Informed Consent & Malpractice Flashcards
4 Ds of Negligence
- Duty, 2. Dereliction of Duty, 3. Direct Causation, and 4. Damages
“Res Ipsa Loquitur”
“The thing speaks for itself.” Successful malpractice suits usually require expert witness testimony stating that a physician practiced medicine that deviated from the usual standard of care. If a situation occurs in which the substandard care is obvious to non-experts, a judge can declare “res ipsa loquitur.” This declaration makes expert testimony unnecessary and shifts the burden of proof to the defense. The defense would have to prove they were not negligent.
What are the four requirements necessary for a judge to declare “res ipsa loquitor?”
- Harm rarely occurs in the absence of negligence, 2. The situation must have been under the sole control of the defendant, 3. The plaintiff did not contribute to the bad result, and 4. Only the defendants have access to info. about what happened
“Respondeat superior”
A physician may be held liable for the acts of his employees
Natanson v. Kline*
- Established the “Reasonable Practitioner” standard.
Canterbury v. Spence*
- DCCOA. Established the “Materiality of the Information” standard. Also known at the “Reasonable Man” standard.
Truman v. Thomas*
Supreme Court of California, 1980. Patient must be informed of the benefits and risks of both accepting AND declining recommended tests or treatments.
Dr. Osheroff v. Chestnut Lodge Hospital
- Treatment alternatives must be presented to patients regardless of a physician’s or a facility’s inability to offer certain treatments.
Clark v. Geraci
- If a patient gives a doctor permission to make disclosures regarding his illness, the patient cannot limit the disclosure. (?)
Clites v. Iowa*
- Iowa Court of Appeals. Psychiatrists must appropriately prescribed meds and monitor for the side effects of their meds (TD in this case). See “Faigenbaum v. Oakland Medical Center” & “Hedlin v. U.S.” for other TD cases. Court cited “Youngberg” (right to tx) and “Rennie” and “Rogers” (right to refuse tx) in its decision.
Ramona v. Ramona
Psychotherapists have a duty to third parties if the third party is damaged by “therapy” or advice.
Roy v. Hartogs*
- NY Appellate Supreme Court (NY Court of Appeals). Psychiatrists cannot sleep with their patients; patients cannot give consent due to the power differential in the relationship. Psychiatrist prescribed sex as therapy for 13 months. Pt. sued and was awarded $153K in comp. and punitive damages in trial court. Appellate court reduced comp. damages to $25K and denied punitive damages entirely. Punitive damages were denied due to the perceived absence of evil or malicious intentions by the doctor.
Aetna v. McCabe*
US Dist. Court, Pa., 1983. Psychiatrist began having sex with a patient and then eventually developed a long term six year relationship with her. He physically abused her and fractured her skull. She sought damages for physical injuries, embarrassment, and mental suffering. Insurance company initially said it will only cover compensatory damages not cover any punitive damages. Insurance company eventually decided it would cover no damages because they viewed his acts as intentional. Trial court awarded former pt. $275K comp. & $300K punitive. Dist. Court said insurance company was responsible for compensatory and NOT punitive damages. The relationship arose out of the negligence that occurred during the course of their professional relationship. The court also concluded that intentionality was irrelevant under the terms of the contract.
Mazza v. Huffaker (or Medical Mutual?)*
Supreme Court of NC, 1984. From Hooper’s: ‘Huffaker had sex with wife of his patient, Mazza. Mr. Mazza sued & won. He then sued to make Insurance co. pay everything including punative damages, Ins co fought. Court said language of contract said “all damages,” this meant punitive as well. Case hinges on technical wording, ie, exact phrases, Dr. did not intend to cause harm, was negligent. Vague insurance policy is “always decided in favor of INSURED.”’
