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At least 397 records · Page 22Linked to original sources
PubMed2003

Impact of the National Practitioner Data Bank on resolution of malpractice claims.

Policymakers and commentators are concerned that the National Practitioner Data Bank (NPDB) has influenced malpractice litigation dynamics. This study examines whether the introduction of the NPDB changed the outcomes, process, and equity of malpractice litigation. Using pre- and post-NPDB analyses, we examine rates of unpaid claims, trials, resolution time, physician defense costs, and payments on claims with a low/high probability of negligence. We find that physicians and their insurers have been less likely to settle claims since introduction of the NPDB, especially for payments less than dollars 50,000. Because this disruption appears to have decreased the proportion of questionable claims receiving compensation, the NPDB actually may have increased overall tort system specificity.

Attitude of Health Personnel↗
PubMed2002

The role of the autopsy in medical malpractice cases, II: controversy related to autopsy performance and reporting.

CONTEXT: We studied 99 appellate court records in cases of alleged medical malpractice and found no relationship between discrepant clinical and autopsy findings and outcome of litigation. Standard-of-care issues and not diagnostic accuracy were at the heart of every case. OBJECTIVE: To characterize and discuss issues related to the autopsy and/or pathologist behavior that were raised in court records of medical malpractice litigation. DESIGN: In 18 appellate court records, issues were raised about quality of autopsy performance and reporting or about death certification. The details of these controversies are succinctly reported here in a manner intended to be instructive to pathologists who perform autopsies in a hospital setting or on a private fee-for-service basis. CONCLUSION: Autopsy reports are intended to provide objective medical information in a coherent format to the patient's medical record, to the attending physician and other concerned staff physicians, to other health care professionals, and to the families of the deceased. Inevitably, occasions arise that require legal counsel to be added to this list of parties with a legitimate interest. Our findings emphasize that incomplete, incoherent, obfuscated, or delayed reporting of autopsy findings do not meet professional standards, are unethical if intentional, and may be counterproductive.

Adult↗
PubMed1994

Characteristics of potential plaintiffs in malpractice litigation.

OBJECTIVE: To characterize patients calling plaintiff attorneys' offices and claiming to have suffered injury caused by medical negligence. DESIGN: Telephone interviews with an inception cohort of callers to law firms with malpractice complaints before the callers talk to attorneys. SETTING: Six law offices in five states. PARTICIPANTS: 502 of 730 callers over 10 randomly selected days in 1991. MEASUREMENTS: Demographics of potential plaintiffs, types of health care providers named by callers, factors prompting calls, economic and noneconomic motivations for claims, and disposition of claims. RESULTS: An average of 12 calls per office per day were received by law firms concerning malpractice complaints. Many factors affected patients' decisions to call: poor relationships with providers before an injury (53%); television advertising by law firms (73%); explicit recommendations by health care providers to seek legal counsel (27%); impressions of not being kept informed or appropriately referred by providers; and financial concerns (for example, 36% with earned income and outstanding medical bills had bills equaling or exceeding 50% of their annual income, 33% were unemployed, and 31% lacked health insurance). One in 30 calls led to the filing of a lawsuit. CONCLUSIONS: Calls to plaintiff law firms by patients are common, are motivated by diverse factors, represent dissatisfaction with modern health care, and infrequently lead to lawsuits.

Demography↗
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↗
PubMed2003

Patient safety and medical malpractice: a case study.

The system of tort liability for medical malpractice is frequently criticized for poorly performing its theoretical functions of compensating injured patients, deterring negligence, and dispensing corrective justice. Working from an actual malpractice case involving serious injury but no apparent negligence, the authors explore these criticisms from the perspectives of both the plaintiff-patient and the defendant-physician. They then examine the tort system through the lens of patient safety and conclude that the tensions between the system and patient safety initiatives suggest a need to reexamine our attachment to adversarial dispute resolution in health care. They propose targeted reforms that could improve the functioning of the system and create incentives to improve safety and quality.

Female↗
PubMed2004

Malpractice reform must include steps to prevent medical injury.

In the current malpractice insurance crisis, physicians have focused their advocacy and energy primarily on rapidly increasing liability premiums; problems in access to care; and demands for legal reform, especially caps on damages. An even more important focus, however, is prevention of injury and improvement of patient safety. Physicians largely control patient care and can play a critical role in systematically reducing injury. Reforms should go beyond liability issues; they should also harness and enhance physicians' ability to act. More visible efforts by physicians to reduce harm, better communication with patients and others, and true evidence of improved patient safety should reduce patient anger and litigiousness. Individually and collectively, physicians can and should ensure that "doing no harm" comes first in the malpractice debate.

Health Care Reform↗
PubMed2006

Missed and delayed diagnoses in the ambulatory setting: a study of closed malpractice claims.

BACKGROUND: Although missed and delayed diagnoses have become an important patient safety concern, they remain largely unstudied, especially in the outpatient setting. OBJECTIVE: To develop a framework for investigating missed and delayed diagnoses, advance understanding of their causes, and identify opportunities for prevention. DESIGN: Retrospective review of 307 closed malpractice claims in which patients alleged a missed or delayed diagnosis in the ambulatory setting. SETTING: 4 malpractice insurance companies. MEASUREMENTS: Diagnostic errors associated with adverse outcomes for patients, process breakdowns, and contributing factors. RESULTS: A total of 181 claims (59%) involved diagnostic errors that harmed patients. Fifty-nine percent (106 of 181) of these errors were associated with serious harm, and 30% (55 of 181) resulted in death. For 59% (106 of 181) of the errors, cancer was the diagnosis involved, chiefly breast (44 claims [24%]) and colorectal (13 claims [7%]) cancer. The most common breakdowns in the diagnostic process were failure to order an appropriate diagnostic test (100 of 181 [55%]), failure to create a proper follow-up plan (81 of 181 [45%]), failure to obtain an adequate history or perform an adequate physical examination (76 of 181 [42%]), and incorrect interpretation of diagnostic tests (67 of 181 [37%]). The leading factors that contributed to the errors were failures in judgment (143 of 181 [79%]), vigilance or memory (106 of 181 [59%]), knowledge (86 of 181 [48%]), patient-related factors (84 of 181 [46%]), and handoffs (36 of 181 [20%]). The median number of process breakdowns and contributing factors per error was 3 for both (interquartile range, 2 to 4). LIMITATIONS: Reviewers were not blinded to the litigation outcomes, and the reliability of the error determination was moderate. CONCLUSIONS: Diagnostic errors that harm patients are typically the result of multiple breakdowns and individual and system factors. Awareness of the most common types of breakdowns and factors could help efforts to identify and prioritize strategies to prevent diagnostic errors.

Adolescent↗
PubMed1994

The implications of practice guidelines for physician medical malpractice liability.

Medical practice guidelines are increasingly coming into use, and as more and more physicians are presented with guidelines to follow in the delivery of health care, the question arises of whether these guidelines will become instruments for imposing greater medical malpractice liability on physicians. This column will briefly describe what guidelines are, how they are developed, and how they have been and may be used in litigation against physicians, hospitals, and other health care institutions. As hospitals and managed care organizations continue to implement guidelines, the role these guidelines play in malpractice cases can be expected to increase. It appears, however, that, although guidelines will contribute to the establishment of the standard of care by which a physician's actions will be measured, they are not likely to become the standard that all physician treatment decisions must meet.

Hospitals↗
PubMed1995

Clinical guidelines: a defense in medical malpractice suits.

Clinical pathways, or practice guidelines, have been gaining wider acceptance from physicians and hospitals seeking to constrain increasing operating costs for inpatient care. The authors believe that properly developed and agreed upon guidelines can also be used in certain cases as appropriate standards of care in determining if medical malpractice has occurred. Adherence to the guidelines could then be asserted by defendants as an affirmative defense in a medical malpractice suit.

Defensive Medicine↗
PubMed1999

Developments in clergy malpractice: the case of Sanders v. Casa View Baptist Church.

The courts have so far consistently refused to view misconduct by clergy counselors as constituting clergy malpractice. However, they have increasingly come to view it as a breach of fiduciary duty. More recently, they have also begun to differentiate between the secular and religious aspects of clergy counselors' work. The case discussed in this article (Sanders v. Casa View Baptist Church) provides an instructive example from the United States Court of Appeals, Fifth Circuit, in 1998. The court upheld a district court finding, based on a review of trial testimony, that the defendant's counseling work as a whole (and not merely his sexual misconduct itself) was essentially secular in nature. Thus the plaintiff recovered punitive damages for both breach of fiduciary duty and marriage counseling malpractice.

Clergy↗
PubMed1978

Social work and malpractice: a converging course.

Malpractice actions have not been applied to social workers, to date. Emerging legal sanction for an recognition of social workers as mental health professionals, however, carries a concomitant risk of malpractice suits against social workers in a number of treatment practice areas.

Humans↗
PubMed1978

Malpractice: an ogre on the horizon.

Although social workers are sued for malpractice only infrequently, the possibility exists nonetheless. Drawing analogies with areas of liability that exist in other professions, particularly psychiatry, the author calls attention to ways in which the social worker can protect himself against malpractice suits.

Humans↗
PubMed1978

Risk management: preventive medicine for malpractice.

The remedy for malpractice problems hinges on their identification and subsequent prevention. This study was undertaken to ascertain any patterns of medical negligence, as indicated by patients' allegations, so that specific recommendations could be made to health care providers. In general, it was found that most malpractice suits could have been avoided if more diligent patient care had been provided, particularly with regard to patient communication.

Communication↗
PubMed1979

Medical malpractice litigation: the discoverability and use of hospitals' quality assurance committee records.

Medical staff review committees and their records can play a major role in a hospital's defense against malpractice actions. Members of such committees are liable to varying degrees to actions for conspiracy, tortious interference with a business relationship, defamation and malpractice. Various defenses and statutory immunity in many states provide ample protection where the participant is acting reasonably and in good faith.

Confidentiality↗
PubMed1979

The consumer viewpoint on malpractice.

Our malpractice system is geared to compensate, and perhaps overcompensate, the occasional victim of catastrophic injury, while undercompensating, or even ignoring, smaller injuries. So states the author in presenting arguments for changing the system. She protests attempts to change the tort system, get around limits, tighten statutes of limitations, remove the discovery rule, or do away with res ipsa loquitur and informed consent. She cites California as a state, which has done the most to strengthen its medical discipline as a first step in attacking the "real problem of medical malpractice...the reality of injury due to medical negligence and the frequent difficulty of obtaining legitimate compensation."

California↗
PubMed1979

Avoiding malpractice claims through better hospital management.

Within the control of hospital management is the capability of reducing malpractice claims through better employee and patient communications. Promises of successful treatment, billing charges and medical procedures that are unexplained, unfamiliarity of hospital management with what constitutes hospital liability, and wrong use of informed consent forms are among the factors that increase chances of bein sued for malpractice.

Consumer Behavior↗
PubMed1985

A look at Florida's malpractice crisis.

To solve the malpractice problem, the Florida Medical Association has attempted during the last decade to bring about tort reform through the legislative process, but early successes were declared unconstitutional or ignored by the courts. In 1984, the FMA organized a constitutional initiative campaign called REASON '84, and secured a record 630,000 signatures of registered Florida voters to place a constitutional amendment on the 1984 Florida General Election ballot. The Florida Supreme Court in October 1984 removed the Association's constitutional Amendment 9 from the ballot. Dr. Coleman, past president of the Florida Medical Association, wrote the following during his term as president about the malpractice problem and its grave implications.

Florida↗
PubMed1984

Medical malpractice: a defense attorney's perspective.

Medical malpractice lawsuits are a continuing problem for physicians and other health care professionals. An attorney who specializes in the defense of medical malpractice cases offers his suggestions on how to avoid becoming a defendant.

Informed Consent↗