Liabilities of Hospitals Flashcards
means a place devoted primarily to the
maintenance and operation of facilities for the
diagnosis, treatment, and care of individuals
suffering from illness, disease, injury or deformity
Hospitals
one concerned with the admission and
treatment of a substantial rage of diseases and injuries
General
established to admit specific illness, treatments, organs affected or for a class of people
Specialized
Functional classification of hospitals
- Diagnostic Hospitals – diagnostics
- Maternity Hospitals – expectant mothers
- Rehabilitation Hospitals - disability
- Surgical Hospitals – operations
- Cosmetic Hospitals – aesthetics
Hospitals as control and financial support
- Public
2. Private
operated and maintained either
partially or wholly by the national, provincial, municipal,
or city government
Public/Government
privately owned, especially established and
operated with funds raised and contributed through
donations, or private capital or other means
Private
established for the public benefit and not
conducted for the pecuniary gain of the
management, officers or others
Private charitable or eleemosynary
established for profit and gain
private pay
4 bed capacity for hospitals
25, 50, 100 and 450
The hospital merely agrees to care for the patient by
furnishing him with _________
including nurses and interns.
accommodations and attendants
REASONS WHY A HOSPITAL CANNOT
PRACTICE MEDICINE
- cannot be subjected to government
licensure examinations - the licensed physician employed by the hospital will be
merely receiving orders from the corporate body
DUTIES OF THE GOVERNING BOARD OF THE HOSPITAL
- Policy of hospital = needs of community
- Maintained professional standards
- Coordination with the hospital
- Carry out policies
- provide adequate financing
__________________________________ - To determine the policies of the hospital in relation to the community needs;
- To see to it that the proper professional standards are maintained in the care of the sick;
- To coordinate the professional interest of the hospital with the administrative, financial, and community needs;
- To direct the administrative personnel in order to carry out the policies;
- To provide adequate financing to secure sufficient income and to assure business-like control of expenditures.
The state may impose certain regulations in the
establishment or management of a hospital in the
interest of public health
State Regulation
Both public and private hospitals have the right to
promulgate rules and regulations in relation to the
use of their facilities
Self-regulation
PRIMARY DUTIES OF HOSPITALS
- To furnish a safe and well-maintained building and
ground - To furnish adequate and safe equipment
- To exercise reasonable care in the selection of the
hospital staff
Persons coming within the premises of the hospital
- Trespasser
- Licensee
- invitee
one who enters the property of another
without being granted the privilege to do so.
Trespasser
one who is neither a customer, servant or
a trespasser. He has no contractual relation with the
hospital. He is permitted, expressly or impliedly to be
within the premises for his own interest or
convenience.
Licensee
one who is essential to the operation of a
hospital or for whom the hospital has a purpose.
(e.g. attending physician, nurses, patient, blood
donors)
Invitee
The immunity of the government from the official
acts of its officers, agents and employees is based
on the legal principle that
“there can be no legal
right against the authority that makes the law which
the right depends.”
A state cannot be sued without its___
Consent
should be spent for public purposes
and not diverted to compensate for private injuries and
public service should not be hindered
Government funds
is established and maintained from
the donations, contributions, philanthropic acts and
pays no dividends.
charity hospital
The determination whether a hospital was established for charity would be these 3
- Articles of incormporation
- Consitution
- Corporate by-laws
_____ is not controlling but the
purpose the fee will be used is the measure of charity
Charging fee
must not consist of rendering
charitable acts to a few sporadic cases but must be extended to the public over a period of time
Charitable hospital
hospital established for profit even though some beds
are devoted for charity is not deemed a ____.
charitable institution
Doctrines applied to charitable hospital immunity for the acts of its emplyees
- Trusted fund doctrine
- Impaired waiver threory
- Public Policy theory
- Independent contractor theory
- Private, charitable or voluntary hospital
Charitable hospitals derived support from voluntary
contributions or donations for the reception, care and
treatment of charity patients.
Trust Fund Doctrine
A patient who enters a private hospital, knowing fully
well that it is merely supported by benevolent and
humanitarian contributions, waives his right to claim
damages.
Impaired Waiver Theory
Thoery stating that rendering medical services to indigent patients without remuneration. It is undertaking of the obligation imposed upon the State for the preservation of life and maintenance of health of the people
Public Policy Theory
A patient who enters a private charitable hospital does
not have a contract with the hospital but with the
attending physician
Independent Contractor Theory
May be held vicariously liable for the negligent acts of
its employees
Private Charitable, Voluntary or
Eleemosynary Hospital
The performance of all routine duties which is the very reason why he is appointed in the ordinary sense constitutes administrative duties and any negligent acts committed by such employees in the course of their employment which causes injury, the patient may make the hospital vicariously liable.
PRINCIPLE OF ADMINISTRATIVE
If the hospital has control, then the hospital must be
held liable; if it is the physician, following the “borrowed
servant” doctrine the physician must be made liable
PRINCIPLE OF CONTROL
If the contract has been entered with hospital to render
professional services, the hospital may be held liable
provided the negligent act was committed within the scope of employment.
CONTRACT OF SERVICE
In a physician-patient relationship, the physician is an
independent contractor irrespective as to whether the
medical services of a physician are made in a hospital
INDEPENDENT CONTRACTOR THEORY
co-management of patients
with 2 or more physicians; negligence of a physician and nurse (liability shared by the physician and the hospital)
Shared Responsibility
Those arising from failure of the hospital to furnish
accommodations and facilities necessary to carry out its
purpose or to follow in a given situation, the established
standard of conduct to which the corporation should
conform.
Corporate Liabilities
Corporate liabilities may arise from these 3:
- Failure to furnsih safe and well maintained buildings
- Failure to furnish safe and reliable equipment
3.Recent decisions of the court have extended
hospital liability to the patient for its failure
to make careful review
A hospital must have an admitting department or
section which is its_____
nerve center
A person has ______ to be admitted in a
hospital or to avail of hospital services. The relationship
between the hospital and the patient is ___
no absolute right, contractual
A government hospital has no ______ in as much as it is established and maintained by public funds except for justifiable
grounds
absolute privilege of
choice of patients
Can only be done if the condition of emergency ceases
to be a threat to the life and that the transfer itself will
not impair the life and health of the patient
TRANSFER OF PATIENTS
After further evaluation of the patient’s condition, it is
considered that further hospitalization is no longer
indispensable,
DISCHARGE OF PATIENTS
Refusal of the patient to remain in the hospital will not
be a lawful ground to detain him if he is of ____
sound mind
and of legal age.
The attending physician or nurse must let the patient
sign a release paper. If the patient refuses to sign, the
statement ____ may be written
“patient refused to sign”
The attending physician must appraise the patient of the potential untoward effects if he leaves the hospital
Patient refusuing hospitalization
He may do so in a private hospital but a problem is
created in terms of charity wards in government
hospitals.
REFUSAL OF A PATIENT TO LEAVE THE
HOSPITAL
The attending physician and the hospital may be held liable to the patient if the latter is discharged from the hospital in spite of the fact that further hospitalization is still necessary.
PREMATURE DISCHARGE
patient is made to sign a form or waiver if he insists to
be discharged in spite of medical advice to be admitted
DISCHARGED AGAINST ADVICE
A patient cannot be detained in a hospital for ______The law provides a remedy
for them to pursue by filing the necessary suit in court
for the recovery of such fee or bill.
nonpayment
of the hospital bill.
A hospital may legally detain a patient against his will
when he is a _____ or when
the patient is _____
detained or convicted prisoner, suffering from a very contagious disease
A clinic or hospital may be held liable for failure to afford patients with adequate protection against infection
LIABILITY FOR HOSPITAL INFECTION
Liabilities for the hospital may include these 4
- Infection caused by equipment
- Contact with infected
- Negligence
- Hospital personnel may be the source of infection
Trend of meergency rooms
Management of the hospital entering a
contractual relationship to a partnership of physicians
to render emergency medical services.
Extenet of liability of emergency rooms
depends on the terms of the contract
Whenever the hospital administration enters into
contract with a partnership of physicians to run the
emergency room, the medical staff therein are _____
not
considered employees of the hospital.
TWO ASPECTS OF EMERGENCY CARE
- Examination of the patient to determine his condition
and need for emergency medical procedures - Performance of the specific medical or surgical
procedure which are required without delay to protect
the patient’s health.
3 MALPRACTICE LIABILITY IN THE EMERGENCY ROOM MAY
ARISE
- Failure to admit
- Failure to examine
- Negligence in management
Good emergency room records should be
- kept on
each case handled - properly filed and kept in a
reasonable length of time
Commonly observed in a person who is a victim or
a suspect in the commission of a crime
Emergency Room and the Police
Release of information for public consumption is
primarily the duty and responsibility of the head of
the hospital or the press relations officer
Press Reporter’s Inquiry
The law implies a promise to pay for emergency
services rendered to an unconscious patient in a
hospital.
Compensation for treating an unconscious patient in the
emergency room
The criminal liability of an ambulance driver is ____. However, the civil liability
arising therefrom the ____ must be held liable
the same
as that of an ordinary driver; hospital
It is a compilation of scientific data derived from many
sources, coordinated into a document and made
available for various uses to serve the patient
MEDICAL RECORDS
3 PURPOSE OF MAINTENANCE OF MEDICAL RECORDS
- Document patient’s history
- Aid in continuos care
- Provide a record of biling
PURPOSE OF MAINTENANCE OF MEDICAL RECORDS
(HOSPITALS
- For convenience and necessity
2. As required by statutes (Hospital Licensure Law)
Law stating that the medical practitioner should guard as a sacred trust anything that is confidential or private in
nature that he may discover of that may be
communicated to him in his professional relation
with the patient, even after their death
Sec. 6, Art. II, Code of Medical Ethics
imposed upon any practitioner who violates or fails to comply with the maintenance and keeping of the original records of transactions on any dangerous
drugs
Maintenance and Keeping of Original Records of Transactions on Dangerous Drugs
Penalty for violating the maintenance and keeping of original records of transactions
1 year to
6 years and a fine ranging from 10,000.00 to
50,000.00
Judicial and medical records of drug dependents
under the voluntary submission program shall be
confidential and shall not be used against him for
any purposes, except to determine how many time
by himself or through his parent,
(Confidentiality of Records Under the
Voluntary Submission Program)
The records of a drug dependent who was
rehabilitated and discharged from the Center under
the compulsory submission program or who was
charged for violation of Sec. 15 of this act shall be
covered under Sec. 60 of this act.
Confidentiality of Records Under the Compulsory Submission Program
A person authorized to practice medicine, surgery,
obstetrics cannot in civil case, without the consent
of the patient, be examined as to any information,
which he may have acquired in attending such patient in a professional capacity, which
information was necessary to enable him to act in that capacity, and which would blacken the
character of the patient
Privileged
Communication
WHEN MAY THE CONTENTS OF THE RECORD BE
DISCLOSED?
- Requested by patient or consort
- Requested by law
- Request by court
the appropriate remedy for refusal of the
record custodian to disclose contents of the clinical
records to the patient or his authorized representative
Mandamus
INFORMATION FOR WHICH NO AUTHORIZATION IS NEEDED
name of patient and house officers associated in treatment
Personal circumstances of the patient which are not
ordinarily related to the treatment
- The attending patient has no legal right to determine
who shall and who shall not see the record - Members of the resident staff, student and attending
medical staff may freely consult such records as pertain
to their work
Entries made at, or near the time of the
transactions to which they refer, by a person
deceased, outside the Philippines or unable to
testify,
Entries in the Course
of Business
Entries made at, or near the time of the
transactions to which they refer, by a person
deceased, outside the Philippines or unable to
testify, who was in a position to know the facts
therein stated, may be perceived as ____
prima facie evidence
may be applied to violent or boisterous patients
Reasonable Restraint
if peaceful of non-violent means are not effective
Coercion
When making an arrest without a warrant,
the officer shall inform the person to be
____ and _____, unless the latter is either
engaged in the commission of an offense
arrested of his authority; he cause of
the arrest
Every person so summoned by an
officer shall assist him in effecting the arrest
when he can render such assistance without
detriment to himself.
Method of arrest by a provate person without warrant
