Malpractice

• Malpractice: harmful, incorrect, or negligent practice or

treatment of a patient by a health care provider.
• Definition: is a preventable error in care resulting in harm to a patient
• Evidence of harm is an important part of establishing malpractice.
There must be both an error in the care, as well as evidence that
there has been an adverse effect on the patient
• Malpractice has occurred with the following and if harm has occurred
• If a physician has acted with deviations from local standards of care:
 for example performing laparotomy to stage patient rather than
doing CT scan in a patient with cancer
Complications of therapy do not imply malpractice.
 The main issue in determining malpractice is whether the patient
was fully informed that the harm could occur and whether or not he
was informed of other valid options in therapy. If he was fully
informed and he signed consent anyway, then malpractice has not
necessarily occurred
Informed refusal is as important as informed consent
• lf a patient refuses therapy it is not sufficient to say that the patient was a
competent adult who had the ability to refuse therapy. The patient must be fully
informed of the effects and possible outcomes of refusing therapy including all
the harm that could occur. If the patient still refuses then there has been no
malpractice.
• It is also not acceptable to say that a patient was difficult, abusive, or unable to
understand a language. The physician has an obligation to provide information to
adult patients with decision-making capacity in a language that they can
understand.
• In addition to informing a patient of the complications of therapy, you must also
inform them of the complications of not receiving the therapy
Patients must fully inform the physician of their past or
recent medical problems, physicians are not responsible if
harm occurs due to lack of full information from patients
 a patient comes with new onset of DVT, physician asked for past
medical history, patient says no. The physician administered heparin
and warfarin, patient develops ICH. Family suit physician for
malpractice of giving anticoagulant for a patient who had ICH 3
months back. >>> no malpractice if patient does not have record in
same hospital