11/14 licensure Flashcards
malpractice increases in suits due to
- role of medical advances
- changing social conditions
- patient expectations
malpractice claims increasing?
yes
- likely due to increases in tech- like CBCT readings
highest claim in what specialty
prosth, endo, restorative, diagnosis
ortho least
lifecycle of a lawsuit
- doctor recieves complaint letter from patient or attorny that states doctor is being sued
- letter contains allegations that describe harm to the patient
- could be incident or complaint
- can incident be managed? - if complaint? – this letter from an attorny must be reported to a malpractice carrier
incident is
disgrunted patient
complaint is
from the patietns attorny
if recieve complaint?
this letter from an attorny must be reported to a malpractice carrier
contacting insurance can affect coverage?
Yes - if hear from you frequently – increased risk management?
increase cost of premiums? or may not want to insure you anymore
in general overtime – premium increases
contacting your malpractive carrier?
retrieve patient record - write down in own words what happened on a separate piece of paper and keep it separate from patient file – this is your work product – not part of patient’s treatment record
do not change anything in patient record
doctor should notify malpractice carrier (insurance company)
- any letter from an attorny representing a patient should be reported. claiims adminster will be assigned to you and perhaps an attorny
trial phase
after discovery
will occur
trial phase
after discovery
will occur in STATE CIVIL COURT SYSTEM
elements of a dental malpractice claim must be established by patient
forms?
DUTY - of care owed to patient
BREACH
HARM
CAUSATION
forms the basis of the legal claim
fair preponderance of the evidence?
part of level of proof to be established
- majority
burden of proof
vs beyond a reasonable doubt (BARD–which is true for other court systems )
statue of limitations
maximum time after an event that legal proceedings based on that event may be initiated
like foreign objects – left in bodies can last up to 10 years
statue of limitations
occrence vs discovery state
maximum time after an event that legal proceedings based on that event may be initiated
like foreign objects – left in bodies can last up to 10 years
in MA - basically 7 years from tx or when pt. knew or should have known
OCCURENCE – time to sue begins at time of dentistry whether patient is aware or not - so length of time starts
DISCOVERY – starts when pt. is aware or ‘should have been aware’ – MA is a disocvery state – 7 years)
statue of limitations
maximum time after an event that legal proceedings based on that event may be initiated
like foreign objects – left- can last up to 10 years
in MA - basically 7 years from tx or when pt. knew or should have known
how the juries learn the standard of care
legal process
- patient tesifies
- doctor testifies
- patient expert testifies
- doctor expert testifies
- doctor’s attorny sums up
- patients attorny sums up
negligence vs contract
legal complaint under contract is patient abandonment
time for contract - have less time that negligence tort
who qualifies as an expert
they can be cross examined
want them to
- know treatment in the geographic area
- educaitonal background
- prior writings
- prior depositions
- prior testifying
deposition do what?
ALWAYS TELL THE TRUTH
NEVER SAY NEVER
NEVER SAY ALWAYS
NATIONAL DATABASES ARE
NPDB AND HIPDB
- national practitioner data bank
- healthcare integrity and protection data bank
access to informatino in the NPDB and HIPDB is limited to those entities speified by law
if you receive a complaint, must?
complaint is from patients attorny – MUST report this to your malpractice carrier
premiums with professsional liability
increases over time
- your premiums go up with increase in care
phase after complaint
discovery
discovery / examination before trial (EBT)
interrogatories
written questionares during EBT/ discovery period
depositions
verbal examination
- fact finding - during discovery / EBT
lawsuit starts when
when you receive a complaint letter from patient or attorny
basic two reasons to sue
- harmed in treatment / no treatment
2. wants money
complaint letter usually involves what main four things
- failure to follow protocol / standard of care
- failure to refer
- failure to diagnose
- emotional distress
arbitration
outside settlement outside the court system
trial phase occurs usually in
state civil court
in state civil court?
judge and jury – human and have biases and their own ideas of justice – no one can predict outcome of a trial
are settlements an admission of guilt
NO
incident vvs claim
is it managebale? inicdent = near miss
claim = collison
an arbitration would occur
before the trial
jusdgements =
decisions of the court and are reportable to a national provider databanks and licensing boards
EBT drect questioning through
depositions – direct questioning of each party to the lawsuit by the opposing attorny
binding arbitration means
both parties agree that the result will be at the end of the lawsuit
non- biding - further litigate the case if either party feels the result of arbitration was not fair
both deal with each others attorny’s then look at judge = highly expereinced attorny
standard of care elements
reasonable degree of knowledge and ability
treatment in the community
keep abreast of information
best judgement and use of reasonable care
legal claim you could bring against doctor under a theory of contracts is?
abandonment
courtroom
- judge applies the law
- jury finds the facts
- jury determines the standard of care
- jury finds liability and damages
who determines standard of care in court
jury
most important defenses?
RECORDS
what gets reported to state licensing boards?
ANY AND ALL SETTLEMENTS
how can a settlement impact ones license to practice in a state?
depends - if keep occuring – will cause problems
national databases are? reported to them within?
within 30 days
NPDB
- National Practitioner Data Bank
HIPDB
-Healthcare Integrity and Protection Data Bank
