Chapter 5 and 6 Flashcards
- Liable
Legally responsible or obligated
5Standard of care
The level of performance expected of a health care practioner in carrying out his or her professinal duties
5Duty of care
The legal obligation of health care workers to patients and sometimes non patients
5Reasonable person standard
That standard of behavior that judges a persons actions in a situation according to what a reasonable person would or would not do under similar circumstances.
5Confidentiality
The act of holding information in confidence, not to be released to unauthorized individuals
5Privilages communication
Information held confidential within a protected relationhsip
5Malfeasance
The performance of a totally wrongful and unlawful act
5Misfeasance
The performance of a lawful act in an illegal or impproper manner
5Nonfeasane
The failure to act when one should
5res ipsa loquitur
The thing speaks for itself: also know as the doctrine of common knowledge. A situation that is so obviously negligent that no expert witness need be called
5Damages
Monetary awards sought by plaintiffs in lawsuits
5Wrongful death statutes
States statue that allow a person beneficiaries to collect for loss to the estate of the deceased for future earnings when a death is judged to have been due to negligence
5Summons
A written notification issued by the clerk of the court and delivered with a copy of the complaint to the defendant in a law sui, directing him or her to respond to the charges brought in a court of law
5Subpoena
A legal document requiring the recipient to appear as a witness in court or to give a deposition
5Deposition
Sworn te the testimony given and recorded outside the courtroom during the pretrial phase of a case
5Interrogatorry
A written set of questions requiring written answers from a plaintiff or defendant under oath
5Subpoena duces tecum
A legal document requiring the recipient to bring certain written records to court to be used as evidence in a lawsuit
5Testimony
Sratements sworn to under oath by withnesses testifying in court and giving depositions
5Alternative dispute resolution ADR
Settlement of civil disputes between parties using neutral mediators or arbitrators with out going to court
A physician who owns a physician’s office is legally responsible for her employees. What is the term for this responsibility?
Liable
As employers, physicians have general liability for many aspects of their business. Which of the following does not fall under the responsibility of the employer?
Employee safety going to and from the work place-
In a hospital setting a certain standard of care is expected of health care practitioners. Which of the following best describes this concept?
An expected level of performance-
A physician working in an emergency room is obligated to treat all the patients who come through the door. This is an example of which of the following concepts?
Duty of care
A physician treating patients in a long-term care facility determines that a patient has a communicable disease that could cause an outbreak in the facility. The physician works with the administrator of the facility and the public health department to protect other residents and employees from exposure to the disease. Under some state laws, this physician is obligated to protect nonpatients in accordance with which of the following standards?
Duty of care-
A health care worker is responsible for his or her actions or failure to act. Which of the following best describes this responsibility to prevent negligence from occurring?
Reasonable person standard-
In a court of law, it was decided that a patient was injured when a nurse failed to act according to the reasonable person standard. This nurse is guilty of which of the following torts?
Negligence
A physician is a specialist in obstetrics. Which of the following is true regarding the standard of care expected of this physician?
The physician will be held to the same standard of care as other obstetricians.-
A physician has an informal consultation with another physician in his office. Which of the following opinions have the courts generally held in cases of negligence related to the information discussed in informal consultations?
They do not establish a doctor-patient relationship.-
A nurse recording data in a patient’s medical record maintains confidentiality at all times. Which of the following describes this practice?
Not releasing patient information to unauthorized individuals-
Which of the following is an example of privileged communication
A patient tells his physician that he is addicted to pain killers.-
In many states, revocation of a physician’s license may occur due to which of the following acts?
Breach of confidence-
Since health care procedures and facilities present numerous opportunities for a breach of confidentiality, health care practitioners must make every effort to safeguard each patient’s privacy. Which of the following is a recommended guideline for protecting a patient’s privacy?
When on the telephone with a patient, do not use his or her name if others may hear.-
In which of the following situations may patient confidentiality be waived?
When a third party requests a medical examination of a person for employment-
Which of the following is the basis for professional malpractice claims and the most common liability in medicine?
Negligence-
A nurse dispenses a painkiller to a patient without the physician’s order for the medication. This is an example of which of the following torts?
Malfeasance-
Which of the following is an example of misfeasance?
A nurse is changing a patient’s IV line, but does not wash her hands prior to procedure.-
A physician who is treating a patient who has pancreatic cancer provides competent care for his patient, thereby preventing a charge of negligence. Which of the following four Ds of negligence refers to this responsibility to properly care for a patient?
Duty
A surgeon removes the wrong limb from a patient. Which of the following four Ds of negligence refers to the current condition of the patient?
Damages-
There are four elements (4 Ds) that must be present in a given situation to prove that a health care professional is guilty of negligence. Which of the following is not one of the “four Ds of negligence?”
Defense-
A health care provider breaches the duty of care to a patient. This element of negligence is defined as:
dereliction.-
A patient sues a physician for malpractice. Upon whom is the burden of proof for the charge of negligence?
The plaintiff-
In some states medical review panels must screen claims before they are brought to court. Which of the following are usually members of these panels?
Physicians with expertise in the medical specialty in question-
The Joint Commission addresses accurately identifying patients and improving communication among caregivers by making sure all accredited health care organizations implement which of the following requirements?
Use a process for taking verbal or telephone orders or critical test results that requires a verification read-back by the person receiving the information.-
The Joint Commission addresses improving the safety of infusion pumps, improving the effectiveness of clinical alarm systems, and reducing the risk of health-care acquired infections. Which of the following is a recommended guideline to accomplish these goals?
Manage as sentinel events all identified cases of unanticipated death or major permanent loss of function associated with a health care-acquired infection-
A surgeon removes a patient’s kidney and later finds out that she removed the wrong kidney. This patient can sue under which of the following doctrines?
Res ipsa loquitur-
A patient files for negligence under the doctrine res ipsa loquitur. What is the English meaning of this Latin wording?
The thing speaks for itself”-
Which of the following is a stated condition for res ipsa loquitur to apply to a lawsuit?
It must be apparent there would be no injury had reasonable care been used-
Which of the following examples of negligence would fall under the doctrine of res ipsa loquitur?
A patient suffers an infection caused by the use of unsterilized instruments.-
A patient was harmed when the oxygen tank she was using exploded. When filing a lawsuit what type of damages might this patient be awarded?
Consequential-
In an informal proceeding of arbitration, each side presents evidence and witnesses. In the alternative dispute resolution method called med-arb, who resolves the dispute if the two parties are unable to reach agreement after mediation?
The mediator
When no written contract exists, who chooses an arbitrator to resolve disputes?
The two involved parties select an arbitrator and the two arbitrators select a third
Some states require mediation and/or arbitration for certain civil cases, while in other states alternative dispute resolution methods are voluntary. Under the terms of a written contract, who chooses an arbitrator?
The court
Alternative dispute resolution has become increasingly popular over the years. What is the reason for this increase in ADR?
Overcrowding of court calendars
Instead of going to court, two disputing parties agree to a neutral third party listening to both sides of the argument and helping resolve the dispute. What is the term for this type of dispute resolution?
Mediation
A nurse is testifying as a fact witness in a malpractice lawsuit. Which of the following is a recommended guideline for this process?
Answer all questions straightforward, even if answers appear to help opposing side.
A physician is testifying as a fact witness in trial of a coworker. Which of the following is the best example of properly worded testimony?
As I recall, that is all that occurred in the operating room”
Which of the following are recommended guidelines for a health care practitioner who is summoned to appear in court?
Answer the questions asked, no more and no less.
A nurse who observed a surgeon commit negligence due to improper surgical technique, states only what she observed when giving testimony. What type of testimony is this witness giving?
Fact
An attorney for the defendant makes an objection to a question the plaintiff’s attorney asks the witness. Which of the following occurs when this happens?
The objection may be sustained and the witness should not answer the question.
A health care practitioner is asked to give testimony in an attorney’s conference room in a pretrial proceeding. What is the term for this method of obtaining testimony?
Discovery deposition
A set of written questions requiring written answers are given to a plaintiff while under oath. What is the term for this practice?
Interrogatory
Which of the following is an example of a pre-trial motion?
A defendant may request a change of venue.
The judge in a lawsuit issues a summons. Which of the following is true about this process?
A summons is delivered to the defendant.
A deposition may be taken in which phase of the lawsuit?
Interrogatory
Which of the following would occur in the pleading phase of a lawsuit?
The defendant’s attorney files an answer to the summons
The family of a patient sues for wrongful death when the patient’s death was judged to have been due to the negligence of health care practitioners. What might the family collect from a settlement of this case?
An award for loss to the patient’s estate of future earnings
The judge in a negligence case states that the rights of the patient were violated, though no actual loss was proven. The judge awards the plaintiff $1.00. This is known as what type of award?
Nominal
A health care practitioner who practices the “four Cs of medical malpractice prevention” finds two important benefits related to one of the “Cs”, that is, improvement in patients’ medical condition and decreased likelihood that they will sue. Which “C” is most likely to provide these benefits?
Caring
When showing people they care, what would be the best advice for a nurse caring for patients who have complaints about dissatisfaction with their treating physicians?
Listen carefully to the patient’s complaints and remarks and see that the comments reach the treating physician.
Therapeutic communication is key to avoiding medical malpractice lawsuits. Which of the following is a recommended guideline when communicating with patients?
Communicate clearly and ask for confirmation that you have been understood.
A physician assistant (PA) is constantly updating his knowledge and skills by attending in-services and seminars. This PA is practicing which of the “4 Cs of medical malpractice prevention?”
Competence
For legal purposes, the health care professional should know that if it isn’t in writing and explained completely and accurately, it wasn’t done. To which of the following “4 Cs of medical malpractice prevention” does this statement refer?
Charting
Administrators of a medical facility are attempting to reduce liability risks in the workplace environment. Which of the following is a recommended guideline to accomplish this goal?
Have a medical assistant of either sex present during examinations.
From a medical/legal standpoint, in an article in the March 2003 issue of Family Practice Management, Dr. R.J. Roberts of the University of Wisconsin Medical School identified seven common reasons for medical malpractice lawsuits. Which of the following is not one of these seven identified reasons?
Failure to triage emergency department patients
The first major study to determine why patients sue hospitals and health care practitioners and what might prevent an injured patient or his or her family members from filing a lawsuit was conducted in 1992 by Gerald B. Hickson and others. According to Hickson, which of the following is the most common reason for patient lawsuits?
The plaintiffs were advised by knowledgeable acquaintances to sue.
Which of the following was the most highly agreed upon statement of why injured patients sued in the Charles Vincent et al study?
To receive an explanation
ust over 41 percent of the respondents in the Vincent study said that certain actions after their injuries might have prevented litigation. Which of the following is the highest rated action that might prevent litigation?
An explanation and apology
A report by the American Society of Anesthesiologists Committee on Professional Liability stated that one of the most common reasons patients start legal proceedings is due to which of the following?
Communication failures between physicians and patients.
Which of the following - according to Micalizzi’s Suggestions for Things NOT to Say After Medical Complications - should not be said to the patient or family following an adverse event?
These things happen, and you may never know what went wrong.”
Using effective interpersonal communication in the physician-patient relationship may help deter medical malpractice lawsuits. Which of the following is a recommended guideline for therapeutic communication?
Sit rather than stand when interviewing patients.
Which of the following is a recommended communication technique to prevent medical malpractice lawsuits?
Avoid statements that could be construed as an admission of fault.
Health care practitioners should know that patient records are often used as evidence in medical malpractice cases, and improper documentation can lose a case. Which of the following does not need to be documented?
ll non-telephone patient conversations
A physician being sued for medical malpractice claims that a patient did not follow the treatment regimen she prescribed, thereby contributing to his own injury. This physician is using which of the following defenses?
Contributory negligence
A physician assistant (PA) accused of medical malpractice claims that the charge does not meet all of the elements of the theory of recovery. Which of the following defenses is being used by the PA?
Denial
Many health care professionals use affirmative defenses in medical professional liability suits. With these defenses, defendants are allowed to present evidence of which of the following?
That the patient’s condition was caused by other factors than defendant negligence
It was decided in a professional liability suit using the process of comparative negligence that the plaintiff contributed 30% to the patient injury and the physician contributed 70%. Which of the following would be the outcome of this case?
the patient damage award would be reduced by 30%.
In which of the following types of defenses to professional liability suits is informed consent one of the most important elements?
Assumption of risk
A physician who came to the aid of a person who was injured during an earthquake is being sued by that person for malpractice. The physician would not be held liable under common law if the defense established which of the following?
The appropriate standard of care was met, given the emergency situation.
A physician who is named in a malpractice lawsuit uses the defense that the statute of limitations has run out, and the plaintiff can no longer file charges. This is an example of which of the following types of defenses?
Technical
A victim in a medical malpractice lawsuit receives compensation for all medical expenses from the defendant. Which of the following would almost always be an absolute defense in this case?
Release of tortfeasor
A medical malpractice lawsuit has been decided under the doctrine of res judicata. What does this Latin term mean?
“The thing has been decided.”
Which of the following accurately describes an element of the doctrine of res judicata?
If a physician has been sued by a nonpaying patient for negligence and does not file a counterclaim for the fee during defense, the patient cannot be sued later for unpaid bills.
The statute of limitations for filing professional negligence suits varies with states but generally specifies how many years?
1 to 6 years
What is the most common amount of time allowed for filing legal actions, including collections, damages for child sexual abuse, retaining of medical records, wrongful death claims, medical malpractice, and many other causes of action?
2 years
Establishing when the statute of limitations begins varies with state law, but one of the most common dates for marking the beginning of the statutory period is which of the following?
The day the alleged act was committed
The physician who owns a physician’s office examines the practices and behaviors of his employees to determine and eliminate problems that may lead to a malpractice lawsuit. What is the term for this practice?
Risk management
Which of the following is an example of a physician using risk management to reduce the likelihood of a malpractice lawsuit against his office?
Providing written job descriptions for employees
Methods used to manage risk are considered a part of which of the following?
Quality assurance
The employer physician puts a plan in place to ensure that all government regulations are enforced in her office. What is the term for this plan?
Compliance
Which of the following would most likely be involved in completing the process of credentialing for health care institutions and organizations?
An insurance company
What instrument of risk management is particularly beneficial for following coding and billing regulations for Medicare, Medicaid, and other government plans?
Compliance plan
A health care clinic begins the process to receive credentialing. Which of the following is the final step verifying a health care provider’s credentials?
A peer review process approves the credentialing procedure
A physician purchases liability insurance to work in a partnership with other physicians. What does this insurance cover?
Potential damages incurred as a result of a negligent act
Upon which of the following is the cost of a liability premium based?
Physician specialty and dollar amount covered by the policy
A physician decides his liability insurance coverage is too high and drops the policy. On which of the following aspects of this physician’s employment will this decision have the greatest impact?
Having hospital privileges
A physician assistant carries claims-made liability insurance to protect against malpractice suits. Which of the following describes the coverage this policy would provide for the designated period?
The determining factor is when the claim is made, not when the injury occurs.
Which of the following insurance policies covers incidents that occurred before the beginning of the new insurance relationship but have not yet been brought to the insured’s attention as a claim?
Prior acts insurance coverage
A physician who has liability insurance finds that a lawsuit is imminent. Which of the following is a recommended guideline when this occurs?
Do not mention the lawsuit in any correspondence
As medical malpractice insurance premiums have continued to rise, self-insurance coverage has become an option for health care practitioners in some states. What is one advantage of self-insurance coverage?
Lower premiums
There are three types of insurance that health care practitioners can purchase to extend coverage of a canceled claims-made policy or for claims-made coverage when the insured switches to a different insurance carrier. Which of the following is not an extended insurance plan?
Occurrence insurance
6.Denial
A defense that clains innocence of the charges or that one or more of the four Ds of negligence are lacking
- Affirmative defenses
Defenses used by defendants in medical professional liablity suits that allow the accused to present factual evidence that the patients condition was caused by some factor other than the defedants negligence
- Contributory negligence
An affirmative defense that alleges that the plaintiff through a lack of care, caused or contributed to his or her own injury
- Comparative negligence
An affirmative defense claimed by the defendant alleging that the plaintiff contributed to the injury by a certain degree.
- Assumption of risk
A legal defense that holds that the defendant is not guilty of a negligent act because the plaintiff knew of and accepted beforehand any risks involved
- Emergency
A type of affirmative defense in which the person who comes to the aid of a victim in an emergency is not held liable under certain circumstances
6.Technical defense
Defenses used in a lawsuit that are based on legal technicalities
- Release of torfeasor
A technical defense that prohibits a lawsuit against the person who caused an injury the tortfeasor if he she was expressly released from futher liability in the settlement of suit.
6.Res judicata
The thing has been decided. Legal principle that a claim cannot be retried between the same parties if it has already been legally resolved
- Statue of limitations
That period of time established by state law during which a lawsuit may be filed
- Risk Management
The taking of steps to minimize danger, hazard and liability
- Quality improvement or Quality assurance (QI)
A program of measures taken by health care providers and practioners to uphold the quality of patient care
- Liability insurance
Contract coverage for potential damages incurred as a result of a negligent act.
- Claim made insurance
A type if liability insurance that covers the insured only for those claims made (not for any injury occurring) While the policy is in force
- Occurence insurance q
A type of liability insurance that covers the insured for any claims arising from an incident that occurred, or is alleged to have occurred, during the time the policy is in force, regardless of when the claim is made.
- Tail Coverage
An insurance coverage option available for heath care practitioners: when a claims made policy is discontinued, it extends coverage for malpractice claims alleged to have occurred during those dates that claims made coverage was in effect.
- Prior acts insurance coverage.
A supplement to a claim made insurance policy that can be purchased from a new carrier when health care practitioners change carriers
- Self insurance coverage.
An insurance coverage option whereby insured subscribers contribute to a trust fund to be used in paying potential damages awards.
