Medical Ethics Ch 6

4 C's of malpractice prevention

caring, communication, competence, charting

7 common reasons for malpractice

1.cancer misdiagnosis/failure or delay
2.birth injury/negligent maternity care
3.wrong diagnosis or misdiagnosis of negligent fracture or trauma
4.delay in diagnosis or failure to consult in timely manner
5.medication errors or medication malpractice from

Reasons people sue

-Prevent injury from happening to anyone else
-To receive an explanation
-Wanted the doctors to realize what they had done
-To get an admission of negligence
-To make the doctor realize how I felt
-My feelings were ignored
-Wanted financial compensation
-

8 guidelines or actions that might prevent malpractice lawsuits

-Explanations and apology
-Corrections of the mistake
-financial compensation
-correct treatment at the time
-an admission of negligence
-"should have been listened too"
-disciplinary action against medical personnel involved
-honesty
-investigation by th

what does OSHA stand for?

Occupational Safety and Health Administration

What does MSDS stand for?

Material Safety Data Sheets (used for hazardous materials)

LItigation

a legal proceeding in a court

What not to say after complications

-YOU signed the consents for surgery and anesthesia.
-Are you receiving counseling? You need to get over it.
-These things happen and you may never know what went wrong.
-I have no idea what happened�go ask a specialist.
-I guess I can squeeze you in for

Things patients and families want and need following an adverse event:

-Immediate unbiased investigation with complete disclosure.
-To be listened to and taken seriously. Don't protect us. Don't lie to us. Don't diminish our need to know.
-Practices and systems changed to prevent a similar event.
-Standards of care mandated

Guidelines for theraputic communication

...

Communicating with patients

-develop good listening skills
-set aside time of day to advise and call back patients
-thoroughly explain illnesses and procedures
-make sure informed consent forms are signs
-avoid statements admitting guilt
-use tact, good judgement and professionalism

what should be documented in patient charts?

-referrals
-missed appointments
-dismissals
-treatment refusals
-all other patient contact

types of defenses

-denial of wrongdoing (defense by innocense)
-affirmative defenses (contributory negligence, comparative negligence, assumption of risk, emergency)
-technical defenses
-release of tortfeaser
-Res Judicata (element of doctrine-"the thing has been decided"=

TRUE OR FALSE....
A physician claims that a patient was negligent in following her treatment plan and caused her own injury. This type of defense is known as assumption of risk.

FALSE...
A physician claims that a patient was negligent in following her treatment plan and caused her own injury. This type of defense is known as CONTRIBUTORY NEGLIGENCE. Assumption of risk is a defense based on the contention that the patient knew of

Conditions for emergency defense

-a true emergency situation existed and was not caused by the defendant
-the appropriate standard of care was met, given the emergency situation

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 suit.
(the victim cannot sue the physician unless the right to do so w

Res Judicata

The thing has been decided" - a clain cannot be retried between the same parties if it has already been resolved

TRUE OR FALSE: A physician who loses a malpractice suit cannot afterwards sue the patient for breach of contract based on information presented in the trial.

TRUE= A physician who loses a malpractice suit cannot afterwards sue the patient for breach of contract based on information presented in the trial. This defense is called "RES JUDICATA" ="THE THING HAS BEEN DECIDED.

Statue of limitations

time limit for filing a lawsuit:
-vary from state to state
-generally specifies one to six years with two years most common
---specifies when the statute of limitations begins
---may be modified for minors or people who are legally insane

Risk management

-identifying problem practices or behaviors and eliminating them
-providing written job descriptions
-providing office procedure manuals and employee handbooks
---includes charging, scheduling patients, communicating with patients, and writing prescriptio

Quality Improvement/Quality Assurance

-program to uphold the quality of patient care and reduce liablity risk
-part of the methods used to manage risk
---may assume responsibility for compliance with government regulatory agencies

Professional Liability Insurance

-Covers costs of defending a medical malpractice lawsuit up to policy limit
-Cost of insurance based on physicians specialty and dollar amount of the policy
-usually required to obtain hospital privileges or work in a HMO

Medical Malpractice Insurance/Types

Claims-made Insurance
-covers the insurer only for claims made (not for injury occurring) while policy is in force
Occurrence insurance
-covers the insurer for any claims made that occurred while policy is in force regardless of when it occurred
---not an

Extended Coverage Insurance

-Tail coverage
-prior acts insurance coverage
-self-insurance coverage
---advantage: lower premiums

Credentialing process conists of the following

1.A provider fills out an application and attaches copies of his or her medical license, proof of malpractice insurance coverage, and other requested credentials.
2.The listed sources are asked to verify the information.
3.Medicare and Medicaid sanctions

Types of Affirmative Defenses to a professional liability lawsuit

-Contributory negligence
-Comparative negligence
-Assumption of risk
-Emergency

Under what type of defense would a health care practitioner who comes to the aid of an accident victim at the scene would not be held liable?

EMERGENCY DEFENSE

When the defendant alleges that he or she did no wrong, that defense is called what?

DENIAL

If the patient knew the inherent risk before treatment, the defendant may use _________________ as a defense in a lawsuit

ASSUMPTION OF RISK

RES JUDICATA is what type of defense?

TECHNICAL DEFENSE

When damages are apportioned according to the degree a plaintiff contributed to his or her injury, this is called?

CONTRIBUTORY NEGLIGENCE

RES JUDICATA is Latin for

The thing has been decided

Risk Management is a process to...

Minimize danger, hazard or liability

Medical malpractice insurance that covers the insured only for those claims made while the policy is in force is called...

CLAIMS-MADE COVERAGE

Medical malpractice 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 was in force, regardless of when the claim is made, is called...

OCCURANCE INSURANCE

Prior Acts Coverage

Supplemental insurance to medical liability insurance