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By: Carol Wells, MBA, BS, RN, Paralegal (Guest Blogger)
Part III of our Medical Malpractice Series

Okay, okay, I must admit I was totally going to pretend that I got a day off from blogging yesterday (Manic Monday) in honor of Mother’s Day. However, I didn’t make it very far on my blogging hiatus. There I sat, in my home office last night, around 8:40 p.m., working to get this post up! What can I say – I just couldn’t help myself. Back to business as usual, folks. 

Today, we’re continuing your medical malpractice education with Part III of our series, compliments of Carol Wells.

Standard of Care

Briefly touched upon in the previous post, was the issue of standard to care and duty to care. All health care workers must maintain a standard of care. Direct patient care providers such as Nurses, Nurse Practitioners, Physicians, and Physician Assistants, have a duty to care. This duty includes the level of expertise provided to the patient in order to provide a remedy of relief, and to restore the patient to health – as much as can be restored.

Relationship between Negligence and Adverse Events

Within the health system is an issue of Adverse Events. Adverse Events are basically errors that have occurred. Errors in the health system have been studied and are a cause for harm for the patient that could lead to a worsening of a health condition and in some extreme cases, death. A few years ago a well known Actor and his wife had twins by surrogate. It was a well documented case, covered by the media, whereby the Nurse taking care of the newborn twins had given the twins an overdose of a blood thinner. Thankfully the twins were not irreparably harmed. This would be classified as an Adverse Event. The reason this occurred was not only because the Nurse was not vigilant about checking the medication given, but also because the Pharmacy in the Hospital sent the wrong medication to the unit. Because medication orders in Hospitals are either faxed to the Hospital Pharmacy or ordered through a computer system, this mistake should have been picked up prior to the medication being sent to the unit. A second check should have occurred prior to the Nurse administering the medication. This didn’t happen.

These mistakes, and others like it, are the primary reason Hospitals get sued. Other examples are mistakes that occur in surgery. If one were to go online and plug in surgical mistakes, there are, unfortunately, many examples cited in the media. Wrong side surgery is one example. When a patient is admitted for surgery, there should be a check system in place that should prevent this. Most, if not all Hospital and Surgical Care Centers have such a system in place. This check system should begin in the doctor’s office prior to admission. Since Medical offices have to arrange admission to a Hospital or Surgical Care Centers, this information is passed on from the doctor’s office. Once the patient is admitted this should be the second step. The admission Nurse should review admission documents with the patient, and check his or her understanding of the reason for admission. Pre-op is another step. A final check is done in the OR. If anything is wrong, the surgery should stop. This is supposed to prevent surgical errors, but unfortunately, errors still occur.

Informed Consent

What is informed consent? This is the step in the patients’ care where he or she is given information about their treatment options by the Doctor, usually with a Nurse present, and then the patient signs a consent form. Informed consent includes the risks that may occur with or without his or her treatment. This acknowledgement from the patient is proof that he or she has received this information and that there is an understanding of the information. Usually an information sheet printed in lay persons language is provided to the patient either prior to or at the time of the consent. If the patient has any questions, this the time to discuss in depth with the patient all options and all risks he or she has. Failure to obtain an informed consent is one cause for a lawsuit. 

There are two instances in which the Physician does not need or may not get informed consent. The first is in the case of an emergency. If the patient is admitted to the ER after an accident unconscious and with a life threatening injury or has a heart attack and needs resuscitation, there is not a need to receive the consent. The emphasis here is on doing everything possible to save the patient’s life.

In every stage in the care of a sick person the emphasis again is on documentation. It cannot be stated enough that documentation on the medical record is the only proof that something has been done — or not.

Patient Contribution to Malpractice/Negligence

In a very basic way, a patient can contribute to problems in their own care. This can occur if they do not disclose to the Physician, Nurse Practitioner, or Physician Assistant, any or all information needed to make recommendations about treatment options. Another way they can contribute is to refuse recommended medical treatment, or to ignore recommended medical advice. In this case, documentation by the care giver will prove what information and recommendations were given to the patient.

Wonder what Carol has in the works for Part IV of this in-depth series? I guess we’ll just have to wait and see…

Carol Wells is a 52-year-old woman with 30 years nursing experience in diverse areas of the health system. She became a Nurse in 1983, after graduating as a LPN, achieving her ASN in 1987, a Bachelor’s degree in Health Care Management in 1999, and MBA’s in Management Information Systems, Health Care Management, and Marketing. Carol is currently on leave from a Doctorate in Health Administration.

Be sure to check out Carol’s blog, Leftist Moderate Speak, which features political discussions about healthcare topics at: www.leftistmoderatespeak.com.

We’ll see you Wednesday, when we’ll learn more about another fascinating member or TPS! See you then…with a fella. Who…you ask? We ain’t gonna tell ya!