Chpt 7

Question 1

Assumption of risk

Answer 1

A defense to medical malpractice that physicians can use to prove they made the patients aware of the risks of their procedures
Relies on a detailed consent form signed by patient

Question 2

Claims-made policies

Answer 2

One of 2 types of malpractice insurance
Policies that protect policyholders from malpractice claims only when the insurance company insuring the policyholders at the time of alleged malpractice is the same company at the time the claim is filed in court.

Question 3

Comparative negligence

Answer 3

When both the physician and the patient are found to be responsible for an injury.

Question 4

Compensatory award

Answer 4

Money that is awarded to a patient or patient’s family to compensate for the cost of medical care, disability, mental suffering, any loss of income, and the loss of future income as a result of injury.

Question 5

Continuing education

Answer 5

Educational courses or seminars taken by professionals to further knowledge or skills

Question 6

Contributory negligence

Answer 6

A malpractice defense in which a physician may have been at fault for a patient’s injury but can prove that the patient aggravated the injury or in some way worsened it.

Question 7

Damages

Answer 7

The actual costs associated with the injury sustained, such as medical care
Patient must prove they sustained damages: physical or mental disability , loss of enjoyment of life activities , loss of financial earnings , medical expenses, pain and suffering, loss of relationships

Question 8

Dereliction of duty

Answer 8

Physicians must meet standard of care guidelines for a healthcare provider with the same training, in the same location , and under the same circumstances

Question 9

Direct cause

Answer 9

A patient must prove that the patient physician’s actions, or lack of actions, directly caused the patient’s injuries

Question 10

Discovery rule

Question 11

Duty

Answer 11

Physicians have a duty to care for patients once they have taken those patients on

Question 12

Immunity

Answer 12

Protection from being held responsible monetarily in a lawsuit

Question 13

Informed consent

Answer 13

Physicians must give patients all information about a procedure, including risks and alternatives to the procedure.
Cuts back on malpractice suits

Question 14

Malfeasance

Answer 14

Performing an incorrect treatment, such an operating on the wrong patient

Question 15

Malpractice

Answer 15

Medical negligence that results in a patient being harmed in some way.
3 types: malfeasance, misfeasance & nonfeasance

Question 16

Malpractice insurance policy

Answer 16

Liability insurance used to protect a physician in the event of a medical mistake or error
Policies available through local and state associations

Question 17

Misfeasance

Answer 17

Performing a treatment incorrectly, such as operating on a patient’s arm and accidentally severing a nerve, leaving the patient without the use of the arm

Question 18

Nominal award

Answer 18

A small award or payment that is made when negligence is proven, but the damages are minimal

Question 19

Nonfeasance

Answer 19

Delaying or failing to perform treatment

Question 20

Occurrence policies

Answer 20

Policies that cover policyholders regardless of when claims are filed provided the policies were in effect at the time of the alleged malpractice events

Question 21

Punitive award

Answer 21

An award made when judges or juries feel that a healthcare provider should be punished for his or her actions
Several states do not allow for punitive damages

Question 22

Res ipsa loquitor

Answer 22

Latin
The thing speaks for itself
The malpractice is obvious
In these cases the physician must prove that what they did is correct

Question 23

Res judicata

Answer 23

Latin
The thing has been decided
Once a case has been decided in a physician’s favor, the case must be dropped.
When finding in a patient’s favor, the doctor can appeal hoping for a lower settlement or reversal a

Question 24

Respondeat superior

Answer 24

Latin
Let the master answer
Lawsuit can be filed against physician for mistake of staff
Each staff member can be named so they should carry malpractice insurance policies
Doctrine covers employees performing within their scope of practice at time of injury.

Question 25

Scope of practice

Answer 25

The skills practiced by a person who has received training in a particular profession

Question 26

Settled

Answer 26

A case is considered to be settled when the two sides in a lawsuit agree on a financial award to the injured patient

Question 27

Standard of care

Answer 27

The amount and type of care that a reasonable and prudent person would provide, given the same training and circumstances

Question 28

Statute of limitations

Answer 28

The period of time provided by law for a patient to file a malpractice lawsuit from the date of the injury. Some states allow this to be from the date the injury is discovered, the discovery rule Some states when a child turns 18, so they can bring the lawsuit on their own behalf.

Question 29

Subpoena

Answer 29

Signed by a judge Authorizes the physician to release information without a patient signature Facility is not required to notify the patient of the subpoena or release of information but many will as a courtesy HIPAA requires medical facilities to keep records of all patient-record disclosures and to make those records available to patients upon request

Question 30

Tort

Answer 30

Wrongful act that leads to damages sustained by another

Question 31

Checking credentials of healthcare professionals

Answer 31

Require copy of state licensure if applicable Follow up: all licenses should be renewed each year- manager can do this or contract out the verification

Question 32

Check on professionals

Answer 32

Licensure Malpractice insurance if not provided by company Verify credentials and work history Research any malpractice claims filed against a provider Check state licensure in other states

Question 33

Personnel files

Answer 33

License Malpractice coverage Copy of CE credits

Question 34

Borrowed servant

Answer 34

Doctrine in which an employee involved in a malpractice event is employed by a temp agency, not the physician or facility, is a borrowed servant and is covered by the physician or facility where the negligence occurred

Question 35

Tail

Answer 35

A rider on a new policy stating that the new company will cover any events for a certain period before the policy’s purchase

Question 36

To prove medical malpractice

Answer 36

4 Ds Duty Dereliction of duty Direct cause Damages

Question 37

Negligent torts

Answer 37

Did not intentionally cause injury

Question 38

Intentional torts

Answer 38

Proven to have been caused purposefully

Question 39

Malpractice awards

Answer 39

1in 10 cases result in awards or settlements

Question 40

Wrongful death statutes

Answer 40

Monetary losses will be limited to financial earnings over course of life. Payment may be made for loss of childcare, cooking and cleaning Some states allow suing for pain and suffering but place a cap on award

Question 41

Apologies

Answer 41

Apparently cut back on lawsuits 29 states: apologies are not considered proof of malpractice

Question 42

Best defense against malpractice suit

Answer 42

An accurate and complete medical record

Question 43

Statute of limitations LA and MS

Answer 43

LA: 1 year from date of injury MS: 2 years from date of injury or date of discovery. Must be filed within 7 years of the date of injury

Question 44

Additional liability

Answer 44

If a member of the healthcare team notices a problem but doesn’t speak up, they can be held partly responsible for the injuries.

Question 45

Federal Claims Tort Act of 1946

Answer 45

Prohibits lawsuits against any U. S. Governmental facility Provides for ordinary negligence, not intentional injury.

Question 46

Fraud

Answer 46

A deliberate act to conceal facts in order to receive illegal or unfair gain.

Question 47

Instances of fraud

Answer 47

Billing for services not rendered Intentionally charging for more extensive services than those performed Kickbacks Falsify medical records Cover up errors

Question 48

Fraud penalties

Answer 48

Can result in criminal charges This can occur due to intentional or nonintentional fraud

Question 49

Reportable conditions

Answer 49

Birth certificates Death Certificates Infectious or communicable disease reporting Lists can be obtained from state or local health departments and should be updated yearly

Question 50

1986 National Childhood Vaccine Injury Act

Answer 50

Vaccine injuries must be reported to alert other physicians of possibly contaminated batches of vaccine Manager reports patient name and age as well as the name and lot number of the vaccine

Question 51

Medical practice acts

Answer 51

Each state has them List duties and responsibilities of physicians and actions that may be causes of disciplinary actions Being convicted of a felony or be proven to have abused a patient can lead to license revocation

Question 52

Invasive procedure protocol

Answer 52

Patient must be given complete information and sign an informed consent indicating that they understand the risks

Question 53

Physicians can refuse patients

Answer 53

New patients or even existing ones Unless there are life-threatening emergent conditions May not abandon a patient-must have someone to cover the practice in the event of an emergency, even for a vacation Policies and availabilities can be changed with proper notification

Question 54

Termination of care

Answer 54

Physicians may terminate a patient for noncompliance with healthcare orders, nonpayment of medical bills, drug-seeking behavior, & not showing up for scheduled appointments Must send the patient a letter alerting the patient of termination of the relationship. Should offer to refer the patient to another physician and to transfer the medical records to the new physician

Question 55

Patient satisfaction survey

Answer 55

Sent randomly to patients Rate pleasantness of staff, cleanliness of office, time spent waiting to be seen, the explanation given regarding the patient’s condition Used to make improvements and to counsel staff and physicians

Question 56

Ethical codes

Answer 56

Found on the websites of each professional organization Often if a physician asks the staff to perform tasks outside their scope of practice they don’t know the scope. Tell the manager. They can explain the scope of practice Patients must be treated lawfully, ethically and to have their charts documented correctly

Question 57

Minors

Answer 57

Laws for releasing minors information vary from state to state, the manager must know the laws in their state. Minors may receive copies of only those documents their parents can’t see. Parents would receive copies of the other. Ex. Std info, birth control or abortion, mental health, alcohol or drug rehab Versus vaccines