A note on where this comes from: Over 30 years of trying personal injury cases, I have handled some of the most complex medical malpractice litigation in Oregon. These cases are expensive, technically demanding, and emotionally grueling for families who have already been through something devastating. What I describe below is what serious representation actually requires, not what the brochure says.
Medical malpractice is the hardest category of personal injury litigation. Winning requires rigorous case screening, early investment in expert review, and the capacity to sustain a multi-year fight against well-resourced defense teams. Our goal at VWSH is to rapidly build the strongest winnable case and then present it with enough force to compel a fair result.
Case Selection: Why We Are Selective About What We Take
Medical malpractice cases are expensive to prosecute. Depending on complexity, out-of-pocket costs for experts, records review, depositions, and litigation preparation typically run between $50,000 and $500,000. These costs are borne by the firm, not the client, and are recovered only if we win.
Given that structure, we prioritize cases involving significant permanent injury or death. VWSH generally does not take medical malpractice cases valued under $3 million. That is not an arbitrary threshold. It reflects the economics of bringing a case that can withstand what the defense will spend to defeat it.
Being selective is not about turning people away. It is about being honest, and about bringing only the cases where we can win.
Proving the Four Elements: Duty, Dereliction, Direct Cause, and Damages
Every medical malpractice claim must establish four things:
- Duty. The provider owed you a duty of care, which exists whenever a formal physician-patient relationship has been established.
- Dereliction (Breach). The provider deviated from the accepted standard of care. This is the critical question, and it almost always requires expert testimony from a qualified physician in the same specialty.
- Direct Cause. The breach directly caused your injury. It is not enough that care was substandard. The deviation must be what produced the harm. Causation is often the hardest element to prove, particularly in cases involving pre-existing conditions.
- Damages. You suffered measurable harm, including physical injury, lost wages, medical costs, and pain and suffering. Cases without significant quantifiable damages rarely justify the cost of prosecution.
Why Early Expert Engagement Is Non-Negotiable
The standard of care determination cannot be made without a medical expert who practices in the relevant specialty. We engage our expert network early, before we file a case. Early review serves two purposes: it tells us whether a breach occurred, and it allows the expert to begin building the opinion that will carry the case at trial.
We spend thousands of dollars on expert review before ever filing an action. This is not unusual. It is the cost of building a case that can actually win.
Investigation: Records, Witnesses, and Discovery
Strong medical malpractice cases are built on comprehensive investigation. That means collecting every record from every provider, including the full treatment history leading up to the incident and all subsequent care. It means interviewing medical professionals, including the treating team, when possible. It means locating witnesses who have direct knowledge of what happened and what the standard of care required.
We use informal early discovery to develop our case theory before filing. After filing, formal discovery requests for production fill in gaps and lock in the other side’s position. Both phases require time and discipline.
Timeline: These Cases Take Two to Four Years
Medical malpractice cases in Oregon routinely take two to four years from filing to resolution. Expert schedules, complex discovery, and court calendars all contribute to that timeline. We are honest about it with every client from the first conversation.
Our goal is to reduce that timeline where possible by building the case efficiently and moving aggressively toward trial when the evidence supports it. A prepared, well-resourced team that shows it is ready to go to trial creates settlement pressure. A case that drags because the plaintiffs side is unprepared does not.
Communication Throughout
Medical malpractice clients are often families navigating grief alongside litigation. We keep communication lines open throughout the case with regular updates on strategy and timeline. You will never wonder where your case stands. Our job is to simplify the complex and give you a clear picture of what we are doing and why.
Do you have a medical malpractice case?
Free consultation. No obligation. We will tell you honestly whether we think you have a viable case and what it would take to pursue it. No fee unless we win.
Partner · Vames Wang Sosa Hood
Drake Hood is a partner at Vames Wang Sosa Hood with over 30 years of trial experience in complex personal injury and medical malpractice litigation. He is consistently recognized among Oregon’s top trial attorneys and has obtained multi-million dollar results for seriously injured clients throughout the Pacific Northwest.
View full profileThis article is for informational purposes only and does not constitute legal advice. Oregon law is subject to change. Statutory references are current as of the date of publication. Contact Vames Wang Sosa Hood for legal counsel specific to your situation.