DEMAND FOR SETTLEMENT - MEDICAL MALPRACTICE

STATE OF MINNESOTA

[FIRM NAME]
Attorneys at Law
[Street Address]
[City, Minnesota ZIP]
Telephone: [Phone]
Facsimile: [Fax]
Email: [Email]
Licensed in the State of Minnesota

DATE: [Date]

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

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

RE: MEDICAL MALPRACTICE CLAIM - SETTLEMENT DEMAND
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 constitutes formal notice of our client's claim and our demand for settlement.

I. MINNESOTA-SPECIFIC LEGAL FRAMEWORK

A. Statute of Limitations - CRITICAL NOTICE

Under Minnesota Statutes Section 541.076, the statute of limitations for medical malpractice claims is:

Four (4) years from the date the cause of action accrued.

IMPORTANT: Minnesota has NO discovery rule for medical malpractice claims. The cause of action accrues when the negligent act occurs, NOT when the injury is discovered. Molloy v. Meier, 679 N.W.2d 711 (Minn. 2004).

Exceptions:
- Fraudulent Concealment: If the healthcare provider fraudulently concealed the negligence, the statute may be tolled. Minn. Stat. Section 541.076, subd. 2.
- Foreign Object: For foreign objects left in the body, the statute runs from the date of discovery. Minn. Stat. Section 541.076, subd. 1.

Minor Tolling: For minors under age 18, the statute does not begin to run until the minor reaches age 18, but the claim must be brought by age 19. Minn. Stat. Section 541.15.

B. Modified Comparative Fault

Minnesota follows a modified comparative fault standard under Minn. Stat. Section 604.01. A plaintiff may recover damages reduced by their percentage of fault, but if the plaintiff's fault is 50% or greater than the total fault of all defendants, recovery is completely barred.

Our client exercised all reasonable care in connection with [his/her] medical treatment and bears no fault for the injuries sustained.

C. Affidavit of Expert Review Requirement

CRITICAL MINNESOTA REQUIREMENT: Under Minn. Stat. Section 145.682, a medical malpractice complaint must be accompanied by:

Subdivision 2 - Affidavit of Expert Review:
An affidavit by the plaintiff's attorney stating that:
1. The attorney has reviewed the facts of the case with a qualified expert;
2. The expert has concluded that one or more defendants deviated from the applicable standard of care; and
3. The deviation was a direct cause of the alleged damages.

Subdivision 3 - Affidavit of Expert Identification (Within 180 Days):
Within 180 days of the commencement of discovery, the plaintiff must provide an affidavit identifying the expert and stating the substance of the facts and opinions to which the expert will testify.

Subdivision 4 - Expert Disclosure (Within 180 Days):
Within 180 days, the plaintiff must also serve answers to interrogatories identifying the expert's opinions regarding applicable standard of care, defendant's departure from the standard, and causal relationship.

Failure to comply may result in mandatory dismissal with prejudice. Minn. Stat. Section 145.682, subd. 6.

We hereby certify that we have complied with the requirements of Minn. Stat. Section 145.682.

D. Damage Caps

Minnesota has no statutory caps on medical malpractice damages.

The Minnesota Supreme Court struck down damage caps as unconstitutional in Kreiss v. Simonds, No. A21-1003 (Minn. Jan. 2023), finding that caps on non-economic damages in personal injury cases violate the right to a jury trial.

Both economic and non-economic damages may be recovered without limitation.

E. Joint and Several Liability

Under Minn. Stat. Section 604.02, Minnesota has modified joint and several liability:
- A defendant who is less than 50% at fault is liable only for their percentage of fault
- A defendant who is 50% or more at fault is jointly and severally liable for the entire award

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
• Informed consent documents
• Patient correspondence and communications
• Incident/occurrence reports
• Policies, procedures, and protocols in effect at the time of treatment
• Credentialing files for involved healthcare providers
• Staffing records and schedules
• Equipment maintenance records

Minnesota courts recognize claims for spoliation of evidence. Patton v. Newmar Corp., 538 N.W.2d 116 (Minn. 1995). Destruction or alteration of evidence may result in adverse inference instructions and sanctions.

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]
- [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. Date of Discovery

[Note: Given Minnesota's lack of discovery rule, document the date of the negligent act carefully]

The negligent act(s) occurred on [Date]. This claim is being brought within the four-year statutory period.

IV. STANDARD OF CARE ANALYSIS

A. Minnesota Standard of Care

Under Minnesota law, a healthcare provider must exercise "that degree of care, skill, and treatment which, in light of all relevant surrounding circumstances, is recognized as acceptable and appropriate by reasonably competent [medical professionals] in the same field." Plutshack v. University of Minnesota Hospitals, 316 N.W.2d 1 (Minn. 1982).

National Standard: Minnesota generally applies a national standard of care rather than a strict locality rule, particularly for specialists. Id.

B. Breaches of the Standard of Care

[Defendant Healthcare Provider] breached the applicable standard of care in the following ways:

Breach 1: [Detailed description]
- What the standard required: [Describe]
- What the provider did or failed to do: [Describe]

Breach 2: [Detailed description]

C. Expert Certification

We have retained a board-certified [Specialty] physician who has reviewed the relevant medical records and concluded, to a reasonable degree of medical probability, that:

1. The defendant(s) departed from the applicable standard of care;
2. Such departure was a direct cause of [Client Name]'s injuries; and
3. The injuries described herein resulted from the negligent care.

This expert is qualified to render opinions in this matter and will provide testimony as required.

V. CAUSATION

A. Causation Standard in Minnesota

Under Minnesota law, the plaintiff must prove that the defendant's negligence was a "direct cause" of the injury. A direct cause is a cause that had a "substantial part" in bringing about the injury. Frey v. Snelgrove, 269 N.W.2d 918 (Minn. 1978).

But for the defendant's negligence, our client would not have suffered the injuries described herein.

B. Loss of Chance Doctrine

Minnesota recognizes the loss of chance doctrine in medical malpractice cases. Under Dickhoff v. Green, 836 N.W.2d 321 (Minn. 2013), a patient may recover for the loss of chance of a better outcome when:

1. The patient had a pre-existing condition;
2. The healthcare provider's negligence reduced the patient's chance of recovery; and
3. The loss of chance is compensable as a distinct injury.

Damages are calculated proportionally based on the percentage of chance lost. Id.

[If applicable:] The defendant's negligence reduced our client's chance of [survival / recovery / better outcome] from [percentage]% to [percentage]%.

C. Res Ipsa Loquitur

[If applicable:] The doctrine of res ipsa loquitur applies to this case. Under Minnesota law, res ipsa loquitur allows an inference of negligence when: (1) the instrumentality causing injury was within the exclusive control of the defendant; (2) the accident would not ordinarily occur without negligence; and (3) the plaintiff did not contribute to the injury. Sievert v. Kelpin, 231 Minn. 252 (1950).

VI. VICARIOUS LIABILITY AND HOSPITAL LIABILITY

A. Respondeat Superior

Under Minnesota law, a hospital may be held vicariously liable for the negligence of its employees under the doctrine of respondeat superior. Strommen v. Prudential Ins. Co., 183 N.W.2d 291 (Minn. 1971).

B. Apparent Agency

Minnesota recognizes the doctrine of apparent agency for hospital liability. A hospital may be held liable for the negligence of independent contractor physicians if: (1) the hospital held out the physician as its employee or agent; (2) the patient relied on that representation; and (3) such reliance was reasonable. Larson v. Wasemiller, 738 N.W.2d 300 (Minn. 2007).

C. Corporate Negligence

Minnesota recognizes claims for direct hospital negligence based on:
- Negligent credentialing of medical staff
- Negligent supervision
- Failure to adopt and enforce adequate policies
- Failure to maintain safe facilities and equipment

Larson v. Wasemiller, 738 N.W.2d 300 (Minn. 2007).

D. Government Immunity

Minnesota Tort Claims Act: Claims against state agencies and employees are governed by Minn. Stat. Chapter 3.736, which provides a limited waiver of sovereign immunity.

Municipal Liability: Claims against local governmental entities are governed by Minn. Stat. Section 466.01 et seq.

Notice Requirement: Claims against governmental entities generally require notice within 180 days of the incident. Minn. Stat. Section 466.05.

Cap on Government Liability: Minn. Stat. Section 466.04 limits governmental tort liability to $500,000 per claimant and $1,500,000 per occurrence.

VII. INFORMED CONSENT

A. Minnesota Informed Consent Standard

Minnesota follows a patient-centered standard for informed consent. Under Cornfeldt v. Tongen, 262 N.W.2d 684 (Minn. 1977), a physician must disclose information that a reasonable patient would want to know in making a treatment decision.

B. Required Disclosures

Required disclosures include:
1. The nature of the proposed procedure;
2. The risks of the proposed procedure;
3. Alternative treatments and their risks;
4. The consequences of no treatment.

C. Informed Consent Breach

[If applicable:] The defendant failed to obtain proper informed consent by failing to disclose [describe undisclosed material information]. Had our client been informed of [the specific risk / alternative treatment], [he/she] would not have consented to the procedure.

VIII. WRONGFUL DEATH (If Applicable)

[If this is a wrongful death case:]

This claim includes a wrongful death action under Minn. Stat. Section 573.02. The trustee for the decedent's next of kin may bring the action.

Recoverable Damages:
- Medical and funeral expenses
- Loss of income and services
- Loss of guidance, counsel, aid, comfort, assistance, and protection
- Reasonable compensation for pain, suffering, and emotional distress of the decedent before death

The wrongful death statute of limitations is three (3) years from the date of death. Minn. Stat. Section 573.02, subd. 1.

IX. DAMAGES

A. Medical Expenses

Past Medical Expenses:

Future Medical Expenses: $[Amount]

B. Lost Earnings

C. Non-Economic Damages

No statutory cap applies in Minnesota

• Physical pain and suffering
• Emotional distress
• Loss of enjoyment of life
• Disfigurement and disability
• Loss of consortium

D. Summary of Damages

X. SETTLEMENT DEMAND

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

$[DEMAND AMOUNT]

This demand will remain open for forty-five (45) days from the date of this letter, through and including [Expiration Date].

XI. DOCUMENTATION ENCLOSED

• Complete medical records from all relevant providers
• Medical expense itemization and bills
• Employment and wage loss documentation
• Expert affidavit (to be filed with complaint per Minn. Stat. Section 145.682)
• Expert curriculum vitae
• HIPAA authorizations

XII. CONCLUSION

This case involves clear medical negligence that caused significant harm to our client. The breach of the standard of care is supported by qualified expert opinion, and the causal connection between the negligence and our client's injuries is direct.

We believe early resolution serves both parties' interests. However, we are fully prepared to file suit and litigate this matter through trial if necessary.

Please respond within the time specified above.

Respectfully submitted,

[FIRM NAME]

By: _________________________________
[Attorney Name]
Minnesota Attorney License Number: [Number]
Attorney for [Client Name]

ENCLOSURES: As noted above

cc: [Client Name]
File

MINNESOTA-SPECIFIC PRACTICE NOTES

No Discovery Rule: This is critical. Minnesota's four-year statute runs from the date of the negligent act, not from discovery. This can bar claims in latent injury cases. The only exceptions are for fraudulent concealment and foreign objects.

Expert Affidavit Requirements: Strictly enforced. The initial affidavit must be filed with the complaint, and the expert identification affidavit must be served within 180 days of commencement of discovery. Missing these deadlines can result in dismissal with prejudice.

No Damage Caps: Unlike many states, Minnesota has no caps on medical malpractice damages following the Kreiss decision.

Loss of Chance: Minnesota's recognition of loss of chance doctrine (per Dickhoff v. Green) is significant for delayed diagnosis cases.

Government Claims: Remember the 180-day notice requirement and damage caps for claims against governmental entities.

Comparative Fault: The 50% bar applies. If the plaintiff is found to be 50% or more at fault, there is no recovery.

This template must be customized for the specific facts of your case. Minnesota's lack of a discovery rule and strict expert affidavit requirements are critical considerations. Consult with experienced Minnesota medical malpractice counsel.