Mock Final Exam II Flashcards
Which federal law established the National Practitioner Data Bank (NPDB)?
A) HIPAA
B) Health Care Quality Improvement Act
C) Patient Protection and Affordable Care Act
D) Emergency Medical Treatment and Labor Act
B) Health Care Quality Improvement Act
Which of the following is NOT a required element for peer review immunity under HCQIA?
A) Actions taken in reasonable belief of furthering quality healthcare
B) Reasonable effort to obtain facts
C) Adequate notice and hearing procedures
D) Proof of actual improvement in patient outcomes
D) Proof of actual improvement in patient outcomes
What is the primary purpose of a living will?
A) To provide financial planning for end-of-life care
B) To designate someone to make healthcare decisions
C) To specify treatment preferences when incapacitated
D) To distribute property after death
C) To specify treatment preferences when incapacitated
In which case did the Supreme Court uphold the ACA’s individual mandate as a valid exercise of Congress’s taxing power?
A) King v. Burwell
B) NFIB v. Sebelius
C) Cruzan v. Director, Missouri Department of Health
D) Burwell v. Hobby Lobby
B) NFIB v. Sebelius
What legal principle prevents relitigation of issues that have already been decided in a previous case between the same parties?
A) Stare decisis
B) Res judicata
C) Res ipsa loquitur
D) Due process
B) Res judicata
Which doctrine holds that “the thing speaks for itself” in negligence cases where the injury wouldn’t occur without negligence?
A) Respondeat superior
B) Res ipsa loquitur
C) Stare decisis
D) Res judicata
B) Res ipsa loquitur
Compare and contrast the Quinlan case with Cruzan v. Director, Missouri Department of Health. How did these landmark decisions shape the legal framework for end-of-life decision making?
In re Quinlan (1976) established a constitutional right to privacy that extended to refusing life-sustaining treatment, allowing Karen’s father as guardian to exercise this right on her behalf. The New Jersey court emphasized the family’s role in decision-making. Cruzan (1990) was the first Supreme Court case on this issue, recognizing a constitutionally protected liberty interest in refusing unwanted treatment but also upholding Missouri’s requirement for “clear and convincing evidence” of the patient’s wishes. While Quinlan focused on privacy rights and family decision-making, Cruzan focused on liberty interests and evidentiary standards.
Together, these cases established that:
1) patients have a right to refuse treatment,
2) this right extends to incompetent patients,
3) states have legitimate interests in protecting life, and
4) advance directives are critical for documenting wishes.
he “captain-of-the-ship” doctrine in healthcare liability:
A) Has been strengthened by recent court decisions
B) Makes hospital administrators liable for all decisions
C) Has largely been abandoned in favor of recognizing the team approach to healthcare
D) Makes insurance companies the primary liable party
C) Has largely been abandoned in favor of recognizing the team approach to healthcare
Under EMTALA, a hospital is required to do all of the following EXCEPT:
A) Provide an appropriate medical screening examination
B) Stabilize emergency medical conditions before transfer
C) Accept all transfers from other facilities
D) Maintain a list of on-call physicians
C) Accept all transfers from other facilities
Which case established that a hospital can be liable for negligently granting privileges to an incompetent physician?
A) Darling v. Charleston Community Memorial Hospital
B) Johnson v. Misericordia Community Hospital
C) Thompson v. Nason Hospital
D) Bing v. Thunig
B) Johnson v. Misericordia Community Hospital
Evaluate the evolution from the “locality rule” to a national standard of care in medical malpractice. What factors drove this change and how does it impact rural healthcare providers?
The locality rule originally limited the standard of care to physicians in the same or similar communities, recognizing geographic disparities in resources and training.
The evolution to a national standard was driven by:
1) standardization of medical education and board certification,
2) improved communication and access to information,
3) nationwide practice guidelines, and
4) recognition that geography shouldn’t determine quality of care.
Rural providers now face challenges including: being held to standards developed in resource-rich environments, difficulty recruiting specialists, limited access to cutting-edge technology, and potential increased liability exposure.
Courts have addressed this through the “justifiable circumstances” defense, acknowledging that rural providers aren’t responsible when necessary resources are unavailable despite reasonable efforts to obtain them.
Under the doctrine of apparent agency, hospitals may be liable for independent contractors when:
A) The contractor carries malpractice insurance
B) Patients reasonably believe the contractor is a hospital employee
C) The hospital has more than 100 beds
D) The contractor has privileges at multiple facilities
B) Patients reasonably believe the contractor is a hospital employee
What legal doctrine makes an employer liable for the negligent acts of employees performed within the scope of employment?
A) Respondeat superior
B) Corporate negligence
C) Personal jurisdiction
D) Informed consent
A) Respondeat superior
In the case Schloendorff v. Society of New York Hospital, the court established:
A) The duty to provide emergency care
B) The right to determine what happens to one’s body
C) The standard for hospital liability
D) The requirement for written consent
B) The right to determine what happens to one’s body
Explain how the Ostrowski v. Azzara case changed how courts view patient conduct in contributory negligence claims. What implications does this have for healthcare providers treating patients with health-harming behaviors?
Ostrowski v. Azzara established that patient pre-treatment negligence (like smoking despite diabetes) should be evaluated separately from post-treatment conduct. The court recognized that patients’ harmful habits may be the very reason they need medical care, and that addiction and socioeconomic factors complicate behavioral change.
Healthcare providers must:
1) document thorough counseling about behavioral modifications,
2) avoid discriminating against patients with harmful habits,
3) recognize that recovery depends on both provider care and patient cooperation, and
4) understand that while patients bear responsibility for post-treatment compliance, their pre-treatment lifestyle typically doesn’t reduce provider liability.
This creates a balanced approach that holds providers to professional standards while acknowledging patients’ responsibility in their recovery.
Which of the following is NOT a type of Alternative Dispute Resolution in healthcare?
A) Arbitration
B) Mediation
C) Statutory intervention
D) Negotiation
C) Statutory intervention
What does the “reasonable patient standard” for informed consent require physicians to disclose?
A) Only what other physicians typically disclose
B) All possible risks, regardless of likelihood
C) Information a reasonable patient would consider material to their decision
D) Only information contained in standardized consent forms
C) Information a reasonable patient would consider material to their decision
A strict liability claim in healthcare typically applies to:
A) Services provided by healthcare professionals
B) Defective medical products or devices
C) Administrative decisions by hospital executives
D) Policy decisions by insurance companies
B) Defective medical products or devices
In Tarasoff v. Regents, the court established that healthcare providers have a duty to:
A) Report all mental health conditions to authorities
B) Warn identifiable third parties of threats
C) Prevent all patient violence
D) Breech confidentiality in all dangerous situations
B) Warn identifiable third parties of threats
Analyze how ERISA preemption affects malpractice claims against managed care organizations. What has been described as the “tangled ERISA regime” and how does it impact patient remedies?
RISA preemption creates a bifurcated system where state law claims against MCOs for coverage decisions are preempted when employee benefit plans are involved, while direct care decisions may still be subject to state law.
The “tangled ERISA regime” refers to this complex framework where:
1) patients with employer-based plans have limited remedies (typically only the cost of denied benefits, not consequential damages),
2) identical medical decisions may face different liability standards depending on plan type, and
3) courts struggle to distinguish between “quality of care” and “benefits administration” decisions.
This regime impacts patients by restricting meaningful compensation for injuries resulting from improper coverage denials, creating inconsistent protections, and shifting liability disproportionately to providers even when MCO policies influenced care decisions. Despite criticism, Congress has not clarified or reformed this system.
What is “corporate practice of medicine” prohibition?
A) The restriction on physicians practicing in multiple states
B) Laws preventing corporations from directly employing physicians
C) Rules against physicians forming their own corporations
D) Regulations preventing hospitals from advertising
B) Laws preventing corporations from directly employing physicians
Which of the following is NOT a requirement for EMTALA compliance?
A) Appropriate medical screening for emergency conditions
B) Treatment to stabilize emergency medical conditions
C) Following proper transfer procedures
D) Providing ongoing care until full recovery
D) Providing ongoing care until full recovery
According to Ybarra v. Spangard, res ipsa loquitur can be applied to:
A) Multiple defendants who had control over the patient
B) Only the surgeon who performed the procedure
C) Hospital administrators exclusively
D) Third-party payers who denied coverage
A) Multiple defendants who had control over the patient
Compare how courts have treated wrongful birth versus wrongful life claims. Why have most courts been reluctant to recognize wrongful life claims despite acknowledging wrongful birth?
Courts have generally recognized wrongful birth claims (brought by parents) while rejecting wrongful life claims (brought on behalf of children). Most courts accept wrongful birth because damages are calculable based on extraordinary costs of raising a child with disabilities that parents would have avoided with proper information.
Courts reject wrongful life claims because they:
1) struggle philosophically with the notion that non-existence is preferable to life with disability,
2) find it impossible to calculate damages comparing existence with non-existence,
3) worry about devaluing lives of disabled persons, and
4) fear expanding liability beyond reasonable bounds.
The few states recognizing wrongful life typically limit recovery to special damages like medical costs rather than general damages for “being born.” This distinction reflects courts’ comfort with compensating parents’ economic losses while avoiding philosophical determinations about the value of impaired life.
