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This case presents interesting lessons in both substance of medical malpractice cases and in procedures for resolving allegations of medical malpractice. On the substance, the primary issues in this case revolved around the delayed diagnosis: whether the delay fell below the applicable standard of care, and whether the delay directly caused the patient’s injuries. A patient alleging medical malpractice has the burden of demonstrating both of these elements, among others.
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Using medical simulators for obstetrics training can lower the incidence of medical malpractice claims, according to recent research from CRICO/Risk Management Foundation of the Harvard Medical Institutions, Brigham and Women’s Hospital, Harvard Medical School, and the Center for Medical Simulation. OB/GYNs who participated in medical simulation training experienced fewer claims in the retrospective analysis. The researchers compared malpractice claim rates for 292 OB/GYNs who were insured by the same company and attended at least one simulation training session over 17 years.
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When dealing with video that might be used in a malpractice or premises liability case, the risk of spoliation arises when the owner of the evidence knows it could be relevant to the case and destroys it anyway. When that happens, the court may order the jury to assume that whatever was on the video was damaging to the party that destroyed it.
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Video surveillance data can be either helpful or harmful in defending a malpractice claim. Healthcare organizations should strictly adhere to their policies on the preservation of video.
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The COVID-19 pandemic still has many hospitals and healthcare facilities straining to maintain anything like normal operations. But that pressure will eventually ease, and more patients will return for routine care and elective surgeries. Some risk managers and healthcare leaders worry this will prompt an increase in medical malpractice cases.
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A complaint filed against a nursing license can destroy a nurse’s career. It is crucial for risk managers and nurses to understand the risks and the best practices to protect against these complaints.
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This case highlights important provisions of EMTALA, which is a less common basis for allegations of improper medical care when compared to standard allegations of medical malpractice. It also is an important reminder about how courts evaluate allegations of fraudulent concealment.
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Engaging with the patient can help ED nurses avoid these risky situations. Nurses can notice subtle signs of escalation, treat with medications when appropriate, offer food, perform regular assessments, and facilitate hygiene. It also is important for ED nurses to demonstrate they did everything in their power to transfer the patient to a higher level of care, if that is what the patient needs.
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Team training — on communication skills, monitoring patients, and sharing information while the patient still is in the ED — can ensure the correct tests are ordered and acted on.
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This case demonstrates both procedural and substantive defenses for physicians and care providers. For the procedural side, the reversal by the appellate court reveals defendants in malpractice cases need not always wait for a jury to determine the care provider did not act negligently.
