Archive for the ‘Uncategorized’ Category

Forms of Fraud and Deceit by Physicians and Dentists

Thursday, July 22nd, 2010

Fraud and deceit usually occur in one of the following forms:

1. Assuring the patient that a diagnosis known to be wrong is correct.

2. Deliberately making a false prognosis as to the risks or outcome of treatment, especially if it is to persuade you to submit to surgery, treatment, or expense you would not have had otherwise.

3. Falsely representing what happened while the patient was unconscious or under anesthesia.

4. Falsely representing what was done during surgery and what organs or tissues were removed.

5. Pretending to have skills or training which he does not have.

6. Concealing vital information or a material fact, such as having left a sponge, instrument, etc. inside a patient.

7. Conspiring with another doctor, or any other person, to mislead or deceive you.

Effects of Fraud and Deceit by Physicians and Dentists

Earlier it was stated that a medical malpractice case or a dental malpractice case is not a criminal case, and the court is not going to punish the doctor beyond making him pay for your losses and pain and suffering.  All you can hope to be awarded is what is known as compensatory damages.  That means compensation for the following damages:

1. Your medical and other expenses.

2. Loss of income or the support you would have received from the person who was disabled or died.

3. Pain and suffering, including emotional suffering.

However, if a doctor is guilty of fraud and deceit to induce you to undergo treatment or conceal malpractice, or if he alters or destroys medical or dental records and you discover it, it can strengthen your case in the following ways:

First, jurors do not like doctors, who do these things and will likely award damages.

Second, the judge or jury can award punitive damages, which are in addition to your compensatory damages and are designed to punish the doctor.  They are like a fine, not just to compensate the injured person, but to teach the wrongdoer a lesson.  They are actually a fine, but not like a criminal fine, because the money does not go to the court.  The money from punitive damages goes to the victim.

Third, if a doctor uses fraud or deceit to obtain your consent to treatment or a surgical procedure, the consent is null and void.

Fourth, if the doctor conceals his malpractice after the treatment, it tolls the statute (stops the clock) on the time limit for you to file your case until you find out about the doctor’s fraud.  But, it has to be active concealment, such as lying to you.  If the doctor failed to tell you there was malpractice that does not count.  The United States Constitution says he does not have to incriminate himself or testify against himself.

Fraud and Deceit by Physicians and Dentists

Wednesday, July 7th, 2010

Fraud and deceit by physicians and dentists are serious words. They mean the doctor either defrauded you or deliberately deceived you. There are usually four ways in which a doctor can be guilty of these unethical actions.

First, the doctor intentionally misleads you as to the nature of your condition and what the treatment involves.

A North Carolina surgeon told a patient that a heart operation held no risk. The patient was not yet 40 years old, the operation was not really necessary, and he could have lived for many years without it. But, since the doctor had assured him there was not any risk, he decided to go ahead with it, just to be on the safe side. After the operation, the patient developed an air bubble to the brain and died.

Postoperatively, the patient’s family found out the operation was considered dangerous by heart surgeon, and as many as 10% of the people who have it die. Even though the doctor had performed the operation correctly and had not committed malpractice, he had willfully concealed the dangers of the operation to get the patient to agree to the surgery. The family sued, charging that the doctor had deliberately deceived the patient about the risks, and he did it for the money. The jury thought so, too.

Second, the doctor intentionally misleads you as to what went wrong with a treatment and gives you a false story to keep you from suing him, until the statute of limitations (time limit) runs out.

Third, the doctor alters or destroys his office records, or the hospital records, in order to conceal the truth from your lawyer and the jury. This is known as spoliation of evidence and is the most serious of all.

In a New York case, a woman was sent home from the hospital with pneumonia and she died. When the family’s lawyer obtained the hospital chart, all the reports of laboratory tests were normal. Since that did not square with the patient’s condition, the lawyer obtained a court order to see the original records in the hospital laboratory. It turned out that when the doctor was notified he was being sued for medical malpractice, he went to the hospital and removed the original laboratory report slips that showed his patient had a raging infection. He substituted forged reports that showed a normal white blood count when he sent her home. When that was brought out at trial, the jury not only gave the victim’s family an award for compensatory damages but added an amount for punitive damages, to punish the doctor for attempting to deceive the court.

Since reports of surgical operations and discharge summaries are very important, most hospitals require doctors to dictate the report of an operation before he leaves the surgical suite and the discharge summary within 48 hours after his patient is discharged from the hospital. The dates these reports are dictated and transcribed are indicated by a notation in the lower, left corner that read like this: D: 01/22/09, T: 01/24/09.

In a New Jersey case, a team of neurosurgeons botched a major brain operation, and the patient died. When the patient’s family filed a lawsuit for medical malpractice, and their lawyer obtained the medical records from the hospital, he discovered the report of the operation and the discharge summary had been dictated and typed a year after the patient died and two months after the lawsuit had been filed. Under hospital policy, the doctors would have been suspended and would not have been able to admit patients to the hospital, if the chart had not been completed. But, they had been admitting patients all along, since the patient died, so it was obvious they had destroyed their original reports and substituted falsified reports. The secretary was honest and noted the correct dates she typed the revisions and exposed the doctors’ scheme to deceive the court. The patient’s family won at trial.

Not all cases of alteration of medical records and spoliation of evidence are as easily detected as in this New Jersey case. Sometimes it requires an Authenticator of Disputed Documents (handwriting expert) to prove it to the satisfaction of the court. In a Virginia case, the authenticator found that the doctor had used a pen that was not even manufacturer until after the dates on his handwritten note. If you can show medical records have been altered or destroyed, it puts you in a strong position.

Fourth, a doctor offers to help you with your medical malpractice case or dental malpractice case or promises to be your expert witness. At the last minute, he fails to appear to testify or changes his opinion on the witness stand.

A Utah lawyer was suing an anesthesiologist for medical malpractice, which resulted in the death of a patient during surgery. The surgeon, who had performed the operation was critical of the anesthesiologist and offered to act as the lawyer’s medical expert witness. The lawyer did not bother to look for another expert or obtain any other opinion. The surgeon was also helpful in preparing an airtight case against the anesthesiologist, and there was never any question that the surgeon was responsible, too.

Three weeks before the case was due to go to trial, the surgeon announced that he would not be able to act as the expert witness “for personal reasons.” When the lawyer went to an independent expert, who was located in another city, he was astonished to learn that the surgeon, who had been so helpful, was the one who had committed malpractice and should have been sued. The lawyer did not have a case at all against the anesthesiologist. The surgeon had led the lawyer along until it was too late to sue him. When confronted, the surgeon admitted he never had any intention of testifying. It was too late to find a substitute expert, and the case was lost.

Releases in Medical Malpractice and Dental Malpractice Cases

Wednesday, June 23rd, 2010

Release

You became dissatisfied with your doctor and went to another doctor without telling him.  It happens all the time.  Or, you signed yourself out of the hospital, and the nurses and doctor made you sign a statement that you were leaving of your own accord and against the doctor’s advice.  If you do that and terminate your relationship with a doctor or a hospital, you have released them.  They are no longer responsible for what happens to you.  You become responsible for everything that happens to you from that moment onward, including aggravation or complications of your previous injuries because of failure to follow-up with your medical care.

However, it is important to note that a release, whether just implied by your actions or actually written out, only releases the doctor or hospital for whatever happens in the future.  It does not cancel out any responsibility for what has already been done to you.  If you go to another doctor or hospital, they become responsible for everything that is done from the time they accept you as a patient.

Just because you signed a release does not mean you have given up any of your rights for what was done to you before you signed the release.  If you are asked to sign a release for things that have already happened, it is illegal, and the courts will not recognize it.

What if you are asked to sign a release before you are treated?  That is only good for getting your consent to risky treatment, as already explained in the post on assumption of the risk, and it cannot be used as an excuse for medical malpractice or dental malpractice, because no one can ask you to sign away your protection under the law.

The exception to this is a consent to submit any dispute or malpractice claim to arbitration, instead of going to court.  Some states recognize and enforce such agreements.  Others consider them an infringement of your constitutional right to have your case decided by a jury of your peers.  You will have to check with your lawyer to find out whether arbitration agreements are legal and binding in your state.

Insurance Release

It is important for you to know that the release an insurance company adjuster might ask you to sign, in return for a quick settlement of your claim, is different and is legally binding.  That is because it has nothing to do with the doctor’s treatment and is a contract between you and the insurance company.  You are getting valuable consideration in the form of a quick settlement of your claim, in return for your agreement to settle for a smaller amount.  Since the insurance company is not the person who caused your injuries, it does not have to justify its actions.

The Rule Is: If you believe that you have been the victim of medical malpractice or dental malpractice, do not sign anything without your lawyer’s approval.  If you do not have a lawyer, do not sign anything until you do and he or she approves.

Assumption of the Risk in Medical Malpractice and Dental Malpractice Cases

Wednesday, June 9th, 2010

Assumption of the Risk is a legal term that means you knowingly assumed responsibility for what happened, because you agreed to take an unnecessary risk.  Your doctor tells you that you can have an operation that will cure you right away, but it is risky and has a 50% chance of a bad result.  He explains the safe alternative is a long course of medical treatment.  You want to get it over with and decide to go ahead anyway.  You have assumed the risk and cannot hold the doctor responsible for what goes wrong.

You have been in a hospital with pneumonia and are feeling a lot better.  The doctor tells you that you are not out of the woods and should remain in the hospital.  If you go home, you could suffer a relapse or serious complications.  But, you have urgent business and sign yourself out of the hospital against the doctor’s advice.  You have assumed the risk, and if something goes wrong, you are solely to blame.

It is another way of stating that you have released the doctor from responsibility for the outcome of his treatment.  You knew what you were doing and took your chances with your eyes wide open.  This defense is usually trotted out when the doctor has done something unusually risky, and it has turned out badly.  He says, “I explained all the risks to my patient, but she decided to go ahead anyway.”

Does it relieve the doctor of all responsibility?  No.  It does not excuse medical malpractice or dental malpractice and only excuses the doctor when he can show that your bad result was due to risks inherent in the treatment or arising out of your own actions, like not following his orders.  If he warns you the treatment he is going to give you is risky and also commits malpractice, he cannot blame you for the bad result.

Why not?  Because you cannot consent to a wrongful act.  No matter what you agreed to, or how flagrantly you disregarded your doctor’s advice, if your injuries were due to his malpractice, he cannot lay the blame on you.  It is not enough for the doctor just to tell you that something is risky.  He also has to explain precisely what the risks and dangers are.  He has to tell you about all the common risks, even if they are not serious, and about the uncommon risks if they have serious consequences.

It is not enough for the doctor to say you assumed the risk.  He has to offer some proof that you consciously took the additional risks, such as a reliable witness or a written consent.  This is because the courts assume you are what lawyers call the Reasonable Person, someone who would not take unreasonable risks or do foolish things.  If the doctor wants to justify himself by saying you took an unnecessary risk, then he has the burden of coming forward with evidence to show that you did.  You do not have to show that you did not.

What if the doctor says, “Everybody knows brain surgery is dangerous.  The patient should have asked me about the risks.  If he did not bother to or care enough to ask, then he was careless and assumed the risk.”  How do you answer that?  The same rule we just explained also applies here.

The Rule Is: A patient cannot be criticized for placing complete trust and confidence in the doctor.  The doctor is the expert, who knows what the risks and dangers are.  He has to offer the warnings, you do not have to ask.

Comparative Negligence in Medical Malpractice and Dental Malpractice Cases

Wednesday, May 26th, 2010

Some states have what is called comparative negligence.  Under this theory, the court estimates what percentage of the responsibility is due to your actions, and how much can be blamed on the doctor or the hospital.

Imagine that you went to a hospital ER with pneumonia.  The doctors and nurses told you that you should stay in the hospital but failed to warn you of the dangers and risks you ran by leaving.  You did not think it was serious and signed yourself out against their advice.  You later developed serious complications and want to sue the hospital.

In a state that uses contributory negligence, you would probably be barred from collecting anything, because your behavior in defiance of the doctor’s orders was a substantial cause of your damages.  However, in a comparative negligence state, the jury might say that the doctor was 20% responsible, the hospital was 20% responsible, and you were 60% at fault.  Under the legal theory of comparative negligence, it is possible to be awarded damages, even if you were 90% to blame for what happened to you.

Effect of Comparative Negligence on Your Case

Comparative negligence is more favorable to you.  The judge or jury cannot dismiss your case, because you were partly to blame.  Theoretically, you can receive something, even if you were almost entirely responsible for what happened to you.  However, your chances of winning anything are not very good, if your actions were responsible for more than 50% of your damages.  Jurors are not impressed by people who are largely responsible for their own troubles.  Lawyers call it “going into court with unclean hands.”  Even though the law says you can receive an award when you were the one mainly responsible for your bad results, the jury will probably see you as an opportunist and side with the doctor.

If you think you may have been partly to blame, you should discuss it openly with your lawyer and let him decide whether your chances of winning merit the cost and trouble of going ahead with the case.

Contributory and Comparative Negligence States

Only five states still recognize the pure contributory negligence rule, which says that a damaged party cannot recover any damages if he is even 1% at fault: Alabama, District of Columbia, Maryland, North Carolina, and Virginia.

THE RULE IS: If you are accused of contributory or comparative negligence, the defendants must prove your action met the following conditions:

1. It must have been willful and deliberate.

2. It must have occurred at the same time as the doctor’s malpractice.  If it occurred later, it can only be used by the doctor’s lawyer as a mitigating factor to reduce the dollar value of your damages.

3. It must have made your bad result worse than it would have been if you had followed instructions.  If it did not have any effect on the course or the outcome of your illness, it cannot be used against you at all - no matter what you did.

Contributory Negligence in Medical Malpractice and Dental Malpractice Cases

Wednesday, May 12th, 2010

An Illinois man went to a hospital ER after being hit in the head with a bottle during a bar fight.  He was belligerent, staggering, confused, and had slurred speech.  The doctors thought he was drunk and did not pay much attention to him.  They allowed him to sign himself out against their advice.  He went home; his family put him to bed to sleep it off.  In the morning, they could not wake him.  He was rushed back to the hospital where it was found that he had been suffering from a skull fracture and brain injury and was not drunk at all.  He could have been saved when he first went to the ER, but by the time he returned to the ER, the pressure on his brain had caused an irreversible coma and he died.

His family sued the hospital, claiming he should never have been allowed to leave the hospital without a thorough work-up, which would have revealed the head injury and allowed surgeons to save his life.  The hospital claimed contributory negligence, because the patient had signed himself out of the hospital against medical advice.  The court said his action was not negligent, because it was not willful.  In his confused mental state from the brain injury, he did not realize what he was doing.

A Florida man suffered a broken leg in a motorcycle accident.  It was set incorrectly in the hospital.  He ended up permanently lame due to a crooked leg.  When he sued, the doctor moved to have the lawsuit dismissed because of contributory negligence.  The doctor claimed the bad result of his treatment had been made worse, because the patient had been too active while still in the cast.  The Florida court refused to dismiss the case, because the contributory negligence had occurred long after the doctor’s malpractice in setting the leg.  However, it did reduce the amount of the jury award, because the man had actually tried to play football, and his activity made the results of the doctor’s malpractice much worse.

It is not contributory negligence, if you dismiss a doctor who has lost your confidence.  You certainly do not have to continue following the advice of a doctor, if you think he is not handling your case right.  If that happens, and you are not in a hospital, you simply go to another doctor.  If you are in a hospital, you should ask your doctor to call in a qualified consultant.  If your doctor refuses to call in another doctor, ask the hospital administrator to intervene.  If he refuses, call your lawyer.  You are always entitled to a substitution of doctors, if a qualified substitute is available.

The Effects of Contributory Negligence on Your Case

Contributory negligence can have two effects on a medical malpractice lawsuit or dental malpractice lawsuit.  First, if the defense lawyers can show that your willful conduct seriously influenced the outcome, they can ask the judge to dismiss your complaint.  Second, they can use it to persuade the jury to rule for the defendant.  If the jury decides your actions were 50%, or more responsible, it will probably award you nothing.

An Indiana man suffered severe chest pains while playing tennis.  He went to a hospital ER where an ECG (electrocardiogram) showed signs of an early heart attack.  Hospital admission was advised but he refused and left the hospital against medical advice.  Later that day, he resumed playing tennis and dropped dead on the court.  The widow’s malpractice suit against the hospital for failure to use more vigorous persuasion was dismissed, because of her husband’s contributory negligence in ignoring the advice of the ER doctor.

Medical and Dental Malpractice

Thursday, April 29th, 2010

Were You Partly to Blame?

A doctor gives you a prescription for medication, or tells you that you need emergency surgery, and you do not follow through and ignore his advice.  You are in a hospital and decide that you want to go home.  The doctors tell you that you are in no condition to leave, but you sign yourself out and go home anyway.  You secretly take your own sleeping pills to the hospital, in violation of the hospital rules.  Are you responsible if something bad happens?  Yes.  You cannot hold a doctor responsible for the results of your willful disregard of his advice.

It is known as Contributory Negligence in some states and Comparative Negligence in other states.  There are important differences in the two concepts and the effects they can have on a medical malpractice case or a dental malpractice case.  Check which concept applies in your state.  You could have a valid case in one state and a meritless case in another state.

If your doctor advises you to have treatment and you refuse and something goes wrong, or if you sign yourself out of the hospital against the advice of the doctors.  In a contributory negligence state, it will probably prevent you from collecting a judgment.  In a comparative negligence state, it will reduce the amount of your award.

Sometimes a patient who is drugged, mentally disturbed, confused, or senile will do something against a doctor’s order, and something bad will happen.  The defense attorneys will claim there was contributory negligence, but that argument will not stand up.  It has to be a deliberate and conscious act by someone who knows what they are doing.

In a Maryland case, a confused, senile elderly lady climbed over the bedrails and walked as far as the bathroom before she passed out.  As she fell, she grabbed a hot water pipe with both hands.  By the time she was found, her hands were so badly burned by holding the hot pipe that they had to be amputated.  The defense lawyers claimed contributory negligence, but the court said no, because she did not do it deliberately.

It is not enough for a doctor to say that you left the hospital against his advice, or agreed to a risky treatment.  He has to either show you agreed in writing or he has to produce a reliable witness.  It is up to the defendants to prove you were guilty of contributory negligence or that you knowingly assumed an unusual risk.  You do not have to prove that you did not.

THE RULE IS: Your actions must have been willful and deliberate, have occurred at the same time as the medical malpractice or dental malpractice, and have contributed to the bad results.

Negligent Errors in Making a Diagnosis

Tuesday, April 13th, 2010

A doctor’s duty to make a correct diagnosis requires him to inform himself by ordering the necessary tests, interpreting the test results correctly, and arriving at a logical conclusion by putting all the pieces of the diagnostic picture in their proper places and perspectives.  With the sophisticated diagnostic tools today, a wrong diagnosis is more often the result of negligent or careless diagnostic work-up than lack of medical knowledge.  It is often impossible to make a precise diagnosis, but there is rarely an excuse for making a wrong diagnosis.  The following are some of the most common negligent errors:

1. Failure to do all routine screening tests indicated by the patient’s history or physical findings.

2. Ignoring test results which do not fit in with the doctor’s preconceived idea of what is wrong with the patient, especially when those results are positive.

3. Failure to repeat laboratory tests periodically or if the patient’s condition does not respond as expected.

4. Attributing the patient’s illness to a previous disease without checking to learn whether or not a new condition has developed.

5. Reliance on negative laboratory results, which do not square with other test results or the patient’s general condition, especially if the patient’s condition continues to decline.

6. Failure to repeat physical examinations and laboratory tests at frequent intervals during the course of a long illness.

In a Florida case, a 50 year-old man, with a history of smoking, went to a doctor complaining of wheezing and pain in the chest, a clinical picture suggestive of lung cancer.  Even though the doctor was a specialist in Internal Medicine, he treated the patient and failed to take a chest x-ray for almost a year.  When another doctor finally ordered a chest x-ray, the man’s lung cancer was inoperable.

In a Georgia case, an elderly man in a nursing home complained of passing blood in his urine.  This is a cardinal sign of cancer of the urinary tract and demands an immediate and complete work-up to identify the cause.  However, the nursing home doctor did nothing about it for over a year, even though the bleeding was repeatedly noted in his chart, and the nursing home staff did nothing to notify the man’s family or any other doctor.  When his family finally found out and took him to a urologist, he was found to have terminal kidney cancer and died within a few weeks.

Now that you know what constitutes medical malpractice or dental malpractice, you can decide whether your doctor actually committed a departure from good and accepted practice that caused your bad results and is grounds for a malpractice lawsuit.  Do not think about the words malpractice or negligence, which carry a moral implication of wrongdoing.  Think about a departure from good and accepted practice.  Did the doctor or the hospital employee do something that was not in keeping with accepted practices by good doctors?  Did he make a serious mistake that a good and careful doctor should not have made?

The Rule Is: A valid medical malpractice case or dental malpractice case should be based upon a showing that the doctor did something that a good and careful doctor, in the same or similar situation, under the same or similar circumstances, would not have done.

Rules in Medical and Dental Malpractice

Tuesday, March 30th, 2010

The Best Judgment Rule

Another thing you may run into is the best judgment rule.  This says that your doctor did not guarantee a good result.  He only promised to do his best for you and cannot be faulted, if your condition did not respond as you had hoped or for making an honest mistake.  The practice of medicine or dentistry is an art, not a science.  Some diseases are so obscure it is impossible to make an accurate diagnosis.  Sometimes what looks like ideal treatment produces disastrous results.  But, with the sophisticated diagnostic equipment available today, doctors should not make serious mistakes in diagnosis.

For example, your doctor says, “When we got into your abdomen, you did not have a perforated stomach ulcer.  It turned out to be pancreatitis, and you did not need surgery.”  Can he do that and get away with it?  Yes.  But, not that easily.  To plead an honest mistake, he has to satisfy four conditions:

1. He has to have performed a careful diagnostic work-up.  The rule is that errors in diagnosis and treatment are malpractice, if based on a careless or inadequate diagnostic work-up.  The doctor who performed surgery failed to do a white blood cell count or some other important diagnostic test before surgery.  This is malpractice.  This is where a lot of doctors get caught.  The doctor is in a hurry to get away from the office, or operating room, or to see too many patients and skips over an important test.

2. The doctor must interpret the test data correctly.  You are going to have exploratory abdominal surgery but might be pregnant.  The surgeon orders a pregnancy test but goes ahead without learning the result of the test.  You later learn the pregnancy test was positive, and he operated on a pregnant uterus and you lost the baby.  Is he liable?  Yes.  The doctor has to have made a diligent attempt to put the big picture together from all the test data before making his decision.

3. There must be a legitimate choice between different and competing techniques.  The doctor has to be able to produce a textbook or authoritative medical article that says you can do it either way, and he chose one that turned out to be wrong.

4. The choice has to be one that a respectable minority of doctors would have made.

If the doctor says he used his best judgment, he has to have met these four conditions to justify a bad result and not be guilty of malpractice.  He is admitting that he made a mistake and is offering the excuse that he committed a justifiable error of judgment.  In order to do so, he has the burden of showing that his error was truly justifiable and not due to negligent behavior on his part.

Rules in Medical and Dental Malpractice

Wednesday, March 17th, 2010

The Respectable Minority Rule

You are sitting outside the treatment room of a hospital when you hear one nurse say to another, “Dr. Jones is butchering that poor patient!”  The patient is your mother.  Or, you have a broken leg set by one doctor and go to another doctor to have the cast removed.  He says something like, “Who did this?  I certainly would not have done it this way!”  Your leg still hurts, and you do not like the look of it.  Or, your friend tells you that you could have been treated painlessly with an inexpensive medicine, after you have had expensive and painful surgery.

Right away you think the doctor committed medical malpractice and maybe he did.  A lot of malpractice only comes to light by listening to unguarded comments and hospital gossip.  But, do not be too quick.  Maybe the nurse does not know what she is talking about when she criticizes the doctor’s treatment of your relative.  Maybe the technique for setting the broken leg is highly regarded by 30% of doctors.  Maybe the surgery saved your life, and medicine would have killed you.  The practice of medicine is not a popularity contest.  The U.S. Supreme Court once ruled that if 51% of the doctors in the U.S. do one type of treatment, it does not mean that the other 49% are guilty of malpractice.  If the doctor can show that his ideas are those of a respectable minority, he is okay.

What is a respectable minority?  It can be a certain percentage of doctors or members of the same specialty, such as 30% of all family practitioners, or 30% of neurosurgeons treating a rare disease, or it can be a few eminent doctors.

Do not go off half-cocked, because a doctor or a nurse does not agree with what your doctor did.  Almost 40% of medical malpractice lawsuits and dental malpractice lawsuits are set off by a nurse or a doctor bad-mouthing another doctor.  The criticism may be an honest difference of opinion or just envy.  Before you spend time and money on a lawsuit, be sure there really was malpractice.

     
Site design by James D. Lake
© 2007 JD.MD, Inc.
Abbreviations Glossary   ·  Links   ·   Sitemap