What must a physician provide to a patient once a doctor patient relationship has formed?
- Standard of Care
- Informed Consent
What are the exceptions to confidentiality?
- Gunshot and knife wounds
- Resonable suspicion of abuse or neglect
- Communicable diseases
- Neurological impairment that affects driving
- Patient poses imminent danger to self or others
What is medical malpractice?
Breach of any duty owed as a physician
What are the most common reasons for a malpractice claim in the inpatient and outpatient setting?
Inpatient - surgical errors (34%)
Outpatient - diagnostic errors (46%)
What are the primary reasons malpractice patients give for sueing?
- Concern with standards of care - patients/relatives want to prevent similar incidents in the future
- The need for an explanation - to know how the injury happened and why
- Compensation - for actual losses, pain, and suffering, or to provide care in the future for an injured person
- Accountability - a belief that the staff/organization should have to account for their actions
What is a PRONE score?
A score that predicts the risk of becoming the subject of repeated patient complaints.
What are the four elements of malpractice litigation?
- Duty - determining what your duty was to that patient
- Breach of Duty - determining if you breached that duty
- Causation - determining the cause of that breach
- Damages - determining what the damages will be
Is a failure to disclose information to a patient considered breach of duty?
What are the three elements to establishing that a lack of disclosure lead to the patient being injured?
- Had disclosure been made, the patient would not have consented
- Had disclosure been made, a reasonable person in the patient's circumstances would not have consented
- The materialized risk must have been caused by the intervention
How is causation determined in a malpractice trial?
Expert opinion is used to provide numbers for the risk of patient harm before and after the physician's breach of duty. If the physician's breach of duty caused 50% or more of the patient's risk of harm, the patient is awarded 100% of damages. If the physician's breach of duty caused 49% or less of the patient's risk of harm, the patient is awarded 0% of the damages.
Differentiate negligence from gross negligence
Negligence - lack of care due to carelessness
Gross Negligence - greater lack of care than ordinary or reckless disregard of substantial risk
No awareness or consciousness required to declare either
What are good samaritan laws? What are the requirements for them to apply?
Laws that protect volunteers from civil liability for acts or omissions that cause injury to another while providing assistance in an emergency.
No protection agains gross negligence
- Outside medical setting
- No pre-existing duty to provide care
- No expectation of remuneration of any sort
- Recipient does not object