MIDTERM Flashcards
2 sides of the scale of the law
Legal system
The law
Lawmaking body
Congress
Creates rules (more sepcific laws) to enforce the law
President
Interpret law
Supreme court
Sources of law: state and federal
Constitutional law
Statutory and regulatory law
Judicial opinion
Written legal document establishing government
Constitutional law
The supreme law of the land because any law state or federal that is in conflict with the US constitution is invalid
US constitution
US Constitution type of law
Constitutional law
Statutes are
Laws passed by a legislative body
Sometime create agencies designated for a specific purpose
Legislatures
May authorize agencies to make laws which become known as rules and regulations
Legislatures
Department of health and human services (HHS)
Statutory and regulatory law
Centers for medicare and medicaid services (CMS)
Statutory and regulatory law
Centers for disease control and prevention (CDC)
Statutory and regulatory law
Food and drug administration (FDA)
Statutory and regulatory law
Important laws statutory and regulatory law
HIPAA
HITECH
Patient protection and affordable care act - affordable care act
HIPAA
Health insurance portability and accountability act
HITECH
Health information technology for economic and clinical health act
43-9-2
Creation of board; members; qualifications; residence requirements; terms
43-9-6.1
Scope of board’s authority
43-9-7
Qualifications of applicants for license to practice chiropractic
43-9-9
Reciprocity
Board authorized to adopt, amend, and repeal such rules and regulations not inconsistent with this chapter necessary for the proper administration and enforcement of said chapter
TRUE
Board authorized to examine, issue, renew, and reinstate the licenses of duly qualified applicants for licensure to practice chiropractic in this state
True
Board authorized to deny, suspend, revoke, or otherwise sanction licenses to practic chiropractic in this state
True
Board authorized to initiate investigations for the purpose of discovering violations of this chapter
True
Board authorized to conduct hearings upon charges calling for the discipline of a licensee or on violations of this chapter
True
Board authorized to issue to chiropractors, licensed under this chapter, certificates under the seal of the board evidencing such licensure and signed, either by hand or facsimile signature, by the president of the board and the division director
True
Board authorized to Expunge or delet from the disciplinary record of any licensee advertising violations not defined in the rules of the board as immoral and unprofessional conduct or relating to reasonable care and skill in the treatment of a patient GA
True
Legal cases for violation of the law are brought and heard in
State and federal trial courts
Outcome of trials are known as
Rulings
Outcome of trials are documented as
Judicial opinions
Interpretation of the law
Judicial opinions
Explanation given by a judge for the reasoning and president of a court’s decision
Judicial opinions
Courts apply general principles of law (statutes or common law) to specific situation brought before the court which in effect interpret the law through
Their decision
Opinions have the force of law in that
Jurisdiction
Traditional principles of law not typically written in statutes
Common law
Examples of common law
Tort law
Contract law
Highest court in teh federal system
9 justices, washington DC
Appeals jurisdiction through certiorari process
Limited original jurisdiction over some cases
Supreme court
Intermediate level in the federal system
12 regional circuit courts, including DC circuit
No original jurisdiction; strictly apellate
Court of appels
Lowest level in the federal system
94 judicial districts in 50 states and territories
No appellate jurisdiction
Original jurisdiction over most cases
District courts
Court of last resort
Supreme court
General jurisdiction court
Superior court
Intermediate appellate court
Court of appeals
Limited jurisdiction courts
Civil court State court Juvenile court County recorders Probate court Magistrate court - municipal court
A patient can sue for anyting if they believe
You caused a negative outcome with treatment
Common claim triggers
Board issues Insurance audits Lack of communication Billing disputes Rib fracture Failure to refer
Types of policies
Claims made
Occurrence
If you move to a new carrier
Purchase tail coverage which is 1.5 -2x annual premium
Prior acts coverage
Claims made policy
An alleged injury must take place on or after retroactive date, while policy is still active in order to be covered
An alleged injury must have taken place when policy was active
Occurrence policy
Tail coverage built in from the beginning
Occurrence policy
Own corporation
Add as named entity to your malpractice policy
DBA
Doing business as
No liabilty
Supplemental coverage
Board Hippa Sexual misconduct Billing errors and omission Cyber liability EPLI
Parties to a case
Plaintiff vs defendant
Individual or business sues another individual or business
Civil law
Tort Contract Property Probate Family Corporate
Civil law or civil suit involves all cases that are not
Criminal law
Generally carry monetary damages or awards as compensation for harm
Most settle for monetary award out of court
Civil law
Wrongful act committed against another person or property, resulting in harm
Elements of tort
HARM
The defendant must suffer a mental or physical injury caused by the plaintiff
Causation
This harm to plaintiff must be caused by wrongful act of defendant
Person intentionally or deliberately injured by another
Intentional torts
Unlawful touching of another
Lacking consent
Battery
Forcing a patient to do anything against their wishes or without their knowledge
Battery
Threat of bodily harm to another
Does not have to be an actual touch
Assalt
The voluntary agreement that a patient gives to medically trained person the permission to touch, examine, and perform a treatment
Consent
Patient agrees to the proposed course of treatment after having been told about the possible consequences of having or not having certain procedures and treatment
Informed/expressed consetn
Signature indicates that the patient understands the limits or risks involved in the pending treatment
Informed/expressed consent
Goals of informed/expressed consent
Protect patient’s rights to decide for themselves about their own treatment
Disclose information to the patient so that he or she can a reasoned decision
Mohr v. Williams
Informed/expressed consent
Information to provide on informed consent
Patient diagnosis if known Nature and purpose of proposed treatment or procedure Advantages and risks of treatment Alternative treatments available Potential outcomes of the treatment Potential risk if they decline treatment
Obtain consent from a patient before initiating any treatment. May be evidenced by a consent form, when needed, or simply by asking the patient
Consent - best practices
If a patient refuses treatment and there is no threat to his life or well-being
Do not force treatment, notify those who need to be notified, and document the refusal and the notifications
Never threaten a patient or family member in any way or act in a menacing manner
Consent best practices
Never threaten to hit a patient or family member or actually do so
Consent best practices
Never make sexual advances towards a patient or family member
Consent best practices
Occurs when patient’s nonverbal communication may indicate a consent for treatment or examination
Implied consent
Can be difficult to interpret because it is based on another person’s interpretation
Implied consent
When a patient is seen for a routine exam, there is implied consent that the doctor
Will touch the paitne
Implied consent in emergencies when patients can respond is
Assumed
The unauthorized publicity of information about a patient
Invasion of privacy
Inherent duty to maintain patient confidentiality
Invasion of privacy
Estate of Berhiaume v Pratt
Invasion of privacy
This tort provides a remedy whenever a person owes a duty of confidentiality to another and breaches that duty
Breach of confidence
Privileged communication refers to
Confidential information that has not been told to a doctor
No information, test results, patient hxs, or even the fact that the patient is a patient, can be transmitted to another person without the p
Patien’ts consent
Smith v Datla
Confidentiality
Medical records should not be released to third parties without
Patient’s consent
Patients should sign release form prior to sending
Medical records
The original version of the medical record
Should never be sent
Only the specific information requested should be released, not
The entire medical record
Violation of the personal liberty of another person through unlawful restraint
False imprisonment
Takes action to confine a patient
False imprisonment
Patient not being allowed to leave a room or building and had no reasonable mean of escape
False imprisonment
Deliberate concealment of the facts from another person for unlawful or unfair gain
Fraud
Illegal billing for services that may or may not have rendered
Fraud
Dishonesty when conducting medical research
Illegal sale of drugs
Fraud
Billing fraud includes
Billing for services not needed
Billing for nonexistent patients
Billing for products not needed or supplied
Overutilization of services such as treatments including office visits, testing, and therapy
Medical fraud
Supplies that were not delivered or providing lower priced supplies and billing for higher prices supplies
Medical fraud
Legal scams such as workers comp fraud and false injury claims
Medical fraud
Kickbacks which are improper payments in order to induce healthcare professionals to refer patients to a healthcare facility
Medical fraud
The wrongdoing or negligence committed by a professional person like chiropractors
Malpractice
Professional misconduct or demonstration of an unreasonable lack of skill with the result of injury, loss, or damage to the patient
Malpractice acts
Professional misconduct
Improper discharge of professional duties
Failure to meet professional standards of care that result in harm to another person
Malpractice acts
Negligence by a healthcare professional is considered
Malpractice
Person performs or fails to perform an action that a reasonable professional person would or would not have performed in a similar situation
Unintentional tort
Both action and inaction (omissions) can be considered
Negligence
Every mistake or error is NOT
Malpractice
When a treatment or diagnosis does not turn out well,
The provider is not necessarily negligence
4 elements of negligence
Provider owes a duty of care
Breach in the applicable standard for carrying out duty
A compensable injury was the proximate cause of the breach of duty
Compensable damages or injury to the patient
Responsibility established by the provider-patient relationship
Duty
The obligations the provider has to the patient
Duty
Patient/plaintiff has to prove that a relationship has been established
Duty
Duty is assessed based on
The reasonable person standard
Chiropractor and other healthcare professional must act within the standard of care appropriate for their profession, with attention to
Their special field or their particular level of practice
All providers are held to the same
Standard in their field of practice
The test for standard of care is
Reasonable person standard
Generally necessary to prove either compliance with or deviation from the standard of care
Expert testimony
Continuous sequence of events, unbroken by any intervening cause that produces an injury and without which the injury would not have occurred
Direct or proximate cause
The injury was proximately or closely related to the provider/defendant’s negligence
Direct or proximate cause
There was no intervening forces between the defendant’s action and the plaintiff’s patient injury
Direct or proximate cause
The last negligent act that contributed to a patients injury without which the injury would have resulted
Direct or proximate cause
The thing speaks for itself
Res Ipsa Loquitur
Breach is so obvious that it does not need further explanation
Res ipsa loquitur
Injury would not have occurred without the negligence of someone
Res ipsa loquitur
Injuries caused by the defendant
Damages
Plaintiff seeks recovery compensation for a damages
Permanent physical disability
Permanent mental disability
Loss of enjoyment of life
Personal injuries
Past and future loss of earnings
Medical and hospital expenses
Pain and suffering
Recovery for the actual loss of income, emotional pain and suffering, or injury suffered by the plaintiff related to the injury
Compensatory damages
Lost income
Past, current, and future lost wages
Monetary award by a court to a person who has been harmed in an especially malicious or willful way.
Punitive damages
Not always related to the actual cost of the injury or harm
Punitive damages
Punishment
Punitive damages
Defendant present evidence that the patient’s condition was the result of factors other than the defendant’s negligence
Affirmative defense
Undesirable side effects; informed consent documents
Assumption of risk
Patient was fully or in par at fault for the injury; plaintiff will recover nothing
Contributory negligence
Plaintiff can recover based on the percent of the damage caused by the defendant
Comparative negligence
Limits the time frame for a lawsuit to be filed
Statute of limitations
Rule of discovery - statutes does not begin to run until the injury is discovered
Exception
Exercise the standard of care or any other business owner
Conditions of the premises
Conditions of the premises
Respondant superior
Professional liability
Conditions of the premises examples
Broken steps
Malfunctioning elevators or doors
Defective carpets
Safety
Employer is liable for the consequences of the employee’s action committed in the scope of employment
Respondeat superior
Does not necessary require wrong directly by the employer
Respondeat superior
Gala vs fisher
Malpractice prevention
