Introduction: Here I will begin with a statement by one of my questionnaire volunteers regarding how medical malpractice is a concern in their future careers.
Audio-Visual Aid: And here’s another. Start: 0:56 Stop: 1:33.
Background Information: Here I will describe my experience at the University of Pittsburgh Health Career Scholar’s Academy. This was a intense four week program where I was able to research a topic of my choosing while attempting to implement a project at home.
Four Components of Medical Malpractice: There are four components of malpractice and “[medical professionals] should all be aware of the four components of malpractice. First, the physician had a duty. Second, the physician breached that duty, which, third, results in harm to the patient. And finally, the harm was caused by that breach of duty. Typically, if a lawyer proves all four elements are present, the physician is liable for damages” (Moore).
Three Fundamental Elements of Malpractice: The injured patient is entitled to compensation under the law of medical malpractice, which is a particular application of tort law, the web of rules that governs injuries to person or property where crime or contract is not at issue. Of course, there are to other fundamentals of medical malpractice, “[injury], negligence, and proximate cause are the three fundamental elements that determine a malpractice case” (Gots 28). All three of these elements are necessary to create a case for the disgruntled patient.
Injury: Injury can be defined as either “[an] operation complication, a serious drug side effect, an unusually prolonged hospitalization, an unexpected death, the loss of a limb from a seemingly minor injury. [These] may or may not lead to court action” (Gots 28). For a patient to determine whether or not their case is valid, they must “divide [their] complaints into two categories: physical impairments, and pain and suffering” (Gots 29). Physical impairments are more outwardly noticeable, such as deafness, blindness, or the loss of limb. These are easily documented and can be reassured to a jury in case of trial.
Negligence: Next, negligence is an essential ingredient in a medical malpractice case and is defined as a deviation from standard care. Patients often believe that any unusual and unanticipated complication as evidence of negligence, or the failure to exercise that degree of care that, in the circumstances, the law requires for the protection of other persons or those interests of other persons that may be injuriously affected by the want of such care. Patients “go to their physicians with confidence and high hopes, and when events take a surprising turn for the worse, they are certain that the doctor must be at fault” (Gots 45).
Proximate Cause: Finally, there is proximate cause, “the third element of a medical malpractice case, and the most difficult to prove. It is the link that connects negligence to injury” (Gots 37). For proximate cause to take place, “[not] only must the doctor have done something wrong and an injury have occurred, but the specific act of negligence must have directly produced the injury for the plaintiff to win his case” (Gots 37). Sometimes an injury is so severe that negligence is so apparent that the plaintiff may not have to prove probably or certain cause. In order for a physician to be liable for malpractice, a judge or jury must find that the physician’s conduct falls below the standard of medical care.
Process: The initial phase of any lawsuit begins with the physician receiving a summons or complaint “which alleges medical malpractice” (Feld). Once the physician in question has been served, he or she must contact their attorney. Once the attorney has been contacted, they must review the claims and decide to either answer, or rebut the claims. Essentially, they are denying malpractice. The next phase is the discovery where “attorneys for both parties attempt to determine the facts, seek expert opinions, and develop their sides of the case” (Feld). This can progress from at least one year, however, it can continue for several years and occasionally may last almost a decade. As this discovery period continues, one party may obtain enough information to propose a settlement, but if there is no settlement, the case will go to trial and a verdict will be reached. If the physician loses, the claim is paid, and “a report will be filed with the National Practitioner Databank (NPDB); this will be reportable during medical credentialing processes” (Feld). This is an extremely taxing process in which the physician will lose credibility, even if the claim is dropped. They have still been charged with malpractice and they record is smeared for it. Even worse, this is incredibly time consuming! A physician may be in this process for years, sometimes just for the discovery phase.
Consequences: The fear of getting caught in a lawsuit is pervasive in medicine and may affect how a physician practices. The simple stress of knowing that someone believes you have wronged them is unbelievable. Even worse is the fact that you attempted to help this person and this is how they repay you! How dare they? Doctors do not deserve this type of disrespect because at the end of the day, these lawsuits may be taking away professionals that were meant to save another human life, but now they will not have that opportunity because their name and career have been tarnished. However, “[the] consequences of being sued are not merely the time spent in defense preparation but may involve personal loss of self-esteem, depression, family stress, credentialing issues and financial worry” (Feld). For example, just the fact that someone is handed with a court summons is an immense ordeal, “[the] deputy hands you the malpractice claim document (summons) and you return to your office embarrassed and angry” (Nasca 245). Nasca goes on to state the emotional pain that occurs within, “this is one of the most gut-wrenching experiences you will encounter. It is hard to believe that someone you attempted to help and care for could now make such a claim against you” (Nasca 245).
Statistics: However, luckily there is some hope. If one feels that this may ruin their career, “[they] should consider the following statistics: Overall, plaintiffs won just 30.5% of medical liability cases in 2002. Of the 7% of cases proceeding to a jury verdict, the defendant won 82.4% of the time” (Nasca 247). This is a fairly comforting statistic. Not all cases end in unfavorable results and thus doctors have a chance.
Cases: 1. Here is one case from Pennsylvania: Kenneth Hamil was brought to a hospital late at night with severe chest pains. The supervisor told his wife to bring him in, however, the electrocardiograph would not work and a second machine could not be found. Mr. Hamil was taken to a physician’s office where he died while an ECG was being taken. His wife sued the hospital and the doctor ordering the ECG at the hospital (Rapp 22). The Pennsylvania Supreme Court decided that the jury should determine the case and they stated that a chain of causation was unnecessary. 2. Another situation occurred as follows: A sixteen-year old boy had a curvature of the spine secondary to polio. He would need surgery if he were to have any chance of a normal life. His doctor wanted to operate, but not under the ‘no transfusions’ restriction placed by the child’s Jehovah’s Witness mother. The Pennsylvania Supreme Court refused to substitute its judgment for the mother’s, citing the lack of an immediate threat to the child’s life (Rapp 36). When a doctor believes that a parent or guardian is keeping a child from receiving a life-saving treatment, the doctor is required to contact the child welfare authorities. According to Pennsylvania law, “a court can transfer temporary legal custody of a ‘dependent child’ to a qualified individual” (Rapp 36). A dependent child is a child without proper parental care or control who requires medical attention. This situation alone can result in many emotional displays and conflicting rights and interests. However, physicians frequently find themselves in these situations, but they are always acting with the patient’s best interest in mind. Also, sometimes religion may come in the way of medicinal decisions, “[religious] beliefs, for example, may interfere with what is considered proper diagnosis and treatment. Jehovah’s Witnesses prohibit the transfusion of blood, and Christian Scientists rely on prayer as the only therapy for disease” (Rapp 36).
Prevention Methods: Do not ignore post-complication care out of embarrassment, fear, or concern that your answers to questions may later be quoted in a suit” (Feld). This means that a physician must always make sure to discuss every aspect of the patent’s care to the patient and give them ample warning of all results and possible complications.
Prevention: Next, remember that the media is not a medical professionals’ best friend. The media is corruptible and can always be discovered. Specifically, “e-mails are discoverable. Remember the old saying: never e-mail anything you would not want on the front page of your newspaper” (Feld).
Prevention: Another important method to maintain privacy is to pay attention to the Electronic Medical Record (EMR). For example, “[the] EMR may become a fertile area for the plaintiff’s attorneys. EMR policies regarding timing of response and completeness for staff-to-staff and patient-to-staff communications may prevent challenges about poor follow-up” (Feld). This essentially means that a physician must make sure that everything in their practice is malpractice free. They should make sure to keep records up to date and make sure that all logs are kept.
Prevention: Finally, one must always keep in check their staff and other professionals who work with them. For example, “[vicarious] liability pertains to your responsibility for your subordinates. Ensure adequate training and policies for office staff. Your duty to your patients involves appropriate office wait time and routing of the emergency call received by your office staff. You may be vicariously liable for the emergent call taken by your staff, even though you never received the message (Feld).
Project: Describe project and reference certain goals.
Project: Reference the table and describe the answers.
Conclusion: Here are some points that I would like to reiterate: There are to other fundamentals of medical malpractice, “[injury], negligence, and proximate cause are the three fundamental elements that determine a malpractice case” (Gots 28). All three of these elements are necessary to create a case for the disgruntled patient. Injury can be defined as either “[an] operation complication, a serious drug side effect, an unusually prolonged hospitalization, an unexpected death, the loss of a limb from a seemingly minor injury. Next, negligence is an essential ingredient in a medical malpractice case and is defined as a deviation from standard care. In order for a physician to be liable for malpractice, a judge or jury must find that the physician’s conduct falls below the standard of medical care. The fear of getting caught in a lawsuit is pervasive in medicine and may affect how a physician practices. Review prevention methods. However, luckily there is some hope. If one feels that this may ruin their career, “[they] should consider the following statistics: Overall, plaintiffs won just 30.5% of medical liability cases in 2002. Of the 7% of cases proceeding to a jury verdict, the defendant won 82.4% of the time” (Nasca 247). This is a fairly comforting statistic. Not all cases end in unfavorable results and thus doctors have a chance.
Class Discussions No No No No No Yes No Yes 3 Class Devoted No No No No No No No No Terms Unsure Unsure Yes 1 Yes 1 Yes 1 Yes Unsure Yes Important Factor Maybe No Yes 2 Yes 2 Yes 2 Yes 2 No Yes 2 Worried Yes Yes Yes Yes No Yes No No 1 Based on prior knowledge and private studies. 2 Away from certain practices: OBGYN 3 Few
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