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RADIOGRAPHY AND CLINICAL TECHNOLOGY D AY 8 NOVEMBER 2011

RADIOGRAPHY AND CLINICAL TECHNOLOGY D AY 8 NOVEMBER 2011. TRENDS IN MEDICO LEGAL CLAIMS. TERMS USED MEDICAL MALPRACTICE MEDICAL NEGLIGENCE. Medical malpractice is defined as a negligent act or omission by a medical professional that results in personal injury to a patient. .

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RADIOGRAPHY AND CLINICAL TECHNOLOGY D AY 8 NOVEMBER 2011

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  1. RADIOGRAPHY AND CLINICAL TECHNOLOGY DAY 8 NOVEMBER 2011

  2. TRENDS IN MEDICO LEGAL CLAIMS

  3. TERMS USED • MEDICAL MALPRACTICE • MEDICAL NEGLIGENCE Medical malpractice is defined as a negligent act or omission by a medical professional that results in personal injury to a patient.

  4. MEDIAL CLAIMS AGAINST • PAIN AND SUFFERING • LOSS OF INCOME • COST IN MEDICAL TREATMENT FOR THE PATIENT

  5. WHO CAN BE SUED ? • MEDICAL DOCTORS, DENTISTS • NURSES & HEALTH CARE PROFESSIONALS • MEDICAL FACILITIES & NURSING HOMES

  6. STUDIES • 18% increase in the number of medical malpractice claims in excess of one million Rand over the last decade • Plus a 900% increase in claims over five million Rand “one can certainly understand the rash of radio and TV advertisements calling on patients to seek legal assistance at the hint of malpractice,” concludes Fanning. - I-Net Bridge

  7. A TYPICAL ADVERT If you or a member of your family received a CT scan, MRI, X-Ray, ultra-sound, fluoroscopy, venogram, Doppler ultrasound, mammogram or mammography, or other radiological test or analysis in one of the above regions, please provide your information contact below or email one of lawyers at X

  8. CURRENT SCENARIO • The haves having luxury ofsuing • New appetite of legal practitioners to explore • The poor now enjoy access to legal redress in government hospitals (Contigency Fees Act)

  9. What will it cost you? In the event that your claim is unsuccessful we will not charge you for our services... essentially we carry the risk of proceeding with legal action on your behalf. However, should your claim be successful, you will be charged according to a predetermined, and agreed fee. If you believe that you have been a victim of medical malpractice and that you are entitled to financial compensation, contact X by completing the form on the right and we will arrange a consultation with you, free of charge

  10. Failure to utilise a new but widely acknowledged method of treatment with resultant prejudice to the patient; • Knowingly performing surgery or embarking on treatment without the necessary knowledge or experience; • Incorrect diagnosis or misdiagnosis of a condition; SOURCE OF MALPRACTICES

  11. A delay in diagnosis or treatment leading to prejudice to the patient • Failing to provide sufficient warning of the risks associated with a medical procedure or treatment; and • Failing to inform the patient of alternative treatments or procedures.

  12. COMMON MEDICAL NEGLIGENCE CLAIMS • ·Prescription errors • ·Hospital/Emergency Room negligence • ·Treatment delays • ·Misread X-rays/mammograms • ·Negligence in diagnosing/treating breast cancer • ·Plastic surgery malpractice • ·Dental malpractice • ·Pediatric malpractice • ·Anesthesia accidents • ·The inappropriate intervention to address complications of labour and birth • ·Faulty blood transfusions • ·Amputation of the wrong limb

  13. WHY MEDICAL LITIGATIONS • PUBLIC AWARENESS • ROAD ACCIDENT FUND (RAF) CLOSURE ON GAPS

  14. APPROACH TO LITIGATIONS • DEFENDANT HAS ONLY TWO OPTIONS • SETTLE OR • DEFEND

  15. RECENT STUDIES • Of 8500 doctors invited to participate, 2999 returned completed surveys, 36% response rate • 65% involved in a medicolegal matters • 14% were involved in a current matter. • Male doctors who worked in high-intervention areas of medicine (surgery and obstetrics/gynecology) • Worked longer hours

  16. SUCCESSOF MEDICAL NEGLIGENCE CLAIM • DUTY OF CARE WAS OWED TO THE PATIENT • TREATMENT RECEIVED FELL BELOW THE STANDARD OF CARE EXPECTED FROM A REASONABLY COMPETENT PRACTITIONER • ONLY 7% OF EVIDENCE NEEDED TO WIN THE CASE

  17. IMPACT OF LITIGATION • PSYCHOLOGICAL • PROFESSIONAL & • FINANCIAL TRAUMA

  18. In May 2000 I received a writ concerning a woman with cerebral palsy, who was born 20 years ago. I had been the general practitioner obstetrician who attended her mother until I handed over to a specialist obstetrician for a caesarean section. At first I felt confident that my management was proper and there could be no case. Two years ago, however, a court settlement of $14 million changed everything. Since then I have been through intensive examination of everything I did during the 4 hours she was under my care. The notes and written answers to highly detailed questions now fill a 12 cm deep file box and I have become totally disillusioned with medicine and the law. The only records that exist from that time were the notes I wrote during her labour. Instead of providing a solid basis for my defence, as I thought, my notes have been dissected, with every nuance of each word explored and even the punctuation and layout questioned. The lawyers even questioned the fact that notes at different times during the labour were written in different pen. This threw me until I realised the event took place late at night into the early hours and I had probably attended in a tracksuit without a pen, and had used whatever I could borrow at the time I wrote each note. As the case approached I was forced to question and requestion everything. The stress began to take its toll on me, but I believed it would not affect my family and practice partner. How conceited! In retrospect my relationship with my wife, my children, my colleagues and staff all suffered as they each tried to support me. My practice has changed. I am constantly asking myself: “Did I miss anything? Have I performed all the tests?” — beyond any sensible practice of good medicine. Of course, I quit delivering babies two years ago. GP obstetrics was never a well paid practice, but I loved it. I had undertaken extensive training overseas as well as in Australia so that I could fulfil my role as a rural GP, caring for women in labour. When I found myself doubting everything I could no longer continue. From time to time, the lawyers would iterate that I would be judged by the standards of my peers. However, the repeated examinations made it plain that only a specialist obstetrician could be considered competent. The plaintiff’s lawyers couldn’t find an obstetrician in Australia to criticise my care, so imported one from overseas.

  19. OTHER FACTORS ADDING TO LEGAL COMPLICATION • Billing practices, conflicts of interest, self-referral, right to refuse care, employment practices • Changes in our Health Care System may cause new legal obligation. Large claims could cripple the healthcare system

  20. WHAT NEEDS TO BE DONE • CONTINUING PROFESSIONAL DEVELOPMENT • INFORMING THE PATIENT: CLEAR & THOUROUGH • METICULOUS RECORDING OF CONVERSATIONS RELATED TO CONSENT • IMPROVED UNDERSTANDING OF LAW & ITS RAMIFICATIONS

  21. . • SOURCES • 1. Problems posed to obstetrics by the escalating costs of litigation: • Professor Edward Coetzee, Head of Fetal Medicine at the University of Cape Town. • 2. Medical Law Cases - For Doctors,Vol 1: 1; pgs 34, 35 • Case 1: Medical Literature in Aid to Justify Medical Action • Department of Radiology, Michigan State University, East Lansing, USA

  22. THANK YOU

  23. DISCUSSION

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