Medical Malpractice

Most patients have a primary care provider who specializes in Internal Medicine or general practice. Internists typically handle the patient's first interaction with a medical provider and are important in not only treating patients with routine illnesses but also in identifying indications of serious illness. Internists who specialize in providing these services in the hospital setting are known as Hospitalists. Internists must recognize signs and symptoms of disease or illness, order appropriate tests when indicated and refer patients to appropriate specialists when necessary. If the Internist neglects to fulfill those obligations and harms the patient as a result, the Internist is responsible for his or her malpractice.

As an example, an Internist has a duty to review imaging test results ordered for patients being screened for possible cancer. Internists may be responsible for failing to review and communicate test results to patients where possible cancer is indicated in imaging or other diagnostic tests.

Radiologists are physicians who have undergone additional years of training in the interpretation of imaging tests including CT scans, MRIs, x-rays and other modalities. Radiologists have a duty to carefully review imaging studies for indications of disease or illness, and to promptly report on their impressions to physicians or other providers who will factor the Radiologist's report into their evaluation of the patient's condition. If the Radiologist fails to identify and alert other providers to apparent indications of disease or illness, he or she will be responsible for patients who are injured as a result.

Surgeons have a great deal of responsibility to manage patients who are candidates for surgery, to conduct surgery skillfully and to properly manage patients who have undergone surgery. General Surgeons perform many different types of surgery that are most frequently needed by hospitalized patients. Other surgeons may have more narrow fields of expertise. Many hospitals have contractual agreements with outside surgical practice groups to handle their patients, though some hospitals directly employ staff surgeons. Surgeons who handle emergency room (ER) patients must rapidly evaluate patient needs, at times in the middle of the night. The surgeon evaluating ER patients works with other providers including ER physicians, Radiologists and hospital staff.

Surgeons can be responsible for malpractice claims when they fail to properly evaluate patients and proceed with surgery when necessary. Surgeons must make appropriate diagnostic decisions based on patient complaints and histories, physical examinations, patient signs and symptoms and results of appropriate labs and imaging tests. The timing of surgery can be vitally important in certain cases where hours may make the difference between life and death, or between good outcomes and bad outcomes where patients suffer disabling injuries or other preventable complications.

Surgeons can be responsible for malpractice claims when they fail to perform surgery skillfully and in compliance with proper techniques. The surgeon is the leader in the operating room who must coordinate care among multiple providers including anesthesiologists, nurses and other hospital staff. One classic type of malpractice claim involves a foreign object such as a surgical instrument or sponge which is inadvertently left in the patient's body following surgery.

Surgeons can be responsible for malpractice claims when they neglect to properly manage post-operative patients. Surgeons typically devote much of their practice to rounding on patients in the hospital and in seeing patients during office hours to assess and monitor their condition. Surgeons rely on hospital staff to notify them about important test results, or changes in the patient's condition that may require interventions or updated orders from the physician. Surgeons are required to properly respond when post-surgical patients develop complications, for example by issuing new orders, by prescribing appropriate medications or by requesting consultations or interventions from specialists in other disciplines.

There are many departments and staff members within the hospital who may be responsible for patient injuries. Nurses are responsible for monitoring patients, administering medications that have been ordered and for notifying physicians or other care providers when patients exhibit concerning signs or symptoms. Nurses are responsible for multiple patients and must document their activity to show compliance with assigned duties. Hospitals typically issue nursing protocols that indicate how nurses are required to handle patient care situations that are frequently encountered. Nursing activity is generally documented using computer software programs that may include prompts or alarms when nursing activity is required for a given patient. This software creates an electronic medical record of patient care and can be used to obtain both routine and specialized reports that may be helpful when evaluating legal claims.

Nursing homes are often subject to malpractice claims arising out of patient neglect due to inadequate staffing and lack of resources. Many nursing homes are staffed by poorly paid, low level providers who are not trained nurses. Nursing homes are highly regulated by the state and federal governments which are often great resources for reports about nursing home performance and even patient injuries. Nursing homes typically have a designated Medical Director who is a physician tasked with managing patient care. Managing Directors may be stretched thin but typically visit with patients on at least a monthly basis. Nursing home residents are often at risk for injuries such a pressure sores (also known as decubitus ulcers) that occur when bedridden patients with poor skin integrity are left in contact with bed surfaces for extended periods of time without being moved by staff members. If not treated properly, pressure sores can progress into ghastly infections of bone and surrounding tissues that require hospitalization and can result in limb loss or death due to infection.

Pharmacists can be liable for patient injuries caused by improperly filled prescriptions. A dispensing error occurs when there is a discrepancy between a prescription and the medicine that the pharmacy delivers to the patient or distributes to the hospital ward on the basis of this prescription. Patients can be injured when the medication delivered is at an incorrect dosage other than the prescribed amount. Claims can also arise from a failure to detect and prevent drug interaction problems during dispensing.

Malpractice claims can arise from negligent care and treatment performed by dentists, oral surgeons and similar providers. Some of the more serious claims involve nerve injuries causing chronic pain that require additional surgeries or prolonged use of narcotic pain and other medications.