When patients go the doctor, they expect to be diagnosed and then treated for their illnesses. Unfortunately, there are some patients who receive incorrect or improper treatment. This can result in errors from small mistakes all the way up to death. In our current healthcare system, there is a strong emphasis on cost control. Sometimes this takes priority over patient safety and needs. Doctors can be hindered from exercising their duty to a patient by insurance companies and concerns of treatment or diagnostic cost. Failure to diagnose or a delay in diagnosis can expose medical providers to negligence liability.
For example, Wayne Smith is very concerned about his health. He sees his doctor much more frequently than his health insurance plan would like. The visits are usually short, and he likes to focus on preventive health care instead of waiting to be treated for an illness. Wayne’s doctor is committed to Wayne's overall well-being, but has claims returned with nonpayment because Wayne is exceeding his available coverage because of his frequent appointments.
Wayne is in his doctor’s office again, but today he is complaining that he does not feel well. Wayne is not really sure why or what is wrong. He has heartburn, and he just feels off. Wayne wants the doctor to run some tests. The doctor is concerned about his patient, but he is also concerned about his insurance not paying him for these new tests. He does not have a history of any heart condition or anything that might be serious. He tells Wayne it is probably just heartburn or even acid reflux, something for which he does have a history. He tells him he could go to the emergency room now, or he could wait and see if the pain gets worse tonight and then go to the emergency room. Wayne trusts his doctor and decides he will just go home and sleep it off. It still hurts, but it is probably nothing, or the doctor would have been more alarmed. He will call his insurance in the morning to see what coverage he has for these kinds of tests. Wayne’s doctor feels he has fulfilled his duty to his patient by telling him to go the emergency room if things get worse.
Unfortunately, Wayne dies of a massive heart attack at home in bed. He had a previously undiagnosed heart defect that contributed to his heart attack. In this kind of tragedy, there are multiple contributing factors to Wayne’s death, but the blame keeps returning to a failure to diagnose both the heart attack and the underlying condition. The doctor felt constrained by the health insurance company, and the patient did not pursue additional treatment.
This case is similar what happened to the actor John Ritter. His death was from a heart defect that, despite having multiple scans, was undiagnosed for over two years. When he was taken to the emergency room complaining of chest pains, he was treated for a heart attack, which further hastened his condition and led to his death.
No one is immune to medical errors. Patients can fall victim to misdiagnosis, failure to diagnose, mistaken treatment options, and delays in diagnosis or treatment. These are a few of the many types of legal claims that can be brought against a medical provider during a negligence law suit.
Another area of potential liability is medication error. Medication errors in this country have been significantly reduced through the implementation of modern computer systems that monitor all medications that are dispensed and in inventory. There are also manual safeguards in place to ensure patients receive the correct medication and dosage. The medication errors that do occur can be potentially deadly for patients.
We have discussed the elements of negligence in previous units. Negligence requires a duty to a patient, evidence of a breach of that duty, and evidence that the breach of duty directly or indirectly caused harm to a patient.
Medical providers of all disciplines are constantly subjected to liability from patients. An often overlooked category of liability is nursing. Nurses are also subject to negligence claims. While they may not have the same negligence exposure as doctors, they can also be involved in negligence and other claims brought by patients.
Nursing
Nursing duties are defined by each state individually. This means that the level of liability can vary by the state in which the nurse works. There are, however, universal claims of which nurses are subject. Nurses can be sued individually or as part of a larger lawsuit. They may be sued for failure to monitor, failure to document a patient’s medical condition or changes to his or her condition, failure to follow orders and provide prescribed treatment, or medication errors.
For example, a nurse is given orders by the doctor to monitor a patient recovering from surgery every half an hour. The nurse is juggling multiple patients and decides that there is no harm in monitoring the patient every two hours so she can still monitor all her other patients. The patient comes out of surgery and goes into the recovery room. The nurse reviews the patient and his records as he is still sleeping and recovering from the invasive surgery.
The nurse conducts her rounds to monitor other patients and returns just over two hours later. The patient is still sleeping. The nurse is concerned there may be something wrong. At this point the patient does not wake up or regain consciousness. The nurse was given orders to monitor the patient closely and failed to do so. The patient’s family brings a claim of negligence specifically against the nurse.
MHA 5101, Legal Foundations of Health Care 3
UNIT x STUDY GUIDE
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Allied Health Professionals
In addition to doctors and nurses, the category of providers called allied health professionals can also be exposed to liability. Allied health professionals provide support and complementary treatment for patients. Allied health professionals are not doctors or nurses, but they still treat patients. Some examples of allied professionals are chiropractors, medical assistants, dental hygienists, physician assistants, and physical therapists.
Allied health professionals can also be sued for negligence and malpractice. These professionals treat patients for a variety of illnesses, but they are not medical doctors. Chiropractors, for instance, manipulate the spine to alleviate pain and pressure. This can sometimes go wrong and injure patients.
A patient goes to her chiropractor for her regular appointment. She does not have any injuries, but she seeks the treatment to relieve the stress on her body from sitting for hours at a time for her job. She has done this for years and feels that it helps her prevent serious injury. She has a spinal manipulation, and hours later she starts to feel pain in her lower back. The pain becomes unbearable, and she goes to the emergency room. She is then diagnosed with a herniated disk in her back.
It appears her last spinal manipulation caused the injury and now she has ongoing pain. In order to relieve her pain, she will need surgery, which requires a long recovery time away from work. She brings a lawsuit against the chiropractor. Even though the chiropractor is not a traditional medical doctor, he is still subject to a medical malpractice lawsuit.
In this instance, however, after the patient left the chiropractor’s office, she went home and made dinner and did some laundry. She was moving some furniture to sweep, and she then picked up a laundry basket. She immediately felt a stabbing pain in her lower back. The pain became so intense that she went to the emergency room.
In the scenario above, there may have been other causes for her injury. The chiropractor, however, must now vigorously defend against this lawsuit. This can be an expensive proposition. Even if the lawsuit against the chiropractor is eventually dismissed, it will still be costly to hire a lawyer to defend the chiropractor. All providers must carry malpractice insurance to be able to defend against these types of claims and to be able to compensate patients for unintentional injuries.
Conclusion
There are many potential areas of negligence, and malpractice claims can be brought against all areas in healthcare practice. Doctors and nurses are not the only providers subject to lawsuits by patients. Any professional who is involved in the treatment of patients can be susceptible to liability.
Patients must be their own advocates and contribute actively to their own well-being. The combination of provider diligence and patient awareness is one way to reduce negligence claims.
Neurology Advisor. (2015). AMA provides tips to improve physician-hospital relationship. Retrieved from http://www.neurologyadvisor.com/practice-management/ama-physician-hospital-relationship/article/419416/