Legal Aspects of Health Care: Managing Adverse Patient Outcomes and Ethical Disclosure (Full Transcript)

Speaker 1: Legal Aspects of Health Care Administration Introduction Practitioners have little or no control over many aspects of medical practice. This reminds these professionals that despite the long-term clinical training they underwent, they are not guaranteed a favorable patient outcome. This paper evaluates the approaches a lawyer of a hospital may recommend in a situation when they have experienced adverse patient outcomes. Laws and Legal Rules Health care facilities and providers have certain laws and legal rules to guide their behaviors and actions in case of an adverse event during practice. They have a legal and ethical compulsion to disclose to patients or their representatives an adverse occurrence that the facility sustains during their treatment. In turn, the patient has a right to include family members in the process of disclosure of a medical error and an anticipated adverse outcome. In case the patient dies or becomes incapacitated and is unable to participate in the disclosure of an adverse event, the hospital must involve his or her representative. The United States applies an act that allows medical experts to report any adverse events associated with care delivery, of their own volition, to Autonomous Patient Safety Organizations – PSOs. PSOs accept error reports confidentially, with guaranteed legal protection from the federal government. Such organizations can divulge limited information they receive to specific researchers. Law enforcement can use disclosed information if the discloser has substantial grounds to believe that the adverse event comprises a crime. The Act states that the responsibility of PSOs is to gather, expand, analyze, and maintain the safety of patient information. An organization or person that deliberately infringes the confidential statute is liable to penalties. Legal Advice to the Care Team and Mr. Z Good communication provides a simple, but effective means for minimizing problems arising in case of a medical error and subsequent unfavorable outcomes. Often, in such a situation, the discussion that ensues provides some insight into the ways of dealing with the consequences. The care team should not undermine the power of good communication to avert or minimize legal actions. The physician must control the situation and alleviate the stress that a tragedy can cause. The care team should provide appropriate care to the patient in the hospital, a nursing home, a residential home, or in their home. Particularly, the care team should transfer Mrs. Z to a High Dependency Unit, HDU. The team should be composed of different staff members rather than those who were involved in the tragedy. They should update the new physician on the clinical condition of the patient and possible reviews on every note on the patient. An inspecting physician should notify the care team of any errors committed during the treatment of the patient to provide a complete and truthful explanation and a sincere apology to Mr. Z. Mr. Z should not file a lawsuit against the hospital as he had signed informed consent, possibly, for the operation the physician scheduled for Mrs. Z. To strengthen my position, I will explain that medical error like any other error in any human endeavor is possible and that the unfavorable outcome was not deliberate. The adverse outcome was beyond human comprehension. Recommendation on Life Support Therapies I will advocate for the discontinuation of life support therapy for Mrs. Z because this intervention will not reverse the persistent vegetative state, PVS. Mrs. Z cannot take an active role in her life and the lives of those around her. Besides, this intervention does not offer any improvement in the quality of her life, but instead prolongs her dying process, which is emotionally devastating to Mr. Z and the staff providing care to her. Conclusion Dealing with an adverse event that arises from a medical error is complicated and needs caution and intelligence. Medical providers must cross-check their prescriptions to prevent the precipitation of adverse events during practice. Moreover, they must take full control of the situation to save the reputation of the hospital and prevent litigation from representatives of the patient if adverse events occur. Nevertheless, good communication of the facts associated with the occurrence to the patient's representative can prevent litigation.