Case Study I have attached the instructions for the assignment Florida National University HSA-4421 Legal Aspects and Legislations: Assignment W

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I have attached the instructions for the assignment

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HSA-4421 Legal Aspects and Legislations: Assignment Week 3

Case Study: Chapters 10, 11, 12.

Objective: The students will complete a Case study assignments that give the opportunity to synthesize and apply the thoughts learned in this and previous coursework to examine a real-world scenario. This scenario will illustrate through example the practical importance and implications of various roles and functions of a Health Care Administrator. The investigative trainings will advance students understanding and ability to contemplate critically about the public relations process, and their problem-solving skills. As a result of this assignment, students will be better able to comprehend, scrutinize and assess respectable superiority and performance by all institutional employees.

ASSIGNMENT GUIDELINES (10%):

Students will critically measure the readings from Chapters 10, 11, 12 in your textbook. This assignment is planned to help you examination, evaluation, and apply the readings and strategies to your Health Care organization, and finance.
You need to read the PowerPoint assigned for week 4 and develop a 3-4 page paper reproducing your understanding and capability to apply the readings to your Health Care organization and finance. Each paper must be typewritten with 12-point font and double-spaced with standard margins. Follow APA style 7th edition format when referring to the selected articles and include a reference page.

EACH PAPER SHOULD INCLUDE THE FOLLOWING:

1. Introduction (25%) Provide a brief synopsis of the meaning (not a description) of each Chapter and articles you read, in your own words that will apply to the case study presented.
2. Your Critique (50%): Case Study
Lauren was taken to the hospital ED. Hospital personnel contacted the physician by phone. He returned the call & prescribed a Phenergan injection. He did not go to the hospital & had not been given Lauren’s vital signs when he suggested such an injection, & further failed to order any blood or urine tests. Hospital records revealed that Laurens glucose level was 507 at the time of admission. Lauren’s went into respiratory failure & eventually died. (Futch v. Attwood)
Was the physician liable?
CASE STUDY CHALLENGE

1. Was the physician liable? if so why?
2. Describe the wide variety of negligent errors by various health care professionals.
3. Discuss the purpose of certification, licensure, & reasons for revocation of licenses.?
3. Conclusion (15%)

Briefly summarize your thoughts & conclusion to your critique of the case study and provide a possible outcome for the Health Care Center. How did these articles and Chapters influence your opinions about Legal aspects?
Evaluation will be based on how clearly you respond to the above, in particular:
a) The clarity with which you critique the case study;
b) The depth, scope, and organization of your paper; and,
c) Your conclusions, including a description of the impact of these Case study on any Health Care Setting.

ASSIGNMENT DUE DATE:

The assignment is to be electronically posted in the Assignments Link on Blackboard no later than noon on Sunday, September 20, 2020.

ASSIGNMENT RUBRICS

Assignments Guidelines

1 Points

10%

Introduction

2.5 Points

25%

Your Case Study Critique: Challenges

5 Points

50%

Conclusion

1.5 Points

15%

Total

11 points

100%

ASSIGNMENT GRADING SYSTEM

A

90% – 100%

B+

85% – 89%

B

80% – 84%

C+

75% – 79%

C

70% – 74%

D

60% 69%

F

50% – 59% Or less.

Dr. Gisela Llamas 2

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Library of Congress Cataloging-in-Publication Data
Pozgar, George D.

Legal and ethical essentials of health care administration / George D. Pozgar.2nd ed.

3

mailto:[emailprotected]

http://www.jblearning.com

http://www.jblearning.com

mailto:[emailprotected]

p. ; cm.
Rev. ed. of: Legal essentials of health care administration / George D. Pozgar ; legal review, Nina M. Santucci. c2009.
Related ed. of: Legal aspects of health care administration / George D. Pozgar ; legal review, Nina M. Santucci. 11th

ed. c2012.
Includes bibliographical references and index.
ISBN-13: 978-1-4496-9434-0 (pbk.)
ISBN-10: 1-4496-9434-9 (pbk.)
I. Pozgar, George D. Legal essentials of health care administration. II. Pozgar, George D. Legal aspects of health care

administration. III. Title.
[DNLM: 1. Delivery of Health Carelegislation & jurisprudenceUnited States. 2. Delivery of Health Care

ethicsUnited States. 3. Legislation, MedicalUnited States. W 32.5 AA1]
KF3821
344.7304’1dc23

2013010477

6048

Printed in the United States of America
17 16 15 14 13 10 9 8 7 6 5 4 3 2 1

4

Dedication

Mary Ann Pozgar-Berkebile

My Sister

Precious moments when she took my hand,

And said,

Lets Dance.

At that moment,

I knew from her touch,

How much she loved me.

5

Contents

Epigraph

Preface

About the Book Layout

Acknowledgments

Chapter 1 Government, Law, and Ethics

Learning Objectives

Government Organization

Sources of Law

Government Ethics

Chapter 2 Healthcare Ethics

Learning Objectives

Ethics Overview

Morality

Ethical Theories

Principles of Ethics

Virtues and Values

Spirituality and Religion

Secular Ethics

Situational Ethics

Reasoning and Decision-Making

Summary Thoughts

6

Chapter 3 Reflections on the Past

Learning Objectives

Early Hindu and Egyptian Hospitals

Greek and Roman Hospitals

Hospitals of the Early Christian Era

Islamic Hospitals

Early Military Hospitals

Medieval Hospitals

The Dark Age of Hospitals

Hospitals of the Renaissance

Hospitals of the 18th Century

Early Hospitals in the United States

Late 19th-Century Renaissance

20th-Century Progress

Health Care in the 21st Century

The Challenge Ahead

Chapter 4 Tort Law

Learning Objectives

Negligence

Intentional Torts

Products Liability

Chapter 5 Criminal Aspects of Health Care

Learning Objectives

Criminal Procedure

Healthcare Fraud

Patient Abuse

Criminal Negligence

Murder

Theft

Chapter 6 Contracts

Learning Objectives

What Is a Contract?

Types of Contracts

7

Elements of a Contract

Breach of Contract

Corporate Contracts

Partnerships

Agents

Independent Contractor

Legality of Object

Conditions

Performance

Nonperformance Defenses

Remedies

Employment Contracts

Exclusive Contracts

Noncompetitive Contract Clauses

Transfer Agreements

Insurance Contract

Chapter 7 Civil Procedure and Trial Practice

Learning Objectives

Pleadings

Discovery

Motions

Pretrial Conference

Notice of Trial

Memorandum of Law

The Court

The Jury

Subpoenas

Burden of Proof

Res Ipsa Loquitur

Opening Statements

Examination of Witnesses

Evidence

Defenses Against Plaintiffs Claims

Closing Statements

Judges Charge

Jury Deliberation

8

Awarding Damages

Appeals

Execution of Judgments

Chapter 8 Corporate Structure and Legal Issues

Learning Objectives

Authority of Healthcare Corporations

Corporate Committee Structure

Organizational Ethics

Corporate Negligence

Doctrine of Respondeat Superior

Independent Contractor

Duties of Healthcare Corporations

CEO/Administrator

Medical Staff

Corporate Reorganization

Chapter 9 Medical Staff Organization and Physician Liability

Learning Objectives

Medical Staff Ethics

Medical Staff Organization

Medical Staff Privileges

Common Medical Errors

PhysicianPatient Relationship

Chapter
10 Nursing and the Law

Learning Objectives

Scope of Practice

Nursing Diagnosis

Nurse Licensure

Classification of Nurse Staff

Advance Practice Nurses

Legal Risks of Nurses

Chapter
11 Hospital Departments and Allied Health Professionals

9

Learning Objectives

Professional Ethics

Chiropractor

Emergency Department

Laboratory

Medical Assistant

Nutritional Services

Paramedic

Pharmacy

Physical Therapy

Physician Assistant

Podiatrist

Respiratory Therapist

Certification of Health Professionals

Licensing Health Professionals

Professional Misconduct

Helpful Advice for Caregivers

Chapter
12 Patient Rights and Responsibilities

Learning Objectives

Patient Rights

Patient Responsibilities

Chapter
13 Patient Consent

Learning Objectives

Informed Consent

Information to Be Disclosed

Assessing Decision-Making Capacity

Adequacy of Consent

Verbal Consent

Written Consent

Consent for Routine Procedures

Consent for Specific Procedures

Implied Consent

Statutory Consent

10

Judicial Consent

Who May Consent

Right to Refuse Treatment

Defenses for Failure to Provide Consent

Ethics and Informed Consent

Chapter
14 Procreation and Ethical Dilemmas

Learning Objectives

Abortion

Sterilization

Artificial Insemination

Surrogacy

Wrongful Birth, Life, and Conception

Chapter
15 End-of-Life Issues

Learning Objectives

Patient Autonomy and Case Law

Legislative Response

Preservation of Life with Limits

Euthanasia

Advance Directives

Futility of Treatment

Withholding and Withdrawal of Treatment

Do-Not-Resuscitate Orders

Ethics Committee

Autopsy

Organ Donation

Research, Experimentation, and Clinical Trials

Human Genetics

Stem Cell Research

Chapter
16 AIDS

Learning Objectives

Spread of AIDS

11

Confidentiality

Discrimination

Negligence

Reporting Requirements

AIDS Emergency Act

Occupational Safety and Health Act

AIDS Education

Chapter
17 Legal Reporting Requirements

Learning Objectives

Child Abuse

Elder Abuse and Neglect

Births and Deaths

Communicable Diseases

Adverse Drug Reactions

Hospital-Acquired Infections

Physician Competency

Incident Reporting

Chapter
18 Medical Records

Learning Objectives

Managing Information

Contents of the Medical Record

Ownership and Release of Records

Documentation of Treatment

Retention of Records

Electronic Records

Medical Record Battleground

Legal Importance of Records

Illegible Handwriting

Timely Completion of Records

Confidential and Privileged Communications

HIPAA

ChartingSome Helpful Advice

12

Chapter
19

National Health Insurance and Managed Care

Learning Objectives

National Health Insurance

Managed Care

PPACA and State Law

Chapter
20 Professional Liability Insurance

Learning Objectives

Insurance Policy

Liability of the Professional

Medical Liability Insurance

Self-Insurance

Trustee Coverage

Mandated Medical Staff Insurance Coverage

Investigation and Settlement of Claims

Chapter
21 Labor Relations

Learning Objectives

U.S. Department of Labor

National Labor Relations Act

Norris-LaGuardia Act

Labor-Management Reporting and Disclosure Act

Fair Labor Standards Act

Civil Rights Act

Occupational Safety and Health Act

Rehabilitation Act

Family and Medical Leave Act

State Labor Laws

Labor Rights

Management Rights

Patient Rights During Labor Disputes

Affirmative Action Plan

Injunctions

Administering a Collective Bargaining Agreement

13

Discrimination in the Workplace

Chapter
22 Employment at Will and Discharge

Learning Objectives

Employment at Will

Public Policy Issues

Retaliatory Discharge

Fairness: The Ultimate Test

Termination

Constructive Discharge

Effective Hiring Practices

Clear Communications

Chapter
23 Employee Rights and Responsibilities

Learning Objectives

Employee Rights

Employee Responsibilities

Helpful Advice

Caregivers Pledge

Chapter
24 Tort Reform

Learning Objectives

Arbitration and Mediation

Structured Awards

Pretrial Screening Panels

Collateral Source Rule

Contingency Fee Limitations

Countersuits and Frivolous Claims

Joint and Several Liability

Malpractice Caps

No-Fault System

Regulation of Insurance Practices

Physician Participation in Tort Reform

14

Chapter
25

Culture of Safety

Learning Objectives

Developing a Culture of Safety

Improve Communications

Evaluating Safe Patient Care

CQI Approach to Performance Improvement

Implementation of Best Practices

Risk Management

Failure Mode Effects Analysis

Sentinel Events

Chapter
26 World Wide Search

Learning Objectives

Searching the Web

Legal Websites

Ethics Websites

Government Websites

Best Practices

Hospital and Physician Finders

International Medical Websites

Chapter
27 Journey to Excellence

Learning Objectives

Ideas for Getting Started

Adopt a Hospital

Funding Your Dreams

Baldrige Performance Excellence Program

Glossary

Case Index

Subject Index

15

Epigraph

In civilized life, law floats in a sea of ethics.
EARL WARREN, CHIEF JUSTICE OF THE UNITED STATES (18911974)

I consider ethics, as well as religion, as supplements to law in the government of man.
THOMAS JEFFERSON, PRESIDENT OF THE UNITED STATES (17431826)

In law a man is guilty when he violates the rights of others. In ethics he is guilty if he only
thinks of doing so.

IMMANUEL KANT, PHILOSOPHER (17241804)

It is curiouscurious that physical courage should be so common in the world, and moral
courage so rare.

MARK TWAIN, AMERICAN AUTHOR AND HUMORIST (18351910)

16

Preface

He has achieved success who has lived well, laughed often and loved much; who has gained
the respect of intelligent men and the love of little children; who has filled his niche and
accomplished his task; who has left the world better than he found it, whether by an improved
poppy, a perfect poem, or a rescued soul; who has never lacked appreciation of earths beauty or
failed to express it; who has always looked for the best in others and given them the best he had;
whose life was an inspiration; whose memory a benediction.

BESSIE STANLEY

Legal and Ethical Essentials of Health Care Administration, Second Edition has become more
than an abridged version of Legal Aspects of Health Care Administration, Eleventh Edition.
The content has been updated and fully expanded to bring excitement into the learning
process. This Second Edition delivers to the reader a comprehensive updated review of both
health law and ethics. The substantive material in the Second Edition has been carefully
selected based on the common legal and ethical issues the practitioner will face during his
or her career. Although this book is mandatory reading for many students enrolled in
health management and patient care courses, it is particularly valuable as a supplemental
reading in the curricula of many healthcare programs. The Second Edition is also an
invaluable desk reference for those in managerial positions and professionals providing
direct patient care.

The authors unique experience in health care includes consulting and surveying more
than 1,000 hospitals and ambulatory sites from Alaska to Puerto Rico, as well as his
experience as administrator, educator, consultant, and speaker. Every attempt has been
made to arm the student with the knowledge gained through his extensive healthcare
experiences.

As a result of his background, one of the unique features of this book is that in each
chapter the focus on the various issues includes more than merely definitions or
descriptions of words. There is an infusion of life into the material by using cases that have
been litigated or discussed in the press, as well as real-world events through reality checks
experienced by healthcare professionals. In that way, the law and ethics spring to life and
inspire dynamic discussion and excitement in the learning process, thus creating an

17

atmosphere of interest and participation, which is conducive to learning.
The study of Legal and Ethical Essentials of Health Care Administration, Second Edition

affords health professionals with the opportunity to apply the concepts learned to what they
will face on a daily basis in a practical way. It details the actions healthcare providers can
take to help prevent the wide variety of harmful events that occur in patient care settings.
Although there will always be a next time for human error, the reader who synthetizes the
contents in this book and understands its lessons will better understand how failures can
turn to success and the pain of past mistakes can turn to hope.

18

About the Book
Layout

Legal and Ethical Essentials of Health Care Administration, Second Edition lays a strong
foundation in both health law and ethics. Chapter 1 begins with an introduction to
government organization, sources of law, and government ethics and Chapter 2 progresses
to a discussion of ethical theories, principles, virtues and values, and related topics. Chapter
3 provides an overview of the historical development of hospitals as influenced by medical
progress, allowing the reader to look at their successes and failures through the centuries,
and then drawing conclusions about what can be done to avoid repeating the failures of the
past. In Chapter 4, the reader is introduced to negligent and intentional torts, progressing
to criminal acts in Chapter 5, and contract law in Chapter 6 as they relate to health care.
The reader is then introduced to civil procedure and trial practice in Chapter 7. The
journey continues with a discussion of legal issues involving corporations in Chapter 8,
medical staff organization and physician liability in Chapter 9, nursing and the law in
Chapter 10, and a discussion of various hospital departments and allied health professionals
in Chapter 11.

The first 11 chapters provide a solid basis for a more complete understanding of the
following remaining chapters: Chapter 12 provides an overview of patient rights and
responsibilities; Chapter 13 patient consent; Chapter 14 procreation and ethical issues;
Chapter 15 end-of-life issues; Chapter 16 AIDS; Chapter 17 legal reporting requirements;
Chapter 18 medical records; Chapter 19 national health insurance and managed care;
Chapter 20 professional liability insurance; Chapter 21 labor relations; Chapter 22
employment at will and discharge; Chapter 23 employee rights and responsibilities;
Chapter 24 tort reform; Chapter 25 culture of safety; Chapter 26 world wide search;
Chapter 27 the journey to excellence; and a glossary of common legal and ethics
vocabulary.

The practical application of ethics in the healthcare setting is accomplished by
interspersing the thoughts of great minds through Quotes, applicable Newspaper Clippings,
provider and organizational experiences through Reality Checks designated by a symbol,
and patient experiences through legal rulings and summaries through Case Law. When
reviewing the various cases in this book, the reader should consider both the ethical and

19

legal implications of a dilemma and how they intertwine with one another. It is important
to recognize that the decisions in the cases described are generally governed both by
applicable state and federal statutes and common-law principles. When reviewing a case,
the reader must keep in mind that the case law and statutes of one state are not binding in
another state.

There is no one magic legal or ethics book that can possibly compress the plethora of
issues that have bombarded the healthcare industry into one book. This book is merely a
beginning of the study of legal and ethical issues and is an adventure that all caregivers
should take. Although there is always much more that could be discussed on any one topic,
the good student will understand that this book provides a solid foundation for practical
everyday use as well as further study.

Each life is like a novel. Filled with moments of happiness, sadness, crisis, defeat, and
triumph. When the last page has been written, will you be happy or saddened by what you
read?

AUTHOR UNKNOWN

The reader is presented in the Second Edition with real-world life experiences that bring
the reader through a journey of learning that provides an effective transitional stage from
the classroom to the reality of the everyday work environment.

When people consider matters of law and ethics they are usually considering matters of
freedom in regard to personal choices, ones obligations to other sentient beings, or
judgments about human character and the right to choose. The authors objective is to
equip the reader with the background knowledge necessary to understand that legal and
ethical behavior begins with understanding that we have alternatives and choices in our
behavior. To make good decisions, we must first understand that they will be only as good
as our knowledge of what is right and what is wrong. This book is not an indictment of any
profession or organization. There is a deluge of ethical issues in every aspect of human
existence. Although cultural differences, politics, and religion influence who we are, it is all
of lifes experiences that affect who we will become. If we are compassionate it is most likely
compassionate people have influenced us.

Authors Note: This book is not a definitive treatise but is a portrait of the ever-
evolving story of health care through the study of law and ethics. It is educational in
nature and should not be considered a substitute for legal advice on any particular
issue. Moreover, each chapter presents an overview, rather than an exhaustive
treatment, of the various topics discussed.

The author, legal reviewers, and/or publisher cannot be responsible for any errors
or omissions, including: additions to, interpretations of, and/or changes in the
regulations presented in this book.

20

Acknowledgments

The author especially acknowledges the staff at Jones & Bartlett Learning whose guidance
and assistance was so important in making this Second Edition a reality. Special thanks to
Mike Brown, Publisher at Jones & Bartlett Learning, who has once again been truly an
amazing leader and mentor over the years. I would like to thank Chloe Falivene, Editorial
Assistant, who worked diligently and tirelessly with me on this Second Edition. I would also
like to thank the other Jones & Bartlett staff, including Rebekah Linga, Associate
Production Editor; Sean Fabery, Editorial Assistant; and Sophie Teague, Senior Marketing
Manager; who have also worked with me on this Second Edition. Thanks for allowing me to
leave behind this legacy of writing.

I am grateful to the very special people in the more than 1,000 hospitals and
ambulatory sites from Alaska to Puerto Rico with whom I have consulted, surveyed, and
provided education over many years. Their shared experiences have served to remind me of
the importance to make this book more valuable in the classroom and as a reference for
practicing healthcare professionals.

To my students in healthcare law and ethics classes at the New School for Social
Research, Molloy College, Long Island UniversityC.W. Post Campus, Saint Francis
College, and Saint Josephs College; my intern from Brown University; my resident in
hospital administration from The George Washington University; and those I have
instructed through the years at various seminars, I will always be indebted for your
inspiration.

Many thanks are also extended to all those special people at the National Library of
Medicine and the Library of Congress for their guidance over the years in locating research
materials.

21

1
Government, Law,
and Ethics

As the patriots of seventy-six did to the support of the Declaration of Independence, so to the
support of the Constitution and Laws, let every American pledge his life, his property, and his
sacred honorlet every man remember that to violate the law, is to trample on the blood of his
father, and to tear the character of his own, and his childrens liberty. Let reverence for the laws,
be breathed by every American mother, to the lisping babe, that prattles on her laplet it be
taught in schools, in seminaries, and in colleges; let it be written in Primers, spelling books, and
in Almanacslet it be preached from the pulpit, proclaimed in legislative halls, and enforced in
courts of justice. And, in short, let it become the political religion of the nation; and let the old
and the young, the rich and the poor, the grave and the gay, of all sexes and tongues, and colors
and conditions, sacrifice unceasingly upon its altars.

ABRAHAM LINCOLN

Figure 11 United States Constitution James Steidl/ShutterStock, Inc.

22

Learning Objectives

The reader upon completion of this chapter will be able to:

Discuss the three branches of government, and the importance of separation of powers.
Describe the organization structure of the Department of Health and Human Services.
Explain the development of case law and how it differs from statutory and

administrative law.
Describe the function of various government ethics committees herein presented.

This chapter introduces the reader to the purpose and sources of law, the functioning of the
legal system, and the roles of the three branches of government in creating, administering,
and enforcing the law. There is also a brief overview of the Department of Health and
Human Services and selected agencies within the department.

GOVERNMENT ORGANIZATION

The three branches of the federal government are the legislative, executive, and judicial
branches (Figure 12). A vital concept in the constitutional framework of government on
both federal and state levels is the separation of powers. Essentially, this principle provides
that no one branch of government is clearly dominant over the other two; however, in the
exercise of its functions, each can affect and limit the activities, functions, and powers of
the others.

Executive Branch

The primary function of the executive branch of government on the federal and state level is
to administer and enforce the law. The chief executive, either the president of the United
States or the governor of a state, also has a role in the creation of law through the power to
approve or veto legislative proposals.

The president serves as the administrative head of the executive branch of the federal
government. The executive branch includes 15 executive departments, as well as a variety of
agencies, both temporary and permanent. Each department is responsible for a different
area of public affairs, and each enforces the law within its area of responsibility.

On a state level, the governor serves as the chief executive officer. The responsibilities of
a governor are provided for in the states constitution. The Massachusetts State
Constitution, for example, describes the responsibilities of the governor as presenting an
annual budget to the state legislature, recommending new legislation, vetoing legislation,
appointing and removing department heads, appointing judicial officers, and acting as
Commander-in-Chief of the states military forces (the Massachusetts National Guard).

Legislative Branch

23

On the federal level, legislative powers are vested in the Congress of the United States, which
consists of the Senate and the House of Representatives. The function of the legislative branch
is to enact laws that can amend or repeal existing legislation and to create new legislation.
The legislature determines the nature and extent of the need for new laws and for changes
in existing laws. Committees of both houses of Congress are responsible for preparing
federal legislation.

Judicial Branch

As I have said in the past, when government bureaus and agencies go awry, which are
adjuncts of the legislative or executive branches, the people flee to the third branch, their courts,
for solace and justice.1

JUSTICE J. HENDERSON,
SUPREME COURT OF SOUTH DAKOTA

The function of the judicial branch of government is adjudicationresolving disputes in
accordance with law. As a practical matter, most disputes or controversies that are covered
by legal principles or rules are resolved without resort to the courts.

Scarcely any political question arises in the United States that is not resolved, sooner or
later, into a judicial question.

ALEXIS DE TOCQUEVILLE (18051859)

The decision as to which court has jurisdictionthe legal right to hear and rule on a
particular caseis determined by such matters as the locality in which each party to a
lawsuit resides and the issues of a lawsuit. Each state in the United States provides its own
court system, which is created by the states constitution and statutes. Most of the nations
judicial business is reviewed and acted on in state courts. Each state maintains a level of trial
courts that have original jurisdiction, meaning the authority of a court to first conduct a
trial on a specific case as distinguished from a court with appellate jurisdiction, where
appeals from trial judgments are held. This jurisdiction can exclude cases involving claims
with damages less than a specified minimum, probate matters (i.e., wills and estates), and
workers compensation. Different states have designated different names for trial courts
(e.g., superior, district, circuit, or supreme courts). Also on the trial court level are minor
courts such as city, small claims, and justice of the peace courts.

Each state has at least one appellate court. Many states have an intermediate appellate
court between the trial courts and the court of last resort. Where this intermediate court is
present, there is a provision for appeal to it, with further review in all but select cases.
Because of this format, the highest appellate tribunal is seen as the final arbiter for the
particular states system of jurisprudence.

The trial court of the federal system is the U.S. District Court. There are 94 district
courts in the 50 states (the larger states have more than one district court) and one in the
District of Columbia. The Commonwealth of Puerto Rico also has a district court with
jurisdi

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