PT Role As Employee — Legal And Malpractice

Question 1

What is administrative law

Answer 1

• Health service providers must be licensed to provide reimbursable clinical services
• License is evidence that individual has met requirements of the state practice and act and are qualified to practice
• After a license is issued in the licensee must meet his/her responsibilities as stated in the practice act.

Question 2

What is purpose of Illinois practice act

Answer 2

Enacted for the purpose of protecting the public health, safety, and welfare, and for providing the state administrative control, supervision, licensure, and regulation of the practice of physical therapy.

Question 3

more on practice acts

Answer 3

• State laws enacted to protect residents
• Administrative law is determined by a hearing panel consisting of health professionals and public representatives
• Responsibility of the licensee - be aware of the practice act and the associated rules and regulations
• State boards can regulate professional conduct outside of patient interaction

Question 4

What is torts

Answer 4

our biggest thing - negligence and malpractice falls here
- 2 general types of tort: negligent and intentional

Question 5

Negligence tort

Answer 5

Omission or commission of an act that is reasonable and prudent person would or would not do under given circumstances

• professional negligence: occurs when the alleged wrongdoer is a licensed professional and the requisite action is within the scope of practice, thus requiring the knowledge, and skills of a professional.

Question 6

Intentional tort

Answer 6

An act that is intentionally committed knowing harm is a likely result
- assault — threat to touch another without consent
- battery — intentional touching of another without his or her consent. Plaintiff does NOT need to prove injury.

Usually comes with not telling someone that is cog intact that you are gonna touch them or someone says stop and you don’t stop.

Question 7

False imprisonment

Answer 7

Confinement of a person to the extent that there is no reasonable exit and physical restraint was not necessary

Question 8

Defamation

Answer 8

Communication to a third party or parties that is unfounded and negative to their character
- slander — oral communication
- libel — written communication

Question 9

Fraud

Answer 9

Intentional misrepresentation in a manner that could cause harm

Question 10

Invasion of privacy

Answer 10

Intentional deprivation of one’s right to be left alone — (disclosure of personal facts)

Question 11

Infliction of emotional distress

Answer 11

Intentional actions or omission that would cause a reasonable person to suffer emotional trauma

Main example here is ROM post op — its gonna hurt but we have to do it so we HAVE to educate

Question 12

Negligence

Answer 12

Both ordinary negligence and malpractice plaintiff must prove that all four elements below exist:
1. Duty
2. Breach
3. Damages
4. Causation

Question 13

What is duty

Answer 13

There was a duty owed to a person…
1. Legal duty exists whenever a healthcare facility or provider undertakes care or treatment of a patient
2. Corporate liability — the company has a duty to hire qualified staff, supervise, employees, and monitor employee performance

In healthcare - the legal duty starts as soon as we undertake their care so eval

Question 14

What is breach

Answer 14

Demonstration that the duty was not met, either by failure to act (omission) or by failing to meet the standard of care for the circumstance at the time (what a reasonable professional would have done under similar circumstances)

Expert witness has to establish a minimum standard of care.

Question 15

What are damages

Answer 15

Party who has owed a duty incurred damages
1. Direct — lost wages, current and future medical expenses
2. Indirect — value for pain, emotional distress, and loss of consortium
3. Punitive — may be added with conduct was intentionally harmful or so negligent that it demonstrates a willful disregard for standard of care.

Question 16

What is causation

Answer 16

Causal relation between the breach of duty and damages that occurred

Have to prove there is an exact relationship between the two

Question 17

What is malpractice

Answer 17

Negligence case must meet all of the above examples and IN ADDITION… expert witness has to be involved

They have testimony required to demonstrate ordinary professional’s standard of care

Question 18

What is malfeasance

Answer 18

An act that is legally unjustified, harmful, or contrary to law

Question 19

What is misfeasance

Answer 19

Performance of a lawful action but in an illegal or improper manner

Question 20

What is nonfeasance

Answer 20

Failure or omission to do something that should be done

Question 21

What is an example of something that can establish standard of care

Answer 21

Documentation

Question 22

What is an event

Answer 22

This is what triggers the case — misunderstanding, accident, clearly defined injury

As soon as event occurs if you are aware it has occurred:
1. Attempt to remedy the situation
2. Alert appropriate health professional if you need additional professional assistance
3. Document thoroughly, accurately, and objectively
4. Likely facility has a report to fill out for risk management

when in doubt - fill out incident report

Question 23

What is summons and complaints

Answer 23

Lawsuit is formally initiated when 2 documents are filed
1. Summons = written legal document given to defendant in a lawsuit which names the defendant, plaintiff, jurisdiction, and when/where the defendant should appear
2. Complaint = gives detail about the case against the defendant and outlines the basis of the suit,

Question 24

What should defendant do should they receive a summons and complaints

Answer 24

1. Notify liability insurance carrier
2. Notify employer
3. Review all records
4. Preserve all records

Question 25

What should NOT happen if you get a summons and complaints

Answer 25

1. Distribute original records without advice from legal counsel
2. Make changes to the records
3. Converse about case with colleagues, family, friends, or emails

Question 26

What is retrial discovery

Answer 26

• Where both parties research relevant facts to be presented to court
• Oral depositions, written depositions, and requests for production of records — medical records, office calendars, correspondence, and personal notes
• Oral depositions are taken under oath

Question 27

What/when/how are depositions

Answer 27

• You can be a part of a deposition as both a fact witness and as a defendant
• Review your records prior to deposition
• Ask the attorney to repeat or rephrase question if you do not understand
• Give answers to the questions but do not give additional info
• Listen to your attorney’s advise
• Act professional and confident
• Avoid use of words: always and never!!!!

Question 28

The trial…

Answer 28

If judgement is in favor for the plaintiff in a malpractice case…
1. Financial consequences
2. Employment consequences
3. Licensure consequences — censure, suspension, revocation
4. National practionaer data bank — not good

Question 29

Settlement

Answer 29

An option up until the case goes to trial

A settlement is not an admission of fault

Two advantages
1. Less expensive than paying for attorneys, expert witnesses, court costs
2. Amount may be significant;y less than what jury would aware

Question 30

Two types of fraud

Answer 30

1. Civil — claiming a certain care plan will cure patient while knowing that it will not
2. Criminal — billing for services that were never rendered

Question 31

Workplace harassment provisions

Answer 31

U.S Equal Employment Opportunity commission — harassment is a form of employment discrimination that violates Title VII of the civil rights act of 1964, adage of discrimination in employment act of 1967, and Americans with disabilities act of 1990.

Question 32

When does harassment become unlawful

Answer 32

1. Offensive conduct becomes enduring and a condition of continued employment OR
2. Conduct is severe or pervasive enough to create a work environment that a reasonable person would consider intimidating, hostile, or abusive.

Question 33

What is OSHA

Answer 33

Assures the safety and health of American workers by setting and enforcing standards, providing training, outreach, and education

Impacts PT — safe environment like cords covered and out of walkway, equipment well maintained, training of all new equipment with therapists

Question 34

Look at strategies to minimize risk

Answer 34

Slides 37-40

Question 35

External vs. Internal workplace audits

Answer 35

External — assessment of specified data points to determine compliance with previously identified standard

Internal — assessment to determine compliance performed by, or initiated by, the organization or facility itself to look for inproprieties, errors, or other wrong doing

Question 36

Sampling vs. Comprehensive audits

Answer 36

Sampling — assessment conducted on a statistically valid portion of the entire body of data

Comprehensive — assessment of the entire body of data to determine compliance with previously identified standards

Question 37

What are types of problems

Answer 37

1. OVERT — non compliant event that is obvious or easily seen
2. COVERT — noncompliant event that is not obvious or easily seen
3. TREND ANALYSIS — a review and assessment of data taken over a period of time with the intention of identifying patterns in the organization
4. OCCULT PROBLEMS — noncompliant event that is deeply hidden and cannot be identified without an in-depth investigation

Question 38

Who does internal audits

Answer 38

Companies can have staff complete, staff positions solely for the purpose of compliance, or hire companies to audit internally

Question 39

What are some organizations that perform external audits

Answer 39

1. Recovery Audit Contractors
2. Occupational Safety and Health Administration
3. Department of Justice
4. Office of the Inspector General
5. The Joint Commission
6. Health and Human Services

Question 40

Responding to patient complaints

Answer 40

1. In house complaints — acknowledge the patient concern -> attempt to immediate remedy situation -> manager or patient relations -> grievance policy
2. Patient complaints to accrediting agencies — report filed and company is required to respond