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PubMed1993

Nurse consultant and professional liability.

The expanded role of nurse consultant brings greater responsibility and risk of professional liability in a litigious society. The nurse consultant needs to be aware of the elements that constitute malpractice and be able to plan for the management of risks involved. When purchasing a liability policy, the nurse consultant must consider the practice setting, types of policies, components of the policy, cost, and means to obtain adequate coverage. Other strategies for protection include proper use of the consultant process, client communication, and individualized client contracts. A well-written contract serves as a legal document to delineate responsibilities and outcomes, provide a professional image, and protect against possible negative developments.

Consultants↗

PubMed2001

[Expert assessment of medical malpractice].

Conciliation boards are advisory commissions of the medical societies. They deal with clarification of extrajudicial patient claims based on factual or putative treatment mistakes. In perhaps 90% of the cases, an extrajudicial solution is possible, whereby the federal average for recognition is 30%. Within the framework of this study, first the legal basis for the liability of doctors is explained, especially the importance of patient information and consent as well as the responsibility for documentation. The material of the conciliation board of the medical society of Saxony consists of 1375 medical expert opinions rendered between 1 January 1992 and 23 September 2000, of which 165 cases were due to orthopedic treatment. The most common health injuries resulting in compensation claims are described.

Expert Testimony↗

PubMed1986

Litigation risk management. Home care challenge.

Although realizing the potential for proliferation of liability litigation, home care administrators are not fully cognizant of the numerous ways that exposure manifests itself and the necessary methods of responding to this risk. Implementing a Litigation Risk Management (LRM) program will provide a comprehensive approach to decrease the agency's risk in all areas of exposure: clinical care, personnel management, financial management, criminal activities and indirect care-related activities.

Financial Management↗

PubMed1979

[Ophthalmological opinions for liability affairs. The question of smart-money (author's transl)].

Besides the compensation of the damage German Law includes also to compensate the noneconomical damage as pain, cosmetic or psychic damage etc. The ophthalmological expert is to state his opinion in accordance with individual consequences of the damage for the given person. He is not obliged to make proposition about the amount of financial compensation of smart-money because this point has to deal with other juridical circumstances of the specific conditions of every individual case.

Expert Testimony↗

PubMed1987

Directors' and officers' liability: a crisis in the making.

Concern is growing about the liability exposure faced by directors and officers of both for-profit and not-for-profit organizations. To determine the seriousness of the liability problem and the steps necessary to correct it, a survey of leaders in corporate and not-for-profit organizations was conducted. Three hundred and fifty hospital CEOs responded; their answers point to a conviction that a crisis is brewing and that executives in the healthcare sector are in favor of Federal or state legislative measures to eliminate some of the causes of the problem.

Data Collection↗

PubMed1975

Liability and compensation independent of medical negligence: the new Swedish system.

On the 1st of January 1975 a new system of Treatment Injury Insurance was introduced in Sweden. (Until then the rules of tort law governed all liability insurances.) Almost all medical attendance within, and much of the attendance outside, hospitals is managed by County Councils (Landstingen). The new insurance is contracted by the managing County Council to a pool of Swedish Insurance Companies. The total amount of the premiums for this first year is calculated to be 16 milj Skr (4 milj $ = 1/2$ per inhabitant per year). By treatment injury shall be understood "injury or illness of a physical nature...as a direct consequence...of...treatment (excepting natural or probably consequences of an act justified from a medical point of view), or of incorrect result(s) of technical examination or clinical diagnostics, or of accidents in hospitals, doctors' offices or in connection with ambulance services".

Diagnostic Errors↗

PubMed1977

Thoughts on the prevention of urologic liability claims.

We have approached the problems of increasing urological liability claims with a superficial study of their causes and some suggested solutions. We believe that this approach is important because it is one that the urological community can take immediately rather than waiting for changes in state and federal laws that may be of benefit in decreasing the impact of these suits. It seems to be the common disease and the simple operation that lead to the lodging of a claim.

Humans↗

PubMed1976

Thoughts on the prevention of urologic liability claims.

Humans↗

PubMed1988

The future of family practice. Implications of the changing environment of medicine. Council on Long Range Planning and Development in cooperation with the American Academy of Family Physicians.

The Council on Long Range Planning and Development of the American Medical Association has identified trends in the environment of medicine and the implications of these trends for specific medical specialties. This report considers the evolution of family practice as a specialty and its role in the future of health care delivery. As a specialty established less than 20 years ago, family practice has successfully surmounted several obstacles to achieve recognition within the medical community and among the public. However, the Council has identified new challenges and opportunities facing this specialty. In particular, the areas of graduate medical education, reimbursement, professional liability, and several health-related societal and ethical issues will pose challenges for and place constraints on family physicians. Family practice will encounter a number of opportunities in the evolving environment of medicine, due in part to demographic trends in the population and the growth in managed care. The Council concludes that, despite the challenges, the increasing demand for the services of family physicians has positive implications for the future of this specialty.

Education, Medical, Graduate↗

PubMed1988

Providers assume responsibility for overpayment in liability cases.

The Health Care Financing Administration (HCFA) has informed hospitals that they can no longer bill or file liens against liability proceeds involving Medicare beneficiaries. HCFA also told providers that before they request conditional payment from Medicare, they must provide their fiscal intermediaries with complete information about any payments received from primary payers, or else reimburse Medicare for any overpayments. This article examines situations in which providers can be held liable for Medicare overpayment and explains how to lessen the facility's risk.

Centers for Medicare and Medicaid Services, U.S.↗

PubMedDate not supplied

The role of risk management in maternal-child health.

In today's litigious medical environment, risk managers serve as a support to health care providers by managing potential or actual liability situations. They analyze the facts in an untoward event, help clinicians communicate the appropriate information to the patient and family, and document it in an objective manner. This article briefly describes the inception of the risk managers' role, details how risk managers can provide support to members of the medical and nursing staffs and what their role is in patient safety, and explains various basic legal concepts that are important to understand should litigation ensue following an adverse event.

Humans↗

PubMed1989

The AMA alternative to medical liability litigation: pros, cons, and fatal flaws.

The AMA proposal for an administrative scheme to replace professional liability litigation has many positive features. It abolishes jury trial and allows administrative determination of fault, representation by appointed lawyers, and limited recovery but for a wider range of injuries during treatment. Attractive as these provisions may seem to medical providers, several of them are radical enough to ensure rejection by the courts as unconstitutional. The "total package" approach to professional liability reform is less promising than concentration on the introduction of a few key items of proven or probable efficacy. Medical providers should concentrate their limited resources on tort reform providing for "caps" on noneconomic damages (pain and suffering), an absolute statute of limitations, reversal of the collateral sources (double recovery) rule, limitations on attorneys' fees, and periodic payments, rather than lump sums, for large awards. The new TMA proposal for neurological birth injuries is discussed briefly.

American Medical Association↗

PubMed1993

Liability issues for occupational health nurses: an overview.

Occupational health nurses need to be familiar with the Nurse Practice Act within their states. Most malpractice suits against nurses are based on negligence. The occupational health nurse should also be aware of potential liability for intentional torts, such as assault and battery, breach of patient confidentiality, and informed consent. The elements of a malpractice case are: a) the duty to conform to standard of care (which is usually established by expert testimony); b) breach of that duty, or the failure to conform to the standard of care; c) a causal connection between the breach of duty and the resulting injuries; and d) actual damages suffered by the patient-plaintiff.

Humans↗

PubMed1999

Caps on malpractice awards: update.

Tort reform for professional liability is in the best interests of not only all physicians, but for industry and the citizenry as a whole. The enormous sums of money donated by the Trial Lawyers Association, whose livelihood is at stake, makes initial passage of tort reform difficult and, once passed, brings it under constant attack. Even if a well-disposed legislature passes a professional liability law, state supreme courts are ever ready to invalidate such laws. Thus, once tort reform has been passed, the next battleground is the state supreme court. ACS chapters should be preparing their membership for educating the public as well as themselves as to the danger of a state supreme court comprised of members opposed to tort reform, and be prepared to help the election of those individuals who are more sympathetic to tort reform.

Cost Control↗

PubMed1978

Vasectomy and lowering surgeon's risk of liability.

The increased demand for vasectomy as a method of fertility control has resulted in an increase in professional liability suits against those surgeons performing this procedure. In some instances this litigation appears to arise from vague or casual instructions from the surgeon, but an additional causative factor is a misunderstanding on the part of the patient regarding the operative and postoperative periods and his responsibility for utilizing alternative contraceptive methods. I suggest some means for addressing these problems, and comment on the factors to consider when the surgeon finds himself the defendant in a lawsuit on "failed" vasectomy.

General Surgery↗

PubMed1989

Family practice obstetrics in Michigan. Factors affecting physician participation.

The purpose of this study was to describe the characteristics of family physicians in Michigan who practice obstetrics and to identify important factors relating to a decision to discontinue obstetric practice. Questionnaires were mailed to all members of the Michigan Academy of Family Physicians (MAFP) who were listed as currently practicing obstetrics. Two hundred ninety-one questionnaires from the 357 mailed questionnaires were returned for a response rate of 81.5 percent. Two hundred thirty-five of the 291 respondents (80.8 percent) were practicing obstetrics in 1986. Twenty-two of the 235 physicians (9.4 percent) planned on discontinuing obstetric practice by early 1987. Reasons for discontinuing obstetrics included malpractice liability risk and cost and interference with lifestyle. Physicians who had recently discontinued or were planning to discontinue obstetric practice were significantly less likely than physicians practicing obstetrics to have a residency program affiliation (33 percent vs 58 percent). While malpractice concerns were found to be an important factor in deciding to discontinue the practice of obstetrics, practice arrangements and educational affiliations were other important factors that may be more amenable to change through educational or administrative interventions.

Adult↗

PubMed1986

Medical malpractice litigation: do the British have a better remedy?

Medical malpractice claims are filed nearly ten times more frequently in America than they are in Great Britain. British patients generally adopt a less adversarial stance toward medical malpractice than do American patients. This Article examines the British malpractice system, as compared with the American system, and explores the differences between the two, in terms of costs and fees, liability rules, statutory provisions, and judicial attitudes toward malpractice litigation. The Article also discusses British social and institutional factors, such as the "taint" of litigation and the National Health Service, and evaluates how these factors affect British malpractice litigation. The Article presents the alternative forums available to British patients in seeking satisfaction for their medical service complaints. The Article concludes with an evaluation of how these factors achieve the three societal objectives of malpractice litigation: reparation, emotional vindication and deterrence.

Attitude↗

PubMed2001

No-fault compensation for medical injuries: the prospect for error prevention.

Leading patient safety proposals promote the design and implementation of error prevention strategies that target systems used to deliver care and eschew individual blame. They also call for candor among practitioners about the causes and consequences of medical injury. Both goals collide with fundamental tenets of the medical malpractice system. Thus, the challenge of addressing error in medicine demands a thorough reconsideration of the legal mechanisms currently used to deal with harms in health care. In this article, we describe an alternative to litigation that does not predicate compensation on proof of practitioner fault, suggest how it might be operationalized, and argue that there is a pressing need to test its promise. We tackle traditional criticisms of "no-fault" compensation systems for medical injury-specifically, concerns about their cost and the presumption that eliminating liability will dilute incentives to deliver high-quality care. Our recent empirical work suggests that a model designed around avoidable or preventable injuries, as opposed to negligent ones, would not exceed the costs of current malpractice systems in the United States. Implementation of such a model promises to promote quality by harmonizing injury compensation with patient safety objectives, especially if it is linked to reforms that make institutions, rather than individuals, primarily answerable for injuries.

Actuarial Analysis↗