Am I in trouble? Difficult patient might sue us.

[traxxradiorocks]

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Just started my one week elective in U/S at the women's health building... (I'm on my research block and I signed up to do U/S during afternoons for a week)
Today, the senior resident at L/D asked me to setup the U/S in a patient's room because she's suspected to have retained products causing her prolonged hemorrhage. She looked to be in a lot of pain.
I walked in with the U/S and introduced myself. The patient's husband looked pissed off. He was like, "I don't want you to do any more procedures on my wife".
I said, "it is not up to me, you should discuss it with the resident." Then I tried to educate them why she needed the u/s.
He looked pissed off and I was hoping to calm them down by offering him and the patient my help, "is there anything I can get you two" not realizing that the patient was crying on the phone.
He yelled, "look, kid, can she have some privacy here"
So I apologized and walked out.

Later, the resident and I walked back into the room. He did the u/s and the husband was still looking pissed at me. Then the patient cried out again and the husband said, "you guys are making my wife very uncomfortable, I will sue you all"
That was WTF.....

 

[turkeyjerky]

I wouldn't worry about it.

 

[BigRedder]

He's just upset. The fact that you walked in with an ultrasound wouldn't open you up to anything, it's not like you left the products in there...

 

[glade]

Then the patient cried out again and the husband said, "you guys are making my wife very uncomfortable, I will sue you all"

I was going to write a long reply, but the bottom line is: who gives a **** about what he says? The patient is in pain, both she and the husband are ignorant laypeople and they have unreasonable expectations, which led to them getting upset and him shooting off his mouth. That's the long and short of it. The guy won't sue and even if he did no lawyer would touch the lawsuit with a stick. End of story.

Also, you forgot to tell us if the patient was hot. If yes, elaborate further.

 

[Winged Scapula]

He's just upset. The fact that you walked in with an ultrasound wouldn't open you up to anything, it's not like you left the products in there...

While I agree with the others that patients making this statement don't always sue, you are making the mistake of thinking that just because the OP didn't do "anything wrong" he isn't a candidate to be sued.

Many med mal suits in this country aren't the result of negligence but because the patient didn't like the outcome, even if it was a possible complication they were warned about. And yes, medical students *can* be sued - its the reason your school carries malpractice for you. Now, most medical students will be dropped because your pockets will be empty for years and plaintiff's attorneys will find it hard to build a case that you were culpable.

So bottom line, don't worry about this based on what the patient said.

 

[ForamenMagnumPI]

The best advice I've had about how to deal with emotionally charged situations like the one you describe came from one of my fellowship mentors. He said that when he feels his stomach clench and he starts to feel anxious and defensive, he steps back and asks himself, "Where is the suffering here?"
Usually, there is an emotion behind the anger. Most of us get angry or defensive or scared (of things like getting sued) so we respond quickly to calm people down. As in, please don't be mad at me. Or, don't blame me because I didn't do anything wrong. When we feed into that, we miss an opportunity to address the true suffering behind the anger.
Obviously, this woman and her husband were upset. Why were they upset? Does anyone even know? The real question isn't usually, "Will these people sue me?" The question is, "Where is the suffering here?"
Yes, some people are emotionally or psychologically unstable. You can't reason with those people. However, most patients and families I've encountered are decent people who are grappling with illness, sleep deprivation, fear, and vulnerability. It's hard to be rational about the indication for a test when those other factors are involved. A few minutes of empathetic listening and validation can go a long way.
You obviously have good instincts. You care about the patient's dignity and comfort (as evidenced by your apologies and attempts to accommodate and assist the patient). Keep nurturing that. This is just my opinion, but I think the best way to avoid a lawsuit and be a successful, happy physician is to be competent, be honest, and be empathetic.

 

[lildave2586]

He wants to sue you because you made his wife uncomfortable? Maybe you should sue him, he made you feel uncomfortable.

 

[glade]

He wants to sue you because you made his wife uncomfortable? Maybe you should sue him, he made you feel uncomfortable.

Remember: it's the patient's fault that they are stupid. But it's a lawyer's fault that they can do something about it. So direct your anger towards the appropriate target and beat a lawyer to death.

 

[J ROD]

I would not worry....unless the jelly was TOO cold....

remember the hot coffee and McDonalds suit.....

 

[Luv2Cut]

I wouldn't worry about it. Sounds like you acted appropriately and I commend you. Many times patients or patient's families lash out at you because your the closest one that happens to be present. Most of the times when patient's sue it is because they believed they were treated disrespectfully or maybe their doctor was just a plain jackass.

The truth is you can do every thing you were supposed to do and followed standard of care and still have a bad outcome. You can also have screwed up multiple times and the patient did well despite mistakes. If you were nice to your patient you are less likely to get sued. This is been studied at length. Improved interpersonal skills and communication goes a long way. Bottom line: Don't be a jackass.

I remember moonlighting a weekend as a resident (indulge me a war story here) at a rural ER. I stayed at a little house owned by the hospital across the street. I was called over as one of the patients was coded. We were unsuccessful and I called it. The patients family, who I had NEVER MET, were in the waiting area and had no idea we had just coded their mother and she died. I had to tell them "out of the blue" that she died. After I broke the news they (and these were big ladies) jumped up, started yelling, screaming, crying at me, "I told you guys to transfer her to the big hospital last week!" I literally thought they were going to kick my *****. Then their biker brother came and I thought for sure I'm a goner. I didnt' say much or try to explain or give details. I just said I was sorry and excused myself, I knew they were just lashing out at me because I was the closest one there. But I lived in fear the rest of the weekend thinking they were going to come for me at the little house. I expected to get some type of communication from the hospital administrator at some point in the next few months. I never heard from them again and I never got sued.

 

[SouthernSurgeon]

This is ridiculous. If you freak out every time a patient gets mad and says "I'm going to sue!" you will have a very stressful time in medicine and residency.

This isn't in any way a threat of a real lawsuit, it was just a guy who is pissed off and emotional about what he and his wife are going through.

 

[Winged Scapula]

There is some inaccurate advice here.

Has anyone in this thread been sued? Probably not except for me.

And I can tell you that while yes, there is data to substantiate that your risk of being sued is less if your patient likes you, it does not protect you from being sued.

Patients and their attorneys see suing doctors as business, they do not understand why we take it personally. Patients sue doctors they like all the time. They sue for disappointing outcomes, known complications. Their families will often encourage them to sue (so major teaching point here - you have to be nice to everyone). I was sued by a patient who liked me, a patient with a known possible complication and patient who knew I was sorry she had that outcome and told me so.

So being nice helps but it does not protect you from being sued. DOCUMENTATION doesn't protect you from being sued either but can save your arse when the plaintiff's attorney realizes they can't win the case or in a court of law (which it did in my case).

Be nice, but don't be naive folks.

 

[joestar]

stop thinking about such things .The patient husband cant sue if yes also u can argue for urself and get a result favour u.so keep ur SMLILE with u

 

[Luv2Cut]

WS good clarification. Being nice doesn't protect you from anything, and neither does being smart and competent. (By the way, WS from my limited exposure to her is as nice and sharp as they come, and if we lived in the same city I would send my patients and family to her, so if she can get sued then yes so can we.)

That brings up another point that OP should know is that many times pts use the "sue" word to try and get something they want from you. Its an attempt to coerce you into giving them some type of medication or to manage their case "their way". Anytime a pt comes in and they mention they once sued their doctor or recently "fired" their doctor recently, then I'm automatically wary of the pt. They left the previous practice for some reason and its usually the pt was extremely demanding or terrorized staff.

Unfortunately, these types of patients are the ones that end up making us all cynical. I can tell you that I DO understand why those old docs that became so cantankerous and mean, became that way. I don't agree with it, but I don't blame them either. You try and help your patients and sometimes they do something to make you not trust them anymore. There's this saying, "You give a mouse a cookie, he'll be back the next day for a glass of milk." Or in my case, it seems they come back for the whole carton. I have come to a realization though. PEOPLE ARE NUTS SOMETIMES. But this is what I signed up for and you just learn to deal with it.

 

[glade]

Has anyone in this thread been sued? Probably not except for me.

In all fairness, the only reason I sued her was because she was inappropriately touching me.

 

[Dirt]

There are 3 reasons you get sued:

1. A good reason
2. A bad reason
3. No reason at all

 

[BigRedder]

To be clear, in this country, anyone can sue you for anything. That doesn't mean they will win, or even be heard in court. There are ethical rules that theoretically dissuade lawyers from bringing frivolous lawsuits, but some certainly sneak through.

This case is about a student going into a room and accurately explaining a medically necessary, non-invasive procedure, then watching said procedure be performed by a physician. There is presumably no negligence and no harm done by anyone, let alone the student. The idea of any judge allowing a lawsuit based on that is absolutely ridiculous.

 

[glade]

there are ethical rules that theoretically dissuade lawyers from bringing frivolous lawsuits

ahahahahahahahahahahahahahaha

 

[MJB]

Jthe husband said, "you guys are making my wife very uncomfortable, I will sue you all"

What for, exactly?

I cannot wait to live in a society where people discontinue thinking they can and SHOULD sue or threaten to sue at every juncture in which they are not 100% happy. This country is really starting to make me sad.

 

[glade]

I cannot wait to live in a society where people discontinue thinking they can and SHOULD sue or threaten to sue at every juncture in which they are not 100% happy.

Uh, got news for you: that would eliminate roughly 95% of all lawsuits. Most lawsuits have nothing to do with anything except "I'm mad, someone needs to pay me money." Even stuff that most people think constitute valid lawsuits, like "I slipped on your sidewalk," are bullcrap. It used to be you slipped on a sidewalk and got up and walked away. Now it's like a federal case and the homeowner needs to be punished.

 

[MJB]

Uh, got news for you: that would eliminate roughly 95% of all lawsuits. Most lawsuits have nothing to do with anything except "I'm mad, someone needs to pay me money." Even stuff that most people think constitute valid lawsuits, like "I slipped on your sidewalk," are bullcrap. It used to be you slipped on a sidewalk and got up and walked away. Now it's like a federal case and the homeowner needs to be punished.

That would be fine by me...

The way I see it, I've never met a Doc that has a sole mission in life to punish or hurt people.

I've met plenty of lawyers with that mentality, and even more sad....some of them don't care if the reasons are just or not. They just want the money.

 

[glade]

That would be fine by me...

I'm not saying it wouldn't be fine by you. I'm saying that 95% of lawsuits are crap. But whatever you and I think is irrelevant because we don't matter. The only people who matter in lawsuits are the ******ed juries composed of poor people who are like "the important thing is that corporations or doctors or small businesses have so much money that they can afford to pay for these lawsuits."

 

[Winged Scapula]

To be clear, in this country, anyone can sue you for anything. That doesn't mean they will win, or even be heard in court. There are ethical rules that theoretically dissuade lawyers from bringing frivolous lawsuits, but some certainly sneak through.

This case is about a student going into a room and accurately explaining a medically necessary, non-invasive procedure, then watching said procedure be performed by a physician. There is presumably no negligence and no harm done by anyone, let alone the student. The idea of any judge allowing a lawsuit based on that is absolutely ridiculous.

Again, to be clear: I nor anyone else here was proposing that if the OP or any other student were to be sued in such a case that the plaintiff would win or that the student wouldn't be dropped from the case.

I think most of you don't understand how these things work.

Being sued doesn't require "a judge to allow a lawsuit". Any one can file a suit, send a settlement request or file a complaint to the Medical Board against you. They do not have to prove that they have a "legitimate" case to do so and many attorneys will gladly take bogus cases (especially for settlement requests) BECAUSE ITS EASY MONEY.

Will the case get dropped or "thrown out of court?" Possibly or maybe even probably. But don't discount the emotional, psychological and financial costs to you simply being served. Even in cases where you know your actions are defensible, it is a terrific weight to carry. I have been subpoenaed and deposed in a case against another physician. Although I wasn't being sued, I had to take time off work to talk to my medical defense company, my attorney, for the deposition, etc. It was also very stressful emotionally since the other physician is a colleague.

My point is this: do not be naive and think that if you're nice you won't be sued. That as long as you weren't operating the ultrasound/drawing the labs/holding the Bovie, etc. you won't/can't be sued. If you were involved in the case in any way, if your name is "on the chart" you will be named in a "bomb" suit...everyone who ever touched the patient will be named. My business partner was named even though she's never seen the patient - the assumption was that because we are partners, we are responsible for the actions of each other.

Eventually usually only the attending physician will be left (but there have been cases of attendings letting residents hang out to try and trying to pass blame off on them...do even then you aren't safe) but until you reach that point it will be very stressful. This is the state of the game in the United States.

 

[naus]

I cannot wait to live in a society where people discontinue thinking they can and SHOULD sue or threaten to sue at every juncture in which they are not 100% happy. This country is really starting to make me sad.

Unfortunately this country is run by a bunch of lawyers who failed precalc.

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Shakespeare's King Henry VI: The first thing we do, let's kill all the lawyers.

Teddy Roosevelt: A man who never graduated from school might steal from a freight car. But a man who attends college and graduates as a lawyer might steal the whole railroad.

Thomas Jefferson: If the present Congress errs in too much talking, how can it be otherwise in a body to which the people send one hundred and fifty lawyers, whose trade it is to question everything, yield nothing, and talk by the hour?

Spanish proverb: It is better to be a mouse in a cat's mouth than a man in a lawyer's hands.

Fred Rodell: While law is supposed to be a device to serve society, a civilized way of helping the wheels go round without too much friction, it is pretty hard to find a group less concerned with serving society and more concerned with serving themselves than the lawyers.

Ambrose Bierce: Lawyer, n. One skilled in circumvention of the law.

Will Rogers: Make crime pay. Become a lawyer.

Robert Frost: A jury consists of twelve persons chosen to decide who has the better lawyer.

Jean Giraudoux: We all know here that the law is the most powerful of schools for the imagination. No poet ever interpreted nature as freely as a lawyer interprets the truth.

Jean Giraudoux: You're an attorney. It's your duty to lie, conceal and distort everything, and slander everybody.

 

[KeyzerSoze]

Actually, this country was founded by lawyers. Don't confuse the law and lawyers, both essential to an orderly society, with an overly litigious culture.

Unfortunately this country is run by a bunch of lawyers who failed precalc.

---

Shakespeare's King Henry VI: The first thing we do, let's kill all the lawyers.

Teddy Roosevelt: A man who never graduated from school might steal from a freight car. But a man who attends college and graduates as a lawyer might steal the whole railroad.

Thomas Jefferson: If the present Congress errs in too much talking, how can it be otherwise in a body to which the people send one hundred and fifty lawyers, whose trade it is to question everything, yield nothing, and talk by the hour?

Spanish proverb: It is better to be a mouse in a cat's mouth than a man in a lawyer's hands.

Fred Rodell: While law is supposed to be a device to serve society, a civilized way of helping the wheels go round without too much friction, it is pretty hard to find a group less concerned with serving society and more concerned with serving themselves than the lawyers.

Ambrose Bierce: Lawyer, n. One skilled in circumvention of the law.

Will Rogers: Make crime pay. Become a lawyer.

Robert Frost: A jury consists of twelve persons chosen to decide who has the better lawyer.

Jean Giraudoux: We all know here that the law is the most powerful of schools for the imagination. No poet ever interpreted nature as freely as a lawyer interprets the truth.

Jean Giraudoux: You're an attorney. It's your duty to lie, conceal and distort everything, and slander everybody.

 

[glade]

Actually, your post is the reason everyone thinks lawyers are douchebags, as I imagine you're either a former lawyer or related to one. This country wasn't "founded by lawyers," which would indicate that it was founded by lawyers doing lawyer work. What, this country was litigated into existance? I don't even know what the professions of the majority of the Founders were -- and nor do I care, before you start listing them. The fact that you'd even try to sneak that piece of B.S. past anyone is pathetic.

Let's say that they were ALL lawyers by profession (which they weren't). Then your statement would TECHNICALLY be true, but IN FACT would be completely false, which is just the sort of thing that lawyers love to do. I mean, some of the Founders were pewtersmiths. So is that to say that this country was founded by pewtersmiths who were molding candlesticks? Only a ***** would say yes. OR A LAWYER.

And lawyers are "essential to an orderly society"? How so? Because they make laws? Guess what? Anyone can make laws. We could have a dictator who made laws and had an orderly society. Lawyers are perhaps the most non-essential profession. All they do is leech off the work of others by transferring money and taking a cut. All lawyers have done to our modern society is guarantee that nobody can participate in the legal system without hiring a lawyer, which was never the intent of anyone. Most of our politicians are lawyers and all they do is sit around siphoning money from society, but of course it's in an awesome "orderly way."

 

[KeyzerSoze]

Actually, your post is the reason everyone thinks lawyers are douchebags, as I imagine you're either a former lawyer or related to one. This country wasn't "founded by lawyers," which would indicate that it was founded by lawyers doing lawyer work. What, this country was litigated into existance? I don't even know what the professions of the majority of the Founders were -- and nor do I care, before you start listing them. The fact that you'd even try to sneak that piece of B.S. past anyone is pathetic.

Let's say that they were ALL lawyers by profession (which they weren't). Then your statement would TECHNICALLY be true, but IN FACT would be completely false, which is just the sort of thing that lawyers love to do. I mean, some of the Founders were pewtersmiths. So is that to say that this country was founded by pewtersmiths who were molding candlesticks? Only a ***** would say yes. OR A LAWYER.

I am indeed related to a lawyer, although I believe my post stems from the fact that I have a modicum of intelligence.

As you so astutely guessed, the majority of the attendees at the Continental and Constitutional Congresses, and half the signatories of the Declaration of Independence, were indeed lawyers.

Now, I'm not sure what you mean by "lawyer work", but I'd think that drafting the rules for a fair and well-run society, including the rights of the individual, separation of powers, mechanism of making and enforcing laws, etc, is "lawyer work" par excellence. It certainly isn't pewtersmith work.

And lawyers are "essential to an orderly society"? How so? Because they make laws? Guess what? Anyone can make laws. We could have a dictator who made laws and had an orderly society. Lawyers are perhaps the most non-essential profession. All they do is leech off the work of others by transferring money and taking a cut. All lawyers have done to our modern society is guarantee that nobody can participate in the legal system without hiring a lawyer, which was never the intent of anyone. Most of our politicians are lawyers and all they do is sit around siphoning money from society, but of course it's in an awesome "orderly way."

As you say, anyone can make laws. In this country, laws are made by elected legislators. For a good example of dictatorial legislative work, please see Woody Allen's "Bananas". In any case, given good laws, we will now need people who know the law well, and are able to apply it fairly and consistently to the many different situations which will inevitably arise in a complex society. Heck, let's call them jurists... lawists... lawyers... something like that.

 

[naus]

Actually, this country was founded by lawyers. Don't confuse the law and lawyers, both essential to an orderly society, with an overly litigious culture.

Japan is an orderly society, is it not? The US has 24 times more lawyers than Japan on a per capita basis.

All these lawyers in America are looking to be fed after law school; the more lawyers there are, the more litigious the culture gets. This is a no-brainer.

 

[glade]

Now, I'm not sure what you mean by "lawyer work", but I'd think that drafting the rules for a fair and well-run society, including the rights of the individual, separation of powers, mechanism of making and enforcing laws, etc, is "lawyer work" par excellence.

Really?? Do tell! Because I'm pretty sure those lawyers who drafted the Constitution would be THRILLED that OTHER lawyers have so perverted their work.

People like this guy are the *****s who think that lawyers are the ones who "maintain an orderly society" and without them we'd be all like "Lord of the Flies." The reality is that lawyers suck ass, including his relative, who probably sucks MAJOR ass.

 

[KeyzerSoze]

Really?? Do tell! Because I'm pretty sure those lawyers who drafted the Constitution would be THRILLED that OTHER lawyers have so perverted their work.

People like this guy are the *****s who think that lawyers are the ones who "maintain an orderly society" and without them we'd be all like "Lord of the Flies." The reality is that lawyers suck ass, including his relative, who probably sucks MAJOR ass.

Having read some of your other posts here, I realized I'm basically arguing with The Todd, so I'm going to call it quits. Ass sucking lawyer high five, broseph.

 

[glade]

You probably should have called it quits before you tried to advance the argument that "you can't hate lawyers, they founded the United States of America!"

 

[DOtoCanada]

You said that the patient was on the phone. The husband might have been upset because she was talking to a family member. My rule with seeing patients is 1) if the TV is on, I walk in the room and shut it off before we start to talk and 2) I ask them to hang up the phone. If they cannot do those things, they are not sick enough to be seen and I walk out.