Medical Legal Issues Flashcards
Define Standard of Care
the caution and action that a reasonable provider in a similar circumstance would exercise in providing care to a pt
Define negligence
improper action that falls below the standard level of care and causes harm
Define fraud
willful wrongdoing
What does malpractice insurance cover?
Malpractice but not fraud
Four elements required to prove negligence in malpractice:
Duty: would another provider act similarly?
Breach of Duty: did provider fail to provide standard of care
Harm: did pt sustain physical/emotional damage
Causation: was inappropriate care the cause of injury?
What public law was passed by congress to reduce incompetent practitioners from freely moving from hospital to hospital or state to state?
The Health Care Quality Improvement Act (1986)
Can PAs be named in malpractice suits?
Yes
Top 5 examples of malpractice suits:
Diagnoses related Treatment related Medication related Surgery related Monitoring related
Common reasons PAs are sued:
Lack of Adequate Supervision Untimely Referral Failure to Dx Inadequate Examination Lack of Documentation Lack of Communication
When must you document discussing a patient with your supervising physician?
Always document it
Does the supervising physician have to be on site?
No, but must be reachable by phone and within 60 minutes.
Do you need to document if labs are routine or STAT?
YES!
Within Ohio, how long does the patient have from time of discovery to file a claim?
One year to file suit
What does “discovery” mean?
Time the injury is discovered
How long is the typical cut off for any claim regardless of discovery?
4 years
Compensatory lawsuit
Refers to actual costs: medical bills, lost wages
No cap
Non-economic damages lawsuit
Pain and suffering
Limit 250,000 or 3X compensatory award
Cap 500,000
Punitive damages
Fraudulent or reckless malicious behavior
Limit 2X compensatory award
Not typically covered by malpractice insurance
Contributory negligence
If pts actions/noncompliance are contributory to outcome, suit has no claim and damages are not rewarded
Comparative negligence
Patients contribution is considered and may decrease the settlement
Often if pts is found responsible for >51% case is thrown out
How do you document mistakes on paper charts
Single line, initial, date, “error”
Describe occurrence malpractice insurance
Traditional
Premium paid annually
Coverage is for the year that is paid
Covers claims made in that time period regardless of if provider is currently insured
Describe a claims made policy
Premiums paid annually
Once insurance is dc or provider stops paying premiums, coverage ceases completely
Can negotiate a retroactive date when switching
“tail coverage”: usually 5 years coverage
In the long run which is cheaper occurrence or claims made coverage?
Generally claims made
