The Los Angeles County Medical Association co-sponsored a mock trial put on by the USC Keck School of Medicine and the USC Gould School of Law as part of a curriculum intended to impress upon medical students the importance and application of ethics and the law in medical practice.

Conducted Feb. 9 at the California Superior Court of Los Angeles County in downtown Los Angeles by the Pacific Center for Health Policy and Ethics, a joint effort by the Keck and Gould schools, the mock trial was the first to be staged in an actual courtroom. Fourth-year medical students made up the vast majority of the approximately 200 people packing the courtroom's audience and mock jury for the event. "We regard it as essential that medical students today get an education across the full range of medical, social and legal issues, and not simply equate medical malpractice with the universe of what's relevant," says Alexander Capron, professor of law and medicine at the Gould school.

The event was a short re-enactment of a fairly typical medical malpractice case known as Kelly Brown v. Rick Smith, DO. In the trial, Kelly Brown sued Dr. Smith for wrongful death of her husband, Guy Brown, who died in 2002 from pneumonia after four visits to Dr. Smith's office. The trial was mock-adjudicated by Hon. Judith Chirlin, the judge who presided over the actual trial in January 2007.

The trial's central issue is "whether it was appropriate to manage this kind of patient and his pneumonia in a hospital or not," says Capron. Following two routine visits to Dr. Smith, Guy Brown returned complaining of a bowel obstruction, vomiting, coughing and shortness of breath. On the next visit, he showed signs of pneumonia and received an antibiotic injection. On his last visit, Brown's bowel obstruction was clearing up, but he showed signs of sepsis and hypoxia. Brown died four days later in the hospital.

Kelly Brown argued that Dr. Smith should have sent her husband to the emergency room on his last visit, basing her complaint around several key points. First, Dr. Smith claimed that the infection had been a virulent organism, which was impossible to know, since the antibiotic injection prevented an identifying bacterial culture. Next, Dr. Smith told Guy Brown to go to the hospital after his fourth visit if he felt nauseous, but did not say to go because of respiratory or other symptoms. When Dr. Smith sent Brown home that day, he did so based on improving clinical symptoms, as is common procedure, and he did not take an X-ray. Last, Kelly Brown alleged--and Dr. Smith denied--that when she told Dr. Smith of her husband's death, he replied, "It was a bad judgment call."

Many other facts and perceptions influenced the mock trial's outcome, but ultimately the jury of medical students decided that Dr. Smith had properly practiced medicine, and had not caused Brown's death.