Hampton Roads – Virginia

The name “Hampton Roads” originated nearly four hundred years ago when Virginia was a British Colony. Hampton Roads refers to both a body of water and the region of land bordered by the Elizabeth and James Rivers, the Western edge of the Chesapeake Bay and the Waterfronts of Virginia Beach and Sandbridge.

The waterways of Hampton Roads create one of the world’s biggest natural harbors. The area is occupied by the United States Navy, Coast Guard, Air Force, NASA, Marines, and Army facilities, shipyards, coal piers, and hundreds of miles of waterfront property and beaches, all of which contribute to the diversity and stability of the region’s economy.

Hampton Roads is populated by seven cities and a host of smaller communities. The seven cities are Norfolk, Portsmouth, Newport News, Chesapeake, Hampton, Virginia Beach and Suffolk. The region is an extremely popular vacation and tourism destination and is within a few hours of Richmond, Williamsburg, Washington D.C., Southern Maryland and Northern Virginia.

Norfolk

Norfolk consists of a mixture of the old and new architecture. Much of the the waterside area has undergone renovations with modern shopping and dining locales but the area still retains many of the older buildings which lend character and historical significance to the neighborhood. Visitors are taken aback by the centuries old churches which occupy the downtown area. Norfolk’s waterside is striking, with its population of banking centers, luxury hotels, fine dining, museums and parks.

Portsmouth

Portsmouth is a community along the Elizabeth River. Portsmouth is closely connected with Norfolk, both physically and in spirit. It’s tunnel is known for traffic backups although local residents take a variety of paths around rush hour traffic. The city is a mix of shopping, museums, historical buildings, industrial complexes and residential neighborhoods. Portsmouth has a waterside park which is extremely popular among residents.

Newport News

Newport News is one of the independent cities of Hampton Roads, Virginia. It lies along the James River waterfront to the river’s mouth at Newport News Point. Newport News contains the U.S. Army base at Fort Eustis and other military bases and suppliers. Fort Eustis, and other military installations have a huge impact on the city’s economy. The harbor and miles of waterfront attract the shipping and boating industries. Another asset of the city is Newport News Seafood Industrial Park, off interstate 664. The harbor is said to be one of the busiest small ports in the East Coast.

Chesapeake

Chesapeake is a another city in Southern Hampton Roads. The community is a mix of urban areas, forests and wetlands, including a substantial portion of the Great Dismal Swamp. Chesapeake is the third largest city in Virginia in terms of population. Chesapeake is bordered by Portsmouth, Suffolk and Virginia Beach.

Hampton

Hampton, one of the oldest cities in the USA, lies between Norfolk and Newport News. Hampton is home to Fort Monroe, Langley Air Force Base, NASA Langley Research Center, the Virginia Air and Space Center, and a host of other business and industrial complexes. The city also contains residential areas, historical sites, and waterfront access.

Virginia Beach

Virginia Beach is the largest city in the state of Virginia. Thousands of tourists visit every year on vacation, attracted by miles of hotels, top-notch restaurants and shops. Virginia Beach is known for its mild seaside weather. With over 200 sunny days a year, bikinis, flip flops and shorts are worn for much of the spring, summer and fall. Virginia Beach tourists visit the resort in summer to swim and sunbath, but the city has become a year round attraction with world class fishing, boating, festivals, shows and other events.

Suffolk

Suffolk is located in the heart of southeastern Virginia. The area offers family attractions, accommodations, shopping, arts and recreational activities. Suffolk hosts a range of events and festivals including the Suffolk Peanut Festival, Nansemond Indian Tribal Pow Wow, Taste of Suffolk Downtown Street Festival, Great Dismal Birding Festival and others. The area around Suffolk is known for peanut production. Planters’ Peanuts was established in Suffolk beginning in 1912 and peanut processing remains a major industry for the city.

A Tourist Guide to North Carolina’s Outer Banks

1. Introduction

Remote and removed, the thin band of interconnected barrier islands that stretch some 130 miles along the coast of North Carolina and form the Outer Banks seem more a part of the Atlantic than the continent to which they are appendaged by causeways, bridges, and ferries. Islands in and of sand, whose dunes ebb and flow with the sometimes wicked winds like bobbing boats, they serve as the threshold to North America-or the end of it-depending upon the direction of travel.

Defined by land, or the lack of it, a trip here can entail sailing, fishing, kayaking, water skiing, parasailing, hang gliding, kite surfing, dune climbing, dolphin watching, and sand surfing. More than anything, however, it is about firsts-the first English colonists to leave footprints in the sand, the first aviators to leave tracks in the sand as they conquered flight, and the sea and dunes and wind which made both possible.

2. From Mountains to Shores

Although these flat, marshy islands and splotches of the Outer Banks could not be more opposed to the towering Appalachian Mountains that rise in the west, it is from these peaks that they emanated, becoming the third rendition of them.

Rivers, which are collections of rainwater, flowed eastward from them, sharply dropping from the edge of the second, or lower, topographical feature, the Piedmont. Off shore currents, then acting upon and molding, like clay, their sediment, itself carried from this mountainous origin 25,000 years ago, having created the barrier islands and their water thresholding beaches.

Because currents are anything but static, their never-resting forces continue to reshape and reposition these island masterpieces, as they are subjected to the constantly remolding hands of the wind and the water. This dynamic phenomenon is the very key to their protective nature as they shield the more permanent mainland and, like shock absorbers, they often field the first brunt of hurricanes and other severe weather systems.

Both created and defined by nature’s forces, these sounds form the second largest estaurine system in the US after the Chesapeake Bay, covering almost 3,000 square miles and draining 30,000 square miles of water.

“A thin, broken strand of islands,” according to the National Park Service, “curves out into the Atlantic Ocean and back again in a sheltering embrace of North Carolina’s mainland coast and offshore islands.”

3. Access and Orientation

The Outer Banks consist of Northern Beaches, with towns such as Kitty Hawk, Kill Devil Hills, and Nags Head; Roanoke Island; and Cape Hatteras National Seashore, itself comprised of Bodie, Hatteras, and Ocracoke islands.

Scheduled airline service is provided to Norfolk and Raleigh-Durham International airports located, respectively, in Virginia and North Carolina, while charter fights operate to Dare County Regional Airport on Roanoke Island. Private aircraft serve First Flight Airstrip in Kill Devil Hills and Billy Mitchell Airport on Hatteras Island.

By road, the Outer Banks are served by US 158 and the Wright Memorial Bridge from the north and US 64 via the 5.2-mile-long Virginia Dare Memorial Bridge, Roanoke Island, the Nags Head-Manteo Causeway, and the Washington Baum Bridge from the west. As from the north, the route leads to the four-lane US 158 artery and traverses the 16.5-mile island, accessing shops, outlets, restaurants, and attractions. The narrower, two-lane NC 12-which is also known as the “Beach Road”-serves residential communities, hotels, and restaurants, often with views of the Atlantic. The same road threads its way down Hatteras Island and, after a complementary ferry ride, Ocracoke Island.

4. Kitty Hawk

Despite consensus belief and aviation history books to the contrary, Kitty Hawk did not serve as the site of the world’s first successful flight, although the Wright Brothers stayed in the village. Instead, that historic event occurred about four miles south of it, in Kill Devil Hills. Nevertheless, there is still an aeronautics-related attraction next to the Aycock Brown Welcome Center, which itself offers brochures and trip planning information about area sights, restaurants, entertainment, shops, and hotels.

Designated Monument to a Century of Flight, it was created by Icarus International and dedicated on November 8, 2003 on the centennial of powered flight to celebrate the history, beauty, and mysteries of flight and soaring of the human spirit. Set against the open sky of Kitty Hawk to create a contemplative environment, the monument itself consists of 14 wing-shaped, stainless steel pylons rising from ten to 20 feet in a 120-foot orbit to reflect the distance of the Wright Brothers’ first flight on December 17, 1903 and to represent man’s climb to the sky and space.

“Humankind is a continuum of pioneers,” according to the monument, “sharing timeless dreams and the boundless possibilities of vast unexplored worlds.”

Black granite panels are engraved with 100 of the most significant aviation achievements of the past century and a center, six-foot-diameter dome depicts earth’s continents and is inscribed with the words, “When Orville Wright lifted from the sands of Kitty Hawk at 10:35 a.m. on the morning of December 17, 1903, we were on our way to the moon and beyond.”

5. Kill Devil Hills

Kill Devil Hills is, of course, the site of the world’s first powered, controlled, and sustained flight and the Wright Brothers National Memorial, visible from US 158, pays tribute to it.

Although the Wrights were raised in Dayton, Ohio, they conducted all their early unpowered (glider) and powered (airplane) flight experiments in North Carolina because it offered lofty dunes for foot launches, high winds to generate lift with minimal ground speed, soft sand for wheelless, minimal-damage landings, and isolation from press and spectators.

According to the Visitor Center’s museum-which sports exhibits, 1902 glider and 1903 Wright Flyer reproductions, National Park Service talks and programs, and a book/gift shop-the brothers were inspired by and based their designs upon aerodynamic principles laid down by four earlier pioneers: Sir George Cayley (1773-1857), who established the very foundation of aerodynamics; Alphonse Penaud (1850-1880), who built a rubber band-powered planophone model and flew it 131 feet; Otto Lilienthal (1848-1896), who conducted extensive glider experiments; and Octave Chanute (1832-1910), who became a virtual clearing house for all aviation-related developments and published them in a book entitled “Progress in Flying Machines.” The Wright Brothers’ biplane glider, in fact, was a virtual copy of his own.

According to the museum, the memorial is the birthplace of aviation. “Here, on December 17, 1903, Wilbur and Orville Wright made the first successful, power-driven flight in world history,” it claims. “The Wrights believed that flight by man was possible and could be achieved through systematic study.”

That systematic approach, coupled with their intuitive mechanical ability and analytical intelligence, enabled them to understand that lift opposed weight and that thrust opposed drag, but, more importantly, that flight could only be conquered by controlling its three lateral, longitudinal, and vertical axes. This lack of understanding had caused all previous experimenters to fail.

Devising control surfaces to tame them and thus maintain an aircraft’s stability, they were able to morph their unpowered gliders, subjected to hundreds of foot launches from nearby Kill Devil Hill, into the successful Wright Flyer.

Two reconstructed buildings represent the Wright Brothers’ 1903 camp, that to the left a hangar and that to the right their workshop and living quarters with a stove, a crude kitchen, a pantry, a table, and a ladder to access the burlap slings hung from the rafters that served as their bunks.

The commemorative granite boulder marks the take off point of the four successful flights on December 17, 1903 and the markers positioned on the field indicate each one’s distance and the amount of aerial time required to reach them.

Taking control of the Wright Flyer while Wilbur served as his “ground crew” and stabilized its wings, Orville divorced himself from the take off track at 10:35 a.m. that historic day, covering 120 feet in 12 seconds, while Wilbur himself, piloting the next attempt, covered 175 feet in the same amount of time. The penultimate fight flew 200 feet in 15 seconds and the final, and longest, one traversed 852 feet in 59 seconds, after which damage to the aircraft, along with end-of-the-season weather severities, precluded further testing and the brothers returned to Ohio.

According to the boulder erected by the National Aeronautics Association of the USA on December 17, 1928 to commemorate the 25th anniversary of the event, “The first successful flight of an airplane was made from this spot by Orville Wright, December 17, 1903, in a machine designed and built by Wilbur Wright and Orville Wright.”

The former sea of sands and dunes stretching out from the first flight boulder, still acted upon by the wind as much as the Wright’s gliders and powered designs had been, was now replaced with a sloping green field, but the aerodynamic forces invisibly brushing the delicate tips of its grass still caused them to sway, in memory, perhaps, of this event more than a century later.

The distance from the take off point, marked by the launching track, to the fourth and furthest marker, requires a brisk walk using the feet with which man has been endowed, but in 1903, it was covered with the wings with which birds had been endowed. The Wrights thus successfully crossbred the human and animal species, manifested as a machine.

The 60-foot monument, mounted on top of the 90-foot, now grass-covered Kill Devil Hill sand dune across from First Flight Airport with its 3,000-foot runway, marks the starting point of the Wright’s hundreds of unpowered glider flights.

“… the sand fairly blinds us,” they wrote at the time. “It blows across the ground in clouds. We certainly can’t complain of the place. We came down here for wind and sand, and we got them.”

A full-size stainless steel sculpture of the Wright Flyer, located on the far side of the hill at its base and weighing far more than the original airplane at 10,000 pounds, depicts the historic first flight with photographer John Daniels, from the local lifesaving station, about to snap the only picture ever taken of it.

The Centennial Pavilion, across the parking lot from the combined Visitor Center, museum, and flight room, offers films and aviation and Outer Banks exhibits.

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Virginia Peninsula Foreclosures on the Rise

Are Foreclosures Peaking in Virginia?

While foreclosures in the United States look to be taking a positive turn, it’s a different story in areas of the Virginia Peninsula. Virginia foreclosures have been on the rise, having a major economic impact on those who can’t afford to finance their homes. As the housing marking continues its downturn, the Virginia area may be one of the best places to seek a foreclosure property.

Lately there’s been much talk of Virginia foreclosure auctions with little to no attendance whatsoever. The prices for these auctioned homes are obscenely low, and despite the hook of a good deal, nobody’s biting. When nobody bids, the auctioned home goes back to the bank and assumes the status of an REO foreclosure. Such instances of ill-attended auctions are happening nationwide, with areas such as Virginia currently suffering harshly. Analysts predict that things are only going to get worth as trends show that Virginia will have to weather this storm in the coming months. As far as geography goes, Hampton, Virginia foreclosure numbers were especially high, over 100% of what they had been a year prior.

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Another Bank Failure – How Many More on the Horizon

Yet Another Bank Failure This Week. You probably did not hear that there was yet another bank failure this week.
The Fed closed down Ameribank a 102-year-old West Virginia bank on Friday. Ameribank, founded in January 1906 and had $102 million in deposits and assets of $115 million as of June 30 of this year. What is interesting that in 1999 Ameribank assumed $135 million of one of the largest bank failures of the 1990s, First National Bank of Keystone. The Feds sold all deposits to two other banks Pioneer Community Bank Inc. of Laeger, W.V. and The Citizens Savings Bank of Martins Ferry, Ohio. Both banks also will purchase about $23 million in Ameribank assets. The banks branches will reopen next week under their new guidance..

The closure of Ameribank Inc. was the 12th U.S. bank failure yet this year,. This is another example of the nation’s worst banking crisis in recent times. It is estimated that the cost to the FDIC’s deposit-insurance fund is $42 million The FDIC last month raised to 117 the number of banks it has identified that are in danger of failing, the largest number since mid-2003 and up from 90 at the end of the first quarter. Even though one might say this was a small amount.

Multiply this small amount times 117!

As well it is easy to assume that some of these 117 banks might cost the Fed more than $42 million dollars.

All one has to take into account the largest failure of the year so far is Pasadena, Calif.-based IndyMac Bank, taken down by regulators July 11 cost the Fed (Us) approx $10 billion dollars.

You do the math. How many more banks will be failing?

How safe is your money

Andrew Abraham

My Investors Place

Another Bank Failure

Yet Another Bank Failure This Week. You probably did not hear that there was yet another bank failure this week.
The Fed closed down Ameribank a 102-year-old West Virginia bank on Friday. Ameribank, founded in January 1906 and had $102 million in deposits and assets of $115 million as of June 30 of this year. What is interesting that in 1999 Ameribank assumed $135 million of one of the largest bank failures of the 1990s, First National Bank of Keystone. The Feds sold all deposits to two other banks Pioneer Community Bank Inc. of Laeger, W.V. and The Citizens Savings Bank of Martins Ferry, Ohio. Both banks also will purchase about $23 million in Ameribank assets. The banks branches will reopen next week under their new guidance..

The closure of Ameribank Inc. was the 12th U.S. bank failure yet this year,. This is another example of the nation’s worst banking crisis in recent times. It is estimated that the cost to the FDIC’s deposit-insurance fund is $42 million The FDIC last month raised to 117 the number of banks it has identified that are in danger of failing, the largest number since mid-2003 and up from 90 at the end of the first quarter. Even though one might say this was a small amount.

Multiply this small amount times 117!

As well it is easy to assume that some of these 117 banks might cost the Fed more than $42 million dollars.

All one has to take into account the largest failure of the year so far is Pasadena, Calif.-based IndyMac Bank, taken down by regulators July 11 cost the Fed (Us) approx $10 billion dollars.
You do the math. How many more banks will be failing?
How safe is your money?
Andrew Abraham
My Investors Place
Andrew has been in the financial arena since 1990. He is a Registered Investment Advisor ad affiliate of Abraham Bedick Capital. Since 1993 Andrew has been a proponent of quantitative mechanical trading programs. Andrew’s major concern is not only total return on investment but rather the amount of risk that one would have to tolerate in order to achieve returns He focuses on developing quant models that encompass strict risk adherence and correlation. He has been a speaker at conferences as well as an author of numerous articles. Andrew has spent years researching ideas that have the potential to outperform indices as well as maintain fewer draw downs.

A Summary of Virginia Medical Malpractice Laws

n many respects, Virginia has been more conservative about modifying the common law than its sister states. To the extent modifications have been approved, many restrict rather than expand the rights of the victims of medical negligence. For example, Virginia has adopted three major modifications of medical malpractice law: a damage cap, screening of proposed lawsuits by a medical review panel, and a state fund to compensate victims of birth-related neurological injuries. Much of the legislation specific to medical malpractice can be found in the Medical Malpractice Act, Va. Code Ann. §§ 8.01-581.1 to 8.01-581.20.

Statutes of Limitations

All medical malpractice actions for injury (as opposed to death) must be brought within two years from the date the cause of action accrued. Va. Code Ann. § 8.01-243(A). In § 8.01-230, a cause of action “accrues” at the time of injury: “the cause of action shall be deemed to accrue and the prescribed limitation period shall begin to run from the date the injury is sustained in the case of injury to the person… and not when the resulting damage is discovered.”

This two-year limitation has long been applicable, and strictly enforced, in Virginia. Virginia is one of the minority states that use the “date-of-the-act” rule, which means that the plaintiff must file suit within two years of the date of the injury regardless of how obscure or undiscoverable the injury might have been. Exceptions to the two-year rule are (i) cases involving minors or mentally incompetent people who are in law regarded as unable to know their legal rights and (ii) cases where the injury was fraudulently concealed from the person.

The Virginia Supreme Court rejected the judicial adoption of a discovery rule, Nunnally v. Artis, 254 Va. 247, 492 S.E.2d 126, (1997), but held that “continuing treatment for the same conditions” tolls the statute of limitations until treatment ends. Grubbs v. Rawls, 235 Va. 607, 369 S.E.2d 683 (1988). The court defined “continuous treatment” as not “mere continuity of a general physician-patient relationship; we mean diagnosis and treatment for the same relating illness or injuries, continuing after the alleged act of malpractice.” The court acknowledged, however, the rule would not apply to a single, isolated act of malpractice. Farley v. Goode, 219 Va. 969, 252 S.E.2d 594 (1979). In other words, when an act of malpractice occurred and that physician continued to see the patient over a course of years for an unrelated condition, the rule would not apply.

In foreign object cases (surgical sponges, needles, etc.) and cases of fraud or concealment (i.e., alteration of medical records) the statute is extended to one year from the date the object or injury is discovered or reasonably should have been discovered. However, this extension is subject to a ten-year limit from the time the cause of action accrued. Va. Code Ann. § 8.01-243(C).

In cases in which the health care provider’s negligence caused the patient’s death (Wrongful Death Claims), suit must be filed within two years of death. Va. Code Ann. § 8.01-244(B).

If a person entitled to bring a personal action dies with no such action pending before the expiration of [the two-year] limitation period… then an action may be commenced by the decedent’s personal representative before the expiration of the limitation period… or within one year after his qualification as personal representative, whichever occurs later.

However, § 8.01-229(B)(6) states that:

[i]f there is an interval of more than two years between the death of any person in whose favor . . . a cause of action has accrued or shall subsequently accrue and the qualification of such person’s personal representative, such personal representative shall, for the purposes of [the statute], be deemed to have qualified on the last day of such two-year period.

A parent’s action for medical expenses caused by injury to a minor must be brought within five years. Va. Code Ann. § 8.01-243(B). A minor’s medical malpractice action for injury or death must be commenced within two years from the date of the last act of negligence, unless the child is less than eight years of age, in which case the action must be brought by the child’s tenth birthday. Va. Code Ann. § 8.01-243.1. The Virginia Supreme Court has upheld the constitutionality of this statute. Willis v. Mullett, 263 Va. 653, 561 S.E.2d 705 (2002). Incapacity (typically a substantial mental or physical handicap) also tolls the running of the statute of limitations during the period of incapacity. Va. Code Ann. § 8.01-229(A).

Contributory or Comparative Negligence

Virginia recognizes the doctrine of contributory negligence in medical malpractice cases. A plaintiff’s contributory negligence may bar her recovery entirely, but the patient’s negligence must be concurrent with the defendant’s negligence. Sawyer v. Comerci, 264 Va. 68, 563 S.E.2d 748 (2002); Ponirakis v. Choi, 262 Va. 119, 546 S.E.2d 707 (2001).

Joint and Several Liability

Virginia imposes joint and several liability on joint tortfeasors. Va. Code Ann. § 8.01-443. Thus, any joint tortfeasor against whom judgment is entered is liable to the plaintiff for the entire judgment, regardless of the tortfeasor’s degree or percentage of fault. For example, in a hospital setting, if the attending doctor and nurse are both negligent, then each one can be held responsible for the patient’s entire injury even if part of that injury was caused by the other’s negligence.

Vicarious Liability

Under the doctrine of respondeat superior, hospitals in Virginia are vicariously liable for the negligence of their employees but not that of independent contractors. McDonald v. Hampton Training School for Nurses, 254 Va. 79, 486 S.E.2d 299 (1997). Whether a physician should be considered an employee is a question of fact not to be determined by whether the hospital calls him one, but by the factors of selection and engagement, payment of compensation, power of dismissal, and (most importantly) power to control the physician’s work. A physician’s exercise of professional judgment in the performance of professional duties is a factor, but not the only factor, in deciding whether the hospital has the power to control his work. There is also authority for holding a hospital liable for the act of a physician on the theory of negligent credentialing. Stottlemyer v. Ghramm, 2001 Va. Cir. LEXIS 501 (Va. Cir. Ct. July 13, 2001)(affirmed at 2004 Va. LEXIS 99 (2004). In other words, a hospital can be held legally responsible for granting hospital admission and treatment privileges to an unqualified physician.

Expert Testimony

Except for rare cases within the common knowledge and experience of lay jurors, expert testimony is necessary to establish the standard of care, a deviation from the standard, and the proximate cause of injury. Perdieu v. Blackstone Family Practice Center, Inc., 264 Va. 408, 568 S.E.2d 703 (2002). To testify as an expert on the standard of care a witness must demonstrate expert knowledge of the standards of the defendant’s specialty and have had an active clinical practice in either the defendant’s specialty, or a related field of medicine, within one year of the date of the alleged act or omission. Va. Code Ann. § 8.01-581.20.

Damage Caps

Virginia imposes a cap (limit) on damages of all kinds in medical malpractice cases. For claims arising out of acts or omissions prior to August 1, 1999, the damage cap is $1 million. For acts or omissions on or after August 1, 1999, and before July 1, 2000, the cap is $1.5 million. The cap is increasing by $50,000 every July 1. Two final increases of $75,000 beginning in 2007 will bring the damage cap to $2 million for acts or omissions on or after July 1, 2008. Va. Code Ann. § 8.01-581.15. The Virginia Supreme Court has twice considered this legislation and held that it does not violate the U.S. or Virginia constitutions. Pulliam v. Coastal Emergency Services, Inc., 257 Va. 1, 509 S.E.2d 307 (1999); Etheridge v. Medical Center Hospitals, 237 Va. 87, 376 S.E.2d 525 (1989).

A settlement with one defendant reduces the maximum liability of the others, because the cap limits the total amount recoverable for an injury to a patient, regardless of the number of theories or defendants. FairfaxHospital System v. Nevitt, 249 Va. 591, 457 S.E.2d 10 (1995). This includes punitive damages. Bulala v. Boyd, 239 Va. 218, 389 S.E.2d 670 (1990). In cases arising prior to March 28, 1994, when the definition of “health care provider” was broadened in Va. Code Ann. § 8.01-581.1, a physician’s professional corporation may be subject to uncapped liability. Schwartz v. Brownlee, 253 Va. 159, 482 S.E.2d 827 (1997).

Virginia limits punitive damages to $350,000. Va. Code Ann. § 8.01-38.1. This cap has also been determined to be constitutional by the Fourth Circuit Court of Appeals. Wackenhut Applied Technologies Center, Inc. v. Sygnetron Protection Systems, Inc., 979 F.2d 980 (4th Cir. 1992).

Statutory Cap on Attorneys’ Fees

There is no Virginia statute setting a limit on attorneys’ fees in medical malpractice actions.