeper understanding of the current state of obstetric malpractice litigation Insurance professionals attend in order to obtain valuable insights and strategies for assessing professional negligence claims and to better understand litigation strategies and hospital risk management techniques

Day One: Wednesday, June 25, 2014 9:40 Networking and Refreshment Break 7:15 Registration and Continental Breakfast 8:00 Co-Chairs Opening Remarks Joseph S. Picchi Galloway, Lucchese, Everson & Picchi Norman D. Tucker Of Counsel Sommers Schwartz 8:05 In-House Claims and Risk Management Professionals Speak Out on Obstetric Malpractice Financial & Legal Decisions, Evaluation and Settlement of Cases, Insurance Coverage, and More John S. Moore Director- Specialty Strategic Claims CNA Richard T. Henderson Vice President Transatlantic Reinsurance Cheryl M. DeKleine Director, Claims Coverys Robert Shavelle, PhD, FAACPDM Technical Director Life Expectancy Project Brian S. Kern Area Executive Vice President Bollinger Insurance Services Molly L. Farrell Vice President, Operations MGIS Underwriting Managers, Inc. Keith Rospond Director of Claims MHA Insurance Company Kenneth Appleby Director Healthcare Insurance Services ProMac Specialty Insurance Michael D. Anderson Senior Claims Representative Medical Insurance Exchange of California Moderator Joseph S. Picchi Galloway, Lucchese, Everson & Picchi 9:50 New Trends in Shoulder Dystocia Cases and the Expulsion Defense Robert H. Allen, PhD, PE Associate Research Professor Biomedical Engineering Gynecology & Obstetrics Johns Hopkins University Michael G. Ross, MD, MPH Chairman, Dept. of Ob/Gyn Harbor-UCLA Medical Center Robert H. Debbs, DO, FACOOG, Dist. Director, Pennsylvania Hospital Maternal Fetal Medicine Network University of Pennsylvania James Horwitz Managing Koskoff Koskoff & Bieder, PC The Expulsion Defense: the impact on juror s perception of defense credibility & verdicts Daubert and Davis-Frye Motions in shoulder cases Muhammad v. Fitzpatrick and expulsion forces Understanding the key risk factors for shoulder dystocia, how their managed, and the delivery note Medical literature on expulsion forces as a cause of injury 12:25 Networking Luncheon for Speakers and Attendees 1:25 New Trends in Hypothermia Treatment for Newborns Suffering from Acute Hypoxic Encephalopathy Norman D. Tucker Of Counsel Sommers Schwartz Update on protocols and proving Hypoxic Ischemic Encephalopathy (HIE) Update on the clinical trial results concerning the use of thermal blankets and caps Induced hypothermia in severe bacterial meningitis Treatment s effect on motor function and intellectual utility Manifestation of injury 1:55 The New Tort Reform : Early Recognition of Injury, Disclosure, Investigation, Settlement Negotiations and ADR Crystal Strader, AIC, CPHRM System Director Patient Safety & Risk Management Mount Carmel Health System Daryl J. Douglas Of Counsel Wagstaff & Cartmell LLP

The New Tort Reform the philosophy, economic forces, results driving the new claims approach, and ACOG s position Determining whether to settle or defend a claim and the claims evaluation process Bed side manner contacting injured patients and families, and recommending they contact an attorney Meeting with claimants and counsel to establish willingness to cooperate Voluntary exchange of pre-suit discovery and the new attitude required When, which cases, why, and how one should pursue pre-suit settlement 2:45 Preparing and Presenting Your Witnesses: A Focus on Medical Experts and Depositions Luke M. Pittoni Senior Heidell, Pittoni, Murphy & Bach, LLP Andrew S. Kaufman Kaufman Borgeest & Ryan LLP Joseph S. Picchi Galloway, Lucchese, Everson & Picchi John A. Scully Cooper & Scully, P.C. Ensuring that the witness is adequately prepared for deposition Anticipating where a deposition is heading Key considerations for video depositions Pitfalls to avoid How minor physical and verbal cues can have a major effect on the impact of a deposition Watching videotaped depositions to improve your ability to conduct or participate in a deposition Incorporating the lessons learned into future depositions 4:00 Afternoon Break 4:10 Jury Selection and Communication: Current Voir Dire Strategies and Factoring in the Reptile Theory Eric J. Stockman Principal Neubert, Pepe & Monteith, P.C William F. Cunningham Cunningham Meyer & Vedrine, P.C. Jury Selection Applying the lessons learned from jury focus groups to your jury selection process Making use of critical insights provided by jury consultants to obtain a more favorable jury Using Demonstrative Evidence and Themes Conveying your message and effectively explaining complex theories to jurors Using aids to explain data, provide accurate representations, and debunk opposing theories Using a clear and concise presentation which conveys credibility while staying within legal limits Narrating a Comprehensive Story Using themes to explain the details to the jury Simplifying the critical issues to the jury Demystifying complicated technical issues Persuasively detailing what is a reasonable risk The Reptile Theory: How to Counteract It Overcoming sympathy for injured plaintiffs Overcoming juror bias against doctors - intolerance of virtually any risk of harm - the assumption that given advancements in medical technology, any death or serious injury means that there must have been some form of obstetric malpractice - explaining hard evidence in a way that lay people can internalize - minimizing juror anxiety about injuries to baby and mother 5:00 Electronic Records and Audit Trails: The Benefits and Dangers of a Paperless System Joshua R. Cohen DeCorato Cohen Sheehan & Federico LLP Kimberly Longford Attorney Pessin Katz Law, P.A. Joe Pickard Managing Sweet Law Firm Providing assurance of the integrity of the electronic record and the associated raw data How to train users and the risks involved Form v. narrative notes The use of electronic medical records in documenting labor and delivery and how that impacts the defensibility and expert opinion of the case Cloning records and the retroactive manipulation of electronic records Implementing enhanced documentation tools to capture relevant information in the electronic record 6:00 Conference Adjourns

Day Two: Thursday, June 26, 2014 7:30 Continental Breakfast 8:00 View From the Bench: Renowned Federal and State Judges Will Tell You What Works and What Doesn t in Their Courtrooms, Why Parties Succeed and Don t Succeed in Med Mal Cases, Novel Trial and Case Management Strategies, Examples of Bad Lawyering, and More Hon. Lorenzo F. Garcia U.S. Dist. Ct., D. N.M. Hon. Alan C. Torgerson U.S. Dist. Ct., D.N.M. Hon. Jeanne E. Scott (ret.) U.S. Dist. Ct., C.D. Ill. Hon. Robert B. Collings U.S. Dist. Ct., D. Mass. Hon. Sandra Mazer Moss Philadelphia Ct. of Common Pleas Hon. Lisa M. Rau Philadelphia Ct. of Common Pleas Hon. John M. Younge Philadelphia Ct. of Common Pleas Moderator: Adam Davis Attorney Reminger Co., L.P.A. 9:40 Morning Break 9:50 Affordable Care Act Issues and the Collateral Source Rule: The Future of Future Care Caryn L. Lilling Principal Mauro Lilling Naparty LLP Earn CLE ETHICS Credits Thomas R. Shimmel Principal Kitch, Drutchas, Wagner, Valitutti & Sherbrook, P.C. Obamacare and life care planning: compensability and cost of future care in light of medical reform Effective motion practice to reign in the future claimed damages when certain components are required to be paid Damages: the effect of Obamacare on catastrophic damages Insurance that doesn t adjust the premium for preexisting conditions and the denial of coverage for future special needs The surge of applicants entering an already stressed system as a result of Obamacare 10:40 Trial and Jury Strategy: Harnessing the Power of Social Media to Your Advantage When Gearing Up For an Obstetric Malpractice Trial John E. Hall, Jr. Hall Booth Smith, P.C. Adam Davis Attorney Reminger Co., L.P.A. The Discoverability of the Plaintiff s Presence in Social Media How to utilize information posted on social media sites The use of injury related posts authored by and about the plaintiff The effect of social media in selecting a jury How the Plaintiff s bar is using public information online 11:30 Minimizing Exposure to Obstetric Malpractice Litigation: Implementing Preventive Measures, Reducing Risk and Managing Adverse Outcomes John Rodis, MD Chairman Department of OB/GYN St. Francis Hospital Identifying key drivers of risk Enhancing incident management practices Utilizing a systematic approach to process improvement Developing protocols to enable calm and coordinated team responses in critical situations and reinforce the use of safe practices Developing a culture of safety Initiating timely communication with patients and families following an adverse incident Implementing a joint professional liability program Achieving measurable results 12:20 Networking Luncheon for Speakers and Attendees 1:20 Determining When an Injury Occurred: Infections, Metabolic Disorders, Labor & Delivery and Genetic Defects David A. Clark, MD Chair, Dept. of Pediatrics Albany Medical College Harry F. Farb, M.D. Obstetrician and Maternal Fetal Medicine Specialist Pediatric Neurology: determining when the injury occurred The impact of intrauterine infections and genetic disorders on the placenta and fetus Assessing the role of cytokines in the development of long-term neurological defects

Ascertaining if cytokines were created by HIE injury or infection Detecting signs or symptoms of infection prior to delivery Infection as a causal element of cerebral palsy Assessing new and emerging research concerning genetics, gestational diabetes, cerebral palsy and autism 3:00 The Use and Limitations of Placental Pathology in Untoward Pregnancy Outcome Theonia K. Boyd, MD Department of Pathology Boston Children s Hospital Associate Professor of Pathology Harvard Medical School Use: Assessing mechanisms of intrauterine stress and their timing Limitation: Timing intrauterine stress is not equivalent to injury General principles - Markers of intrauterine stress: meconium and nucleated red blood cells - The more extensive the features, the longer/more severe the stressor - The extent of these findings can be correlated with their timing - Placental pathology commonly seen in untoward pregnancy - Often non-acute mechanisms - Often multiple co-existent pathologies - The more extensive/severe the findings, the greater the risk of untoward outcome 3:50 Afternoon Break 4:00 Litigation and Trial Techniques for Every Stage of an Obstetric Malpractice Case Luke M. Pittoni Senior Heidell, Pittoni, Murphy & Bach, LLP Joshua Cohen DeCorato Cohen Sheehan & Federico LLP Laurence Deutsch North & Deutsch LLP technical details and medical jargon that are inherent in this field of medicine. Moreover, you must master the trial techniques and strategies that are specific to obstetric malpractice cases. This concluding session of the conference will provide you with the tools that you need to obtain the best results for your clients in these difficult cases. Topics to be addressed include: Investigating the facts concerning liability, causation and damages: what is relevant? Formulating a document and e discovery plan that defends against overly aggressive requests while ensuring compliance Developing cost-effective, compliant, and practical e-discovery and document retention policies and procedures The scope of information that defendant hospitals and medical professionals must turn over to plaintiffs attorneys E-discovery as it applies to: o Communication with patients through email and texting; databases; medical records Ensuring preservation of relevant documents o How long must information be preserved? Risks and sanctions that attorneys face if the e-discovery process is not handled properly Confidentiality and privacy issues that arise with patient information Using metadata to establish relevant dates and times Ensuring that litigation is not driven by the cost of discovery Ensuring that your client is prepared for trial Trial briefs and motions in limine Overcoming the challenges of representing the institutional client Jury selection Giving an effective opening statement Effective use of exhibits Final arguments and closing statement Making the case for or against damages o What types of damages and how much? o Damages experts Settlement considerations strategies for success 5:00 Conference Ends Obstetric malpractice cases are extremely difficult to litigate. In order to effectively examine and cross-examine the expert witnesses retained in these cases, you must understand the Media :

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American Conference Institute s 13th Annual Advanced Forum on OBSTETRIC MALPRACTICE CLAIMS PRIORITY SERVICE CODE 653L14.E June 25-26, 2014 The Union League Philadelphia, PA REGISTRATION FORM ATTENTION MAILROOM: If undeliverable to addressee, please forward to: Chief of Obstetrics, Litigation Manager, Medical Malpractice Lawyer Hear from leading physicians, risk managers, insurance professionals, judges, as well as top plaintiffs attorneys and defense counsel. Network with leaders from: CNA Transatlantic Reinsurance Coverys Life Expectancy Project Bollinger Insurance Services MGIS Underwriting Managers, Inc. MHA Insurance Company ProMac Specialty Insurance Medical Insurance Exchange of California Mount Carmel Health System Registration Fee The fee includes the conference all program materials continental breakfasts lunches and refreshments. Payment Policy Payment must be received in full by the conference date. All discounts will be applied to the Conference Only fee (excluding add-ons), cannot be combined with any other offer, and must be paid in full at time of order. Group discounts available to individuals employed by the same organization. Cancellation and Refund Policy You must notify us by email at least 48 hrs in advance if you wish to send a substitute participant. Delegates may not share a pass between multiple attendees without prior authorization. If you are unable to find a substitute, please notify American Conference Institute (ACI) in writing up to 10 days prior to the conference date and a credit voucher valid for 1 year will be issued to you for the full amount paid, redeemable against any other ACI conference. If you prefer, you may request a refund of fees paid less a 25% service charge. No credits or refunds will be given for cancellations received after 10 days prior to the conference date. ACI reserves the right to cancel any conference it deems necessary and will not be responsible for airfare hotel or other costs incurred by registrants. No liability is assumed by ACI for changes in program date content speakers or venue. CONFERENCE CODE: 653L14-PHI o YES! Please register the following delegate for 13th Annual Advanced Forum on OBSTETRIC MALPRACTICE CLAIMS CONTACT DETAILS NAME APPROVING MANAGER ORGANIZATION ADDRESS POSITION POSITION CITY STATE ZIP CODE TELEPHONE EMAIL FAX TYPE OF BUSINESS o I would like to receive CLE accreditation for the following states:. See CLE details inside. Hotel Information American Conference Institute is pleased to offer our delegates a limited number of hotel rooms at a preferential rate. Please contact the hotel directly and mention the ACI Obstetric Malpractice conference to receive this rate. Venue: The Union League of Philadelphia Address: 140 South Broad Street, Philadelphia, PA 19102 Reservations: 215-587-5570 Incorrect Mailing Information If you would like us to change any of your details please fax the label on this brochure to our Database Administrator at 1-877-927-1563, or email data@americanconference.com. 5 Easy Ways to Register * Ê ' : MAIL American Conference Institute 45 West 25th Street, 11th Floor New York, NY 10010 PHONE 888-224-2480 FAX 877-927-1563 ONLINE www.americanconference.com/obmal FEE PER DELEGATE Register & Pay by Apr 25, 2014 Register & Pay by Jun 5, 2014 Register after Jun 5, 2014 o Conference $1995 $2095 $2295 o Please reserve additional copies of the Conference Materials at $499 per copy. PAYMENT Please charge my o VISA o MasterCard o AMEX o Discover Card o Please invoice me NUMBER EXP. DATE CARDHOLDER o I have enclosed my check for $ made payable to American Conference Institute (T.I.N. 98-0116207) o ACH Payment ($USD) Please quote the name of the attendee(s) and the event code 653L14 as a reference. For US registrants: Bank Name: HSBC USA Address: 800 6th Avenue, New York, NY 10001 Account Name: American Conference Institute UPIC Routing and Transit Number: 021-05205-3 UPIC Account Number: 74952405 Non-US residents please contact Customer Service for Wire Payment information EMAIL 8 CustomerService@AmericanConference.com MISSED A CONFERENCE ORDER THE CONFERENCE MATERIALS NOW! If you missed the chance to attend an ACI event, you can still benefit from the conference presentation materials. To order the Conference Materials, please call +1-888-224-2480 or visit: http://www.americanconference.com/conference_papers SPECIAL DISCOUNT We offer special pricing for groups and government employees. Please email or call for details. Promotional discounts may not be combined. ACI offers financial scholarships for government employees, judges, law students, non-profit entities and others. For more information, please email or call customer service.