Transcript Slide 1
Lisa Hogan, RN, LNC Serpe, Jones, Andrews, Callender, & Bell, PLLC 1- Duty 2- Breach in Duty 3- Causation 4- Damages Pertinent to the responsibility at hand (care being rendered) ◦ - Nurse ◦ - Physician ◦ - Other healthcare providers What would a reasonably prudent person do in same or similar circumstances? - Keep in mind what constitutes reasonable care in a given situation Actual Damages- Did a person actually cause the damages by negligence or omission? Proximate Damages- Were the injuries forseeable or too remote to be connected? General Special Punitive (exemplary) ◦ Compensate the claimant for non-monetary aspects of harm suffered (pain and suffering, disfigurement, loss of consortium, loss of future earning capacity) ◦ Past Paid and incurred expenses ◦ Past Loss of earnings ◦ Future medical care and loss of earnings ◦ To punish the defendant and deter similar actions in the future ◦ Often involves someone knowing their actions would cause harm Claim/ Notice (Ch 74) Petition Answer Discovery -Exchanging documents and obtaining documents/records -Expert Reports (Ch 74- 4590i report) - Depositions of parties/fact witnesses - Designation of experts - Depositions of experts Mediation Trial Fact Witness Party Consultant ◦ Employed by a healthcare provider and involved in the patient’s care and treatment (Your name is in the chart!) ◦ Individually named in a lawsuit ◦ To assist in the litigation process or evaluate a case (Plaintiff or Defense) Expert Witness Civil vs. Criminal ◦ Retained to evaluate the case on behalf of Plaintiff or Defense ◦ Civil cases- malpractice, personal injury, premises liability (fact witness) ◦ Criminal cases- SANE, fact witness, consultant Failure to document care and treatment rendered Failure to timely notify the physician of important findings or not following orders Failure to notify a supervisor and/or utilize the chain of command if physicians are unresponsive Failure to know and adhere to policies and protocols Failure of physicians to document and follow up on pertinent clinical/lab findings 32/f underwent C-section All sponge, needle, and instrument counts documented at onset procedure No count documented post procedure Postop - elevated WBC, nausea, abdominal tenderness, and low grade fever KUB on POD #3 revealed retained surgical sponge Returned to OR and sponge removed Case settled on behalf of hospital, surgeon was not sued Lack of documentation of post procedure count Poor training of scrub tech (doubled as the unit secretary) No documentation by nursing staff of notification of surgeon of elevated WBC, subtle GI symptoms, or fever Surgeon documented “WBC within normal limits” Key issues: Poorly trained staff, poor documentation of OR counts, failure to recongize and notify the physician of significant clinical findings 72/m alert and oriented x 3 Total Safety Risk 3= high risk for falls Computerized charting indicates safety program in place Receiving multiple pain medications Attempts to get out of bed alone and falls Injuries include fractured hip No bed alarm is placed after the first fall and the patient falls again Computerized charting indicates a bed alarm is to be in place for all high risk fall patients Policy states clinical judgment can be used for placing bed alarms Computerized charting identifies all safety parameters that are to be in place, but no actual documentation they were instituted Interviews with fact witnesses indicate they round on all high fall risk patients to assure precautions are in place but no documentation confirms No independent recollection of this patient so fact witnesses must rely solely on their documentation Patient is alert and oriented however one nurse documents medications interfere with his ability to retain new information Key Issues: Lack of documentation of fall precautions even though they may have all been in place and policies and protocols inconsistent with actual practice 24/m strangled mother with a lamp cord, shot father in the head, broke off gas valve causing explosion Grandmother was in the house – burn wounds but died due to MI while recovering from burns Long history of MHMR involvement, bipolar disorder, schizophrenia, suicidal ideation, homicidal ideation Defendant tried for Capital Murder Guilty verdict with death penalty rendered 3/m dipped in scalding bath water (waist down) due to having an accident when potty training Skin began to peel off and due to a history with CPS, mother wrapped him in a blanket and drove him to Mexico (at least 4-5 hours away) In Mexico she took him to a hospital where he received insufficient care for his burns There was a 2-3 day time period while trying to transfer him back to a US hospital He transferred to El Paso then was life-flighted to Lubbock While in the county hospital he was receiving tube feedings and was restrained While restrained he aspirated and had a cardiopulmonary arrest – unable to be revived His mother was tried for capital murder – received a guilty verdict.