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Healthcare Risk Management – August 1, 2009

August 1, 2009

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  • Economy may prompt more patients to flee ED early, or against medical advice

    In addition to the other ways that the country's economic downturn is affecting health care providers, emergency departments (EDs) are now seeing an increase in the number of patients leaving the ED early, because they do not want to be hit with a big medical bill when they are without health insurance and possibly without a job.
  • Failure to follow up can lead to lawsuits

    When patients leave the ED early, what your staff do afterward can make the difference between insulating yourself against a lawsuit and encouraging one, says Robert A. Bitterman, MD, JD, FACEP, a lawyer and emergency physician who is president of Bitterman Health Law Consulting Group in Harbor Springs, MI, and also vice president of Emergency Physicians Insurance Company (EPIC) in Auburn, CA.
  • Review AMA forms, follow-up procedures

    Most hospitals already have against-medical-advice (AMA) forms they use when the patient gives the staff a chance, but Helenemarie Blake, JD, a shareholder with the law firm of Fowler White Burnett in Miami, says risk managers should remember that merely having an AMA form and procedure does not guarantee they will be used correctly.
  • Hospital settles after waiting room death

    Health and Hospital Corp., the parent company of Kings County Hospital in Brooklyn, NY, has settled a lawsuit filed by the family of a woman who died on a waiting room floor - but went unnoticed for more than an hour.
  • UMDNJ settles suit for $2 million, and no CIA

    The recent settlement by the University of Medicine and Dentistry of New Jersey (UMDNJ) in Newark has some legal experts concluding that the hospital ended up with a relatively light punishment considering the extent of the alleged billing fraud and the long, contentious litigation that was prompted by a whistle-blower lawsuit.
  • Get your concerns into facility design

    Risk managers may participate in the management of a facility building or remodeling project by overseeing the myriad hazards and liabilities that can crop up along the way, but you may be missing a great opportunity to advance your own concerns if you don't immerse yourself in the earliest stages of the design process.
  • Security, infection control priorities in redesign

    Eric Hess, vice president of Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center (UPMC), provides these examples of how risk management concerns were incorporated into the hospital's recently completed $625 million redesign:
  • Legal Review & Commentary: Improper credentialing of ED physician delays heart attack diagnosis: $3.1 million verdict

    A man presented at an emergency department (ED) complaining of shortness of breath and chest pain. He was seen by an ED physician who ordered blood studies and an EKG.
  • Legal Review & Commentary: Delay in evaluation alleged: $20.5M verdict

    A pregnant woman contacted her doctor with complaints of decreased fetal movement. He advised her to go to the triage outpatient obstetrical department, where she was placed on a fetal heart monitor and underwent a biophysical profile. The monitor showed a nonreactive fetal heart rate pattern, and the profile confirmed that the fetus was in distress.
  • HIPAA Regulatory Alert: H1N1 deaths: What you can and can't say

    As U.S. deaths from the H1N1 virus have mounted in recent months, media reports began to include the inevitable comments from hospital spokespeople that the patients who died had "pre-existing conditions," with no specifics given.