DEMAND FOR SETTLEMENT - MEDICAL MALPRACTICE

DISTRICT OF COLUMBIA

[FIRM NAME]
Attorneys at Law
[Street Address]
Washington, D.C. [ZIP]
Telephone: [Phone]
Facsimile: [Fax]
Email: [Email]
Licensed in the District of Columbia

DATE: [Date]

VIA CERTIFIED MAIL, RETURN RECEIPT REQUESTED
AND FIRST-CLASS MAIL

[Risk Management / Claims Administrator / Insurance Carrier]
[Hospital / Medical Group / Insurance Company Name]
[Street Address]
[City, State ZIP]

RE: MEDICAL MALPRACTICE CLAIM - SETTLEMENT DEMAND AND PRE-SUIT NOTICE
Patient/Claimant: [Client Full Name]
Date(s) of Negligent Care: [Date or Date Range]
Healthcare Provider(s): [Provider Name(s)]
Facility: [Hospital/Clinic Name]
Claim Number: [If assigned]

Dear [Recipient Name]:

This firm represents [Client Name] in connection with the medical malpractice that occurred during [his/her] care and treatment at [Facility Name] by [Healthcare Provider Name(s)]. This letter serves as formal pre-suit notice as required by D.C. Code Section 16-2802 and constitutes our demand for settlement.

I. DISTRICT OF COLUMBIA-SPECIFIC LEGAL FRAMEWORK

A. Governing Law

This claim is governed by the District of Columbia medical malpractice statutes, including D.C. Code Section 16-2801 et seq., which establishes requirements for medical malpractice actions in the District.

B. Pre-Suit Notice Requirement - CRITICAL

Under D.C. Code Section 16-2802, a claimant must provide written notice of intent to file a claim at least 90 days prior to filing suit. This notice must:

1. Be sent by certified mail;
2. Identify the claimant;
3. Identify the alleged negligent act or omission; and
4. Provide a brief description of the injury or death.

THIS LETTER CONSTITUTES SUCH NOTICE. The 90-day notice period will expire on [Date 90 days from this letter].

C. Statute of Limitations

Statute of Limitations: Under D.C. Code Section 12-301(8), actions for medical malpractice must be commenced within three (3) years from the time the right to bring the action accrues.

Discovery Rule: The District of Columbia applies the discovery rule. The limitations period begins when the plaintiff knew or should have known of the injury and its cause. Bussineau v. President and Dirs. of Georgetown Coll., 518 A.2d 423 (D.C. 1986).

Statute of Repose: The District of Columbia does not impose a statute of repose for medical malpractice claims.

Minors: For minors, the limitations period is tolled until the minor reaches age 18. D.C. Code Section 12-302.

Relevant Dates in This Matter:
- Date(s) of negligent care: [Date(s)]
- Date of discovery: [Date]
- Three-year limitations period expires: [Date]

D. Contributory Negligence - CRITICAL

The District of Columbia is one of only four U.S. jurisdictions that still follows the doctrine of pure contributory negligence. Under this doctrine, if the plaintiff is found to have contributed to their injury in any degree whatsoever, they are completely barred from recovery. Wingfield v. People's Drug Store, 379 A.2d 685 (D.C. 1977).

Our investigation has determined that our client was in no way negligent or contributorily at fault for the injuries sustained. Our client fully complied with all medical instructions and had no role in causing or contributing to the malpractice.

E. Standard of Care Under District of Columbia Law

Under District of Columbia law, a healthcare provider must exercise that degree of care and skill expected of a reasonably competent practitioner in the same class, acting in the same or similar circumstances. Meek v. Shepard, 484 A.2d 579 (D.C. 1984).

National Standard: The District of Columbia applies a national standard of care for specialists. Morrison v. MacNamara, 407 A.2d 555 (D.C. 1979).

F. Expert Witness Requirements

Expert testimony is required to establish the standard of care and breach thereof except in cases where the negligence is so obvious that a layperson would recognize it. Kosberg v. Washington Hosp. Ctr., 394 F.2d 947 (D.C. Cir. 1968).

The expert must be qualified by knowledge, skill, experience, training, or education to render an opinion on the applicable standard of care.

Certification: We have retained a qualified medical expert who has reviewed the relevant medical records and has concluded that the applicable standard of care was breached.

G. Damage Caps

The District of Columbia does not impose caps on compensatory damages in medical malpractice cases.

Punitive Damages: Punitive damages are available upon proof of willful or wanton misconduct or fraud. Daka, Inc. v. McCrae, 839 A.2d 682 (D.C. 2003).

Collateral Source Rule: The District of Columbia follows the traditional collateral source rule. Evidence of payments from collateral sources is generally inadmissible. D.C. Code Section 16-2804.

H. Informed Consent

The District of Columbia recognizes informed consent as a basis for medical malpractice liability. A physician must disclose material risks, alternatives, and the consequences of refusing treatment. Crain v. Allison, 443 A.2d 558 (D.C. 1982).

The standard is what a reasonable patient would consider material to the decision. Canterbury v. Spence, 464 F.2d 772 (D.C. Cir. 1972).

I. Vicarious Liability

Hospital Liability: D.C. hospitals may be held vicariously liable for the negligence of their employees under respondeat superior. Sibley Mem'l Hosp. v. Wilson, 488 F.2d 1338 (D.C. Cir. 1973).

Apparent Agency: The District recognizes apparent agency liability when patients reasonably believe physicians are hospital employees. Kapuschinsky v. United States, 248 F. Supp. 732 (D.D.C. 1966).

J. Loss of Chance Doctrine

The District of Columbia has not definitively adopted the loss of chance doctrine. Traditional causation principles generally apply, requiring proof that the defendant's negligence more likely than not caused the harm.

K. Res Ipsa Loquitur

The District of Columbia recognizes res ipsa loquitur in medical malpractice cases where the injury is of a kind that does not ordinarily occur without negligence, the instrumentality was under the defendant's exclusive control, and the plaintiff did not contribute to the injury. Washington Hosp. Ctr. v. Butler, 384 F.2d 331 (D.C. Cir. 1967).

L. Apology Exclusion

The District of Columbia does not have a specific apology exclusion statute. Statements of sympathy may be admissible.

M. Immunity

Federal Employees: Claims against federal healthcare providers (including at VA hospitals and military facilities) are governed by the Federal Tort Claims Act, 28 U.S.C. Section 1346(b), with different procedures and limitations.

D.C. Government: Claims against D.C. government-operated healthcare facilities are subject to the D.C. Public Liability Act.

II. PRESERVATION OF EVIDENCE - LITIGATION HOLD

YOU ARE HEREBY DIRECTED TO PRESERVE ALL EVIDENCE relating to the care and treatment of [Client Name], including but not limited to:

• Complete medical records (paper and electronic)
• All versions of electronic medical records (including audit trails)
• Nursing notes, medication administration records, and flow sheets
• All diagnostic imaging studies and reports
• Laboratory results and pathology reports
• Operative reports and anesthesia records
• Consultation notes
• Informed consent documents
• Incident/occurrence reports
• Peer review materials (to the extent discoverable)
• Policies, procedures, and protocols in effect at the time of treatment
• Credentialing files for involved healthcare providers
• Staffing records and schedules
• Equipment maintenance records
• Any recorded statements

Modification, destruction, or concealment of any records will result in claims for spoliation, sanctions, and adverse inference instructions under District of Columbia law. Holmes v. Amerex Rent-A-Car, 710 A.2d 846 (D.C. 1998).

III. FACTUAL BACKGROUND

A. Patient History and Presentation

[Client Name], a [age]-year-old [male/female], presented to [Facility/Provider] on [Date] with [chief complaint/reason for visit]:

Relevant Medical History:
- [Relevant past medical history]
- [Relevant surgical history]
- [Current medications]
- [Allergies]

Presenting Symptoms:
- [Symptom 1]
- [Symptom 2]
- [Symptom 3]

B. Chronology of Negligent Care

[Date/Time]: [Describe what occurred]

[Date/Time]: [Describe what occurred]

[Date/Time]: [Describe what occurred]

C. The Medical Error(s)

[Describe specifically what the healthcare provider(s) did wrong]

D. Discovery of Malpractice

Our client [did not discover / could not have reasonably discovered] the malpractice until [Date], when [describe discovery circumstances].

IV. STANDARD OF CARE VIOLATIONS

A. Applicable Standard of Care

Under District of Columbia law, [Defendant Healthcare Provider] was required to exercise that degree of care and skill expected of a reasonably competent practitioner in the same specialty, acting in the same or similar circumstances.

Based on our expert's analysis, the applicable standard of care required [Defendant] to:

1. [Standard 1]
2. [Standard 2]
3. [Standard 3]

B. Breaches of the Standard of Care

Breach 1: [Detailed description of breach]

Breach 2: [Detailed description of breach]

Breach 3: [Detailed description of breach]

C. Expert Opinion

We have retained [Expert Name, M.D.], a board-certified [Specialty] physician licensed in [State] with [number] years of experience. [Dr./Expert Name] has concluded, to a reasonable degree of medical certainty, that:

1. [Defendant Provider] breached the applicable standard of care;
2. These breaches were a direct and proximate cause of [Client Name]'s injuries; and
3. Had appropriate care been rendered, [describe avoided outcome].

V. CAUSATION

A. Factual and Proximate Causation

But for the defendant's breach of the standard of care, our client would not have suffered the injuries described herein. Under District of Columbia law, the plaintiff must prove both cause-in-fact and proximate cause. Psychiatric Inst. of Washington v. Allen, 509 A.2d 619 (D.C. 1986).

VI. DAMAGES

A. Physical Injuries

As a direct and proximate result of the defendant's medical negligence, our client has suffered:

Primary Injuries:
- [Injury 1]
- [Injury 2]
- [Injury 3]

Current Medical Status:
[Describe current condition and prognosis]

B. Medical Expenses

Past Medical Expenses:

Future Medical Expenses: $[Amount]

C. Lost Earnings

D. Non-Economic Damages

• Physical pain and suffering
• Mental anguish
• Loss of enjoyment of life
• Permanent disability/disfigurement
• Loss of consortium (spouse's claim)
• Emotional distress

E. Summary of Damages

VII. SETTLEMENT DEMAND

Based upon the clear breach of the standard of care, the severity of our client's injuries, and the substantial damages incurred, we hereby demand:

$[DEMAND AMOUNT]

This demand will remain open for thirty (30) days from the date of this letter, expiring at 5:00 p.m. Eastern Time on [Expiration Date].

Please note: Pursuant to D.C. Code Section 16-2802, the 90-day pre-suit notice period expires on [Date]. We reserve the right to file suit after that date if settlement is not reached.

VIII. RESPONSE AND ADDITIONAL INFORMATION REQUESTED

Please provide:

1. All professional liability insurance policies applicable to this claim
2. Policy limits for each applicable policy
3. Any self-insured retention amounts
4. Excess/umbrella coverage information
5. Hospital liability coverage (if applicable)

IX. DOCUMENTATION ENCLOSED

• Medical records supporting the claim
• Medical bills and itemized statements
• Employment and wage documentation
• Expert curriculum vitae
• Photographs (if applicable)
• HIPAA authorizations

X. CONCLUSION

This case presents clear medical negligence that caused significant harm to our client. The District of Columbia's contributory negligence doctrine does not apply because our client had no role in causing or contributing to the malpractice.

This letter constitutes the 90-day pre-suit notice required by D.C. Code Section 16-2802. We are prepared to litigate this matter through trial in the Superior Court of the District of Columbia if necessary. However, we believe early resolution serves all parties' interests.

Please respond by the deadline stated above.

Respectfully submitted,

[FIRM NAME]

By: _________________________________
[Attorney Name]
D.C. Bar No. [Number]
Attorney for [Client Name]

ENCLOSURES: As noted above

cc: [Client Name]
File

DISTRICT OF COLUMBIA MEDICAL MALPRACTICE PRACTICE NOTES

• Contributory Negligence: D.C. is one of only four jurisdictions following pure contributory negligence - ANY plaintiff fault bars recovery entirely.

• 90-Day Pre-Suit Notice: Required before filing suit - this demand letter typically serves as the notice.

• No Damage Caps: D.C. does not cap compensatory damages in medical malpractice cases.

• No Certificate of Merit: D.C. does not require a certificate of merit at filing.

• National Standard: D.C. applies a national standard of care for specialists.

• Canterbury v. Spence: D.C. is the origin of the patient-centered informed consent standard.

• No Statute of Repose: D.C. has no repose period - only the 3-year statute of limitations with discovery rule applies.

• Collateral Source Rule: Traditional rule applies - collateral source payments generally inadmissible.

• Federal Employees: Claims against federal healthcare providers require filing under FTCA with different procedures.

• Venue: Superior Court of the District of Columbia has exclusive jurisdiction over medical malpractice claims in D.C.

This template is specific to District of Columbia law. Medical malpractice claims in D.C. require 90-day pre-suit notice and are subject to contributory negligence. Always verify current law and consult with qualified D.C. medical malpractice counsel.