Name and briefly describe the four Cs of medical malpractice prevention.
*caring: care about patients and colleagues
*communication: communicate clearly
... [Show More] and accurately
*competence: know your limitations, update credentials, confer with other professionals, stay informed
*charting: documentation is proof, chart clearly and accurately.
Briefly describe how practicing effective communication skills can help prevent a medical malpractice lawsuit.
*Misunderstandings and misinformation often leads to lawsuits.
*If you communicate clearly and accurately and get confirmation from patients that they understand, this can help prevent lawsuits.
If a patient refuses treatment, what legal options remain for the health care practitioner in charge?
*A patient cannot be forced to accept treatment, evaluation, or testing.
*His decision to decline should be documented in his patient record. Ideally, his refusal should be obtained in writing, but should definitely be noted in his record.
Name five reasons often cited for the suing of health care practitioners by patient and their families.
*To prevent the perceived injury from happening to anyone else
*to receive an explanation
*to get an admission of negligence
*I was angry
*to punish the doctor
Denial
a defense that claims that innocence of the charges or that one or more of the four Ds of negligence are lacking
Affirmative defenses
defenses used by defendants in medical professional liability suits that allow the accused to present factual evidence that the patient's condition was caused by some factor other than the defendant's negligence
Contributory negligence
an affirmative defense that alleges that the plaintiff, through a lack of care, caused or contributed to his or her own injury
Assumption of risk
a legal defense that holds that the defendant is not guilty of a negligent act because the plaintiff knew of and accepted beforehand any risks involved
Emergency
a type of affirmative defense in which the person who comes to the aid of a victim in an emergency is not held liable under certain circumstances
Technical defense
defenses used in a lawsuit that are based on legal technicalities
Release of tortfeasor
a technical defense that prohibits a lawsuit against the person who caused an injury (the tortfeasor) if he or she was expressly released from further liability in the settlement of a lawsuit
Res judicata
"The thing has been decided." Legal principle that a claim cannot be retried between the same parties if it has already been legally resolved
Statute of limitations
that period of time established by state law during which a lawsuit may be filed
Risk management
the taking of steps to minimize danger, hazard and liability
What is the difference between an affirmative defense and a technical defense?
*The former allows the accused to present factual evidence that the patient's condition was caused by some factor other than the physician's negligence.
*The lateral hinges on legal technicalities, rather than on factual evidence.
What type of defense is used when the defendant claims they're innocent?
denial
What type of defense is used when the accused is allowed to present factual evidence that the physician's negligence did not cause the patient's condition?
affirmative defense
What type of defense is used when the defendant claims that the patient contributed to his or her own injury?
contributory negligence
What type of defense is used when the informed consent is a vital factor?
assumption of risk
What type of defense is used when it hinges on legal technicalities rather than factual evidence?
technical defense
If a medical malpractice claim is dismissed due to a state's statute of limitations, does this imply that the defendant health care practitioner is exonerated? Explain your answer.
No. The health care practitioner is not exonerated. The length of time during which a suit could legally be filed has passed
Quality improvement (QI) or quality assurance
a program of measures taken by health care providers and practitioners to uphold the quality of patient care
Liability insurance
contract coverage for potential damages incurred as a result of a negligent act
Risk management has become a necessary health care practice component because:
liability is a major factor in health care delivery.
Methods used to manage risk are part of:
quality improvement or quality assurance
What activity can help health care providers avoid litigation?
medical record charting
What is not a duty of a medical practice's quality improvement and risk manager?
scheduling patient appointments
Credentialing consists of:
verifying health care providers' credentials before hiring
Comparative negligence
an affirmative defense claimed by the defendant, alleging that the plaintiff contributed to the injury by a certain degree
Claims-made insurance
a type of liability insurance that covers the insured only for those claims made (not for any injury occurring) while the policy is in force
Occurrence insurance
a type of liability insurance that covers the insured for any claims arising from an incident that occurred, or is alleged to have occurred, during the time the policy is in force, regardless of when the claim is made
Tail coverage
an insurance coverage option available for health care practitioners: When a claims-made policy is discontinued, it extends coverage for malpractice claims alleged to have occurred during those dates that claims-made coverage was in effect
Prior acts insurance coverage
a supplement to a claims-made insurance policy that can be purchased from a new carrier when health care practitioners change carriers
Self-insurance coverage
an insurance coverage option whereby insured subscribers contribute to a trust fund to be used in paying potential damage awards
If a health care practitioner covered by medical malpractice insurance receives notice of lawsuits, he or she should first notify:
his/her insurance company
Claims-made insurance pays for:
claims made during the specified time period the policy is in effect
Occurrence insurance pays for:
claims arising from an incident that occurred or is alleged to have occurred while the policy is in force, regardless of when the claim is made
Name two types of insurance that. in certain circumstances, extend coverage of claims-made insurance:
*Tail coverage
*Prior acts coverage
How might a physician insure himself?
He/She can contribute to a fund, managed by an insurance company that is used to pay medical malpractice judgments, if any.
What are the four Cs of medical malpractice prevention?
*caring
*communication
*competence
*charting
Why do patients sue?
*Cancer misdiagnosis, failure to diagnose, or a delay in diagnosis
*birth injury or negligent maternity care
*wrong diagnosis and misdiagnosis of negligent fracture or trauma
*delay in diagnosis or failure to consult in a timely manner
*medication errors or medication malpractice resulting from negligent drug treatment
*malpractice resulting from a physician's negligent procedures or surgical errors
*failure to obtain informed consent
What general categories of information should be documented for legal purposes?
*what treatment was performed and when?
*referrals
*missed appointments
*dismissals
*treatment refusals
*all other patient contact
What types of defense may be used in a medical malpractice lawsuit?
*denial
Affirmative:
*contributory negligence
*comparative negligence
*assumption of risk
*emergency
Technical:
*release of tortfeasor
*res judicata
*statute of limitations
What purpose does risk management serve?
*Helps minimize liability
*quality improvement (QI) or quality assurance
*verifies credentials
What types of professional liability insurance are available to medical providers?
*occurrence
*self coverage
Claims made:
*Tail coverage
*Prior acts coverage
What is an example of a physician using risk management to reduce the likelihood of a malpractice lawsuit against his office?
Providing written job descriptions for employees
A patient sues a physician for negligence and loses. The patient then sues the physician for breach of contracts. The second suit is dismissed under what doctrine?
res judicata
One of the most common occurrences for marking the beginning of the statutory period for medical malpractice includes:
the time a patient recovers from injury
Determine whether each of the following behaviors is unethical, illegal or both, and explain how each might lead to liability.
A physician intentionally enters a building code on a patient's billing sheet for an examination that was not performed. The code entered means that the patient's insurance carrier will be billed for a more expensive exam than the one that was actually performed.
*Both
*This is considered fraud.
Determine whether each of the following behaviors is unethical, illegal or both, and explain how each might lead to liability.
A hospital instructs its nurses to introduce themselves by name to each new patient in this manner: "I am Susan and I've been assigned to take care of you. I have an associate's degree in nursing [or substitute appropriate educational credentials]. I see your physician is Dr. Wellness, and I can assure you that he is an excellent doctor. Let me know if you need anything at all.
*Unethical
*Susan shouldn't express her opinion of the doctor.
Determine whether each of the following behaviors is unethical, illegal or both, and explain how each might lead to liability.
An anesthesiologist has never administered anesthesia to a child, but conceals this fact from a surgeon who likes her and requests her for an upcoming procedure on a six-year old.
*Unethical
*She should inform the surgeon of her lack of experience. [Show Less]