Sam's family knows that you are taking a legal course at TWU and has asked your advice on the merits of a lawsuit against Dr. Dumpo. What are their options? What defenses will Dr. Dumpo raise if suit is filed? Please provide the family with a memo detailing the above as well as your assessment of their chances of success.

Sam had chronic obstructive pulmonary disease and his doctor, Dr. Dumpo, recommended treatment with the Intermittent Positive Pressure Breathing ventilator (IPPB). Sam had severe side effects from the treatment and died. Dr. Dumpo used the IPPB ventilator properly, but an alternative device, the nebulizer, is cheaper and safer that IPPB for all IPPB used. Despite this, IPPB is still reimbursed by most third party payers and continues to be used by some physicians in the hospital setting for obstructive pulmonary disease.

Your research uncovers the following information about IPPB. Intermittent Positive Pressure Breathing is a technology that diffuses into use in spite of evidence that it did not work. Research studies have confirmed that it is no better than the cheaper and less dangerous nebulizer. While its use has declined, it has not disappeared and reimbursement is still available for its use from Medicare and private insurers. Doctors continue to use such technology in the face of clear evidence and authoritative declarations that it is both ineffective and dangerous. The reasons may include habit; clinical impressions that it gives patients short-term relief; and financial benefits to physicians. The medical director of the respiratory therapy department, the primary source of service orders, often receives a cut of the department's income. As long as third party payors still pay for IPPB, cash will flow for its use.