11/ 06/2011

when they don’t feel they have received treatment living up to that standard

they are becoming more willing to seek legal compensation -$$$

Public has increasing awareness of expected standards of care

Area of law dealing with violations of civil rights, rather than criminal acts

Court attempts to provide a remedy in form of an action for damages ($$$)

2 types-

• IntentionalAssaultBatteryFalse imprisonmentLibel and slanderInvasion of privacy

• Unintentional acts (negligence)

Any act that creates apprehension in another of imminent, harmful, or offensive contact

Or an attempt of an act with intent to commit a batteryTo be guilty: injury doesn’t have to occur or nor

does attempt need to be successful - Throwing a rock and missing

- A punch that doesn’t connect

Assault could be telling Pt. you are going to do an exam they are not supposed to have!!

Making an arrest

Defending yourself

Professional sports

Any willful and unlawful use of force or violence upon the person of another

(even if no bodily harm, pain or physical marks result!)

Harmful or offensive touching of another

Grabbing someone by clothing, or touching them in angry, vengeful, rude or hostile manner

-even if its just that person’s perception

Spitting on someone

Kissing or hugging someone

Fondling or grabbing body parts

…could be construed as battery!

Examples of Battery

Must be willful- intent must be there- act was not accidental (bumping into someone, car accident- not willful)

Assault is the attempt, battery is the success

Battery implies assault- cannot be battery without assault

If punishment is reasonable

But, if an instrument is used likely to cause serious injury,

- then parent could be prosecuted for criminal offense

A reassuring touch on Pt’s shoulder could be battery!

if Pt. has forbidden you to touch them

You might be guilty of battery if –

you have not explained properly everything you are about to do and Pt freaks out and jumps up and hits head on tube

It is OK to restrain a Pt who is a danger to themselves or others

If you take a radiograph against pt’s will

Or radiograph the wrong pt

Or radiograph the wrong body part

Or take Excessive repeat exposures

Make sure you are doing right Pt! Check identification prior to beginning exam

Read requisition carefully

-make sure you are doing right exam -on correct body part

Explain exam fully

Check if female pt. could be pregnant

Shield!

Tech must report any injury to supervisor immediately!

No matter how minor the incident, or how unlikely there is an injury, err on side of caution!

Be careful! Pt could get fingers caught in fluoroscopy unit as it moves, even if they do not mention it and show no signs of injury- you could still be liable!

Make sure to check condition of Pt at all times!

According to Safe Medical Devices Act of 1991:

Techs who fail to report defects and failures in medical devices ..

Could be liable for Civil Penalties from $15,000 up to $1 million per case!

Even broken measuring ruler on tube could be grounds for suit!

Report any equipment breakdown immediately to supervisor!

Intentional confinement without authorization using force, threat of force, confining clothing or structures

(Becomes an issue when a pt wishes to leave and cannot do so)

Inappropriate restraints can constitute false imprisonment, i.e., brat board to restrain a child without first explaining to parents

Not immediately releasing child from pigg-o-stat if parent requests

It is OK to restrain a Pt who is a danger to themselves or others

Torts that effect person’s good name or reputation (information must be untrue)

Slander• Oral defamation of character

Libel• Written defamation of character

Examples: spreading untrue rumors about Pt, staff or students

Writing evaluations that are unfair or using false information

Writing on request that Pt refused repeat, just to get out of doing it

Touching a Pt inappropriately (may only be their perception of it!)

Be careful when checking for landmarks or placing shielding on Pt

Always explain first what you are about to do!

Not protecting a Pt’s modesty:

Not dressing a Pt properly in gownNot covering with sheet or blanket

Gossiping about a Pt

Not protecting confidentiality of records

A failure to live up to the requirements or standards set forth in an agreement, contract or promise….

What is the most common reason for pts suing hospital, doctor or other health care individual?

Breach of confidentiality

Not performing to standards of profession, hospital, or dept.

Examples:

Turning in x-rays which you know are not acceptable, and could be improved

(if Pt gets worse because diagnosis could not be made because of poor films-could be lawsuit!)

Not shielding

Attempting to do an exam you are not qualified to do

Not checking to see if Pt is pregnant

Radiographer unintentionally causes injury to Pt

Between Tech and Pt there is implied contract to provide reasonable care

Neglect or omission of reasonable care or caution in this relationship is negligence

Can result in a malpractice lawsuit!

Wantonly negligent or recklessness in exposing others to danger

Not shielding!

Over-exposing pt. to radiation when using CR or DR with use of intentionally high mAs in order to window and level after to make sure you don’t have to repeat image

Not guarding against Pt falling off table

(2 people walked Tania and I to car in wheel chair after dental surgery- waited until seatbelts on, engine started)

Latin phrase meaning “ let the master answer”

Hospital must pay for torts committed by employees

Injured pt doesn’t have to prove hospital negligent, only technologist

Hospital automatically liable, but tech may still be sued

Latin phrase meaning “thing speaks for itself”

Usuallly plantiff has to prove defendant negligent

In this case, defendant has to prove innocence

Example: pt has radiation burns that could only be caused by negligence on part of tech. Tech must prove they were not the responsible party

1. Duty was expected of the radiographer (Standard of care)

2. Breach of duty by radiographer3. Injury to pt must actually have occurred4. Cause of injury due to radiographer’s

negligence (could a reasonably cautious Tech foreseen consequences?)

When judging whether a Tech has been negligent in their duties:

How would a technologist who is:Reasonably prudent Has comparable education and skillProviding reasonable standard of care, skill

and behaviorrespond in this situation?

Court interviews experts in field to establish standards

Principle of law that holds individual liable for injury that results from a negligent act that could or should have been foreseen

Examples: Not having enough assistance when moving Pt

onto tableUsing table with broken foot rest

Wallboard holder that’s not secure

Outdated drugs

Understaffing- (A Pt dies or suffers damage from too long of a wait, or Tech rushing to

keep up with back log of Pts)

Plaintiff (person initiating law suit) must must prove the connection between injury and Tech’s actions

What if Pt was radiated and later found to be pregnant, and gave birth to a child with birth defects?

Did Tech check if Pt was pregnant?

Did Tech exercise reasonable caution even if Pt thought she wasn’t pregnant?

Plaintiff would have to prove that birth defects were a result of x-rays

Even though hospital may be sued and held legally liable for actions-

Law does not permit wrongdoer (YOU) from escaping legal liability!

You are still legally responsible and accountable!

Radiographer might want to consider getting personal medical malpractice insurance

(You are not responsible for anything hospital or Radiologist may do)

You are negligent under Doctrine of Personal Responsibility!

Never leave Pt unattended in X-ray room!

IF : Supervisor knowingly assigns you to do a task you are not qualified to do, and you do it anyway?

Both of you!

IF: Student decides on their own to attempt an exam they have not been signed off on?

If Supervisor did not assign or know student was going to do exam- student alone is liable

(but hospital has deeper pockets and no doubt has insurance)

Contributory negligence• Pt contributed to injury

Comparative negligence• Fault of Pt and radiographer are equal

Assumption of risk• Pt knew the dangers ahead of time

Had given informed consent

Pt has right to know and participate in his/her own health care

Pt must be informed of:• Nature of treatment/procedure

• Any risk, complications, expected benefits or effects of such treatment

• Any alternatives to procedure and their risks and benefits

Written consentExpressed consent• Verbal

Implied consent• By action• What if pt. is unconscious when they arrive at ER?

All are binding in court!All are binding in court!

If you perform exam without consent- you just committed battery!

Any person over 18 who is declared conscious and competent

Spouses have no authority to consent for each other

Can a minor give consent for themselves?• -No! only parents and legal guardians can consent

unless… Minor is emancipated

If pregnant- automatically emancipated

Life threatening situation occurs during regular school hours- State can consent for minor