Module 5 - Review of Legal Terms

Question 1

Which legal rule substantiates the request for original reports in the health record?

Answer 1

Best Evidence Rule - when it is necessary to prove the contents of a paper, the original must be produced

Question 2

What must take place in court in order to remove the health record from the hearsay evidence category?

Answer 2

Every entry must be identified by the person who made it - Res Gestae

Question 3

How does “invasion of privacy” apply to the health record?

Answer 3

Cannot publish patient’s record without their knowledge and authorization

Question 4

What does RES GESTAE mean?

Answer 4

“Things done” - exception to the Hearsay Rule; admissible as evidence

Question 5

What does RESPONDEAT SUPERIOR” mean?

Answer 5

“Let the master answer” Vicarious liability

Question 6

What is privileged communication?

Answer 6

cannot be forced to divulge in court

Question 7

What is Confidential communication?

Answer 7

Contains sensitive information

Question 8

What is the statue of limitations?

Answer 8

Law which limits period of time in which an action may be brought against another party

Question 9

You have been ordered to appear in court (with the health record) as a witness. Name this document.

Answer 9

Subpoena duces tecum

Question 10

What is the difference between a subpoena and a summons?

Answer 10

Subpoena is a court order to a witness to testify; summons is a writ to sheriff to notify person of action aginst him/her

Question 11

What is a “waiver”?

Answer 11

written authorization giving up a right

Question 12

What is the word for “not doing something” which is part of your job duty?

Answer 12

Breach (will accept negligence)

Question 13

True or False: An example of breaching confidentiality would be the unauthorized disclosure of health information.

Answer 13

True

Question 14

True or False: Health information collected from a spouse on behalf of his wife is called “third party information”

Answer 14

False

Question 15

The case of Ares v Venner confirmed that the medical record could be admitted as evidence as an exception to the hearsay rule.

Answer 15

True

Question 16

Affidavits are frequently accepted by the courts in lieu of a witness testifying

Answer 16

True

Question 17

Hospital employers/administrators are ‘vicariously’ liable for the wrong doings of their physicians on staff.

Answer 17

False

Question 18

What is a document that requires a person to appear at the designated place at a designed time termed as:

Answer 18

a subpoena

Question 19

The health record qualifies as competent evidence because it is A). accurate and complete or B). maintained in the hospital’s regular course of business

Answer 19

B). maintained in the hospital’s regular course of business

Question 20

The rule that requires, that where it is necessary to prove the contents of a document, the original must be produced or its absence accounted for is called the A) Best evidence rule or B) Direct evidence rule

Answer 20

A) Best Evidence Rule

Question 21

The term that applies to evidence that may be properly accepted in a legal proceeding is called what: A). competent evidence; B) exhibit; C) admissability or D) discovery

Answer 21

C) Admissability

Question 22

The physician - patient communication privilege belongs to A) either the patient or the physician depending on the circumstances; B) both the patient and the physician; C) the physician or D) the patient

Answer 22

D) the patient

Question 23

What is an order requiring a person to bring a specified document to court called?

Answer 23

subpoena duces tecum

Question 24

What allows a law enforcement office to seize evidence found at a specific location called?

Answer 24

search warrant

Question 25

document shown by a law enforcement official requesting a document such as a health record in possession of a hospital who is not under investigation called?

Answer 25

Production order

Question 26

document shown to the court indicating that both sides agree on how to proceed

Answer 26

Consent Order

Question 27

document produced by the court just prior to the actual court order

Answer 27

Notice of Motion

Question 28

Another word for masking

Answer 28

Severing

Question 29

A document produced by the coroner allowing them to take the original health record out of the hospital

Answer 29

order to seize

Question 30

A type of writ

Answer 30

summons

Question 31

Can be used in ieu of testimony

Answer 31

affidavit

Question 32

Vicarious Liability

Answer 32

respondent superior

Question 33

Providing consent allowing confidential information to be disclosed

Answer 33

waive claim of privilege

Question 34

Document that must be both signed by a judge and notarized

Answer 34

Court order

Question 35

An example would be the health record which was created in the regular course of business

Answer 35

competent evidence

Question 36

ability to provide authorization

Answer 36

legal capacity

Question 37

an example would be a chart submitted to the court as evidence

Answer 37

exhibit