Court Rules That State’s Medical Malpractice Act Can Apply to Nonpatients

[TheLoneWolf]

https://www.empr.com/home/features/court-rules-that-states-medical-malpractice-act-can-apply-to-nonpatients/

Physician liable to 3rd parties for prescribing opioid. This will make for interesting precedent.

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[bedrock]

https://www.empr.com/home/features/court-rules-that-states-medical-malpractice-act-can-apply-to-nonpatients/

Physician liable to 3rd parties for prescribing opioid. This will make for interesting precedent.

can just tell all the patients, that scumbag lawyers allow us to prescribe nothing to you at all. Medicine will go back to the dark ages, if patients can sue for absolutely anything. Why bother trying to help anyone?

Or it will be procedures, or therapy. That's it, no medications.....ever!

 

[myrandom2003]

This is absolutely ridiculous!!
So in order to prescribe opioids, you must be willing to either have government or essentially anyone injured by your patient come after you.
-maybe I need to tell anyone taking this medication that it impairs driving and I submit their name to the state for eval (which may then open me up for law suit for hipaa violation)…. Or they can go to the practice down the street

Lobel, how do you handle this?

 

[RoloTomassi]

Total BS but it's only a problem if you live in Indiana unless your state defines "patient" this way.

"under the state’s Medical Malpractice Act. To determine this, the court first looked at how the Act defines ‘patient’ as “an individual who receives or should have received health care from a health care provider, under a contract, express or implied, and includes a person having a claim of any kind, whether derivative or otherwise, as a result of alleged malpractice on the part of the health care provider.”

 

[lobelsteve]

This has been going on for decades and is not new (maybe in this state).
Search back in the forums for what I taught the fellows.

Let's say you are writing an Rx for a sweet little old grandma. She fills early 2-3x. Maybe loses an Rx or part of an Rx. You give her one more chance or a going away Rx. Your name is on the bottle. Her grandkids were stealing the medicine. One of them is high as a kite on the oxy 5 #45 Rx you wrote for granny when she plows into a school bus. Several kids injured, driver dies. They find your name on the bottle of pills in the car. Who gets sued?

ICAT/UDS before prescribing. PDMP before any Rx. Talk about all the bad things that can happen with medication and document the heck out of it. When a patient has an aberrant behavior, have a plan of action documented. If they fail to correct the behavior, the Rx stops. If the behavior was severe enough, the Rx stops. Driving is discussed in the ICAT. So is impairment, cognitive aspects, constipation, addiction, etc in the document. We try and make sure ICAT done yearly.

 

[epidural man]

This has been going on for decades and is not new (maybe in this state).
Search back in the forums for what I taught the fellows.

Let's say you are writing an Rx for a sweet little old grandma. She fills early 2-3x. Maybe loses an Rx or part of an Rx. You give her one more chance or a going away Rx. Your name is on the bottle. Her grandkids were stealing the medicine. One of them is high as a kite on the oxy 5 #45 Rx you wrote for granny when she plows into a school bus. Several kids injured, driver dies. They find your name on the bottle of pills in the car. Who gets sued?

ICAT/UDS before prescribing. PDMP before any Rx. Talk about all the bad things that can happen with medication and document the heck out of it. When a patient has an aberrant behavior, have a plan of action documented. If they fail to correct the behavior, the Rx stops. If the behavior was severe enough, the Rx stops. Driving is discussed in the ICAT. So is impairment, cognitive aspects, constipation, addiction, etc in the document. We try and make sure ICAT done yearly.

You know what is kinda crazy about all this - is that almost ALL of our medications that are sedating could cause a crash...yet it doesn't seem that the liability issues are the same.

I had a patient come back to me with his face all smashed up - I asked what the heck happened. He said the gabapentin (or something...can't remember exactly) I gave him caused him to have a seizure and he fell flat on his face.

My point is, if we are using drugs off-label (basically all of them), should we be doing written care agreements with the patients for each individual drug?

 

[lobelsteve]

You know what is kinda crazy about all this - is that almost ALL of our medications that are sedating could cause a crash...yet it doesn't seem that the liability issues are the same.

I had a patient come back to me with his face all smashed up - I asked what the heck happened. He said the gabapentin (or something...can't remember exactly) I gave him caused him to have a seizure and he fell flat on his face.

My point is, if we are using drugs off-label (basically all of them), should we be doing written care agreements with the patients for each individual drug?

You gave him an anti epileptic drug and it caused a seizure? Right. Id laugh him out of there.

 

[Orin]

You gave him an anti epileptic drug and it caused a seizure? Right. Id laugh him out of there.

No, but it probably made him dizzy, pass out, and fall.

Although there are more things in heaven and earth...

Risk factors of paradoxical reactions to anti-seizure medication in genetic generalized epilepsy - PubMed

This study aimed at providing valid estimates for the risk of clinically relevant seizure aggravation by recommended anti-seizure medications in patients with Genetic Generalized Epilepsy (GGE). To this aim, treatment response, side effects and paradoxical reactions to anti-seizure treatment...

pubmed.ncbi.nlm.nih.gov

 

[Orin]

"under the state’s Medical Malpractice Act. To determine this, the court first looked at how the Act defines ‘patient’ as “an individual who receives or should have received health care from a health care provider, under a contract, express or implied, and includes a person having a claim of any kind, whether derivative or otherwise, as a result of alleged malpractice on the part of the health care provider.”

I'm not sure how that's new or novel. The patient's estate, family members, etc can in theory sue you.

The key here is whether this is malpractice and how well you've documented the risks/benefits/etc. It's not really what you're doing, although some things attract more/less attention.

Lets go down the slippery slope. You do an ESI on a patient with an acute radic. They feel great, but your 10 mg of Dexamethasone trigger mania/psychosis as he had underlying bipolar disorder you hadn't noted/documented. He kills a guy because the voices told him to. Are you liable? What do you owe him and the victim's family?

 

[epidural man]

You gave him an anti epileptic drug and it caused a seizure? Right. Id laugh him out of there.

I did, and kicked him the balls on the way out!

 

[lobelsteve]

I did, and kicked him the balls on the way out!

No need for that, just tell him he has a tiny weenie. Emotional>physical assault is always more rewarding. And possibly not even illegal.

 

[dmk5n]

Lawsuits ain't about justice, it's only about da money.