Notes from a Plaintiff’s Attorney: Taking a Defensible Consent – Part 1

By Dr. JD, a plaintiff’s attorney, practicing in the Northeast

 

Consenting a patient is really the entering into of a contractual agreement that will govern the medical care that you will engage in and, as in all contracts, that process requires a meeting of the minds to be valid.

 

The document called a “consent” is, like a written contract, merely a legal formality that memorializes the end result of that process.

 

The only role it really plays in a medical malpractice action is when it is not there at all or looks so deficient on its face that it raises serious questions about the propriety of the care ( e.g.; the physician is not named, suggesting that there may have been “ghost surgery”, or the patient’s signature is a scrawl that suggests that they may not have been competent when they signed, or the document itself is post-dated, suggesting that it was only filled-in after the fact).

 

In fact, since a malpractice claim in which a patient is alleging “lack of informed consent” is actually the patient saying “I did not know something critical to my decision about my care because you did not tell me, and I would not have made the choice about my care that led to my present problem if you had told me what I needed to know”, a signed piece of legal boilerplate is no bar at all to that claim proceeding. At most, it creates a rebuttable presumption that the patient agreed as an informed person, but that simply moves the case forward to the presentation of evidence to provide that rebuttal.

Read more

Sometimes It’s Better to Break Up Sooner Rather Than Later

Everybody knows a couple that’s not going to “make it.” They’re destined to part. The question is how much pain or indifference they’ll endure before the inevitable happens.   Occasionally, there’s a doctor-patient relationship that’s not going to make it.   A dentist recently described his story.   Several years ago, he fashioned upper teeth … Read more

iPads and Implantable Cardiac Devices. Avoiding Death While Surfing?

Doctors understand the need to warn patients about side effects of medications, as well as drug-drug interactions. The list of things to warn about just got longer.   iPads.   Apparently magnetic interference from ubiquitous technology devices can alter the settings or potentially deactivate implantable cardioverter defibrillators (ICDs). A study was performed by a 14 … Read more

Mandatory Urine Drug Screens for Physicians?

A recent article in Journal of the American Medical Association delved into the touchy subject of mandatory alcohol and drug screening programs for physicians. In their piece titled “Identification of Physician Impairment”, the authors Drs. Pham, Provonost, and Skipper concluded healthcare lags behind other high-risk industries in detecting high-risk factors causing injury or accident.   … Read more

A Tough Ethical Conundrum

The NY Times hosts a column each Sunday called the Ethicist. Readers send in their real-life ethical conundrums, and the columnist weighs-in with advice.   Recently, a doctor wrote that “years ago” his patient was having headaches. The patient finally confessed that he committed a serious crime and somebody else “took the fall for it.” … Read more

FL Bill Trims Who Can Be an Expert Witness

Earlier this week the Florida State Legislature passed a bill which would require expert witnesses testifying against a physician in a medical malpractice case to practice in the in the exact specialty of medicine as the defendant physician. This is an important piece of legislation which Governor Rick Scott should sign into law. Florida already … Read more

Your Patient is a Criminal. Carrier Denies Payment. Now What?

Most doctors have taken care of patients who were medically impacted by their illegal act. Some of these patients actually have third party insurance. I know, you’re skeptical. OK, how about a rock star who overdoses? Maybe he’s not come to your ER. But, he came to someone’s ER.

Dzokhar Tsarneav, another criminal, was transported to a hospital to be treated – probably at great cost – for injuries sustained in a gun battle with the police. This issue brings into focus the problems physicians face in getting an insurer to cover patients for what they brought on themselves through illegal acts.

The basic rule of insurance is carriers will not cover an insured for intentional illegal acts. Insurers will cover patients for harm resulting from their illegal act IF that crime was not intended. Therefore, if a driver is injured while trying to run down his neighbor that driver will not be covered. But if the driver drove while drunk – itself an illegal act but without intention to commit a crime – he would be covered for injuries he sustained when he crashes into a lamppost.

Read more

What Does it Mean to be Dzhokhar Tsarnaev’s Doctor?

First, let’s dispense with political correctness. I will not use the words “alleged” or “suspect.” We’re all adults here. Dzhokhar Tsarnaev is the younger brother whose bombs killed 3 innocents or maimed scores of participants or bystanders in the Boston Marathon.   I was proud to be called a physician that day. Not because of … Read more

Online Treatment of Dogs and Cats

Doctors are testing various models of telemedicine. Every state treats the online practice of medicine differently. And, it’s unclear how this will shake out over time. Patients can even obtain sex therapy from a certified therapist – online. As one therapist’s site note: “If the traffic light on the left is green, I am online … Read more

Latest Posts from Our Blog