Malpractice Claims: Standards of Care, Co-Defendants, Special - - PowerPoint PPT Presentation

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Malpractice Claims: Standards of Care, Co-Defendants, Special - - PowerPoint PPT Presentation

Sep 28, 2023 414 likes •673 views

Presenting a live 90-minute webinar with interactive Q&A Pursuing or Defending Anesthesiology Malpractice Claims: Standards of Care, Co-Defendants, Special Liabilities TUESDAY, NOVEMBER 20, 2018 1pm Eastern | 12pm Central | 11am

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Pursuing or Defending Anesthesiology Malpractice Claims: Standards of Care, Co-Defendants, Special Liabilities

Today’s faculty features:

1pm Eastern | 12pm Central | 11am Mountain | 10am Pacific

The audio portion of the conference may be accessed via the telephone or by using your computer's

  • speakers. Please refer to the instructions emailed to registrants for additional information. If you

have any questions, please contact Customer Service at 1-800-926-7926 ext. 1.

TUESDAY, NOVEMBER 20, 2018

Presenting a live 90-minute webinar with interactive Q&A

  • C. Gregory Tiemeier

, Partner, Tiemeier & Stich, Denver Alex Wilschke, Partner, Leventhal & Puga, Denver

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Tips for Optimal Quality

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SLIDE 3

Continuing Education Credits

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  • ext. 2.

FOR LIVE EVENT ONLY

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Program Materials

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Pursuing Anesthesiology Malpractice Claims

Alex Wilschke Leventhal & Puga, P.C. 950 S. Cherry Street, Suite 600 Denver, CO 80246 Phone: (303) 759-9945 Fax: (303) 759-9692 Email: awilschke@Leventhal-law.com

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Defending the Anesthesiology Malpractice Lawsuit

  • C. Gregory Tiemeier

Tiemeier & Stich, P.C. 1000 East 16th Ave Denver, CO 80218 Phone: (303) 531-0022 Fax: (303) 531-0021 Email: gtiemeier@tslawpc.com

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Case Selection

 Ordinary case and client selection criteria

  • Liability
  • Causation
  • Damages
  • Type of Procedure

 Comorbidities can make the anesthesia

case

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Defendant Selection

 State Specific Legal Doctrines Complicate

This Decision

  • Corporate Practice of Medicine
  • Captain of the Ship Doctrine

 Surgical Center  MD  CRNA – Supervisor? Some states are

eliminating the Supervision requirement.

 Consultation with surgeon performing

surgery

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Expert Selection

 Practice in the same type of practice

  • Hospital Based
  • Non-Hospital Based

 Practice in the same type of Community  Practice with the same licensure  Literature  Prior T

estimony

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The Defense Perspective

ISSUES FOR THE DEFENDANT IN ANESTHESIOLOGY MALPRACTICE CASES

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The Defense Perspective

WHY DO ANESTHESIOLOGISTS GET SUED?

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STATISTICS

 HALF of all anesthesiology lawsuits are

the result of an unexpected injury.

  • Failure to save a life (death)
  • Neurologic injury
  • Overdose of anesthesia meds

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STATISTICS

 Common errors leading to lawsuits:

  • Wrong dosage of anesthesia meds
  • Improper intubation
  • Not properly monitoring the patient

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Liability Issues

 Medication Errors

  • Right Patient
  • Right Drug
  • Right Dose
  • Right Route
  • Right Time
  • Right Documentation

 Location Concerns  American Society of Anesthesiologists (ASA)

Grading System

  • Hospital
  • Ambulatory Surgical Center

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Liability Issues

 Pre-Operative Care

  • Complete work up for other conditions
  • Review Medical Records and Imaging
  • History and physical

 Intra-Operative Care

  • Monitoring and Recording

 Post-Operative Care

  • Monitor until stable

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MULTIPLE DEFENDANTS

 Rarely see ONLY anesthesiology

defendant (about 1 in 10)

 Multiple defendants mean multiple

insurance companies

 Non-party Designations

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MULTIPLE DEFENDANTS

 Finger-Pointing – the plaintiff’s dream

come true

 Consider early arbitration/mediation

among defendants ONLY

  • Pushback from insurance company

 The longer it goes, the more it costs

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MULTIPLE DEFENDANTS

 “Captain of the Ship” doctrine

  • Still alive in Colorado

 Leverage settlement with surgeon  Be aware of limitations!

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Evidence Types & Sources of Evidence

 Machine Generated Records  BP/EKG/Pulse Ox/Capnography  Handwritten Chart Notes  Audit Trails  Other Electronic Sources

  • Apps

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DISCOVERY CONSIDERATIONS

 “Audit Trail”  Differences between machine recording

and the paper chart

 Get it FAST! Settlement value may go up

when you disclose chart alterations or errors

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DISCOVERY CONSIDERATIONS

 Equipment errors

  • Alarm failure
  • Metering error
  • Power loss

 Demand preservation from ASC or

Hospital ASAP

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Privileges

 State Specific Concerns

  • Redactions of other medications for privacy
  • Experts desire to know all substances in the

body

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TRIAL CONSIDERATIONS

 Voir Dire:

  • Jurors will likely have some experience,

personal, friend or relative

  • MUST find out their level of satisfaction,

results of the procedure

  • Squeamish about operations?

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TRIAL CONSIDERATIONS

 Voir Dire

  • Understand the complexity of anesthesia

 Not “going to sleep”  More like “bringing them close to death”, then “bringing them back”  Numerous medications, interactions

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TRIAL CONSIDERATIONS

 Plaintiffs win only about 2% of trials

(Medscape 2015 survey)

 But 41% settle before trial  Of Defendant Anesthesiologists, most said

they’d do nothing differently

  • But 17% said “better documentation”

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