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© 2014 Jones and Bartlett Publishers
Chapter 4
Tort Law
© 2014 Jones and Bartlett Publishers
LEARNING OBJECTIVESDescribe what a tort is and the
purpose of tort law. Identify, understand, and describe the
elements of negligence. Identify and describe intentional
torts.Explain the theories a plaintiff could use in pursuing a
products liability case and the defenses a manufacturer might
use to defend itself.
© 2014 Jones and Bartlett Publishers
TortA civil wrong, other than a breach of contract, committed
against a person or property for which a court provides a
remedy in form of an action for damages.
© 2014 Jones and Bartlett Publishers
Objectives of Tort LawPreservation of peace between
individuals.Find fault for wrongdoing.Deterrence by
discouraging the wrongdoer from committing future tortious
actsCompensation to indemnify injured person/s.
© 2014 Jones and Bartlett Publishers
Categories of Tort LawNegligenceIntentionalStrict liability
regardless of fault e.g., products liability
© 2014 Jones and Bartlett Publishers
NegligenceCommission or omission of an act that a reasonably
prudent person would or would not do under given
circumstances.
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Commission of an ActAdministering the wrong
medicationAdministering the wrong dosage of a
medicationAdministering medication to the wrong
patientPerforming a surgical procedure without patient
consentPerforming a surgical procedure on the wrong
patientPerforming the wrong surgical procedure
Omission of an ActFailing to conduct a thorough history &
physical examinationFailing to assess & reassess a patient's
nutritional needsFailing to administer medicationsFailing to
order diagnostic testsFailing to follow up on abnormal test
results
© 2014 Jones and Bartlett Publishers
MalpracticeNegligence of a professional person surgeon who
conducts a surgical procedure on wrong body part
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Criminal NegligenceReckless disregard for safety of
another.Willful indifference to injury that could follow an act.
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Forms of NegligenceMalfeasanceExecution of an unlawful or
improper act, i.e., performing a partial birth abortion when
prohibited by lawMisfeasanceImproper performance of an act,
i.e., wrong sided surgery.NonfeasanceFailure to act when there
is a duty to act, i.e., failing to prescribe medications that should
have been under the circumstances
Degrees of NegligenceSlightMinor deviation of what is
expected under the circumstances. Ordinary NegligenceFailure
to do what a reasonably prudent person would or would not
do.Gross NegligenceIntention or wanton “omission of care” that
would be proper to provide or the “commission of an act” that
would be improper to perform.
© 2014 Jones and Bartlett Publishers
Elements of NegligenceDuty to Use Due CareStandard of
careBreach of DutyInjury/Actual DamagesProximate
Cause/CausationForeseeability
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I. Duty to CareObligation to conform to a recognized standard
of care.
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Standard of CareDescribes the conduct expected of an
individual in a given situation.Describes how a “reasonably
prudent person” would or would not act under “similar
circumstances”.Measuring stick for properly assessing actual
conduct required of an individual.
© 2014 Jones and Bartlett Publishers
Reasonably Prudent PersonA nonexistent - hypothetical person
who is put forward as community ideal of what would be
considered reasonable behavior.
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Similar CircumstancesCircumstances at the time of the
injury.Circumstances of the alleged wrongdoer/s at the time of
injury.AgePhysical conditionEducation & trainingLicenses
heldMental capacity, etc.
Determining StandardEstablished by legislative enactment or
administrative regulation.Adopted by the court from a
legislative enactment or administrative regulation.Established
by judicial decision.Applied to the facts of the case by the trial
judge or jury, if there is no such enactment, regulation or
decision.courts often rely on testimony of an expert witness as
to the standard of care required.
Community v. National StandardCommunity Standardhometown
standard (we want to do things our way).National Standardmost
currently accepted standard of care on a national basis.
© 2014 Jones and Bartlett Publishers
Case: Hiring PracticesNurse hired sight unseen over telephone.
Applicant falsely stated in an employee application that he was
licensed as an LPN. His license was not verified by the
employer. He had committed 56 criminal offenses of theft. He
assaulted a resident a resident & broke his leg.
Case: Hiring Practices
DutyStandard expected:Employer had a “duty” to validate the
nurse’s professional license.
II. Breach of DutyDeviation from the recognized standard of
care.Failure to adhere to an obligation.Failure to conform to or
the departure from a required duty of care owed to a
person.Occurs when a physician fails to respond to his/her on-
call duties.an employer fails to adequately conduct a pre-
employment check (e.g., licensure, background check).
Case: Hiring Practices
Breach of Duty
The employer failed to verify the applicant’s licensure.A more
thorough background check should have revealed this
employee’s previous criminal conduct.
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III. InjuryActual damages must be established.If there are no
injuries, no damages are due.
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Case: Hiring Practices
Injury
The resident suffered a broken leg.Hospital vicariously liable
for nurse’s conduct.
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IV. CausationProximate causebreach of duty was the proximate
cause of the injuryBut-for Rulethe defendant’s action, the injury
would not have occurred
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Case: Hiring Practices
CausationReasonable anticipation that harm or injury was likely
to occur.The patient suffered a broken legDeparting from
recognized standard of carefailure to verify licensure & conduct
an adequate background check
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Hiring Practices – IIIInjury resulted from the breach of
duty.Injury was foreseeable.
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Failure to Hydrate
CausationFailure to administer proper hydration.Not
unreasonable to conclude that one’s dehydration can be caused
by failing to provide water.
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ForeseeabilityReasonable anticipation that harm or injury is
likely to result from an act or an omission to act.
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Test for ForeseeabilityThe test for foreseeability is whether a
person of ordinary prudence and intelligence should have
anticipated danger to others caused by his or her negligent act.
© 2014 Jones and Bartlett Publishers
Case: Hiring Practices
ForeseeabilityA person of ordinary prudence and intelligence
should have anticipated the danger to the resident caused by the
employer’s negligent act.
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Hot Radiator
ForeseeabilityA patient’s left foot came in contact with a
radiator and she suffered third-degree burns.The defendant had
knowledge of the plaintiff’s condition. The defendant should
have shielded the radiator or not placed the plaintiff next to it.
Sponge & Instrument CountDr. Smith owns the local Outpatient
Surgery Center. He instructs employees to count all instruments
& surgical sponges following a surgical procedure, prior to
closing the surgical site. Annie, an employee, failed to conduct
the count following Bills surgery. Two months later, Bill,
suffering from extreme abdominal pain, was noted to have
several sponges and an instrument in his abdomen. He had
developed a massive infection.Was the doctrine of Vicarious
liability applicable in this case?
YESEven though Annie had strict instructions to count the
sponges & surgical instruments prior to closing the surgical
site, she failed to do so. To determine otherwise would
undermine the doctrine of vicarious liability, since employers
would almost always escape liability by presenting evidence
that employees were given careful instructions.
Failure to Follow InstructionsSarah has a minor surgical
procedure under general anesthesia at ABC Surgery Center. She
was instructed not to drive home after release. Her daughter
Leslie picks her up. On the way home Leslie stops for a donuts.
Meanwhile, her mother moves to the driver seat. Upon leaving
the parking lot, Sarah hits Carol’s car. Carol sustains a broken
arm & sues ABC for releasing Sarah before she is completely
recovered from the anesthesia.Was the hospital liable for
Sarah’s injuries?
NO!Sarah was negligent, not the hospital. She failed to adhere
to both verbal & written instructions not to drive following
anesthesia. It was Sarah’s duty not to drive and her breach of
that duty that caused Carol’s injury.
© 2014 Jones and Bartlett Publishers
RememberThe four elements of negligence must be presented in
order for the plaintiff to recover damages caused by negligence.
© 2014 Jones and Bartlett Publishers
Intentional TortsAssault and BatteryFalse
ImprisonmentDefamation of CharacterFraudInvasion of
PrivacyIntentional Infliction of Mental Distress
© 2014 Jones and Bartlett Publishers
AssaultDeliberate threat, coupled with apparent ability to do
physical harm to another. Actual contact not necessary.
Person attempting to touch another unlawfully must possess
apparent present ability to commit battery.
Person threatened must be aware of or have actual knowledge of
an immediate threat of a battery and must fear it.
BatteryIntentional touching of another’s person in socially
impermissible manner without person’s consent.Failure to
obtain consent prior to surgery.Administering blood against
patient’s express wishes.Physically restraining one who refuses
to eat.
False ImprisonmentUnlawful restraint of individual’s personal
liberty or unlawful restraining or confining an
individual.Restraining patient without cause.Locking patient in
secluded room for failing to attend therapy session.
Legal Justification for Restraint or SeclusionPerson represents a
danger to self or others.Criminal conduct.Persons with highly
contagious diseases, as provided by state or federal statutes.
© 2014 Jones and Bartlett Publishers
Reducing Use of Restraints – I Development of policies and
procedures that conform to state & federal guidelinesEducation
& orientation of staffEducation for patients & familiesSound
appraisal of need for restraintsApplication of least restrictive
restraintsContinuous monitoring of patients to determine
continuing need for restraints
Defamation of CharacterThe offense of injuring a person’s
character, fame, or reputation by false & malicious
statements.False oral or written communications to someone
other than person defamed that tends to hold that person’s
reputation up to scorn or ridicule in eyes of others.
© 2014 Jones and Bartlett Publishers
Defamation of CharacterLibel – written form of
defamationSignsLettersPhotographsCartoonsSlander – oral form
of defamation
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Proof of DefamationA false & defamatory
statement.Communication of a statement to a person other than
the plaintiff.Fault on the part of the defendant.Special monetary
harm.
© 2014 Jones and Bartlett Publishers
Proof of Harm Not Required
to recover damages when:Accusing a person of a
crime.Accusing a person of having a loathsome disease.Using
words are harmful to a person’s profession or business.Calling a
woman unchaste.
Libel – Performance AppraisalsPerformance appraisals are not
meant for general publication.To recover damages, the appraisal
must be published in defamatory manner that injures one’s
reputation.
© 2014 Jones and Bartlett Publishers
Cartoon – I Jack draws a cartoon depicting Paul having a
rendezvous with a new grad nurse in an empty patient room.
The incident in fact never occurred.Can a defamatory statement
can take the form of a cartoon?Yes, a defamatory statement can
take the form of a cartoon because it is capable of adversely
affecting a person’s reputation.
© 2014 Jones and Bartlett Publishers
Newspapers ArticlesNewspaper editorial cartoon depicting 3
persons resembling gangsters in dilapidated building, identified
as particular facility that had been closed by state order, was an
expression of pure opinion and was protected by 1st
Amendment.
Accused of an AffairNurse Rachet suggests to Dr. Smith that he
should leave his wife Sharon because she is having an affair
with Dr. Doe. Dr. Smith writes a letter to Mrs. Doe, repeating
Rachet’s statement.Assuming Dr. Smith’s letter is defamatory,
is it libel or slander?
Accused of an AffairIt is libel, even though Dr. Doe is repeating
a slanderous statement.The reverse is not true – the spoken
repetition of a written defamation is still considered libel.The
rule is: once libel, always libel.
© 2014 Jones and Bartlett Publishers
SlanderPerson who brings suit must prove special
damages.When defamatory words refer to person in professional
capacity, professional need not show that words caused damage.
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Defenses to a Defamation ActionTruth – no liability for
defamation if it can be shown that statement is
true.PrivilegeAbsoluteQualified
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Absolute PrivilegeStatements made during judicial & legislative
hearingsConfidential communications between spouses
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Qualified PrivilegeStatements made as result of a legal or moral
duty to speak in interests of 3rd personsStatements must be
without malice
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Public FiguresVulnerable to public scrutinySuits generally
dismissed in absence ofmaliceactual knowledge statements are
falserecklessness as to truth
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Proof of FraudMisrepresentation by the defendant.Knowledge of
falsity.Intent to reduce reliance on misrepresentation.Justifiable
reliance by the plaintiff.Damage to the plaintiff.
© 2014 Jones and Bartlett Publishers
Health Care FraudBilling Tradename Drugs/Issuing
GenericOffice Visits/Double BillingBilling for Services not
RenderedAccepting referral fees
© 2014 Jones and Bartlett Publishers
Invasion of PrivacyThe right tobe left alonebe free from
unwarranted publicitybe free from exposure to public viewbe
free from unwarranted intrusions into a one’s personal
affairspersonal privacyhave records/kept confidential
Intentional Infliction
of Mental DistressConduct that is so outrageous that it goes
beyond bounds tolerated by decent society.
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Mental DistressGriefShamePublic
humiliationDespairShameHuman pride
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Mental DistressMother shown premature infant in a jar.
Johnson v. Womens HospitalVerbally abusive
physician to patient and/or spouse.
Greer v. Medders
© 2014 Jones and Bartlett Publishers
FraudWillful & intentional misrepresentation that could cause
harm or loss to person or property.e.g., purposeful concealment
from patient of the presence of surgical sponges in his/her
abdomen following surgery.
© 2014 Jones and Bartlett Publishers
Products LiabilityLiability of a manufacturer, seller, or supplier
of chattels to a buyer, or other third party for injuries sustained
because of a defect in a product.
© 2014 Jones and Bartlett Publishers
Products Liability Legal TheoriesNegligenceBreach of
warrantyExpressImpliedStrict liability
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NegligenceDutyProduct manufactured by the
defendantBreachProduct defective when it left the
manufacturerInjuryPlaintiff/s injured by the
productCausationProduct proximate cause of injury
© 2014 Jones and Bartlett Publishers
Defective X-ray Unit – I Mindy places Candice on the table of
the hospital’s newly manufacturer-installed x-ray unit. While in
the control room, Mindy hears a crash. She rushes to the patient
& finds that a section of the x-ray unit fell on Candice, further
injuring her already broken leg. Candice sues the manufacturer
for negligence. Can the manufacture be held liable for the
plaintiff’s injuries?
© 2014 Jones and Bartlett Publishers
YES!Duty: manufacturer to properly install the x-ray
unit.Breach: failure to properly install the x-ray unit.Injury:
plaintiff suffered injury.Causation: improper installation was
the proximate cause of the plaintiff’s injury.
© 2014 Jones and Bartlett Publishers
Express WarrantyIncludes specific promises or affirmations
made by seller to buyer.e.g., drug manufacturer represents the
product as free from addiction & is not
Crocker v. Winthrop Laboratories
*
Implied WarrantyA warranty that exists by operation of the law
as a matter of “public policy” for protection of the public.e.g.,
consumers have right to assume that food is not contaminated
Jacob E. Decker & Sons v. Capps
Strict LiabilityLiability without faultElements required to
establish strict liabilityProduct manufactured by
defendantProduct defective at time it left manufacturerPlaintiff
injured by productDefective product proximate cause of injuries
© 2014 Jones and Bartlett Publishers
Wrong Medication – IStanley refills his drug prescription at D
Drugs, where he has been a customer for 10 years. Prior to
taking his nightly dosage, he noticed the pill appeared larger
than normal. He phoned D Drugs & explained his concern. The
Pharmacist assured Stanley generic drugs sometimes are larger
because of formula fillers but that the medication dosage in his
drug was correct.
© 2014 Jones and Bartlett Publishers
Wrong Medication – IIStanley took the drug & never woke up;
the dosage given was 5 times that which had been prescribed.
The container from which the pharmacist filled Stanley’s
prescription had been mislabeled by the manufacturer.
Wrong Medication – III
Court’s DecisionProduct was manufactured by the
defendantProduct defective at time it left manufacturerThe drug
was placed in a mislabeled container.Plaintiff injured by the
productStanley passed away in his sleep.Defective product
proximate cause of injuriesThe mislabeled container was the
proximate cause of Stanley’s death.
Products Liability
Res Ipsa LoquiturMust establishProduct did not perform in way
intendedProduct not tampered with by buyer/3rd partiesDefect
existed at time it left defendant
© 2014 Jones and Bartlett Publishers
Products Liability CasesTainted Tylenol CapsulesElsroth v.
Johnson & JohnsonManufacture of unsafe drugsMerck’s Vioxx
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Products Liability Defenses – I Assumption of the
Riskvoluntary exposure to risks: Smoking, radiation therapy,
ChemotherapyIntervening Causean IV solution contaminated by
product userContributory Negligenceuse of product in a way it
was not intended to be used.
Products Liability Defenses – III Comparative Faultinjury due
to concurrent negligence of both manufacturer &
plaintiff.Disclaimers manufacturers inserts
© 2014 Jones and Bartlett Publishers
Review Questions – I
Describe the objectives of tort law.
Discuss the distinctions among negligent torts, intentional torts,
and strict liability.
What forms of negligence are described in this chapter?
How does one distinguish between negligence and malpractice?
What elements must be proven in order to be successful in a
negligence suit? Illustrate your answer with a case (the facts of
the case can be hypothetical).
© 2014 Jones and Bartlett Publishers
Review Questions – III
Can a "duty to care" be established by statute or contract?
Discuss your answer.
Describe the categories of intentional torts.
How does slander differ from libel? Give an example of each.
What is products liability? Describe what legal theories an
injured party may use in proceeding with a lawsuit against a
seller, manufacturer, or supplier of goods.
Describe the defenses often used in a products liability case.
© 2014 Jones and Bartlett Publishers
Chapter 4
Tort Law
© 2014 Jones and Bartlett Publishers
LEARNING OBJECTIVESDescribe what a tort is and the
purpose of tort law. Identify, understand, and describe the
elements of negligence. Identify and describe intentional
torts.Explain the theories a plaintiff could use in pursuing a
products liability case and the defenses a manufacturer might
use to defend itself.
© 2014 Jones and Bartlett Publishers
TortA civil wrong, other than a breach of contract, committed
against a person or property for which a court provides a
remedy in form of an action for damages.
© 2014 Jones and Bartlett Publishers
Objectives of Tort LawPreservation of peace between
individuals.Find fault for wrongdoing.Deterrence by
discouraging the wrongdoer from committing future tortious
actsCompensation to indemnify injured person/s.
© 2014 Jones and Bartlett Publishers
Categories of Tort LawNegligenceIntentionalStrict liability
regardless of fault e.g., products liability
© 2014 Jones and Bartlett Publishers
NegligenceCommission or omission of an act that a reasonably
prudent person would or would not do under given
circumstances.
© 2014 Jones and Bartlett Publishers
Commission of an ActAdministering the wrong
medicationAdministering the wrong dosage of a
medicationAdministering medication to the wrong
patientPerforming a surgical procedure without patient
consentPerforming a surgical procedure on the wrong
patientPerforming the wrong surgical procedure
Omission of an ActFailing to conduct a thorough history &
physical examinationFailing to assess & reassess a patient's
nutritional needsFailing to administer medicationsFailing to
order diagnostic testsFailing to follow up on abnormal test
results
© 2014 Jones and Bartlett Publishers
MalpracticeNegligence of a professional person surgeon who
conducts a surgical procedure on wrong body part
© 2014 Jones and Bartlett Publishers
Criminal NegligenceReckless disregard for safety of
another.Willful indifference to injury that could follow an act.
© 2014 Jones and Bartlett Publishers
Forms of NegligenceMalfeasanceExecution of an unlawful or
improper act, i.e., performing a partial birth abortion when
prohibited by lawMisfeasanceImproper performance of an act,
i.e., wrong sided surgery.NonfeasanceFailure to act when there
is a duty to act, i.e., failing to prescribe medications that should
have been under the circumstances
Degrees of NegligenceSlightMinor deviation of what is
expected under the circumstances. Ordinary NegligenceFailure
to do what a reasonably prudent person would or would not
do.Gross NegligenceIntention or wanton “omission of care” that
would be proper to provide or the “commission of an act” that
would be improper to perform.
© 2014 Jones and Bartlett Publishers
Elements of NegligenceDuty to Use Due CareStandard of
careBreach of DutyInjury/Actual DamagesProximate
Cause/CausationForeseeability
© 2014 Jones and Bartlett Publishers
I. Duty to CareObligation to conform to a recognized standard
of care.
© 2014 Jones and Bartlett Publishers
Standard of CareDescribes the conduct expected of an
individual in a given situation.Describes how a “reasonably
prudent person” would or would not act under “similar
circumstances”.Measuring stick for properly assessing actual
conduct required of an individual.
© 2014 Jones and Bartlett Publishers
Reasonably Prudent PersonA nonexistent - hypothetical person
who is put forward as community ideal of what would be
considered reasonable behavior.
© 2014 Jones and Bartlett Publishers
Similar CircumstancesCircumstances at the time of the
injury.Circumstances of the alleged wrongdoer/s at the time of
injury.AgePhysical conditionEducation & trainingLicenses
heldMental capacity, etc.
Determining StandardEstablished by legislative enactment or
administrative regulation.Adopted by the court from a
legislative enactment or administrative regulation.Established
by judicial decision.Applied to the facts of the case by the trial
judge or jury, if there is no such enactment, regulation or
decision.courts often rely on testimony of an expert witness as
to the standard of care required.
Community v. National StandardCommunity Standardhometown
standard (we want to do things our way).National Standardmost
currently accepted standard of care on a national basis.
© 2014 Jones and Bartlett Publishers
Case: Hiring PracticesNurse hired sight unseen over telephone.
Applicant falsely stated in an employee application that he was
licensed as an LPN. His license was not verified by the
employer. He had committed 56 criminal offenses of theft. He
assaulted a resident a resident & broke his leg.
Case: Hiring Practices
DutyStandard expected:Employer had a “duty” to validate the
nurse’s professional license.
II. Breach of DutyDeviation from the recognized standard of
care.Failure to adhere to an obligation.Failure to conform to or
the departure from a required duty of care owed to a
person.Occurs when a physician fails to respond to his/her on-
call duties.an employer fails to adequately conduct a pre-
employment check (e.g., licensure, background check).
Case: Hiring Practices
Breach of Duty
The employer failed to verify the applicant’s licensure.A more
thorough background check should have revealed this
employee’s previous criminal conduct.
© 2014 Jones and Bartlett Publishers
III. InjuryActual damages must be established.If there are no
injuries, no damages are due.
© 2014 Jones and Bartlett Publishers
Case: Hiring Practices
Injury
The resident suffered a broken leg.Hospital vicariously liable
for nurse’s conduct.
© 2014 Jones and Bartlett Publishers
IV. CausationProximate causebreach of duty was the proximate
cause of the injuryBut-for Rulethe defendant’s action, the injury
would not have occurred
© 2014 Jones and Bartlett Publishers
Case: Hiring Practices
CausationReasonable anticipation that harm or injury was likely
to occur.The patient suffered a broken legDeparting from
recognized standard of carefailure to verify licensure & conduct
an adequate background check
© 2014 Jones and Bartlett Publishers
Hiring Practices – IIIInjury resulted from the breach of
duty.Injury was foreseeable.
© 2014 Jones and Bartlett Publishers
Failure to Hydrate
CausationFailure to administer proper hydration.Not
unreasonable to conclude that one’s dehydration can be caused
by failing to provide water.
© 2014 Jones and Bartlett Publishers
ForeseeabilityReasonable anticipation that harm or injury is
likely to result from an act or an omission to act.
© 2014 Jones and Bartlett Publishers
Test for ForeseeabilityThe test for foreseeability is whether a
person of ordinary prudence and intelligence should have
anticipated danger to others caused by his or her negligent act.
© 2014 Jones and Bartlett Publishers
Case: Hiring Practices
ForeseeabilityA person of ordinary prudence and intelligence
should have anticipated the danger to the resident caused by the
employer’s negligent act.
© 2014 Jones and Bartlett Publishers
Hot Radiator
ForeseeabilityA patient’s left foot came in contact with a
radiator and she suffered third-degree burns.The defendant had
knowledge of the plaintiff’s condition. The defendant should
have shielded the radiator or not placed the plaintiff next to it.
Sponge & Instrument CountDr. Smith owns the local Outpatient
Surgery Center. He instructs employees to count all instruments
& surgical sponges following a surgical procedure, prior to
closing the surgical site. Annie, an employee, failed to conduct
the count following Bills surgery. Two months later, Bill,
suffering from extreme abdominal pain, was noted to have
several sponges and an instrument in his abdomen. He had
developed a massive infection.Was the doctrine of Vicarious
liability applicable in this case?
YESEven though Annie had strict instructions to count the
sponges & surgical instruments prior to closing the surgical
site, she failed to do so. To determine otherwise would
undermine the doctrine of vicarious liability, since employers
would almost always escape liability by presenting evidence
that employees were given careful instructions.
Failure to Follow InstructionsSarah has a minor surgical
procedure under general anesthesia at ABC Surgery Center. She
was instructed not to drive home after release. Her daughter
Leslie picks her up. On the way home Leslie stops for a donuts.
Meanwhile, her mother moves to the driver seat. Upon leaving
the parking lot, Sarah hits Carol’s car. Carol sustains a broken
arm & sues ABC for releasing Sarah before she is completely
recovered from the anesthesia.Was the hospital liable for
Sarah’s injuries?
NO!Sarah was negligent, not the hospital. She failed to adhere
to both verbal & written instructions not to drive following
anesthesia. It was Sarah’s duty not to drive and her breach of
that duty that caused Carol’s injury.
© 2014 Jones and Bartlett Publishers
RememberThe four elements of negligence must be presented in
order for the plaintiff to recover damages caused by negligence.
© 2014 Jones and Bartlett Publishers
Intentional TortsAssault and BatteryFalse
ImprisonmentDefamation of CharacterFraudInvasion of
PrivacyIntentional Infliction of Mental Distress
© 2014 Jones and Bartlett Publishers
AssaultDeliberate threat, coupled with apparent ability to do
physical harm to another. Actual contact not necessary.
Person attempting to touch another unlawfully must possess
apparent present ability to commit battery.
Person threatened must be aware of or have actual knowledge of
an immediate threat of a battery and must fear it.
BatteryIntentional touching of another’s person in socially
impermissible manner without person’s consent.Failure to
obtain consent prior to surgery.Administering blood against
patient’s express wishes.Physically restraining one who refuses
to eat.
False ImprisonmentUnlawful restraint of individual’s personal
liberty or unlawful restraining or confining an
individual.Restraining patient without cause.Locking patient in
secluded room for failing to attend therapy session.
Legal Justification for Restraint or SeclusionPerson represents a
danger to self or others.Criminal conduct.Persons with highly
contagious diseases, as provided by state or federal statutes.
© 2014 Jones and Bartlett Publishers
Reducing Use of Restraints – I Development of policies and
procedures that conform to state & federal guidelinesEducation
& orientation of staffEducation for patients & familiesSound
appraisal of need for restraintsApplication of least restrictive
restraintsContinuous monitoring of patients to determine
continuing need for restraints
Defamation of CharacterThe offense of injuring a person’s
character, fame, or reputation by false & malicious
statements.False oral or written communications to someone
other than person defamed that tends to hold that person’s
reputation up to scorn or ridicule in eyes of others.
© 2014 Jones and Bartlett Publishers
Defamation of CharacterLibel – written form of
defamationSignsLettersPhotographsCartoonsSlander – oral form
of defamation
© 2014 Jones and Bartlett Publishers
Proof of DefamationA false & defamatory
statement.Communication of a statement to a person other than
the plaintiff.Fault on the part of the defendant.Special monetary
harm.
© 2014 Jones and Bartlett Publishers
Proof of Harm Not Required
to recover damages when:Accusing a person of a
crime.Accusing a person of having a loathsome disease.Using
words are harmful to a person’s profession or business.Calling a
woman unchaste.
Libel – Performance AppraisalsPerformance appraisals are not
meant for general publication.To recover damages, the appraisal
must be published in defamatory manner that injures one’s
reputation.
© 2014 Jones and Bartlett Publishers
Cartoon – I Jack draws a cartoon depicting Paul having a
rendezvous with a new grad nurse in an empty patient room.
The incident in fact never occurred.Can a defamatory statement
can take the form of a cartoon?Yes, a defamatory statement can
take the form of a cartoon because it is capable of adversely
affecting a person’s reputation.
© 2014 Jones and Bartlett Publishers
Newspapers ArticlesNewspaper editorial cartoon depicting 3
persons resembling gangsters in dilapidated building, identified
as particular facility that had been closed by state order, was an
expression of pure opinion and was protected by 1st
Amendment.
Accused of an AffairNurse Rachet suggests to Dr. Smith that he
should leave his wife Sharon because she is having an affair
with Dr. Doe. Dr. Smith writes a letter to Mrs. Doe, repeating
Rachet’s statement.Assuming Dr. Smith’s letter is defamatory,
is it libel or slander?
Accused of an AffairIt is libel, even though Dr. Doe is repeating
a slanderous statement.The reverse is not true – the spoken
repetition of a written defamation is still considered libel.The
rule is: once libel, always libel.
© 2014 Jones and Bartlett Publishers
SlanderPerson who brings suit must prove special
damages.When defamatory words refer to person in professional
capacity, professional need not show that words caused damage.
© 2014 Jones and Bartlett Publishers
Defenses to a Defamation ActionTruth – no liability for
defamation if it can be shown that statement is
true.PrivilegeAbsoluteQualified
© 2014 Jones and Bartlett Publishers
Absolute PrivilegeStatements made during judicial & legislative
hearingsConfidential communications between spouses
© 2014 Jones and Bartlett Publishers
Qualified PrivilegeStatements made as result of a legal or moral
duty to speak in interests of 3rd personsStatements must be
without malice
© 2014 Jones and Bartlett Publishers
Public FiguresVulnerable to public scrutinySuits generally
dismissed in absence ofmaliceactual knowledge statements are
falserecklessness as to truth
© 2014 Jones and Bartlett Publishers
Proof of FraudMisrepresentation by the defendant.Knowledge of
falsity.Intent to reduce reliance on misrepresentation.Justifiable
reliance by the plaintiff.Damage to the plaintiff.
© 2014 Jones and Bartlett Publishers
Health Care FraudBilling Tradename Drugs/Issuing
GenericOffice Visits/Double BillingBilling for Services not
RenderedAccepting referral fees
© 2014 Jones and Bartlett Publishers
Invasion of PrivacyThe right tobe left alonebe free from
unwarranted publicitybe free from exposure to public viewbe
free from unwarranted intrusions into a one’s personal
affairspersonal privacyhave records/kept confidential
Intentional Infliction
of Mental DistressConduct that is so outrageous that it goes
beyond bounds tolerated by decent society.
© 2014 Jones and Bartlett Publishers
Mental DistressGriefShamePublic
humiliationDespairShameHuman pride
© 2014 Jones and Bartlett Publishers
Mental DistressMother shown premature infant in a jar.
Johnson v. Womens HospitalVerbally abusive
physician to patient and/or spouse.
Greer v. Medders
© 2014 Jones and Bartlett Publishers
FraudWillful & intentional misrepresentation that could cause
harm or loss to person or property.e.g., purposeful concealment
from patient of the presence of surgical sponges in his/her
abdomen following surgery.
© 2014 Jones and Bartlett Publishers
Products LiabilityLiability of a manufacturer, seller, or supplier
of chattels to a buyer, or other third party for injuries sustained
because of a defect in a product.
© 2014 Jones and Bartlett Publishers
Products Liability Legal TheoriesNegligenceBreach of
warrantyExpressImpliedStrict liability
© 2014 Jones and Bartlett Publishers
NegligenceDutyProduct manufactured by the
defendantBreachProduct defective when it left the
manufacturerInjuryPlaintiff/s injured by the
productCausationProduct proximate cause of injury
© 2014 Jones and Bartlett Publishers
Defective X-ray Unit – I Mindy places Candice on the table of
the hospital’s newly manufacturer-installed x-ray unit. While in
the control room, Mindy hears a crash. She rushes to the patient
& finds that a section of the x-ray unit fell on Candice, further
injuring her already broken leg. Candice sues the manufacturer
for negligence. Can the manufacture be held liable for the
plaintiff’s injuries?
© 2014 Jones and Bartlett Publishers
YES!Duty: manufacturer to properly install the x-ray
unit.Breach: failure to properly install the x-ray unit.Injury:
plaintiff suffered injury.Causation: improper installation was
the proximate cause of the plaintiff’s injury.
© 2014 Jones and Bartlett Publishers
Express WarrantyIncludes specific promises or affirmations
made by seller to buyer.e.g., drug manufacturer represents the
product as free from addiction & is not
Crocker v. Winthrop Laboratories
*
Implied WarrantyA warranty that exists by operation of the law
as a matter of “public policy” for protection of the public.e.g.,
consumers have right to assume that food is not contaminated
Jacob E. Decker & Sons v. Capps
Strict LiabilityLiability without faultElements required to
establish strict liabilityProduct manufactured by
defendantProduct defective at time it left manufacturerPlaintiff
injured by productDefective product proximate cause of injuries
© 2014 Jones and Bartlett Publishers
Wrong Medication – IStanley refills his drug prescription at D
Drugs, where he has been a customer for 10 years. Prior to
taking his nightly dosage, he noticed the pill appeared larger
than normal. He phoned D Drugs & explained his concern. The
Pharmacist assured Stanley generic drugs sometimes are larger
because of formula fillers but that the medication dosage in his
drug was correct.
© 2014 Jones and Bartlett Publishers
Wrong Medication – IIStanley took the drug & never woke up;
the dosage given was 5 times that which had been prescribed.
The container from which the pharmacist filled Stanley’s
prescription had been mislabeled by the manufacturer.
Wrong Medication – III
Court’s DecisionProduct was manufactured by the
defendantProduct defective at time it left manufacturerThe drug
was placed in a mislabeled container.Plaintiff injured by the
productStanley passed away in his sleep.Defective product
proximate cause of injuriesThe mislabeled container was the
proximate cause of Stanley’s death.
Products Liability
Res Ipsa LoquiturMust establishProduct did not perform in way
intendedProduct not tampered with by buyer/3rd partiesDefect
existed at time it left defendant
© 2014 Jones and Bartlett Publishers
Products Liability CasesTainted Tylenol CapsulesElsroth v.
Johnson & JohnsonManufacture of unsafe drugsMerck’s Vioxx
© 2014 Jones and Bartlett Publishers
Products Liability Defenses – I Assumption of the
Riskvoluntary exposure to risks: Smoking, radiation therapy,
ChemotherapyIntervening Causean IV solution contaminated by
product userContributory Negligenceuse of product in a way it
was not intended to be used.
Products Liability Defenses – III Comparative Faultinjury due
to concurrent negligence of both manufacturer &
plaintiff.Disclaimers manufacturers inserts
© 2014 Jones and Bartlett Publishers
Review Questions – I
Describe the objectives of tort law.
Discuss the distinctions among negligent torts, intentional torts,
and strict liability.
What forms of negligence are described in this chapter?
How does one distinguish between negligence and malpractice?
What elements must be proven in order to be successful in a
negligence suit? Illustrate your answer with a case (the facts of
the case can be hypothetical).
© 2014 Jones and Bartlett Publishers
Review Questions – III
Can a "duty to care" be established by statute or contract?
Discuss your answer.
Describe the categories of intentional torts.
How does slander differ from libel? Give an example of each.
What is products liability? Describe what legal theories an
injured party may use in proceeding with a lawsuit against a
seller, manufacturer, or supplier of goods.
Describe the defenses often used in a products liability case.
© 2014 Jones and Bartlett PublishersChapter 4.docx

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© 2014 Jones and Bartlett PublishersChapter 4.docx

  • 1. © 2014 Jones and Bartlett Publishers Chapter 4 Tort Law © 2014 Jones and Bartlett Publishers LEARNING OBJECTIVESDescribe what a tort is and the purpose of tort law. Identify, understand, and describe the elements of negligence. Identify and describe intentional torts.Explain the theories a plaintiff could use in pursuing a products liability case and the defenses a manufacturer might use to defend itself. © 2014 Jones and Bartlett Publishers TortA civil wrong, other than a breach of contract, committed against a person or property for which a court provides a remedy in form of an action for damages. © 2014 Jones and Bartlett Publishers Objectives of Tort LawPreservation of peace between
  • 2. individuals.Find fault for wrongdoing.Deterrence by discouraging the wrongdoer from committing future tortious actsCompensation to indemnify injured person/s. © 2014 Jones and Bartlett Publishers Categories of Tort LawNegligenceIntentionalStrict liability regardless of fault e.g., products liability © 2014 Jones and Bartlett Publishers NegligenceCommission or omission of an act that a reasonably prudent person would or would not do under given circumstances. © 2014 Jones and Bartlett Publishers Commission of an ActAdministering the wrong medicationAdministering the wrong dosage of a medicationAdministering medication to the wrong patientPerforming a surgical procedure without patient consentPerforming a surgical procedure on the wrong patientPerforming the wrong surgical procedure Omission of an ActFailing to conduct a thorough history & physical examinationFailing to assess & reassess a patient's nutritional needsFailing to administer medicationsFailing to order diagnostic testsFailing to follow up on abnormal test results © 2014 Jones and Bartlett Publishers
  • 3. MalpracticeNegligence of a professional person surgeon who conducts a surgical procedure on wrong body part © 2014 Jones and Bartlett Publishers Criminal NegligenceReckless disregard for safety of another.Willful indifference to injury that could follow an act. © 2014 Jones and Bartlett Publishers Forms of NegligenceMalfeasanceExecution of an unlawful or improper act, i.e., performing a partial birth abortion when prohibited by lawMisfeasanceImproper performance of an act, i.e., wrong sided surgery.NonfeasanceFailure to act when there is a duty to act, i.e., failing to prescribe medications that should have been under the circumstances Degrees of NegligenceSlightMinor deviation of what is expected under the circumstances. Ordinary NegligenceFailure to do what a reasonably prudent person would or would not do.Gross NegligenceIntention or wanton “omission of care” that would be proper to provide or the “commission of an act” that would be improper to perform. © 2014 Jones and Bartlett Publishers
  • 4. Elements of NegligenceDuty to Use Due CareStandard of careBreach of DutyInjury/Actual DamagesProximate Cause/CausationForeseeability © 2014 Jones and Bartlett Publishers I. Duty to CareObligation to conform to a recognized standard of care. © 2014 Jones and Bartlett Publishers Standard of CareDescribes the conduct expected of an individual in a given situation.Describes how a “reasonably prudent person” would or would not act under “similar circumstances”.Measuring stick for properly assessing actual conduct required of an individual. © 2014 Jones and Bartlett Publishers Reasonably Prudent PersonA nonexistent - hypothetical person who is put forward as community ideal of what would be considered reasonable behavior. © 2014 Jones and Bartlett Publishers Similar CircumstancesCircumstances at the time of the injury.Circumstances of the alleged wrongdoer/s at the time of injury.AgePhysical conditionEducation & trainingLicenses heldMental capacity, etc.
  • 5. Determining StandardEstablished by legislative enactment or administrative regulation.Adopted by the court from a legislative enactment or administrative regulation.Established by judicial decision.Applied to the facts of the case by the trial judge or jury, if there is no such enactment, regulation or decision.courts often rely on testimony of an expert witness as to the standard of care required. Community v. National StandardCommunity Standardhometown standard (we want to do things our way).National Standardmost currently accepted standard of care on a national basis. © 2014 Jones and Bartlett Publishers Case: Hiring PracticesNurse hired sight unseen over telephone. Applicant falsely stated in an employee application that he was licensed as an LPN. His license was not verified by the employer. He had committed 56 criminal offenses of theft. He assaulted a resident a resident & broke his leg. Case: Hiring Practices DutyStandard expected:Employer had a “duty” to validate the nurse’s professional license. II. Breach of DutyDeviation from the recognized standard of care.Failure to adhere to an obligation.Failure to conform to or the departure from a required duty of care owed to a person.Occurs when a physician fails to respond to his/her on-
  • 6. call duties.an employer fails to adequately conduct a pre- employment check (e.g., licensure, background check). Case: Hiring Practices Breach of Duty The employer failed to verify the applicant’s licensure.A more thorough background check should have revealed this employee’s previous criminal conduct. © 2014 Jones and Bartlett Publishers III. InjuryActual damages must be established.If there are no injuries, no damages are due. © 2014 Jones and Bartlett Publishers Case: Hiring Practices Injury The resident suffered a broken leg.Hospital vicariously liable for nurse’s conduct. © 2014 Jones and Bartlett Publishers
  • 7. IV. CausationProximate causebreach of duty was the proximate cause of the injuryBut-for Rulethe defendant’s action, the injury would not have occurred © 2014 Jones and Bartlett Publishers Case: Hiring Practices CausationReasonable anticipation that harm or injury was likely to occur.The patient suffered a broken legDeparting from recognized standard of carefailure to verify licensure & conduct an adequate background check © 2014 Jones and Bartlett Publishers Hiring Practices – IIIInjury resulted from the breach of duty.Injury was foreseeable. © 2014 Jones and Bartlett Publishers Failure to Hydrate CausationFailure to administer proper hydration.Not unreasonable to conclude that one’s dehydration can be caused by failing to provide water. © 2014 Jones and Bartlett Publishers ForeseeabilityReasonable anticipation that harm or injury is likely to result from an act or an omission to act.
  • 8. © 2014 Jones and Bartlett Publishers Test for ForeseeabilityThe test for foreseeability is whether a person of ordinary prudence and intelligence should have anticipated danger to others caused by his or her negligent act. © 2014 Jones and Bartlett Publishers Case: Hiring Practices ForeseeabilityA person of ordinary prudence and intelligence should have anticipated the danger to the resident caused by the employer’s negligent act. © 2014 Jones and Bartlett Publishers Hot Radiator ForeseeabilityA patient’s left foot came in contact with a radiator and she suffered third-degree burns.The defendant had knowledge of the plaintiff’s condition. The defendant should have shielded the radiator or not placed the plaintiff next to it. Sponge & Instrument CountDr. Smith owns the local Outpatient Surgery Center. He instructs employees to count all instruments & surgical sponges following a surgical procedure, prior to closing the surgical site. Annie, an employee, failed to conduct the count following Bills surgery. Two months later, Bill, suffering from extreme abdominal pain, was noted to have several sponges and an instrument in his abdomen. He had
  • 9. developed a massive infection.Was the doctrine of Vicarious liability applicable in this case? YESEven though Annie had strict instructions to count the sponges & surgical instruments prior to closing the surgical site, she failed to do so. To determine otherwise would undermine the doctrine of vicarious liability, since employers would almost always escape liability by presenting evidence that employees were given careful instructions. Failure to Follow InstructionsSarah has a minor surgical procedure under general anesthesia at ABC Surgery Center. She was instructed not to drive home after release. Her daughter Leslie picks her up. On the way home Leslie stops for a donuts. Meanwhile, her mother moves to the driver seat. Upon leaving the parking lot, Sarah hits Carol’s car. Carol sustains a broken arm & sues ABC for releasing Sarah before she is completely recovered from the anesthesia.Was the hospital liable for Sarah’s injuries? NO!Sarah was negligent, not the hospital. She failed to adhere to both verbal & written instructions not to drive following anesthesia. It was Sarah’s duty not to drive and her breach of that duty that caused Carol’s injury. © 2014 Jones and Bartlett Publishers RememberThe four elements of negligence must be presented in order for the plaintiff to recover damages caused by negligence.
  • 10. © 2014 Jones and Bartlett Publishers Intentional TortsAssault and BatteryFalse ImprisonmentDefamation of CharacterFraudInvasion of PrivacyIntentional Infliction of Mental Distress © 2014 Jones and Bartlett Publishers AssaultDeliberate threat, coupled with apparent ability to do physical harm to another. Actual contact not necessary. Person attempting to touch another unlawfully must possess apparent present ability to commit battery. Person threatened must be aware of or have actual knowledge of an immediate threat of a battery and must fear it. BatteryIntentional touching of another’s person in socially impermissible manner without person’s consent.Failure to obtain consent prior to surgery.Administering blood against patient’s express wishes.Physically restraining one who refuses to eat. False ImprisonmentUnlawful restraint of individual’s personal liberty or unlawful restraining or confining an individual.Restraining patient without cause.Locking patient in secluded room for failing to attend therapy session. Legal Justification for Restraint or SeclusionPerson represents a
  • 11. danger to self or others.Criminal conduct.Persons with highly contagious diseases, as provided by state or federal statutes. © 2014 Jones and Bartlett Publishers Reducing Use of Restraints – I Development of policies and procedures that conform to state & federal guidelinesEducation & orientation of staffEducation for patients & familiesSound appraisal of need for restraintsApplication of least restrictive restraintsContinuous monitoring of patients to determine continuing need for restraints Defamation of CharacterThe offense of injuring a person’s character, fame, or reputation by false & malicious statements.False oral or written communications to someone other than person defamed that tends to hold that person’s reputation up to scorn or ridicule in eyes of others. © 2014 Jones and Bartlett Publishers Defamation of CharacterLibel – written form of defamationSignsLettersPhotographsCartoonsSlander – oral form of defamation © 2014 Jones and Bartlett Publishers Proof of DefamationA false & defamatory statement.Communication of a statement to a person other than the plaintiff.Fault on the part of the defendant.Special monetary harm. © 2014 Jones and Bartlett Publishers
  • 12. Proof of Harm Not Required to recover damages when:Accusing a person of a crime.Accusing a person of having a loathsome disease.Using words are harmful to a person’s profession or business.Calling a woman unchaste. Libel – Performance AppraisalsPerformance appraisals are not meant for general publication.To recover damages, the appraisal must be published in defamatory manner that injures one’s reputation. © 2014 Jones and Bartlett Publishers Cartoon – I Jack draws a cartoon depicting Paul having a rendezvous with a new grad nurse in an empty patient room. The incident in fact never occurred.Can a defamatory statement can take the form of a cartoon?Yes, a defamatory statement can take the form of a cartoon because it is capable of adversely affecting a person’s reputation. © 2014 Jones and Bartlett Publishers Newspapers ArticlesNewspaper editorial cartoon depicting 3 persons resembling gangsters in dilapidated building, identified as particular facility that had been closed by state order, was an expression of pure opinion and was protected by 1st Amendment.
  • 13. Accused of an AffairNurse Rachet suggests to Dr. Smith that he should leave his wife Sharon because she is having an affair with Dr. Doe. Dr. Smith writes a letter to Mrs. Doe, repeating Rachet’s statement.Assuming Dr. Smith’s letter is defamatory, is it libel or slander? Accused of an AffairIt is libel, even though Dr. Doe is repeating a slanderous statement.The reverse is not true – the spoken repetition of a written defamation is still considered libel.The rule is: once libel, always libel. © 2014 Jones and Bartlett Publishers SlanderPerson who brings suit must prove special damages.When defamatory words refer to person in professional capacity, professional need not show that words caused damage. © 2014 Jones and Bartlett Publishers Defenses to a Defamation ActionTruth – no liability for defamation if it can be shown that statement is true.PrivilegeAbsoluteQualified © 2014 Jones and Bartlett Publishers Absolute PrivilegeStatements made during judicial & legislative hearingsConfidential communications between spouses © 2014 Jones and Bartlett Publishers
  • 14. Qualified PrivilegeStatements made as result of a legal or moral duty to speak in interests of 3rd personsStatements must be without malice © 2014 Jones and Bartlett Publishers Public FiguresVulnerable to public scrutinySuits generally dismissed in absence ofmaliceactual knowledge statements are falserecklessness as to truth © 2014 Jones and Bartlett Publishers Proof of FraudMisrepresentation by the defendant.Knowledge of falsity.Intent to reduce reliance on misrepresentation.Justifiable reliance by the plaintiff.Damage to the plaintiff. © 2014 Jones and Bartlett Publishers Health Care FraudBilling Tradename Drugs/Issuing GenericOffice Visits/Double BillingBilling for Services not RenderedAccepting referral fees © 2014 Jones and Bartlett Publishers Invasion of PrivacyThe right tobe left alonebe free from unwarranted publicitybe free from exposure to public viewbe free from unwarranted intrusions into a one’s personal affairspersonal privacyhave records/kept confidential
  • 15. Intentional Infliction of Mental DistressConduct that is so outrageous that it goes beyond bounds tolerated by decent society. © 2014 Jones and Bartlett Publishers Mental DistressGriefShamePublic humiliationDespairShameHuman pride © 2014 Jones and Bartlett Publishers Mental DistressMother shown premature infant in a jar. Johnson v. Womens HospitalVerbally abusive physician to patient and/or spouse. Greer v. Medders © 2014 Jones and Bartlett Publishers FraudWillful & intentional misrepresentation that could cause harm or loss to person or property.e.g., purposeful concealment from patient of the presence of surgical sponges in his/her abdomen following surgery. © 2014 Jones and Bartlett Publishers Products LiabilityLiability of a manufacturer, seller, or supplier of chattels to a buyer, or other third party for injuries sustained because of a defect in a product. © 2014 Jones and Bartlett Publishers
  • 16. Products Liability Legal TheoriesNegligenceBreach of warrantyExpressImpliedStrict liability © 2014 Jones and Bartlett Publishers NegligenceDutyProduct manufactured by the defendantBreachProduct defective when it left the manufacturerInjuryPlaintiff/s injured by the productCausationProduct proximate cause of injury © 2014 Jones and Bartlett Publishers Defective X-ray Unit – I Mindy places Candice on the table of the hospital’s newly manufacturer-installed x-ray unit. While in the control room, Mindy hears a crash. She rushes to the patient & finds that a section of the x-ray unit fell on Candice, further injuring her already broken leg. Candice sues the manufacturer for negligence. Can the manufacture be held liable for the plaintiff’s injuries? © 2014 Jones and Bartlett Publishers YES!Duty: manufacturer to properly install the x-ray unit.Breach: failure to properly install the x-ray unit.Injury: plaintiff suffered injury.Causation: improper installation was the proximate cause of the plaintiff’s injury. © 2014 Jones and Bartlett Publishers Express WarrantyIncludes specific promises or affirmations
  • 17. made by seller to buyer.e.g., drug manufacturer represents the product as free from addiction & is not Crocker v. Winthrop Laboratories * Implied WarrantyA warranty that exists by operation of the law as a matter of “public policy” for protection of the public.e.g., consumers have right to assume that food is not contaminated Jacob E. Decker & Sons v. Capps Strict LiabilityLiability without faultElements required to establish strict liabilityProduct manufactured by defendantProduct defective at time it left manufacturerPlaintiff injured by productDefective product proximate cause of injuries © 2014 Jones and Bartlett Publishers Wrong Medication – IStanley refills his drug prescription at D Drugs, where he has been a customer for 10 years. Prior to taking his nightly dosage, he noticed the pill appeared larger than normal. He phoned D Drugs & explained his concern. The Pharmacist assured Stanley generic drugs sometimes are larger because of formula fillers but that the medication dosage in his drug was correct. © 2014 Jones and Bartlett Publishers
  • 18. Wrong Medication – IIStanley took the drug & never woke up; the dosage given was 5 times that which had been prescribed. The container from which the pharmacist filled Stanley’s prescription had been mislabeled by the manufacturer. Wrong Medication – III Court’s DecisionProduct was manufactured by the defendantProduct defective at time it left manufacturerThe drug was placed in a mislabeled container.Plaintiff injured by the productStanley passed away in his sleep.Defective product proximate cause of injuriesThe mislabeled container was the proximate cause of Stanley’s death. Products Liability Res Ipsa LoquiturMust establishProduct did not perform in way intendedProduct not tampered with by buyer/3rd partiesDefect existed at time it left defendant © 2014 Jones and Bartlett Publishers Products Liability CasesTainted Tylenol CapsulesElsroth v. Johnson & JohnsonManufacture of unsafe drugsMerck’s Vioxx © 2014 Jones and Bartlett Publishers Products Liability Defenses – I Assumption of the
  • 19. Riskvoluntary exposure to risks: Smoking, radiation therapy, ChemotherapyIntervening Causean IV solution contaminated by product userContributory Negligenceuse of product in a way it was not intended to be used. Products Liability Defenses – III Comparative Faultinjury due to concurrent negligence of both manufacturer & plaintiff.Disclaimers manufacturers inserts © 2014 Jones and Bartlett Publishers Review Questions – I Describe the objectives of tort law. Discuss the distinctions among negligent torts, intentional torts, and strict liability. What forms of negligence are described in this chapter? How does one distinguish between negligence and malpractice? What elements must be proven in order to be successful in a negligence suit? Illustrate your answer with a case (the facts of the case can be hypothetical). © 2014 Jones and Bartlett Publishers Review Questions – III Can a "duty to care" be established by statute or contract? Discuss your answer. Describe the categories of intentional torts. How does slander differ from libel? Give an example of each. What is products liability? Describe what legal theories an injured party may use in proceeding with a lawsuit against a seller, manufacturer, or supplier of goods. Describe the defenses often used in a products liability case.
  • 20. © 2014 Jones and Bartlett Publishers Chapter 4 Tort Law © 2014 Jones and Bartlett Publishers LEARNING OBJECTIVESDescribe what a tort is and the purpose of tort law. Identify, understand, and describe the elements of negligence. Identify and describe intentional torts.Explain the theories a plaintiff could use in pursuing a products liability case and the defenses a manufacturer might use to defend itself. © 2014 Jones and Bartlett Publishers TortA civil wrong, other than a breach of contract, committed against a person or property for which a court provides a remedy in form of an action for damages. © 2014 Jones and Bartlett Publishers Objectives of Tort LawPreservation of peace between individuals.Find fault for wrongdoing.Deterrence by
  • 21. discouraging the wrongdoer from committing future tortious actsCompensation to indemnify injured person/s. © 2014 Jones and Bartlett Publishers Categories of Tort LawNegligenceIntentionalStrict liability regardless of fault e.g., products liability © 2014 Jones and Bartlett Publishers NegligenceCommission or omission of an act that a reasonably prudent person would or would not do under given circumstances. © 2014 Jones and Bartlett Publishers Commission of an ActAdministering the wrong medicationAdministering the wrong dosage of a medicationAdministering medication to the wrong patientPerforming a surgical procedure without patient consentPerforming a surgical procedure on the wrong patientPerforming the wrong surgical procedure Omission of an ActFailing to conduct a thorough history & physical examinationFailing to assess & reassess a patient's nutritional needsFailing to administer medicationsFailing to order diagnostic testsFailing to follow up on abnormal test results © 2014 Jones and Bartlett Publishers
  • 22. MalpracticeNegligence of a professional person surgeon who conducts a surgical procedure on wrong body part © 2014 Jones and Bartlett Publishers Criminal NegligenceReckless disregard for safety of another.Willful indifference to injury that could follow an act. © 2014 Jones and Bartlett Publishers Forms of NegligenceMalfeasanceExecution of an unlawful or improper act, i.e., performing a partial birth abortion when prohibited by lawMisfeasanceImproper performance of an act, i.e., wrong sided surgery.NonfeasanceFailure to act when there is a duty to act, i.e., failing to prescribe medications that should have been under the circumstances Degrees of NegligenceSlightMinor deviation of what is expected under the circumstances. Ordinary NegligenceFailure to do what a reasonably prudent person would or would not do.Gross NegligenceIntention or wanton “omission of care” that would be proper to provide or the “commission of an act” that would be improper to perform. © 2014 Jones and Bartlett Publishers Elements of NegligenceDuty to Use Due CareStandard of
  • 23. careBreach of DutyInjury/Actual DamagesProximate Cause/CausationForeseeability © 2014 Jones and Bartlett Publishers I. Duty to CareObligation to conform to a recognized standard of care. © 2014 Jones and Bartlett Publishers Standard of CareDescribes the conduct expected of an individual in a given situation.Describes how a “reasonably prudent person” would or would not act under “similar circumstances”.Measuring stick for properly assessing actual conduct required of an individual. © 2014 Jones and Bartlett Publishers Reasonably Prudent PersonA nonexistent - hypothetical person who is put forward as community ideal of what would be considered reasonable behavior. © 2014 Jones and Bartlett Publishers Similar CircumstancesCircumstances at the time of the injury.Circumstances of the alleged wrongdoer/s at the time of injury.AgePhysical conditionEducation & trainingLicenses heldMental capacity, etc. Determining StandardEstablished by legislative enactment or
  • 24. administrative regulation.Adopted by the court from a legislative enactment or administrative regulation.Established by judicial decision.Applied to the facts of the case by the trial judge or jury, if there is no such enactment, regulation or decision.courts often rely on testimony of an expert witness as to the standard of care required. Community v. National StandardCommunity Standardhometown standard (we want to do things our way).National Standardmost currently accepted standard of care on a national basis. © 2014 Jones and Bartlett Publishers Case: Hiring PracticesNurse hired sight unseen over telephone. Applicant falsely stated in an employee application that he was licensed as an LPN. His license was not verified by the employer. He had committed 56 criminal offenses of theft. He assaulted a resident a resident & broke his leg. Case: Hiring Practices DutyStandard expected:Employer had a “duty” to validate the nurse’s professional license. II. Breach of DutyDeviation from the recognized standard of care.Failure to adhere to an obligation.Failure to conform to or the departure from a required duty of care owed to a person.Occurs when a physician fails to respond to his/her on- call duties.an employer fails to adequately conduct a pre-
  • 25. employment check (e.g., licensure, background check). Case: Hiring Practices Breach of Duty The employer failed to verify the applicant’s licensure.A more thorough background check should have revealed this employee’s previous criminal conduct. © 2014 Jones and Bartlett Publishers III. InjuryActual damages must be established.If there are no injuries, no damages are due. © 2014 Jones and Bartlett Publishers Case: Hiring Practices Injury The resident suffered a broken leg.Hospital vicariously liable for nurse’s conduct. © 2014 Jones and Bartlett Publishers
  • 26. IV. CausationProximate causebreach of duty was the proximate cause of the injuryBut-for Rulethe defendant’s action, the injury would not have occurred © 2014 Jones and Bartlett Publishers Case: Hiring Practices CausationReasonable anticipation that harm or injury was likely to occur.The patient suffered a broken legDeparting from recognized standard of carefailure to verify licensure & conduct an adequate background check © 2014 Jones and Bartlett Publishers Hiring Practices – IIIInjury resulted from the breach of duty.Injury was foreseeable. © 2014 Jones and Bartlett Publishers Failure to Hydrate CausationFailure to administer proper hydration.Not unreasonable to conclude that one’s dehydration can be caused by failing to provide water. © 2014 Jones and Bartlett Publishers ForeseeabilityReasonable anticipation that harm or injury is likely to result from an act or an omission to act. © 2014 Jones and Bartlett Publishers
  • 27. Test for ForeseeabilityThe test for foreseeability is whether a person of ordinary prudence and intelligence should have anticipated danger to others caused by his or her negligent act. © 2014 Jones and Bartlett Publishers Case: Hiring Practices ForeseeabilityA person of ordinary prudence and intelligence should have anticipated the danger to the resident caused by the employer’s negligent act. © 2014 Jones and Bartlett Publishers Hot Radiator ForeseeabilityA patient’s left foot came in contact with a radiator and she suffered third-degree burns.The defendant had knowledge of the plaintiff’s condition. The defendant should have shielded the radiator or not placed the plaintiff next to it. Sponge & Instrument CountDr. Smith owns the local Outpatient Surgery Center. He instructs employees to count all instruments & surgical sponges following a surgical procedure, prior to closing the surgical site. Annie, an employee, failed to conduct the count following Bills surgery. Two months later, Bill, suffering from extreme abdominal pain, was noted to have several sponges and an instrument in his abdomen. He had developed a massive infection.Was the doctrine of Vicarious
  • 28. liability applicable in this case? YESEven though Annie had strict instructions to count the sponges & surgical instruments prior to closing the surgical site, she failed to do so. To determine otherwise would undermine the doctrine of vicarious liability, since employers would almost always escape liability by presenting evidence that employees were given careful instructions. Failure to Follow InstructionsSarah has a minor surgical procedure under general anesthesia at ABC Surgery Center. She was instructed not to drive home after release. Her daughter Leslie picks her up. On the way home Leslie stops for a donuts. Meanwhile, her mother moves to the driver seat. Upon leaving the parking lot, Sarah hits Carol’s car. Carol sustains a broken arm & sues ABC for releasing Sarah before she is completely recovered from the anesthesia.Was the hospital liable for Sarah’s injuries? NO!Sarah was negligent, not the hospital. She failed to adhere to both verbal & written instructions not to drive following anesthesia. It was Sarah’s duty not to drive and her breach of that duty that caused Carol’s injury. © 2014 Jones and Bartlett Publishers RememberThe four elements of negligence must be presented in order for the plaintiff to recover damages caused by negligence. © 2014 Jones and Bartlett Publishers
  • 29. Intentional TortsAssault and BatteryFalse ImprisonmentDefamation of CharacterFraudInvasion of PrivacyIntentional Infliction of Mental Distress © 2014 Jones and Bartlett Publishers AssaultDeliberate threat, coupled with apparent ability to do physical harm to another. Actual contact not necessary. Person attempting to touch another unlawfully must possess apparent present ability to commit battery. Person threatened must be aware of or have actual knowledge of an immediate threat of a battery and must fear it. BatteryIntentional touching of another’s person in socially impermissible manner without person’s consent.Failure to obtain consent prior to surgery.Administering blood against patient’s express wishes.Physically restraining one who refuses to eat. False ImprisonmentUnlawful restraint of individual’s personal liberty or unlawful restraining or confining an individual.Restraining patient without cause.Locking patient in secluded room for failing to attend therapy session. Legal Justification for Restraint or SeclusionPerson represents a danger to self or others.Criminal conduct.Persons with highly
  • 30. contagious diseases, as provided by state or federal statutes. © 2014 Jones and Bartlett Publishers Reducing Use of Restraints – I Development of policies and procedures that conform to state & federal guidelinesEducation & orientation of staffEducation for patients & familiesSound appraisal of need for restraintsApplication of least restrictive restraintsContinuous monitoring of patients to determine continuing need for restraints Defamation of CharacterThe offense of injuring a person’s character, fame, or reputation by false & malicious statements.False oral or written communications to someone other than person defamed that tends to hold that person’s reputation up to scorn or ridicule in eyes of others. © 2014 Jones and Bartlett Publishers Defamation of CharacterLibel – written form of defamationSignsLettersPhotographsCartoonsSlander – oral form of defamation © 2014 Jones and Bartlett Publishers Proof of DefamationA false & defamatory statement.Communication of a statement to a person other than the plaintiff.Fault on the part of the defendant.Special monetary harm. © 2014 Jones and Bartlett Publishers
  • 31. Proof of Harm Not Required to recover damages when:Accusing a person of a crime.Accusing a person of having a loathsome disease.Using words are harmful to a person’s profession or business.Calling a woman unchaste. Libel – Performance AppraisalsPerformance appraisals are not meant for general publication.To recover damages, the appraisal must be published in defamatory manner that injures one’s reputation. © 2014 Jones and Bartlett Publishers Cartoon – I Jack draws a cartoon depicting Paul having a rendezvous with a new grad nurse in an empty patient room. The incident in fact never occurred.Can a defamatory statement can take the form of a cartoon?Yes, a defamatory statement can take the form of a cartoon because it is capable of adversely affecting a person’s reputation. © 2014 Jones and Bartlett Publishers Newspapers ArticlesNewspaper editorial cartoon depicting 3 persons resembling gangsters in dilapidated building, identified as particular facility that had been closed by state order, was an expression of pure opinion and was protected by 1st Amendment.
  • 32. Accused of an AffairNurse Rachet suggests to Dr. Smith that he should leave his wife Sharon because she is having an affair with Dr. Doe. Dr. Smith writes a letter to Mrs. Doe, repeating Rachet’s statement.Assuming Dr. Smith’s letter is defamatory, is it libel or slander? Accused of an AffairIt is libel, even though Dr. Doe is repeating a slanderous statement.The reverse is not true – the spoken repetition of a written defamation is still considered libel.The rule is: once libel, always libel. © 2014 Jones and Bartlett Publishers SlanderPerson who brings suit must prove special damages.When defamatory words refer to person in professional capacity, professional need not show that words caused damage. © 2014 Jones and Bartlett Publishers Defenses to a Defamation ActionTruth – no liability for defamation if it can be shown that statement is true.PrivilegeAbsoluteQualified © 2014 Jones and Bartlett Publishers Absolute PrivilegeStatements made during judicial & legislative hearingsConfidential communications between spouses © 2014 Jones and Bartlett Publishers
  • 33. Qualified PrivilegeStatements made as result of a legal or moral duty to speak in interests of 3rd personsStatements must be without malice © 2014 Jones and Bartlett Publishers Public FiguresVulnerable to public scrutinySuits generally dismissed in absence ofmaliceactual knowledge statements are falserecklessness as to truth © 2014 Jones and Bartlett Publishers Proof of FraudMisrepresentation by the defendant.Knowledge of falsity.Intent to reduce reliance on misrepresentation.Justifiable reliance by the plaintiff.Damage to the plaintiff. © 2014 Jones and Bartlett Publishers Health Care FraudBilling Tradename Drugs/Issuing GenericOffice Visits/Double BillingBilling for Services not RenderedAccepting referral fees © 2014 Jones and Bartlett Publishers Invasion of PrivacyThe right tobe left alonebe free from unwarranted publicitybe free from exposure to public viewbe free from unwarranted intrusions into a one’s personal affairspersonal privacyhave records/kept confidential
  • 34. Intentional Infliction of Mental DistressConduct that is so outrageous that it goes beyond bounds tolerated by decent society. © 2014 Jones and Bartlett Publishers Mental DistressGriefShamePublic humiliationDespairShameHuman pride © 2014 Jones and Bartlett Publishers Mental DistressMother shown premature infant in a jar. Johnson v. Womens HospitalVerbally abusive physician to patient and/or spouse. Greer v. Medders © 2014 Jones and Bartlett Publishers FraudWillful & intentional misrepresentation that could cause harm or loss to person or property.e.g., purposeful concealment from patient of the presence of surgical sponges in his/her abdomen following surgery. © 2014 Jones and Bartlett Publishers Products LiabilityLiability of a manufacturer, seller, or supplier of chattels to a buyer, or other third party for injuries sustained because of a defect in a product. © 2014 Jones and Bartlett Publishers
  • 35. Products Liability Legal TheoriesNegligenceBreach of warrantyExpressImpliedStrict liability © 2014 Jones and Bartlett Publishers NegligenceDutyProduct manufactured by the defendantBreachProduct defective when it left the manufacturerInjuryPlaintiff/s injured by the productCausationProduct proximate cause of injury © 2014 Jones and Bartlett Publishers Defective X-ray Unit – I Mindy places Candice on the table of the hospital’s newly manufacturer-installed x-ray unit. While in the control room, Mindy hears a crash. She rushes to the patient & finds that a section of the x-ray unit fell on Candice, further injuring her already broken leg. Candice sues the manufacturer for negligence. Can the manufacture be held liable for the plaintiff’s injuries? © 2014 Jones and Bartlett Publishers YES!Duty: manufacturer to properly install the x-ray unit.Breach: failure to properly install the x-ray unit.Injury: plaintiff suffered injury.Causation: improper installation was the proximate cause of the plaintiff’s injury. © 2014 Jones and Bartlett Publishers Express WarrantyIncludes specific promises or affirmations made by seller to buyer.e.g., drug manufacturer represents the
  • 36. product as free from addiction & is not Crocker v. Winthrop Laboratories * Implied WarrantyA warranty that exists by operation of the law as a matter of “public policy” for protection of the public.e.g., consumers have right to assume that food is not contaminated Jacob E. Decker & Sons v. Capps Strict LiabilityLiability without faultElements required to establish strict liabilityProduct manufactured by defendantProduct defective at time it left manufacturerPlaintiff injured by productDefective product proximate cause of injuries © 2014 Jones and Bartlett Publishers Wrong Medication – IStanley refills his drug prescription at D Drugs, where he has been a customer for 10 years. Prior to taking his nightly dosage, he noticed the pill appeared larger than normal. He phoned D Drugs & explained his concern. The Pharmacist assured Stanley generic drugs sometimes are larger because of formula fillers but that the medication dosage in his drug was correct. © 2014 Jones and Bartlett Publishers
  • 37. Wrong Medication – IIStanley took the drug & never woke up; the dosage given was 5 times that which had been prescribed. The container from which the pharmacist filled Stanley’s prescription had been mislabeled by the manufacturer. Wrong Medication – III Court’s DecisionProduct was manufactured by the defendantProduct defective at time it left manufacturerThe drug was placed in a mislabeled container.Plaintiff injured by the productStanley passed away in his sleep.Defective product proximate cause of injuriesThe mislabeled container was the proximate cause of Stanley’s death. Products Liability Res Ipsa LoquiturMust establishProduct did not perform in way intendedProduct not tampered with by buyer/3rd partiesDefect existed at time it left defendant © 2014 Jones and Bartlett Publishers Products Liability CasesTainted Tylenol CapsulesElsroth v. Johnson & JohnsonManufacture of unsafe drugsMerck’s Vioxx © 2014 Jones and Bartlett Publishers Products Liability Defenses – I Assumption of the Riskvoluntary exposure to risks: Smoking, radiation therapy,
  • 38. ChemotherapyIntervening Causean IV solution contaminated by product userContributory Negligenceuse of product in a way it was not intended to be used. Products Liability Defenses – III Comparative Faultinjury due to concurrent negligence of both manufacturer & plaintiff.Disclaimers manufacturers inserts © 2014 Jones and Bartlett Publishers Review Questions – I Describe the objectives of tort law. Discuss the distinctions among negligent torts, intentional torts, and strict liability. What forms of negligence are described in this chapter? How does one distinguish between negligence and malpractice? What elements must be proven in order to be successful in a negligence suit? Illustrate your answer with a case (the facts of the case can be hypothetical). © 2014 Jones and Bartlett Publishers Review Questions – III Can a "duty to care" be established by statute or contract? Discuss your answer. Describe the categories of intentional torts. How does slander differ from libel? Give an example of each. What is products liability? Describe what legal theories an injured party may use in proceeding with a lawsuit against a seller, manufacturer, or supplier of goods. Describe the defenses often used in a products liability case.