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At least 307 records · Page 17Linked to original sources
PubMed1989

Hospitals' direct liability for medical malpractice--implications for the medical staff.

Historically, hospital liability for the wrongful acts of physicians was based on the doctrine of vicarious liability-i.e., the physician was regarded as an employee or agent of the hospital. With the courts' growing recognition of most physicians as independent contractors, the doctrine of corporate or direct liability has emerged as the primary basis upon which courts now hold hospitals liable for failing to adequately monitor and control the standards of medical care and treatment offered within their walls. This article discusses eleven theories for imposing direct liability on hospitals and considers their impact on hospital-physician relations.

Hospital Administration↗
PubMed1995

Legal requirements for tele-assistance and tele-medicine.

In dealing with tele-medicine including tele-diagnosis and tele-assistance, the legal and ethical components of medical liability must be satisfied. With medical tele-diagnosis, the spreading of medical liability is the main risk. How can we ensure a clear identification of the medical liabilities involved in cases where damage occurs? From a legal point of view, the spreading of the liability is not allowed and the use of tele-diagnosis must ensure a total transparence. As we cannot presently estimate the cost of a medical act based on the cost of the image records and the cost of image interpretation, it is necessary to establish a contract. Today the most convenient contract is similar to the contract between laboratories which implies that the liability is on the practitioner who has received the sample. In the future, other legal obligations may appear as tele-diagnosis develops. Indeed, with the increase in reliability in tele-diagnosis it could become a part of the medical obligation to use the latest technology. However, the excessive use of tele-assistance, when there is neither emergency nor medical isolation, is dangerous because it may affect the integrity and the quality of the traditional medical act. In general, medical practice without any clinical examination of the patient is contrary to medical ethics.

Ethics, Medical↗
PubMed1980

Salus populi suprema lex est: comments on governmental regulation of medical professional liability insurance.

In 1975 nationwide turmoil arose regarding medical professional liability insurance, posing a resolute challenge directly to the liability insurance mechanisms traditionally utilized to underwrite the professional risks of medical practitioners. Further they signaled the real possibility of substantive revisions of the tort-fault foundation of legal actions seeking civil relief for medical malpractice.

Government↗
PubMed2003

Medical aspects of malpractice crisis in Greece: medical responsibility: a doctor's view.

Malpractice and medical liability have been introduced into Greek reality over the last decade. Forensic sciences hold a key role in the investigation of medical liability cases. Along these lines, the medical examiner stands between colleagues and lawyers, who have divergent intentions in the investigation of such cases. This article offers an overview of the rapidly changing reality in Greece and approaches medical liability from the doctor's viewpoint. The role of forensic science and the medical examiner is portrayed, along with the emerging difficulties in the investigation of medical liability cases. Also attempted is an interpretation of the crisis phenomena that are very often seen between doctors and lawyers. However, the intent of this article is to search for ways to turn competition and tension between medical and law professionals into cooperation and understanding for the best interest for both professions and, more importantly, for the community.

Forensic Medicine↗
PubMed1998

Snyder v. American Association of Blood Banks: a re-examination of liability for medical practice guideline promulgators.

Medical practice guidelines are playing an increasingly important role in both the medical and the legal context. As tools for the health practitioner, it is thought that medical practice guidelines may contribute to an increase in the quality of patient care and cost-effectiveness. In the legal setting, guidelines may improve the functioning of the medical malpractice system by creating more rational, predictable standards of care. The development and promulgation of medical practice guidelines, while increasing, are still evolving. A number of concerns, especially in the areas of physician autonomy, physician control, and ethics, as well as efficacy, need to be resolved. The use of such guidelines as the legal standard of care in malpractice cases evokes similar concerns, along with fears that the use of guidelines at trial may either lower the standard of care, or, conversely, raise the standard of care to levels that are difficult to meet. Adding to this controversy is the recent case of Snyder v. American Association of Blood Banks (1996), in which the New Jersey Supreme Court upheld a jury finding that the American Association of Blood Banks (AABB) was liable to a plaintiff who contracted AIDS from an HIV-tainted transfusion, for negligent failure to adopt guidelines requiring blood testing for surrogate markers. This opinion is significant as the first to find a duty of care running from a medical guideline promulgator to a third person, the injured patient. The opinion is examined in depth and within the context of other relevant case law. The impact the opinion will have is difficult to gauge. The somewhat unique facts of the case, as well as the court's unusually stinging critique of the defendant, AABB, and its motivations informing its response to the concerns about blood contamination, may limit its value as precedent. However, precedent does exist in analogous non-medical cases for promulgator liability. The pros and cons of promulgator liability are weighed. While closer regulation of guideline development and promulgation or promulgator immunity may be warranted, it is premature to consider either seriously until the impact of the Snyder opinion can be appreciated.

Blood Banks↗
PubMed1984

Reallocating liability to medical staff review committee members: a response to the hospital corporate liability doctrine.

Under the doctrine of hospital corporate liability, the hospital governing board bears the responsibility for detecting the incompetence of its staff physicians. Since hospital governing boards are generally composed of lay community members, they lack the expertise to evaluate the clinical competence of their staff. Therefore, they must delegate their screening responsibilities to medical staff review committees. After analyzing the development of hospital corporate liability doctrine, this Note examines the respective policing capabilities of review committees and the governing board. The Note contends that the board should not be held liable for aspects of the policing process which it is incapable of controlling. The Note concludes that, given their superior ability to evaluate clinical competency, staff review committees should shoulder the responsibility for the clinical aspects of staff evaluation, leaving remaining aspects to the hospital governing board. The Note proposes that courts should recognize a cause of action for negligence against medical staff review committee members in order to upgrade the effective policing of the medical profession.

Humans↗
PubMed1990

The demise of vaginal operative obstetrics: a suggested plan for its revival.

Predictions made more than a quarter of a century ago regarding excessive use of cesarean delivery for cases of dystocia have been realized. Breech presentation, correctable dystocia, and twin gestation are increasingly being delivered by the abdominal route. Recent studies have shown that neonatal morbidity is not inherently improved by cesarean birth, and in fact have reported comparable results with vaginal operative procedures in properly selected and managed cases. Pressure to control the cesarean birth rate is now being exerted by consumer groups, professional groups, and governmental agencies. The reintroduction of vaginal operative procedures to modern obstetrics would help reduce the cesarean birth rate. However, major changes in the medical liability system, medical education and training, and the method of certifying obstetricians will be required before vaginal operative obstetrics becomes a serious alternative to cesarean delivery. Without these changes, I believe there is little hope of reversing the trend toward cesarean birth.

Cesarean Section↗
PubMed1978

Point of view: medical staff liability.

With the current state of medical malpractice affairs, the hospital as a corporate entity must carefully examine the relationship between individual medical staff members and the hospital corporation, as well as the relationship between individual medical staff members and the medical staff as a whole.

Hospital Administration↗
PubMed2004

A description of emergency department-related malpractice claims in The Netherlands: closed claims study 1993-2001.

BACKGROUND: The aim of this study was to assess the quality of care provided at emergency departments (ED) in the Netherlands by analysing medical liability insurance claims. METHODS: A retrospective study performed by reviewing records at MediRisk, presently the largest insurer for medical liability in the Netherlands. The following data were abstracted from the files available for analysis: medical discipline involved, physician involved (resident or consultant), nature and gravity of the complaint, and final claim disposition. RESULTS: Between 1993 and 2001 a total of 326 claims involving the ED were filed at MediRisk. Of these, 256 claims (79%) were closed and were available for analysis. Medical liability claims were filed primarily for alleged errors in diagnosis and treatment. The majority of claims involved minor surgical conditions: fractures, luxations (joint dislocations), wounds and tendon injuries (210/256, 82%). Residents were involved in 76% of the claims; resident supervision by a consultant was documented in only 15% of the medical records. Permanent patient disability resulting from improper ED treatment was alleged in 22% of the claims. Four per cent of the claims involved the death of a patient. Physicians accepted liability in 16% of the claims filed. Indemnity payments during the 8-year study period totalled Euros 504,000. CONCLUSION: The number of medical liability claims is low compared with the number of patients treated in ED in the Netherlands. Claims primarily concerned alleged mistakes in diagnosis and the treatment of minor trauma. Residents were involved in the majority of the claims. More resident supervision is needed, as are specific training programmes for emergency physicians.

Emergency Medicine↗
PubMed2002

Potential physician malpractice liability associated with complementary and integrative medical therapies.

Physicians are increasingly grappling with medical liability issues as complementary and integrative health care practices are made available in conventional medical settings. This article proposes a framework in which physicians can assess potential malpractice liability issues in counseling patients about complementary and integrative therapies. The framework classifies complementary and integrative therapies according to whether the evidence reported in the medical and scientific literature supports both safety and efficacy; supports safety, but evidence regarding efficacy is inconclusive; supports efficacy, but evidence regarding safety is inconclusive; or indicates either serious risk or inefficacy. Clinical examples in each category help guide the clinician on how to counsel patients regarding use of complementary and alternative medical therapies in a given clinical situation. Specific strategies to reduce the risk for potential malpractice liability include the following: 1) determine the clinical risk level; 2) document the literature supporting the therapeutic choice; 3) provide adequate informed consent; 4) continue to monitor the patient conventionally; and 5) for referrals, inquire about the competence of the complementary and alternative medicine provider. This framework provides a basis for clinical decisions involving complementary and integrative care.

Complementary Therapies↗