Ch. 6 Professional Liability and Medical Malpractice

Question 1

Professional Negligence and Medical Malpractice

Answer 1

• Professional misconduct or demonstration of an unreasonable lack of skill with the result of injury, loss, or damage to the patient

Question 2

Negligence

Answer 2

• Unintentional action that occurs when a person performs or fails to perform an action that a reasonable person would or would not have committed in a similar situation

Question 3

Feasance:

Answer 3

Performing an act or duty

Question 4

Malfeasance

Answer 4

• Performing a wrong or illegal act

Question 5

Misfeasance

Answer 5

• Improperly performing on otherwise proper or lawful act

Question 6

Nonfeasance

Answer 6

• Failure to perform a necessary action

Question 7

Four D’s of Negligence

Answer 7

• Duty
  - Responsibility established by physician-patient relationship
• Dereliction
  - Neglect of duty
• Direct to proximate cause
  - Continuous sequence of events, unbroken by an intervening cause, that produced injury and without which injury would not have occurred
• Damages
  - Injuries caused by the defendant

Question 8

Duty

Answer 8

• Responsibility established by physician-patient relationship

Question 9

Dereliction

Answer 9

• Neglect of duty

Question 10

Direct to proximate cause

Answer 10

• Continuous sequence of events, unbroken by an intervening cause, that produced injury and without which injury would not have occurred

Question 11

Damages

Answer 11

• Injuries caused by the defendant

Question 12

Preponderance of Evidence

Answer 12

• One side must demonstrate a greater weight of evidence than the other side

Question 13

Res Ipsa Loquitur

Answer 13

• Means “The thing speaks for itself”
• Three conditions must be present
  - (1) Injury could not have occurred without negligent act
  - (2) Defendant had direct control over cause of injury
  - (3) Patient did not and could not contribute to the injury

Question 14

Compensatory damages

Answer 14

• Court-awarded payment to make up for loss of income or emotional pain and suffering

Question 15

Punitive damages

Answer 15

• Exemplary damages
• Monetary awarded by court to person harmed in malicious and willful way; meant to punish offender

Question 16

Nominal damages

Answer 16

• Slight or token payment awarded by court

Question 17

Fraud

Answer 17

• The deliberate misrepresentation or concealment of facts from another person for unlawful or unfair gain
• One of the fastest-growing crimes in health care
• Medical assistants have been involved in several fraud cases in the medical office; none have been charges so far

Question 18

Office of Inspector General (OIG)

Answer 18

• Protects federal programs from fraudulent activities
  - Department of Health and Human Services (HHS)
  - Medicare;Medicaid
• Violation of statures
• Immunity for charitable organizations

Question 19

Affirmative defense

Answer 19

• Denial, assumption of risk, contributory negligence, comparative negligence, borrowed servant, statute of limitations, and res judicata
• Allows defendant to present evidence that patient’s condition was the result of factors other than negligence

Question 20

Denial defense

Answer 20

• Plaintiff must prove defendant did wrongful or negligent act
• Most common defense
• Jury must determine if defendant caused injury
• May bring in expert witness

Question 21

Assumption of risk

Answer 21

• Prevents plaintiff from recovering damages if plaintiff voluntarily accepts a risk associated with the activity
• Plaintiff must know and understand risk involved, and choice to accept risk must be voluntary
• Should have signature to document that patient authorizes procedure, understands the risks, and consents to treatment

Question 22

Contributory Negligence

Answer 22

• Conduct on part of plaintiff that contributes to cause of injuries
• Complete bar to recovery of damages
• Means plaintiff will receive no monetary damages

Question 23

Comparative Negligence

Answer 23

• Similar to contributory negligence
• Plaintiff’s own negligence helped cause injury
• Not complete bar to recovery of damages
• Allows plaintiff to recover damaged bases on the amount of defendant’s fault

Question 24

Borrowed Servants

Answer 24

• Special application of respondent superior
• Employer lends an employee to someone else
• Employee remains “servant” of employer, but employer is no liable for any negligence caused by employee while in service of temporary employer

Question 25

Ignorance of Facts and Unintentional Wrongs

Answer 25

• Health care professional should understand what is right and wrong under law
• Arguing that a negligent act is unintentional is not a defense

Question 26

Statutes of Limitations

Answer 26

• Set time period for injured party to file lawsuit
• Exception is rule of discovery
• Statute of limitations does not begin to “run” until injury is discovered
• Will not begin to “run” if fraud (deliberate concealment of facts from patient) is involved

Question 27

Res Judicata

Answer 27

• Means “the thing has been decided” or “a matter decided by judgement”
• Once the court decided a case, plaintiff cannot bring new lawsuit on same subject

Question 28

Civil liability cases

Answer 28

• Physician may be sued under a variety of legal theories

Question 29

Physical condition of the premises

Answer 29

• Institution may be liable when regulatory standards have been violated

Question 30

Professional Liability

Answer 30

Employer may not have done anything wrong, yet still be liable

Question 31

Claims-made insurance

Answer 31

• Covers insured party for claims made only during the time period policy was in effect

Question 32

Occurrence insurance

Answer 32

• Covers the insured party for all injuries and incidents that occurred while policy was in effect regardless of when claim is made

Question 33

Malpractice Insurance

Answer 33

• Covers any damages the physician/employer must pay if he or she is sued for malpractice and loses
• All licensed and certified medical professionals should carry malpractice insurance
• An expensive type of insurance- Defensive medicine

Question 34

Arbitration

Answer 34

• Settling dispute without judge; decision is binding

Question 35

Mediation

Answer 35

• Opinion of third party for non-binding decision

Question 36

Med-arb

Answer 36

• Combination of the two
• Arbitration
  
  • Settling dispute without judge; decision is binding
• Mediation
  
  • Opinion of third party for non-binding decision

Question 37

Liability of Other Health Professionals

Answer 37

• Dental assistant
  
  • Laboratory technician
  • Medical assistant
  • Nurse
  • Nursing assistant
  • Paramedic
  • Pharmacist
  • Physical therapist
  • Physician assistant
  • Respiratory therapist

Question 38

Tort Reform

Answer 38

• Malpractice reform
• 32 States have passed reforms
  - Some limit plaintiff’s ability to sue
  - Some cap awarded damages
• Difficult to place a dollar amount on a person’s pain and suffering

Question 39

Malpractice Prevention

Answer 39

• General guidelines
• Safety
• Communication
• Documentation