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Liability protection in litigious states

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teacher2md

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For those of us that practice in states without tort reform (CA/NY/NJ/PA,IL, etc..) lets talk about ways to minimize the risk of getting wiped clean by a plaintiff's suit:

-Does anyone have any special documentation of informed consent for anesthetic risks?

-For those of you in supervising roles, do you include any specific documentation of the your anesthetic plan in case the CRNA omits something major? E.g., for beach-chair position do you document that you instructed the CRNA to keep MAP high? In the event of an intraop emergency, do you record the time at which you were notified of the emergency?

-Beyond 1M/3M liability insurance, I've read about tactics such as titling your home and bank accounts as "Tenancy by the entirety" as a way to shield your personal assets-- does anyone have experience with this?
 

caveat87

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All good ideas. I practice in a state with no malpractice cap but historically a low rate of litigation.

Tenancy of the entirety is easy. If you live in a state which acknowledges this (not where I am unfortunately) you just have to put you and your spouse on the deed. Your home equity is then theoretically protected from litigation. May want able estate lawyer to make sure the correct language is on your quitclaim or transfer deed so it is worth the few grand this will likely cost. Also be aware that in certain states if you do this your spouse now controls 50% of estate equity.

Regarding the crna issue, I doubt that you will be protected by documenting time you are called, etc. if you are in a medical direction role because you attest to say you are monitoring care at regular intervals. That said I do document a few more things in my anesthetic note now (pressure goals, plan for induction in an unstable patient, airway plan) in the event something goes wrong so there is a paper trail that I prescribed a specific plan
 

caveat87

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And it doesn’t hurt to get specific with your language in your pre-op notes. For healthy patients having simple procedures I rarely document extra but for blocks, labor epidurals, spinals I use a EMR dot phrase which documents risk of bleeding, infection, nerve injury were discussed in case I ever get litigated/deposed, etc.
 

ucladoc2b

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For those of us that practice in states without tort reform (CA/NY/NJ/PA,IL, etc..) lets talk about ways to minimize the risk of getting wiped clean by a plaintiff's suit:

-Does anyone have any special documentation of informed consent for anesthetic risks?

-For those of you in supervising roles, do you include any specific documentation of the your anesthetic plan in case the CRNA omits something major? E.g., for beach-chair position do you document that you instructed the CRNA to keep MAP high? In the event of an intraop emergency, do you record the time at which you were notified of the emergency?

-Beyond 1M/3M liability insurance, I've read about tactics such as titling your home and bank accounts as "Tenancy by the entirety" as a way to shield your personal assets-- does anyone have experience with this?

California has pretty low caps on non-economic damage.
 
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nimbus

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California has pretty low caps on non-economic damage.


Yep. We’ve had MICRA since 1975. 250k cap on noneconomic damages but there have been 8 figure awards and settlements if there are economic damages.

There have been times when we’ve paid as little as $30/mo for malpractice insurance. Cheaper than Starbucks.
 
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drsamzie

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Yep. We’ve had MICRA since 1975. 250k cap on noneconomic damages but there have been 8 figure awards and settlements if there are economic damages.

There have been times when we’ve paid as little as $30/mo for malpractice insurance. Cheaper than Starbucks.

Get ready, California-based peeps...

 
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