Articles by mjlst

Go Easy on the Doctors

by Greg Singer, UMN Law Student, MJLST Managing Editor

Thumbnail-Greg-Singer.jpgThe healthcare system in the United States is no stranger to debate. The current president won election, and recently re-election, due in no small part to his promises of reform in the area. It is no surprise that this is the case. People literally place their lives in the hands of the healthcare system, and utilize it so often that the combined spending on it consumes nearly 18% of the entire GDP (a figure that is only expected to rise as time wears on).

Yet anchoring the system that serves almost 315 million Americans is a surprisingly small contingent of no more than 960 thousand medical doctors (of whom only about 350 thousand are considered to be primary care physicians, and many of the remainder employed in non-patient-facing positions). This is an incredible burden placed on the shoulders of so few people, a burden that is only expected to become weightier in future years, as medical schools arguably fail to produce enough new physicians to properly care for the current set of patients, let alone all of the soon-to-be-patients as universal healthcare requirements set in pursuant to Affordable Health Care for America Act.

In Mistake-Proofing Medicine: Legal Considerations and Healthcare Quality Implications, published in volume 14.1 of the Minnesota Journal of Law, Science & Technology, authors John Grout, et al. argue that a significant portion of medical mistakes and errors may be attributable to a character flaw in the psyche of some physicians, specifically that they are beset with “a narcissism that blocks full acceptance of the notion that compliance rules apply to [them].” Moreover, the authors point to other character flaws, such as the performance of duties while under the influence and general substance abuse as significant causal factors for mistakes.

While these issues no doubt exist in one form or another, it is important to remember that the vast majority of doctors do try their best to help their patients. Given the unconscionable hours involved in the job, the relatively modest compensation for many, and the massive debt burdens required to enter the field, it is hard to imagine anyone, narcissistic or not, attempting it without possessing a truly real desire to help those in need. If anything, the simple exhaustion facing many doctors is a more understandable, and sympathetic, cause of error. Medical doctors are among the most overworked professionals in the United States, despite the extremely high stakes involved in their work. The high hours required is partly due to the culture surrounding the field, but the limited number of available physicians, despite the rising amount of time demanded by the growing lists of patients cannot be ignored.

Increasing enrollment in existing medical schools, or even creating new medical schools, may be a pathway to reducing medical mistakes errors, wait times, and perhaps even costs. But in the meantime, be understanding of your doctor. Do not immediately assume that his mistakes are due to arrogance or a flaw in his character. He may simply be tired.


Anti-Law School Scam Blogging Drastically Effecting Law School Application Rates

by Savir Punia, UMN Law Student, MJLST Staff

Thumbnail-Savir-Punia.jpgThe reports of Law School’s death are greatly exaggerated. At least I am hoping that is true. As a current law student I find myself frequenting blogs, websites and articles focused on the state of the law profession hoping I don’t become another “casualty” of law school. Since 2008, it has been a badly kept secret that the law profession is struggling and the internet is full of recent JD graduates sharing horror stories of their experiences in law school. Lucille A. Jewel‘s article, You’re Doing It Wrong: How the Anti-Law School Scam Blogging Movement Can Shape the Legal Profession, in Issue 12.1 of the Minnesota Journal of Law, Science & Technology, discusses just this, a community of malcontent JD graduates who have gathered together online to share personal stories and discourage others from going to law school.

While the argument of whether law school still remains a good investment is still debated, there is one result that has occurred due to the “Law School Scam Blogging” movement, applications are drastically down. According to the Law School Admission Council (LSAC), law school applications are headed for a 30-year low. LSAC expects there to be only 54,000 applications for the current enrollment cycle, which is down 20 percent from last year and a whopping 28 percent from 2010. Furthermore, the 54,000 law school application for this year is almost half of what it was in 2004 when there were 100,000 applications. This is in stark contrast to any other graduate or professional training school (except veterinary school). According to Debra W. Stewart, president of the Council of Graduate Schools, first-time enrollment to masters of business degree programs were steady – a 0.8 percent increase among Americans in 2011. Moreover, these graduate programs experienced a thirteen percent increase in foreign graduate enrollment, and this is after a substantial decade of growth in those degree programs. Unfortunately, an American legal education has less appeal to international students because an American legal education is highly dependent on the American legal system. An American legal education is not easily translatable to other country’s legal system.

This large drop off in applications to law school is strongly connected to the perceived lack of job opportunities in the legal market and much of that perception has been fueled by the rise of blogging JDs. Jewel discusses the impact of the “Anti Law-School Scam Blogging Movement” on the legal profession and the tensions it has created within among the legal community. It is not difficult at all for one to discover threads, memes and new articles discussing the bleak job opportunities new grads face coupled with the prospect of paying back large amounts of student debt taken on to complete law school. These bloggers have claimed their former institutions mislead them into thinking there were rosy career prospects at the end of law school, only to be left unemployed or working at jobs making a fraction of what they were promised outside of the legal profession. They have impacted current law students and potential law students by using a style that aims to shame law schools through the use of vitriolic blog posts. The impact this network has created clearly is beginning to show itself as law schools are struggling to find enough applicants to fill their classes. In fact, the class of 2015 at the University of Minnesota Law School was considerably smaller than the class of 2014 (of which I am a part of), due to the smaller applicant pool my school was faced with.

In my opinion, there exists a terrible disconnect in the legal profession. My personal decision to attend law school did weigh the potential of bleak career prospects before I ultimately decided on attending law school. Now as an insider of the law school community, I find the picture painted by these bloggers to be somewhat different than reality. The two biggest platforms that the bloggers have rested their thesis on according to Jewel are “that law schools are producing an oversupply of lawyers and law schools have purposely over-inflated post-graduation employment data in order to draw in more law students, and that, in essence, law schools and professional institutions, such as the American Bar Association (ABA) should be ashamed of themselves.” While post-graduation employment data has not been proven to be misleading nor has it been proven innocent, it is a topic I will choose to avoid for purposes of this blog. My main contention is with the argument of an oversupply of lawyers in the United States. Currently, there exists a severe shortage of legal help for low-income individuals. New York State’s chief judge, Jonathon Lippman, has responded to this by moving ahead with a groundbreaking rule requiring law students to perform 50 hours of pro bono legal services as a condition of admission to the state bar. Other states are seriously considering this requirement as well. Furthermore, according to Gillian K. Hadfield, professor of law and economics at the University of Southern California, there is a mismatch between demand and supply. She went on to say, that there is exploding demand for legal services for “ordinary folk lawyers” and “big corporate ones.”

To me, like Professor Hadfield believes, there is an atmosphere of feast or famine in the legal profession. Law students lucky enough to receive a high paying internship with a corporate law firm find themselves with high paying internships and post-graduation salaries in the six figures, but public interest and low income legal work often results in unpaid internships and extremely low paying full time positions, commonly below $40,000. Additionally, temporary doc review jobs with terrible working conditions and low paying hourly work muddle the market even more. It is not the oversupply of lawyers that has resulted in bleak career opportunities but a failure by the legal community to create business models that adequately address demand. There is demand from large corporations, who are dissatisfied with the high fees and unsatisfying results produced by large firms, for good attorneys according to Hilliard. Also legal access for “ordinary folk” is extremely strained; there simply aren’t enough attorneys in this line of work to satisfy demand. This is something I have experienced personally, as I am constantly helping my parents find an attorney for their small business who can work on their legal issues in a timely fashion, not an easy task. They have yet to find a good attorney who isn’t overwhelmed by the amount of work they have on their plates. This indicates to me that there is a large amount of demand, at least for good attorneys for small businesses, and the legal profession has failed to keep pace.

A disconnect between the supply of attorneys and the demand for their services is apparent. Too many students are forced to compete for relatively few big law jobs that pay enough to make a legal education a sound investment. The demand for attorneys for small businesses and individuals is high but current legal professions have skewed the funneling of new attorneys to fields of law in oversupply. There is much discussion of change at the education level of the legal field, but no one is discussing the change at the professional level. The legal field has to change the way it does business. Big law firms are not in a rush to change because they continue to enjoy profitability, and their partners regularly take home checks in the seven figures. But big law shouldn’t be required to carry the responsibility of leading; they have a successful business model. Solutions must come from individuals within the legal community to match unsatisfied demand for legal services with an adequately compensated supply of attorneys. When the catalyst for change will come is unclear, but maybe the drastic fall in law school applications will serve as the catalyst for change, or it could exasperate the situation further, but one thing is certain, the demand for affordable and quality legal services does exist.


Discussing the Legal Job Market Online: Optimism, Observation, and Reform

by Elliot Ferrell, UMN Law Student, MJLST Staff

Thumbnail-Elliot-Ferrell.jpgThe average law student incurs $125,000 of debt and pays almost twice as much in tuition as a student did in 2001. Law students are understandably concerned with the legal market’s job prospects, and many are vocal about. Students are not the only ones voicing their concerns, as a lawyers (employed and unemployed), professors, employers, and business people add their opinions and observations to the discourse as well. A common theme is to decry the rise of tuition costs and debt and the fall of enrollment and job openings.

The Minnesota Journal of Law, Science and Technology’s publication, You’re Doing It Wrong: How the Anti-Law School Scam Blogging Movement Can Shape the Legal Profession, describes this dialogue with a sense of optimism. According to the article, unemployed and underemployed lawyers contribute to the legal community through the voice of an outsider, facilitated by the openness and anonymity afforded by the internet. These contributions may contain valuable ideas and observations but are often plagued by gripes and vulgarities so common to internet communications emanating from forums or the blogosphere.

Additionally, the online news world is littered with articles espousing reasons for the gloomy outlook in the legal job market. However, many carry the same sense of optimism as previously indicated. One such article suggests that, after using a little math and some average attrition rates, the number of law school graduates per year and the number of job openings per year will equalize by 2016. This result is due to dwindling average enrollment and approximately equal number of graduates getting jobs each year. Despite the apparent logic of this approach, holding onto all of the variables involved staying the course likely requires an ardently optimistic law student.

Several commentators step back from the optimistic approach and suggest reforms intended to curb the cost of law school and increase a graduate’s job prospects. One proposal would remove the third year of law school to cut the tuition debt and hasten a student’s path into the workforce. However, such an idea is not without its pitfalls, such as a reduced readiness for the bar exam. Another idea is to increase practical education through clinical courses and partnerships analogous to medical residencies. Many schools already offer an array of different clinic experiences, but the notion of a legal residency would seem attractive to law students as it would offer an additional path to permanent employment.

What is the role of the student in this discussion? Perhaps, it is to let it run its course and hope for the job market to right itself. Perhaps, it is to chime in and advocate or simply make observations. Either way, there are certainly valuable contributions to be made, and, with access to the internet, there is little standing in your way.


New Medicine Into Old Bottles, Quality and the US Medical System

by Eric Nielson, UMN Law Student, MJLST Staff

Thumbnail-Eric-Nielson.jpgThis entry discusses some of the challenges identified in Grout et al.’s article Mistake-Proofing Medicine: Legal Considerations and Healthcare Quality Implications from Volume 14.1 of the Minnesota Journal of Law, Science, and Technology. If you don’t have any health problems, have family with health problems, or pay taxes then the problem probably doesn’t impact you. The rest of this paragraph is about me establishing my credentials on the subject, if you don’t care, feel free to skip ahead. I have worked as an R&D engineer developing medical devices for more than 15 years. I have a Masters in Medical Engineering from the University of Washington. I am an inventor on several medical device patents. I have worked for a very large company and for several startups. I have conducted market research, physician training, product design, FDA filing preparation, process development, product development, and implementation, etc. I have worked at nearly every stage of medical device development. Devices I have worked on are in literally millions of people in the United States.

The medical delivery system in the United States is fundamentally unchanged in its approach to quality management since the sixties, with the notable exception of anesthesiology (consider how, malpractice pressure forced reform of anesthesiology in the 80s). The public sector of our economy had to make major revisions when foreign competition in the eighties meant that domestic manufacturing could not compete with other countries. American automotive manufacturers took it in the chops because they could not effectively compete with Japanese and Korean companies. Only in the last decade have the automotive manufactures achieved economic efficiencies similar to their competitors (and finally shed some of their legacy costs). Hospitals and private practices never had this wave of foreign competition and so have never had to reinvent themselves to stay in business. Hospitals are heavily subsidized both directly by the taxpayer and through the federal system. The result has been local monopolies with limited real competition, just like the big three automakers before the Japanese entered the picture.

Japan did not invent quality manufacturing. Japanese industry was known for cheap, poor quality goods well into the sixties. What changed is that Japan got serious about producing quality products as a way to compete internationally and move up the value chain. To do this they relied on the work of several notable Americans: Demming, Juran (University of Minnesota graduate), and Crosby. These three together with Taguchi constitute the key founders of the discipline of Quality Management. There are some key concepts that I want to explore in relation to medical providers.

1) “Quality is free.” It is inherently cheaper to do it right the first time than to have to fix it. It is cheaper to spend more on the process to make it so reliable that you don’t have to continue to monitor the output. Your current business is probably externalizing the costs or hiding them and thus minimizes the real cost of defects in the products you make. Time and money are spent to prevent customers from knowing what the actual quality of health care provided by hospitals.

2) Nobody understands the problem better than all of us together. To find the best solution, you need to understand the system from the point of view of everyone who interacts with it. This requires that line personal have the ability to discuss problems and solutions without fear of negative job impact. This does not exist in modern hospitals. Nurses and staff doing the work are not free to identify problems or concerns with physicians. Decisions are not made with consensus but are top down, command and control by people with very limited information. This prevents identification of effective, realistic solutions and instead encourages ineffective window dressing committees.

3) Quality improvement depends on good information and systematic effort. Bluntly Medical providers have systematically hidden outcomes information in an effort to prevent the consuming public from being aware of how bad a job they’ve done. This includes not gathering the information, not publishing information they have, and playing malpractice claims to keep quiet. Take a typical medical procedure and go find the published complication rate. Then take those numbers and talk with specialists in that field about those numbers. What you’ll find is that the published data invariably understates the prevalence of complications at top flight institutions. This is generally a result of selection bias, where only data sets with exceptional outcomes are submitted for publication (so as not to reflect poorly upon the institution). In the absence of good information, these Potemkin village studies underestimate the scope and cost of the problem and encourage administrators and staff to ignore the problem. Nobody ever says Institution X published a study with only a 3% complication rate for procedure Y, we need to get our numbers to that level. They instead say, I wonder what their real rate is or I wonder how they selected their patients for that study.

4) Management needs to lead or it will not happen. This is a system problem. This is not a problem of people not doing their jobs. It is not about people not trying to do their best. The highly complex medical delivery system does not hold anyone responsible for the error rate. It doesn’t not impact salaries, reputation, or stock price the way it does at private companies. Look at the response from hospitals that are killing people every day compared with Toyota’s response to the “sudden acceleration” fiasco. Is the executive team involved? Are resources focused on the problem? Etc. FDA holds management personally, legally responsible for failures of the quality systems at medical device companies. The same standard hasn’t been applied to medical delivery systems. Maybe it’s time to apply this principle outside of Anesthesiology.


21st Century Problem: Authentication of Prisoner Facebook Status Updates

by Eric Maloney, UMN Law Student, MJLST Staff

Thumbnail-Eric-Maloney.jpgFacebook has become a part of everyday life for people around the world. According to Mark Zuckerberg and Co., over one billion people (yes, with a “B”) are active on Facebook every month, with an average of more than 600 million active users every day in December 2012. Disregarding bogus or duplicate accounts, that means roughly one-seventh of the entire human population is active on Facebook every month (with the world population currently sitting somewhere in the neighborhood of seven billion people).

Apparently, Facebook has become so commonplace and ingrained in the daily routine of some that they feel the need to use the social networking service from the privacy of their prison cells.

A Harlem gang member named Devin Parsons has decided to cooperate with the government against fellow members of his gang, and is currently incarcerated while trial is pending. Instead of having the usual prison contraband smuggled in, he obtained a mobile phone and used it to post Facebook status updates under an assumed name. According to Trial Judge William H. Pauley III:

In some posts, Parsons reflected on his life in jail:

“everybody wanna live but don’t wanna die”;
“Life is crazy thay only miss yu ifyu dead or in jail”; and
“G.o.n.e”

In others, Parsons posted about his cooperation:

“I’m not tellin on nobody from HARLEM but I can give up some bx n****s that got bodys”; and
“be home sooner then yaH hereing 101[.]”

While not exactly “Letter from Birmingham Jail,” Parsons was surprisingly bold about disclosing the fact of his cooperation and about the risk of getting caught with a banned cell phone by the prison administration. The gang against which Parsons is testifying is charged with multiple counts of narcotics trafficking and murder, among other things.

One of the defendants in the case, Melvin Colon, sought to compel the disclosure of these postings under the Brady rule, which requires the government to release evidence to the defense before trial if the evidence is favorable to the defendant. Judge Pauley held that the government was not obligated to turn these postings over to Colon; for various reasons, the government was never in actual possession of the Facebook statuses and therefore had no duty to disclose under Brady.

This case highlights the continually growing relevance that Facebook and other social media data has in legal proceedings. In fact, this is not even the first ruling about Facebook in this case; the defendant Colon had earlier moved to suppress his own Facebook postings which the prosecution sought to introduce. Judge Pauley denied this motion as well, holding that Colon’s sharing of the postings with his Facebook “friends” meant he lacked a reasonable expectation of privacy in them.

A background issue in this case was the idea of authenticity of the Facebook poster; because Parsons was posting under a fake name, both sides were unaware of his conduct until after the account had already been deactivated. While not contested here, ensuring that the Facebook information originated from the user is an increasingly important evidentiary consideration as more and more of this data is used in both civil and criminal contexts.

Professor Ira P. Robbins laid out a possible framework for authenticating social networking evidence in his Minnesota Journal of Law, Science & Technology article “Writings on the Wall: The Need for an Authorship-Centric Approach to the Authentication of Social-Networking Evidence.” While voicing significant concerns about the current lack of a required nexus between the online content and its real-life poster, he proposed detailed admissions criteria for social network postings. He offered several factors to be examined by judges in making rulings about such data, including who owns the account, how secure the account is, and how / when the post in question was created.

As Facebook and other social networking information becomes increasingly important to the outcomes of legal cases, a framework like this is essential to bring our procedures in line with the nature of 21st century evidence and to ensure our system continues to meet Due Process standards. Digital evidence is largely unexplored territory for jurists and scholars alike, and it’s my hope that evidentiary standards like those proposed by Professor Robbins are seriously considered by the legal community.


Will the Good Deed of Respondent John Wiley & Sons, Inc. Go Unpunished?

by David Hanna, MJLST Lead Article Editor, UMN J.D./M.S. in Chemistry Joint Degree Candidate

Thumbnail-David-Hanna-II.jpgOn February 7, 2013, John Wiley & Sons, Inc. [“Wiley”] announced that it would make 12,200 Online Books available in eighty developing countries through the Research4Life initiatives of HINARI (the World Health Organization’s Health InterNetwork Access to Research Initiative.), AGORA (Access to Global Online Research in Agriculture) and OARE ( Online Access to Research in the Environment). With Wiley’s contribution, Research4Life can now boast an impressive number of almost 30,000 peer reviewed scientific journals, books and databases made available to developing countries for free or for low cost access. With the Supreme Court of the United States [“SCOTUS”] currently deciding the fate for Wiley in a pending case against petitioner Supap Kirtsaeng d/b/a Bluechristine99 [“Kirtsaeng”], could Wiley’s charitable contributions come at a more convenient time?

On October 29, 2012, SCOTUS heard oral arguments on behalf of petitioner Kirtsaeng and respondent Wiley in a case involving the first-sale doctrine in copyright law which enables owners to sell or transfer copyrighted items to other parties without seeking permission from the original copyright holder. In the case, SCOTUS is deciding on the particular issue of whether the first-sale doctrine applies to copies of copyrighted works made and legally acquired outside the United States and then imported into the United States.

How does the “good guy” fit into the picture? Wiley brought a copyright infringement suit against Kirtsaeng, a graduate foreign student currently in the United States who had been receiving textbooks produced by Wiley Asia from his family and friends outside of the United States and then selling them for a profit on eBay. In responding to Wiley’s suit, Kirtsaeng presented the first-sale doctrine as a defense. Both the District Court and Second Circuit denied Kirtsaeng the “first sale” doctrine and ruled that the defense did not apply to foreign-manufactured books.

The Minnesota Journal of Law Science & Technology’s recent publication, “John Wiley & Sons, Inc. v. Kirtsaeng: The Uncertain Future of the First-Sale Doctrine,” identifies the important implications of SCOTUS’s upcoming decision on the U.S. economy. Author Benjamin Hamborg states, “In an already struggling economy, the last thing that the country needs is precedent giving companies a further incentive to move manufacturing plants overseas.”

Will Wiley’s recent contributions cast a positive light on the company while SCOTUS decides whether to uphold the lower courts’ holding which denied a first-sale doctrine defense to Kirtsaeng? Will SCOTUS consider the implications of the case on this country’s disintegrating economy? Now, Kirtsaeng has to worry not only about his pending copyright infringement case before the superior court of the land but also about his opponent’s charitable good deed. Perhaps, Kirtsaeng might find it in his best interest between now and the time SCOTUS releases its decision to make a charitable donation from some of the profits earned from his book buying and selling business.


Will the Good Deed of Respondent John Wiley & Sons, Inc. Go Unpunished?

by David Hanna, MJLST Lead Article Editor, UMN J.D./M.S. in Chemistry Joint Degree Candidate

Thumbnail-David-Hanna-II.jpgOn February 7, 2013, John Wiley & Sons, Inc. [“Wiley”] announced that it would make 12,200 Online Books available in eighty developing countries through the Research4Life initiatives of HINARI (the World Health Organization’s Health InterNetwork Access to Research Initiative.), AGORA (Access to Global Online Research in Agriculture) and OARE ( Online Access to Research in the Environment). With Wiley’s contribution, Research4Life can now boast an impressive number of almost 30,000 peer reviewed scientific journals, books and databases made available to developing countries for free or for low cost access. With the Supreme Court of the United States [“SCOTUS”] currently deciding the fate for Wiley in a pending case against petitioner Supap Kirtsaeng d/b/a Bluechristine99 [“Kirtsaeng”], could Wiley’s charitable contributions come at a more convenient time?

On October 29, 2012, SCOTUS heard oral arguments on behalf of petitioner Kirtsaeng and respondent Wiley in a case involving the first-sale doctrine in copyright law which enables owners to sell or transfer copyrighted items to other parties without seeking permission from the original copyright holder. In the case, SCOTUS is deciding on the particular issue of whether the first-sale doctrine applies to copies of copyrighted works made and legally acquired outside the United States and then imported into the United States.

How does the “good guy” fit into the picture? Wiley brought a copyright infringement suit against Kirtsaeng, a graduate foreign student currently in the United States who had been receiving textbooks produced by Wiley Asia from his family and friends outside of the United States and then selling them for a profit on eBay. In responding to Wiley’s suit, Kirtsaeng presented the first-sale doctrine as a defense. Both the District Court and Second Circuit denied Kirtsaeng the “first sale” doctrine and ruled that the defense did not apply to foreign-manufactured books.

The Minnesota Journal of Law Science & Technology’s recent publication, “John Wiley & Sons, Inc. v. Kirtsaeng: The Uncertain Future of the First-Sale Doctrine,” identifies the important implications of SCOTUS’s upcoming decision on the U.S. economy. Author Benjamin Hamborg states, “In an already struggling economy, the last thing that the country needs is precedent giving companies a further incentive to move manufacturing plants overseas.”

Will Wiley’s recent contributions cast a positive light on the company while SCOTUS decides whether to uphold the lower courts’ holding which denied a first-sale doctrine defense to Kirtsaeng? Will SCOTUS consider the implications of the case on this country’s disintegrating economy? Now, Kirtsaeng has to worry not only about his pending copyright infringement case before the superior court of the land but also about his opponent’s charitable good deed. Perhaps, Kirtsaeng might find it in his best interest between now and the time SCOTUS releases its decision to make a charitable donation from some of the profits earned from his book buying and selling business.


Improving Healthcare Quality: Electronic Prescribing

by Johanna Smith, UMN Law Student, MJLSTStaff

Thumbnail-Johanna-Smith.jpgA new study published online on February 20, 2013 in the Journal of the American Medical Informatics Association found that when hospitals used electronic prescribing, it prevented 17 million drug errors–and if implemented more widely and consistently, it could prevent more than 50 million drug errors. But as of 2008, only about one in three acute care hospitals used electronic prescribing. Although there are various methods suggested to improve healthcare quality, one of the simplest is to make medical errors public. If hospitals, and the general public, were more aware of the safety benefits of electronic prescribing, this could lead to increased use and standardization. Another option to increase the use of electronic prescribing is to connect funding or reimbursement to the use of electronic prescribing.

An article in the January 23, 2013 Journal of the American Medical Association reported that once Medicare and Medicaid stopped reimbursing costs due to certain medical errors, the number of times a foreign item was left in a surgical patient dropped by half. The authors note that this number may not be truly accurate, since the hospitals would have financial incentives to hide the errors. Currently, reporting relies mainly on self-reporting by the hospitals, which is not always accurate. A new article in the Minnesota Journal of Law, Science, and Technology (MJLST) by John R. Grout, John W. Hill, and Arlen W. Langvart entitled “Mistake-Proofing Medicine: Legal Considerations and Healthcare Quality Implications,” discusses how to mistake-proof medicine and looks at healthcare quality on a broader level, including electronic prescribing. The MJLST article highlights that many hospital administrators are concerned more with the finances of the hospital than with patient safety. Connecting these two items increases the probability that patient safety will become a priority for hospitals. Although electronic prescribing is not a complete fix for incorrect prescriptions, it is an important part of improving the process. Compared to the cost of medical errors–including incorrect prescriptions–mistake-proofing is generally less expensive.


And the Patent Goes to…… the First to File

by Emily Puchalski, UMN Law Student, MJLST Notes & Comments Editor

Thumbnail-Emily-Puchalski.jpgIn just about one month the most monumental provision of the America Invents Act (AIA) will take effect. As of March 16, 2013 patents will be awarded to the first to file rather than the first to invent. This first to file system will bring the United States in accord with many other countries of the world. However, it is important note that the first to invent rule will still apply to patent applications filed before March 16th 2013.

Many patent lawyers and their clients have already began thinking about what the first to file system will mean for the American patent system. For example, a group of patent attorneys have already outlined some strategies that could be employed by inventors and predictions for how the new system will operate. Patent lawyers are not the only ones thinking about what the new systems will look like. Universities, for example, which can derive significant revenues from the patented inventions of its faculty, have implemented strategies for dealing with the new system. The University of North Dakota, for example, has stressed that the changes in the law as of March 16th govern towards immediate disclosure of any invention to the school’s intellectual property office to make sure that it can obtain patent rights on the invention, if desired, by filing an application as soon as possible with the Patent and Trademark Office.

Despite the prominence of the first to file provision of the AIA, it is important to remember that the AIA has many other important provisions aimed at changing the American patent law system. The AIA has also significantly changed the review available after a patent has been granted. The AIA both strengthens existing review procedures and creates new ones as well. In her article published in Issue 14.1 of the Minnesota Journal of Law, Science & Technology, “The Post-Grant Problem: America Invents Falling Short,” author Kayla Fossen provides an in-depth description of the post-grant review process under the America Invents Act. Fossen also takes a look at whether the new post-grant proceedings can effectuate change on the American patent system where patents are frequently invalidated in infringement litigation. Interestingly, Fossen proposes a pre-grant review process that could be used in addition to the post-grant proceedings under the America Invents Act to ensure that patents issued are strong enough to survive validity challenges in any infringement litigation. Even though March 16, 2013 will mark a big change in US patent law, it is important to evaluate the big changes that the America Invents Act has already made, one of them being post-grant review. Luckily, Fossen’s article does just that.


Time for a New Approach to Cyber Security?

by Kenzie Johnson, UMN Law Student, MJLST Managing Editor

Kenzie Johnson The recent announcements by several large news outlets including the New York Times, Washington Post, Bloomberg News, and the Wall Street Journal reporting that they have been the victims of cyber-attacks have yet again brought cyber security into the news. These attacks reportedly all originated in China and were aimed at monitoring news reporting of Chinese issues. In particular, the New York Times announced that Chinese hackers persistently attacked their servers for a period of four months and obtained passwords for reporters and other Times employees. The Times reported that the commencement of the attack coincided with a story it published regarding mass amounts of wealth accumulated by the family of Chinese Prime Minister Wen Jiabao.

It is not only western news outlets that are the targets of recent cyber-attacks. Within the past weeks, the United States Department of Energy and Federal Reserve both announced that hackers had recently penetrated their servers and acquired sensitive information.

This string of high-profile cyber-attacks raises the need for an improved legal and response structure to deal with the growing threat of cyber-attacks. In the forthcoming Winter 2013 issue of Minnesota Journal of Law, Science, and Technology, Susan W. Brenner discusses these issues in an article entitled “Cyber-Threats and the Limits of Bureaucratic Control.” Brenner discusses the nature, causes, and consequences of cyber-threats if left unchecked. Brenner also analyzes alternative approaches to the United States’ current cyber-threat control regime, criticizes current proposals for improvements to the current regime, and proposes alternative approaches. As illustrated by these recent cyber-attacks, analysis of these issues is becoming more important to protect sensitive government data as well as private entities from cyber-threats.