EMS and the Law: How to Protect Yourself from Medical Negligence Claims and other Legal Considerations. Julia A. Rush, J.D.

Transcription

1 EMS and the Law: How to Protect Yourself from Medical Negligence Claims and other Legal Considerations Julia A. Rush, J.D.

2 Ambulance Chasing The myth of the frivolous malpractice lawsuit Medical, legal, fiscal analysis Malpractice lawsuits Expensive Complicated Time-consuming 18 months to 3 years

3 Ambulance Chasing How attorneys choose lawsuits What you can do to protect yourself: Document... Document... Document...

4 Medical Negligence What is Medical Negligence? Types of Lawsuits Medical negligence Negligent hiring and retention General personal injury actions MVC involving ambulance Drugs and ETOH

5 Medical Negligence Duty, Breach, Causation, and Damages Burden of Proof

6 Standard of Care Standard of Care (SOC) The minimum level of care a reasonable medical care provider, with the same expertise as the defendant, would provide in the same or similar circumstances Local Standard?

7 Standard of Care How to Violate SOC: Failure to review and update policies/procedures Failure to provide/obtain/record CE Failure to follow policies/procedures Protocols AOG/EOG

8 Duty What duty do you owe to patients? Who is the patient? Adult Patients Refusing Care

9 Duty What duty do you owe to patients? Response as employee Follow SOC Response as by-stander Good Samaritan Laws

10 Breach of Duty Medical Record Importance of documentation Experts and SOC Failure to Supervise, Train, Educate Accuracy of recordkeeping State Mandated Education Requirements State Mandated Supervision Legal Advantages in Accreditation

11 Causation Breach of duty caused harm You take the victim as you find him/her Patient s susceptibility? Negligent driving Burden of proof

12 Damages Damages Punitive Damages Everything you need to know about life, you probably learned in Kindergarten: It is better to tell the truth and take a licking, then lie and face punitive damages.

13 Documentation Filling out Run Reports Patient Care Internal Quality Control Education Legal Protection

14 Documentation Spelling and Neatness Count Your penmanship can hurt you! Shredded or Discarded Records Correct vs Creative Abbreviations

15 Documentation Documenting Time Significance of timing in an EMS lawsuits How to Avoid and Remedy Discrepancies Events prior to arrival and on-scene

16 Documenting Time Time Discrepancies Most common documentation errors Conflicting accounts of dispatch, departure, arrival and transport times Conflicting accounts of times between handwritten run report and later transcribed accounts.

17 Documenting Time Differences can occur due to: Watches set to different times. Equipment with automatic times Corrections Addendum

18 Documenting Conditions Documenting conditions with no or little relevance Missing body part Eye, leg, etc. Prosthetic part present Recent trip Out of the county Living conditions

19 Documenting Denials Denial of: Recreational drug or ETOH use Pregnancy, sexual activity, etc. Document Physical/environmental signs Denial

20 Corrections to the Record May be necessary Do at time correction realized NEVER after legal request Addendums Vehicle used for corrections Dated and signed

21 Documentation Pitfalls Magic Numbers Vital Signs Etc. The pitfalls of box checking Assuming normal

22 Documentation Pitfalls The Missing Lung The Glass Eye Tattoos Excessive scar tissue

23 Challenging Behavior The Belligerent Patient The Combative Patient The Offensive Patient The Violent Patient Your Legal Advantage!!

24 A Word About Children Parents refusing care for child Religious grounds Retaliation against other parent Fear of incriminating evidence Medical Consult AMA Refusal

25 Immigration Status Parents refusing medical care for a child due to fears of discovery of immigration status Boulder County DHS

26 Social Media Facebook, Myspace, s, Blogs, Twitter, Cell Phones, Cameras, etc. State Criminal and Civil Penalties for Patient Privacy Violations HIPAA

27 Social Media Minimum and maximum penalties for patient privacy violations. Employee Employer Vicariously liable

28 HIPAA Violations Three Levels Disclosure without malicious intent Privacy breached under false pretenses Selling information for gain Civil, Criminal Prosecutions and EMS

29 Social Media: Legislation Gap in Laws Police and Fire Crime Scenes and Accidents Posting images & videos Crime and/or accident victims, Crime and/or accident scenes

30 Social Media: Personal Behavior Free Speech Promotion New Job Employment Contract Professionalism, Code of Conduct

31 Social Media: Facebook Privacy Settings Assume investigation Divorce, disability, etc. Friend Request Easy access to your information Documenting opinions Consider consequences Delete doesn t delete

32 Uh-Oh! How to survive those moments you were never prepared for Patient as confessor Law enforcement Who has right of way? Suicide calls

33 A Word About The Frequent Flyer No difference between the 30 th & 1 st call May note it s a known patient Document requests for drugs: Use quotes

34 Preventing A Lawsuit # 1 Protection Against Lawsuit Demonstrating respect for the patient Be Nice! In all circumstances

35 Advantages of Accreditation Legal Protection Record keeping and documentation Reputation and Recognition Justifies financial worth

36 Legal Aspects of EMS Care