Although the plaintiff’s expert provided some controversial comments on the standard of care, it is likely that, if given his well-established expertise, a proper analysis and explanation of his testimony will, at the very least, increase the plaintiff’s odds of obtaining a favorable verdict. There always is a standard of care, especially for relatively common procedures. The standard may not exist in written form. Instead, it is considered to be what a reasonable physician would do in similar circumstances within the same community.
An analysis of closed medical malpractice claims related to pain management identifies common areas of risk and reveals the COVID-19 pandemic has created new possibilities for liability. A top contributing factor in 90% of all closed claims was insufficient consent between the physician and the patient or family.
Proposed changes to the Physician Self-Referral Law (Stark Law) and other laws would give healthcare organizations more ability to avoid self-disclosure and refunds. The changes are expected to be finalized soon.
As modern healthcare continues to unfold and advance, new procedures and even positions often are put in place to best serve professionals and patients. One role that has been enhanced in recent years is the physician advisor. These professionals are known as the liaisons between physicians and the administrative side of hospital operations. It is no surprise they rub shoulders regularly with hospital case managers.
Medical malpractice litigation can get ugly, with passionate plaintiffs and indignant clinicians or hospital administrators firing off heated accusations and insults. But where is the line where a malpractice allegation becomes defamation? What can be done when that happens?
Changes in healthcare reimbursement have occurred with lightning speed over the last two decades. Providers billed for services rendered and were reimbursed — with no checks, balances, or control over costs of care. Case management, as a care delivery model, followed a similar course. But as reimbursement changed, so did case management. This month we will begin our discussion of reimbursement, including the changes to case management as it evolved with reimbursement.
The most important lesson for physicians and care providers from this case is to always receive fully informed consent for the actual procedure performed. Receiving consent beforehand is a prerequisite, but if the circumstances change, or if a modification to the procedure appears appropriate, seek and receive consent again.
The recent $50 million settlement by a West Virginia hospital shows the danger of violating or skating on the edge of federal laws regarding kickbacks. It also shows the vulnerability of healthcare organizations to current and former employees who are willing to allege wrongdoing to get a piece of the recovered funds.
This case demonstrates the importance of carefully preparing one’s argument and presenting the evidence to support necessary findings. Another interesting lesson from this case is on the basic elements of medical malpractice: Even in the face of an undisputed breach of the standard of care, medical malpractice liability is not guaranteed.