Medical malpractice

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Medical malpractice is a legal cause of action that occurs when a medical or health care professional, through a negligent act or omission, deviates from standards in their profession, thereby causing injury or death to a patient. [1] The negligence might arise from errors in diagnosis, treatment, aftercare or health management.

Contents

An act of medical malpractice usually has three characteristics. Firstly, it must be proven that the treatment has not been consistent with the standard of care, which is the standard medical treatment accepted and recognized by the profession. Secondly, it must be proven that the patient has suffered some kind of injury due to the negligence. In other words, an injury without negligence or an act of negligence without causing any injury cannot be considered malpractice. Thirdly, it must be proven that the injury resulted in significant damages such as disability, unusual pain, suffering, hardship, loss of income or a significant burden of medical bills. [2]

Medical malpractice law

In common law jurisdictions, medical malpractice liability is normally based on the tort of negligence. [3]

Although the law of medical malpractice differs significantly between nations, as a broad general rule liability follows when a health care practitioner does not show a fair, reasonable and competent degree of skill when providing medical care to a patient. [3] If a practitioner holds himself out as a specialist a higher degree of skill is required. [3] Jurisdictions have also been increasingly receptive to claims based on informed consent, raised by patients who allege that they were not adequately informed of the risks of medical procedures before agreeing to treatment. [3]

As law varies by jurisdiction, the specific professionals who may be targeted by a medical malpractice action will vary depending upon where the action is filed. Among professionals that may be potentially liable under medical malpractice laws are:

Among the acts or omissions that may potentially support a medical malpractice claim are the failure to properly diagnose a disease or medical condition, the failure to provide appropriate treatment for a medical condition, and unreasonable delay in treating a diagnosed medical condition. In some jurisdictions a medical malpractice action may be allowed even without a mistake from the doctor, based upon principles of informed consent, where a patient was not informed of possible consequences of a course of treatment and would have declined the medical treatment had proper information been provided in advance.[ citation needed ]

United Kingdom

The Supreme Court of the United Kingdom decided in 2018 that the duty of care extended to information given to patients by clerical staff of a healthcare provider, such that a medical negligence case might be predicated upon an administrative mistake. A patient at Croydon Health Services NHS Trust's emergency department had severe brain damage having been given misleading information by staff at reception. He was told that he would be seen by a doctor in four or five hours and left the hospital, when actually he would be seen inside 30 minutes by a triage nurse. [7]

£1.7 billion was spent on clinical negligence claims by the NHS in 2016/17. 36% of that was legal costs. In January 2018, NHS England announced that NHS hospitals in England would no longer provide office or advertising space for lawyers who encourage people to take the NHS to court. [8]

In 2019/20 11,682 medical negligence claims and reported incidents were received by the NHS – an increase of 9.3% on 2018/19. In the same time, the total value of clinical negligence claims under the CNST scheme reduced from £8.8 billion, to £8.3 billion. [9]

Litigation

In many jurisdictions, a medical malpractice lawsuit is initiated officially by the filing and service of a summons and complaint. The parties subsequently engage in discovery," [3] a process through which documents such as medical records are exchanged, and depositions are taken by parties involved in the lawsuit. A deposition involves the taking of statements made under oath about the case. Certain conversations are not discoverable due to issues of privilege, a legal protection against discovery, [5]  but most conversations between the parties and witnesses are discoverable.

Consequences

Consequences for patients and doctors vary by country.

A no-fault system may provide compensation to people who have medical outcomes that are significantly worse than would be anticipated under the circumstances, [12] [ non-primary source needed ] or where there is proof of injury resulting from medical error, [13] without regard to whether or not malpractice occurred. Some no fault systems are restricted to specific types of injury, such as a birth injury or vaccine injury. [14]

Demography

Medico-legal action across multiple countries is more common against male than female doctors (odds ratio of 2.45). [15] A 2016 survey of US physicians found that 8.2 percent of physicians under the age of forty reported having been sued for malpractice during their careers, with 49.2 percent of physicians over the age of 54 reporting having been sued. [16]

See also

Related Research Articles

In the law of torts, malpractice, also known as professional negligence, is an "instance of negligence or incompetence on the part of a professional".

Negligence is a failure to exercise appropriate and/or ethical ruled care expected to be exercised amongst specified circumstances. The area of tort law known as negligence involves harm caused by failing to act as a form of carelessness possibly with extenuating circumstances. The core concept of negligence is that people should exercise reasonable care in their actions, by taking account of the potential harm that they might foreseeably cause to other people or property.

Res ipsa loquitur is a doctrine in common law and Roman-Dutch law jurisdictions under which a court can infer negligence from the very nature of an accident or injury in the absence of direct evidence on how any defendant behaved in the context of tort litigation. Although specific criteria differ by jurisdiction, an action typically must satisfy the following elements of negligence: the existence of a duty of care, breach of appropriate standard of care, causation, and injury. In res ipsa loquitur, the existence of the first three elements is inferred from the existence of injury that does not ordinarily occur without negligence.

A tort is a civil wrong that causes a claimant to suffer loss or harm, resulting in legal liability for the person who commits the tortious act. Tort law can be contrasted with criminal law, which deals with criminal wrongs that are punishable by the state. While criminal law aims to punish individuals who commit crimes, tort law aims to compensate individuals who suffer harm as a result of the actions of others. Some wrongful acts, such as assault and battery, can result in both a civil lawsuit and a criminal prosecution in countries where the civil and criminal legal systems are separate. Tort law may also be contrasted with contract law, which provides civil remedies after breach of a duty that arises from a contract. Obligations in both tort and criminal law are more fundamental and are imposed regardless of whether the parties have a contract.

Delict is a term in civil and mixed law jurisdictions whose exact meaning varies from jurisdiction to jurisdiction but is always centered on the notion of wrongful conduct.

Medical malpractice is professional negligence by act or omission by a health care provider in which the treatment provided falls below the accepted standard of practice in the medical community and causes injury or death to the patient, with most cases involving medical error. Claims of medical malpractice, when pursued in US courts, are processed as civil torts. Sometimes an act of medical malpractice will also constitute a criminal act, as in the case of the death of Michael Jackson.

In some common law jurisdictions, contributory negligence is a defense to a tort claim based on negligence. If it is available, the defense completely bars plaintiffs from any recovery if they contribute to their own injury through their own negligence.

In tort law, the standard of care is the only degree of prudence and caution required of an individual who is under a duty of care.

<i>Bolam v Friern Hospital Management Committee</i>

Bolam v Friern Hospital Management Committee [1957] 1 WLR 582 is an English tort law case that lays down the typical rule for assessing the appropriate standard of reasonable care in negligence cases involving skilled professionals such as doctors. This rule is known as the Bolam test, and states that if a doctor reaches the standard of a responsible body of medical opinion, they are not negligent. Bolam was rejected in the 2015 Supreme Court decision of Montgomery v Lanarkshire Health Board in matters of informed consent.

<span class="mw-page-title-main">Personal injury</span> Legal term for an injury to a person

Personal injury is a legal term for an injury to the body, mind, or emotions, as opposed to an injury to property. In common law jurisdictions the term is most commonly used to refer to a type of tort lawsuit in which the person bringing the suit has suffered harm to their body or mind. Personal injury lawsuits are filed against the person or entity that caused the harm through negligence, gross negligence, reckless conduct, or intentional misconduct, and in some cases on the basis of strict liability. Different jurisdictions describe the damages in different ways, but damages typically include the injured person's medical bills, pain and suffering, and diminished quality of life.

<span class="mw-page-title-main">Non-economic damages caps</span> Limitations in lawsuits

Non-economic damages caps are tort reforms to limit damages in lawsuits for subjective, non-pecuniary harms such as pain, suffering, inconvenience, emotional distress, loss of society and companionship, loss of consortium, and loss of enjoyment of life. This is opposed to economic damages, which encompasses pecuniary harms such as medical bills, lost wages, lost future income, loss of use of property, costs of repair or replacement, the economic value of domestic services, and loss of employment or business opportunities. Non-economic damages should not be confused with punitive or exemplary damages, which are awarded purely to penalise defendants and do not aim to compensate either pecuniary or non-pecuniary losses.

Defensive medicine, also called defensive medical decision making, refers to the practice of recommending a diagnostic test or medical treatment that is not necessarily the best option for the patient, but mainly serves to protect the physician against the patient as potential plaintiff. Defensive medicine is a reaction to the rising costs of malpractice insurance premiums and patients’ biases on suing for missed or delayed diagnosis or treatment but not for being overdiagnosed.

A personal injury lawyer is a lawyer who provides legal services to those who claim to have been injured, physically or psychologically, as a result of the negligence of another person, company, government agency or any entity. Personal injury lawyers primarily practice in the area of law known as tort law. Examples of common personal injury claims include injuries from slip and fall accidents, traffic collisions, defective products, workplace injuries and professional malpractice.

Health law is a field of law that encompasses federal, state, and local law, rules, regulations and other jurisprudence among providers, payers and vendors to the health care industry and its patients, and delivery of health care services, with an emphasis on operations, regulatory and transactional issues.

<span class="mw-page-title-main">Tort reform</span> Legal reforms aimed at reducing tort litigation

Tort reform consists of changes in the civil justice system in common law countries that aim to reduce the ability of plaintiffs to bring tort litigation or to reduce damages they can receive. Such changes are generally justified under the grounds that litigation is an inefficient means to compensate plaintiffs; that tort law permits frivolous or otherwise undesirable litigation to crowd the court system; or that the fear of litigation can serve to curtail innovation, raise the cost of consumer goods or insurance premiums for suppliers of services, and increase legal costs for businesses. Tort reform has primarily been prominent in common law jurisdictions, where criticism of judge-made rules regarding tort actions manifests in calls for statutory reform by the legislature.

<span class="mw-page-title-main">Canadian Medical Protective Association</span>

The Canadian Medical Protective Association (CMPA) is a membership-based, not-for-profit organization that provides legal defence, liability protection, and risk-management education for physicians in Canada. The CMPA also provides compensation to patients and their families proven to have been harmed by negligent medical care. In 2016, the CMPA's membership list totaled 95,691 physicians.

Aetna Health Inc. v. Davila, 542 U.S. 200 (2004), was a United States Supreme Court case in which the Court limited the scope of the Texas Healthcare Liability Act (THCLA). The effective result of this decision was that the THCLA, which held Case Management and Utilization Review decisions by Managed Care entities like CIGNA and Aetna to a legal duty of care according to the laws of The State of Texas could not be enforced in the case of Health Benefit plans provided through private employers, because the Texas statute allowed compensatory or punitive damages to redress losses or deter future transgressions, which were not available under ERISA § 1132. The ruling still allows the State of Texas to enforce the THCLA in the case of Government-sponsored (Medicare, Medicaid, Federal, State, Municipal Employee, etc., Church-sponsored, or Individual Health Plan Policies, which are saved from preemption by ERISA. The history that allows these Private and Self-Pay Insurance to be saved dates to the "Interstate Commerce" power that was given the federal Government by the Supreme Court. ERISA, enacted in 1974, relied on the "Interstate Commerce" rule to allow federal jurisdiction over private employers, based on the need of private employers to follow a single set of paperwork and rules for pensions and other employee benefit plans where employers had employees in multiple states. Except for private employer plans, insurance can be regulated by the individual states, and Managed Care entities making medical decisions can be held accountable for those decisions if negligence is involved, as allowed by the Texas Healthcare Liability Act.

The following outline is provided as an overview of and introduction to tort law in common law jurisdictions:

Wrongful birth is a legal cause of action in some common law countries in which the parents of a congenitally diseased child claim that their doctor failed to properly warn of their risk of conceiving or giving birth to a child with serious genetic or congenital abnormalities. Thus, the plaintiffs claim, the defendant prevented them from making a truly informed decision as to whether or not to have the child. Wrongful birth is a type of medical malpractice tort. It is distinguished from wrongful life, in which the child sues the doctor.

<span class="mw-page-title-main">Medical law</span> Area of law dealing with the practice of medicine

Medical law is the branch of law which concerns the prerogatives and responsibilities of medical professionals and the rights of the patient. It should not be confused with medical jurisprudence, which is a branch of medicine, rather than a branch of law.

References

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  2. "What is Medical Malpractice?". American Board of Professional Liability Attorneys. Retrieved March 5, 2021.
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  4. Brock DM, Nicholson JG, Hooker RS (October 2017). "Physician Assistant and Nurse Practitioner Malpractice Trends". Medical Care Research and Review. 74 (5): 613–624. doi:10.1177/1077558716659022. PMID   27457425. S2CID   32586540.
  5. 1 2 "Medical Liability". National Conference of State Legislatures. January 13, 2014. Retrieved November 23, 2017.
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  7. "'Serious consequences' for NHS after negligence ruling over receptionist's advice". Health Service Journal. October 11, 2018. Retrieved November 12, 2018.
  8. "Lawyers who target the NHS banned from advertising or setting up shop in hospitals". NHS England. January 29, 2018. Retrieved August 26, 2019.
  9. "NHS Resolution annual report and accounts 2019/20" (PDF).
  10. Gilmour JM (1994). "Overview of Medical Malpractice Law in Canada" (PDF). Annals of Health Law. 3 (1): 179–204. PMID   10139978. S2CID   8301343. Archived from the original (PDF) on September 5, 2017. Retrieved June 12, 2017.
  11. Stauch MS (June 2011). "Medical Malpractice and Compensation in Germany". 86 (3). Retrieved June 12, 2017.{{cite journal}}: Cite journal requires |journal= (help)
  12. 1 2 3 Bogdan J. "Medical Malpractice in Sweded and New Zealand" (PDF). Center for Justice & Democracy. Retrieved December 13, 2017.
  13. Kadeŭávek F (February 1975). "[Thermodiagnostic evaluation of the vasodilator effects of mydocalm]". Casopis Lekaru Ceskych. 114 (7): 209–12. PMID   1125962.
  14. Coppolo G (December 8, 2003). "Medical Malpractice No Fault Systems". Office of Legal Research. Connecticut General Assembly. Retrieved December 13, 2017.
  15. Unwin E, Woolf K, Wadlow C, Potts HW, Dacre J (August 2015). "Sex differences in medico-legal action against doctors: a systematic review and meta-analysis". BMC Medicine. 13: 172. doi: 10.1186/s12916-015-0413-5 . PMC   4535538 . PMID   26268807.
  16. Guardado, José R. (December 2017). "Medical Liability Claim Frequency Among U.S. Physicians" (PDF). American Medical Association. Retrieved August 8, 2020.