Legal liability has the potential to be a powerful driver pushing implementation of personalized medicine. Individuals injured by adverse drug effects are increasingly likely to bring lawsuits alleging that they have a polymorphism or biomarker conferring susceptibility to the drug that should have been identified and used to alter their drug treatment. Likely targets of such lawsuits include drug manufacturers, third party payors, physicians and pharmacists, of which physicians are most at risk of substantial liability.

A method for the synthesis of the A ring of gibberellic acid is described. The first of the two sequences described leads to the A ring of tetrahydrogibberellic acid. Treatment of ethyl 2-(2-oxocyclopentyl)propionate (1) with homoallyl magnesium bromide leads to 1 -(3-butenyl)-2-oxa-3-oxo-4-methylbicyclo[3.3.0]octane which upon oxidation with osmium tetraoxide and sodium periodate gives l-(3-oxopropyl)-2-oxa-3-oxo-4-methylbicyclo-[3.3.0]octane (3). Cyclization of 3 with potassium zerz-butoxide affords a mixture of the axial and equatorial hydroxy epimers 2-carboxyl-2- methyl-3,6-dihydroxybicyclo[4.3.

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Common issues of mental health liability are examined in relationship to recent legislative and case law. Matters of practical importance to practitioners including the app~icability of insurance coverage to punitive damage awards arising from malpractice are addressed. Specific legal doctrines involving proof of liability, proximate cause and the standard of care are explored as they relate to mental health malpractice cases.