being sued due to lack of information on patient care report

HIPAA allows health care providers to sue patients in court for overdue payments for services rendered and the law requires that health care providers disclose as little information as possible about patients when filing a collections lawsuit. Only as much information about patients as to identify them for collection purposes should be revealed.

Full Answer

Can a patient Sue a healthcare provider for privacy violations?

Patients who believe their health information was improperly revealed or wasn’t properly protected may file a complaint with the Health and Human Services Department (HHS), which will investigate and penalize the offender if warranted. But do patients have a right to sue healthcare providers for privacy violations?

Do support staff prevent or introduce patient errors?

But although support staff can prevent errors, they can also introduce them, the authors said. Furthermore, they can enhance a patient's experience or "anger and frustrate" them.

What are the allegations in the medical malpractice complaint?

The complaint contained allegations of inaccurate recordkeeping, failing to document and report changes in condition, and obtaining reimbursement from Medicare for services not actually rendered.

Did your doctor disclose PHI without consent of the patient?

OCR confirmed that PHI had been disclosed without authorization from the patient and that there had been no sanctions against the physician responsible, despite being warned in advance not to disclose any PHI. Allergy Associates of Hartford paid OCR $125,000 to settle the alleged HIPAA violations.

What 3 things must be present for a healthcare professional to be considered negligent?

To be successful, any medical negligence claim must demonstrate that four specific elements exist. These elements, the “4 Ds” of medical negligence, are (1) duty, (2) deviation from the standard of care, (3) damages, and (4) direct cause.

What are some common reasons nurses are sued?

Factors Leading to Claims of Nursing NegligenceFailure to follow accepted standards of care.Failure to use medical equipment responsibly and correctly.Failure to assess and monitor patient health.Failure to document and communicate patient health status.More items...•

What is the number one factor in whether a patient files a lawsuit against a health care provider or practice?

1. Failure to diagnose a patient's medical condition. Some 31% of physicians surveyed by Medscape said this was the reason for a malpractice lawsuit brought against them, the publication said.

What is negligence in patient care?

Negligence is: A general term that denotes conduct lacking in due care; Carelessness; and. A deviation from the standard of care that a reasonable person would use in a particular set of circumstances.

What type of nurse is most likely to get sued?

Home care includes home health, hospice, and palliative care, and is the most frequently sued nursing specialty (36.1%).

What are the 3 kinds of liabilities in nursing?

A nurse can be found to be negligent if these three standards are present: The nurse owed a ''duty of care'' to the patient, or was obligated to care for the patient. The nurse ''breached'' that duty of care, or failed to properly care for the patient.

How successful are medical negligence claims?

It is authoritatively shown that around 10 to 11 % of hospital admissions each year end in an 'adverse outcome' due to a medical incident.

What are the 4 elements of negligence in healthcare?

The injured patient must show that the physician acted negligently in rendering care, and that such negligence resulted in injury. To do so, four legal elements must be proven: (1) a professional duty owed to the patient; (2) breach of such duty; (3) injury caused by the breach; and (4) resulting damages.

How can I avoid a lawsuit in the medical field?

How to avoid malpractice suitsStrive for trusting, open relationships. ... Good communication is key. ... Document patient visits ASAP. ... The role of practice culture. ... Don't be afraid to refer.

Which of the following are needed to prove negligence?

Legally speaking, negligence is a failure to use reasonable care under the circumstances. In order to establish negligence, you must be able to prove four “elements”: a duty, a breach of that duty, causation and damages.

What is breach of duty of care in nursing?

What is a breach of duty in nursing? A breach of duty in nursing is when a nurse doesn't provide the standard of care that's expected from them, and it can lead to negligence in nursing and life-changing harm to the patient.

What is breach of duty of care?

Breach of duty of care is concerned with the standard of care that ought to have been applied in the situation. Therefore, if the conduct of the individual or organisation fell below the standard that a reasonable person would have expected, they will have been negligent in their duty.

What happens when a nurse charted a resident's condition?

If a nurse is appropriately charting assessments of a resident’s condition, there will be times when that resident undergoes a change of condition or an unusual occurrence. If there is a change of condition, that change should be documented with a detailed description of what happened .

What is documentation in nursing?

Documentation should provide a picture of the resident’s progress, including response to treatment, change in condition, and changes in treatment.”. Accurate documentation reflects the nursing process. Nurses should use critical thinking at all times in their practice.

What time did the nurse call the physician?

The nursing staff called the on-call physician. The call was not returned until 8:30 a.m., when a nurse called from the physician’s office. There was no documentation in the nursing home chart as to what information was exchanged during this telephone call, but no immediate orders were received.

What is 42 CFR 483.10?

The federal regulations under 42 CFR §483.10 (g) (14) require a facility to “immediately inform the resident; consult with the resident’s physician, and notify, consistent with his or her authority, the resident’s representative (s)” of any significant change of condition.

What is clinical record?

The clinical record “must contain enough information to show that the facility knows the status of the individual, has adequate plans of care, and provides sufficient evidence of the effects of the care provided.

What is critical thinking in nursing?

Thus, their documentation should describe the nurses’ critical thinking process: 1) assessment of a resident’s conditions, causative factors, and/or risk factors; 2) analysis of potential outcomes or consequences; 3) a plan of action; and 4) evaluation of the resident’s response to the plan.

When is it inappropriate to wait an hour for a response?

When someone is critically ill and unresponsive, it’s inappropriate to wait over an hour for a response — the nurse must either contact another provider or use nursing judgment to call for emergency transport. If that means calling the director of nursing services or the medical director, then that is appropriate.

Medical Malpractice Defined

When a medical professional fails to exercise due caution when administering care, they can do serious damage. However, in order to successfully hold them accountable for their harmful errors, a few things must be in place:

When Doctors and Nurses Are Guilty of Medical Malpractice

Doctors, nurses, and other hospital staff members can individually commit serious errors that could negatively affect you. If a nurse or other hospital employee commits medical malpractice, the hospital could share in or bear the brunt of the liability for your injuries.

Can You Sue a Hospital for Refusing to Treat You?

Whether or not you can sue a hospital because they refused to treat you depends on a few factors. Legally, a hospital cannot refuse you treatment because of your age, sex, religion, or other personal characteristics. If you’ve been denied treatment, reach out for legal counsel as soon as possible.

The Lawsuit

I received the initial letter of intent while at work. I was in scrubs and completely caught off guard. My medical director was there, too, and told me not to worry. It probably wouldn’t go anywhere, I was told, as my experience with the patient was so brief.

Settle or Stick It Out?

I was among several healthcare providers included in the lawsuit but the only one from my practice. Contrary to what I’d been told in school, I wouldn’t be facing this with the physician I worked with.

The Trial

During the trial, my insurance company brought in a specialty witness who explained that blood cultures wouldn’t have been the standard of care for the patient, and I hadn’t done anything wrong.

Hindsight

Now that the case is over, I’ve been able to reflect on the things I would have done differently. There’s not necessarily much I would’ve done different with the patient. I did the best I could with the information I had, and I know that. But if I were to go back, I would have had a little more faith in myself.

What should a readback between a hospitalist and an ED physician have done?

Readback between the hospitalist and the ED physician should have clarified the urgency of the patient’s condition. And readback between the nursing supervisor and the RN should have revealed the correct elevated blood pressure reading, which would have led to the hospitalist being called.

What orders did the hospitalist give to a patient who was vomiting and nausea?

The hospitalist placed the following orders: admit the patient, obtain 24-hour urine, creatinine, and protein, and begin intravenous fluids.

What was the cause of death of the tamponade?

The autopsy listed the cause of death as cardiac tamponade caused by acute aortic dissection that had been developing over “hours.”. The autopsy also noted that the aortic dissection was caused by “years of hypertensive cardiovascular disease” and that the heart was enlarged (it weighed 550 gm).

What time did the doctor give Percocet?

The hospitalist stated she was not aware of the elevated blood pressure and, if she had been notified, would have come to see the patient and order additional testing.) The doctor ordered Percocet and Compazine, with the Percocet being given at 3:15 a.m.

What time did the emergency nurse report the patient?

At 12:30 a.m., the patient was admitted, and the emergency nurse gave a report to the floor nurse. According to the floor nurse, the emergency nurse mentioned that the hospitalist was aware of the elevated blood pressure and was going to “deal with it in the morning.”.

Why was the defense weakened in the case of the floor nurse?

The defense was further weakened because the floor nurse did not inform the doctor of the elevated blood pressure or the patient’s new complaint of chest tightness, nor question the doctor about why the patient’s hypertension wasn’t being treated.

What does the RN report to the nursing supervisor?

The RN in turn reported the elevated blood pressure to the nursing supervisor, which was hospital policy. The supervisor later stated that she thought the nurse reported the pressure as 212/106; when she asked if the patient was symptomatic, she was told “no.”.

What was the medical information breach?

Medical Informatics Engineering, an Indiana-based provider of electronic medical record software and services, experienced a major data breach in 2015 at its NoMoreClipboard subsidiary. Hackers used a compromised username and password to gain access to a server that contained the protected health information (PHI) of 3.5 million individuals. OCR determined there had been a risk analysis failure and the case was settled for $100,000. MIE also settled a multi-state action with state attorneys general and paid a penalty of $900,000. Read More…

Why was New York Presbyterian Hospital fined?

The Department of Health and Human Services’ Office for Civil Rights (OCR) has fined New York Presbyterian Hospital (NYP) $2.2 million for allowing patients to be filmed for a TV show without obtaining prior permission from the patients.

What did OCR settle with Cottage Health?

OCR agreed to settle multiple alleged HIPAA violations with Cottage Health for $3,000,000. In 2013 and 2015, protections on servers were accidentally removed and files containing ePHI could be accessed over the internet without the need for a username or password. The ePHI of 62,500 patients was exposed. OCR discovered risk analysis failures, risk management failures, a failure to conduct technical and non-technical evaluations following environmental or operational changes, and the disclosure of ePHI to a contractor without first entering into a business associate agreement. Read More…

What was the OCR penalty for Jackson Health System?

OCR imposed a $2.154 million civil monetary penalty against the Miami, FL-based nonprofit academic medical system, Jackson Health System (JHS), for a slew of violations of HIPAA Privacy Rule, Security Rule, and Breach Notification Rule. OCR determined its compliance program had been in disarray for several years. Read More…

What is the penalty for HIPAA violations in Texas?

The Department of Health and Human Services’ Office for Civil Rights (OCR) imposed a $1.6 million civil monetary penalty (CMP) on Texas Health and Human Services Commission (TX HHSC) for multiple violations of HIPAA Rules discovered during the investigation of an exposed internal application containing ePHI. OCR determined there had been a risk analysis failure, access control failure, information system activity monitoring failure, and an impermissible disclosure of 6,617 patients ePHI. Read More…

What is OCR in HIPAA?

Detailed below is a summary of all HIPAA violation cases that have resulted in settlements with the Department of Health and Human Services’ Office for Civil Rights (OCR), including cases that have been pursued by OCR after potential HIPAA violations were discovered during data breach investigations, and investigations of complaints submitted by patients and healthcare employees.

How long does it take for Presence Health to pay OCR?

Presence Health took three months to issue breach notifications, when the Breach Notification Rule requires notifications to be sent within 60 days of the discovery of a breach. Read More…