Physician Risk Management – March 1, 2014
March 1, 2014
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Beware! In claims for routine procedures certain factors are consistently correlated
Claims involving routine medical procedures — scopes, injections, punctures, biopsies, insertion of tubes, or imaging — resulted in $215 million in incurred losses, according to an analysis of 1,497 cases. In this study, legal outcomes often hinged on these factors: failure to obtain or document a thorough, voluntary informed consent; lack of appropriate credentials or experience with the procedure; failure to follow published safety policies. -
Does claim meet all 4 elements of negligence?
While anyone can go to a plaintiff's attorney for what they perceive as a poor outcome, keep in mind that for a malpractice claim to survive, all four elements of negligence must be met, says Jan Kleinhesselink, RN, CPHQ, co-owner of Yin Yang Medical Services, a Nebraska-based provider of risk management services. These elements are: duty, breach of that duty, causation, and damages. -
Why some physicians really need 'tail' coverage: Gaps in coverage might exist when changing carriers
If physicians fail to purchase "tail" coverage when leaving one carrier, they risk having no coverage if a suit is filed before the effective date of their new carrier's policy. -
To avoid suits, MDs must communicate and must partner with other doctors
Insufficient communication between providers is often a contributory cause in malpractice lawsuits that name more than one provider. Providers must be able to request information from other providers who are treating the same patients. Interdisciplinary rounds with a "culture of inclusiveness" encourage individuals to speak up. In the outpatient setting, physicians can call a colleague to obtain a different perspective. -
Prevent successful suits alleging failure to transfer
Physicians have a legal obligation to transfer a patient when the standard of care or the facility's licensure requires it. This documentation can make "failure-to-transfer" claims more defensible: the criteria for meeting exceptions to transfer requirements; how criteria in policies were met; an appropriate patient plan of care. -
Risk-prone practices continue in office setting — 'Vicarious liability' claims are rising
Office-based practices face increased legal risks due to more patient care occurring in the ambulatory setting. Physicians often fail to realize that they can be held vicariously liable for the actions of their staff. -
Failure to review previous X-ray results, and the patient wasn't notified
A patient saw multiple physician internal medicine practices for an upper respiratory complaint, including one practice in which a nurse practitioner (NP) ordered a chest X-ray. -
Must expert be in same specialty? Not necessarily! Rules 'may not protect defendant physicians'
Requirements for medical expert witnesses vary by state regarding the need to practice in the same specialty, where the physician is licensed, and other factors. Various medical societies have set forth rules for qualifications and conduct. Exceptions may be made to allow a witness to testify due to a scarcity of a particular specialty. The trial process allows the parties to test the expert's credibility. -
Can expert testify? Often, it depends on what state you're in
Whether a medical expert is qualified to testify often turns on a particular state statute, says Thomas R. McLean, MD, JD, CEO of American Medical Litigation Support Services in Shawnee, KS. -
Family members awarded $3.75 million in lung cancer diagnosis delay case
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Misdiagnosis results in bowel obstruction, patient's death, and a $2.4 million verdict