“Can Medical Justice solve my problem?” Click here to review recent consultations…
all. Here’s a sample of typical recent consultation discussions…- Former employee stole patient list. Now a competitor…
- Patient suing doctor in small claims court…
- Just received board complaint…
- Allegations of sexual harassment by employee…
- Patient filed police complaint doctor inappropriately touched her…
- DEA showed up to my office…
- Patient “extorting” me. “Pay me or I’ll slam you online.”
- My carrier wants me to settle. My case is fully defensible…
- My patient is demanding an unwarranted refund…
- How do I safely terminate doctor-patient relationship?
- How to avoid reporting to Data Bank…
- I want my day in court. But don’t want to risk my nest egg…
- Hospital wants to fire me…
- Sham peer review inappropriately limiting privileges…
- Can I safely use stem cells in my practice?
- Patient’s results are not what was expected…
- Just received request for medical records from an attorney…
- Just received notice of intent to sue…
- Just received summons for meritless case…
- Safely responding to negative online reviews…
As physicians, if you suspect child abuse, you are mandated to report to the appropriate authorities, such as Child Protective Services (CPS). In Texas, where our vignette played out, professionals are beholden to the following law.
Section 261.101 of the Texas Family Code mandates that anyone who suspects child abuse or neglect must report it immediately. The report may be made to (1) any local or state law enforcement agency; or (2) the Department of Family and Protective Services.
All persons are required to make the report immediately, and individuals who are licensed or certified by the state or who work for an agency or facility licensed or certified by the state and have contact with children as a result of their normal duties, such as teachers, nurses, doctors, and day-care employees, must report the abuse or neglect within 48 hours.
Deric Cahill took his toddler to an urgent care center in Dallas. He alleged the doctor turned him into CPS for leaving a one-star Google review. In other words, the doctor weaponized the duty to report because of a nasty review.
The Cahill family is a content creator for Instagram and TikTok with 750,000 followers. What followed, predictably, did not go well for the physician.
To state the obvious, what follows are only allegations. As to whether the doctor believed, in good faith, she suspected abuse and HAD to report, is unknown.
And in Texas:
A person acting in good faith who reports or assists in the investigation of a report of child abuse or neglect is immune from civil or criminal liability. Failure to report suspected child abuse or neglect is a Class A Misdemeanor, punishable by imprisonment of up to one year and/or a fine of up to $4,000. Merely reporting the incident to a supervisor or manager is insufficient.
The incentive TO report based on reasonable suspicion is high. The penalty for NOT reporting is steep.
Back to the urgent care center.
Cahill’s toddler had a fever for several days. He called a nurse’s hotline. He then took the child to pediatric urgent care center.
Cahill says the physician checked his ears, nose, and throat and listened to his breathing. After a few minutes, Cahill says the doctor told them that his fever could have been caused by anything and recommended they visit the emergency room to get blood work, urinalysis, and other tests to rule everything out. Cahill says he and his wife sat in stunned silence after the doctor’s recommendation and were surprised the provider hadn’t asked them more questions. After the doctor repeated her recommendation, Cahill said he wasn’t happy with how the appointment went and left.
Miffed, Cahill wrote his online review in the parking lot.
“This is the most transactional experience I’ve ever had with a caregiver. We brought our son in with a fever, and after five minutes of normal tests: check ears, check throat. The doctor tells us to just go to the hospital to get urine, blood, and x-rays to figure out if it’s pneumonia, UTI, or some other infection. Bring your kid here if you just need antibiotics…anything else, it’s a waste of time and money.”
And, he emailed the corporate office for the urgent care center to express his displeasure. He wanted a refund for the perceived lack of service.
Within two hours of leaving the urgent care center, a report was filed to CPS about a severely dehydrated child. Within one hour of filing, a CPS officer showed up at the Cahill’s house.
Cahill says the case worker told him she expected to see a severely ill child but left after 30 minutes of sitting, talking with the family, and observing [the child].
Cahill went back to the urgent care center to speak with the physician about the CPS report. He received the records related to dehydration, but was instructed to wait outside. Meanwhile the staff called the police. All of this was documented in a TikTok video.
After speaking with the police and learning that the provider would not speak with him, he left with his child’s paperwork.
For Cahill, there is a clear connection between his critique of the care and the CPS report. “Why would she wait an hour and a half to call CPS if she was so concerned? Why wouldn’t she follow up with us to ask if we followed the guidance?” Cahill says. “It feels malicious.”
After the CPS visit, the family took the toddler to their usual urgent care, where Cahill says the provider spent 30 minutes with the family and asked more questions. The record of the appointment describes a very different toddler. Rather than “sick looking, weak cry” in the first visit, the second report describes a child that is “alert, pleasant, well-nourished and in no acute distress.” The provider told them to monitor their son, and his fever broke for good that night.
“Based on everything we experienced that day, the only thing I am led to believe is that this doctor was offended that I called her out in her office, that I left a Google review, that I emailed her senior leadership team, and she retaliated against us by weaponizing her position and calling CPS,” he said in a video post.
Cahill filed complaints with the Texas Medical Board and Texas Attorney General Consumer Services Division. In Texas, falsely reporting child abuse with the intent to deceive is a felony. Still, given the incentives to report and penalties for not reporting, I doubt criminal penalties will be imposed.
CPS cases move slowly.
The CPS case isn’t closed yet, but Cahill says the case manager told them she has no concerns and is working on character references to end the investigation. In a conversation with [the] Urgent Care management, Cahill reported that the organization said it would explore ways to improve its policies and that providers are bound by mandatory reporting standards.
Cahill is a man on a mission.
“Money is not my motive. My motive is to hang this doctor’s license in my bedroom because she will no longer be able to practice medicine. That’s the mission.”
What are the evolving lessons?
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- Physicians need to understand what their obligations are for reporting suspected child abuse.
- The protections from civil and criminal liability apply if the report to authorities is made in good faith and without malice (at least in Texas).
- As to whether good faith and without malice apply, reviewers will look to the totality of the circumstances – the facts of the case, the timing of the report, and any extraneous circumstances.
- Doctors should be cautious about reporting someone to CPS FOR a one-star Google review. They should report FOR suspected child abuse.
- If the timeline suggests the father wrote the online review, and then Google sent an email to the physician about the one-star review, and then this email was opened and read, and then the report to CPS was filed, well, you can draw your own conclusions.
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What do you think?
Medical Justice provides consultations to doctors facing medico-legal obstacles. We have solutions for doctor-patient conflicts, unwarranted demands for refunds, online defamation (patient review mischief), meritless litigation, and a gazillion other issues. If you are navigating a medico-legal obstacle, visit our booking page to schedule a consultation – or use the tool shared below.
“Can Medical Justice solve my problem?” Click here to review recent consultations…
all. Here’s a sample of typical recent consultation discussions…- Former employee stole patient list. Now a competitor…
- Patient suing doctor in small claims court…
- Just received board complaint…
- Allegations of sexual harassment by employee…
- Patient filed police complaint doctor inappropriately touched her…
- DEA showed up to my office…
- Patient “extorting” me. “Pay me or I’ll slam you online.”
- My carrier wants me to settle. My case is fully defensible…
- My patient is demanding an unwarranted refund…
- How do I safely terminate doctor-patient relationship?
- How to avoid reporting to Data Bank…
- I want my day in court. But don’t want to risk my nest egg…
- Hospital wants to fire me…
- Sham peer review inappropriately limiting privileges…
- Can I safely use stem cells in my practice?
- Patient’s results are not what was expected…
- Just received request for medical records from an attorney…
- Just received notice of intent to sue…
- Just received summons for meritless case…
- Safely responding to negative online reviews…
Weaponization works both ways. Many patients are using review weaponization to bully the healthcare profession when they dont get their way and there is no way to adequately defend yourself or even respond due to Hippaa concerns.
It sounds like this kid wasnt that sick and if the doctor did this she should be accountable. It also sounds like the parents were trying to hold the urgent care to the same standards as an ER or perhaps had unrealistic expectations about the capabilities of the urgent care that THEY decided to go to.
How arrogant for this person to want to hang the providers medical license on his wall. Social Media is becoming a way for narcissitic bullies to abuse others and there needs to be accountability for ALL, not just Medical Professionals.
This doctor charged that the toddler was severely dehydrated, which for a very young child is a serious condition. After looking up the clinical signs, I came to the conclusion that it is not THAT easy to make an accurate diagnosis. Possible I’m sure for a pediatrician, but not so easy for a clinician without pediatric experience.
A country doctor would try to get some kind of urinalysis sample. Capillary filling time is subject to misinterpretation.
But ORT therapy is necessary and should start ASAP. But in the absence of REAL dehydration can cause electrolyte imbalances that are dangerous for children.
The big red light here is LATE reporting for the doctor angry with the bad review. She should have accepted it as a “part of doing business.”
Instead, it just got way worse for her. Pediatrics is difficult and requires a keen sensitivity toward seeing lots of children. Unless you have that wealth of experience, you should probably not advertise yourself as a clinician who knows kids.
Michael M. Rosenblatt, DPM
If everything is true as described, then this physician is not very smart and deserves a slap on the wrist, perhaps a few parent communication tips. Certainly not to lose her license. I have not heard of an Urgent Care Center that could not do at least a urinalysis, and when I worked at several we could send out or do lab tests, and had X-ray. What was this, an urgent care Closet?
For me, the hooker is the mention of dehydration by the social worker.
If the child at an UCC without capability appeared in need of hydration and was not taking fluids, then sending the to an ED for IVs and simultaneous blood draws and possible x-rays would not have been remiss. If the parent immediately announced they had no intention of doing so, it could conceivably raise an issue about child endangerment.
Does Google actually notify you immediately about bad reviews? Why so, if there is no recourse? It would seem to invite retaliation.
We are living in incredibly uncivil times. This reminds me somewhat of the person(s) who livestreamed their being refused entry to EDs without masks at the height of Covid.
Retaliation for a 1-star review is insane – especially as an urgent care employee protected behind the wall, with an unending flow of sick people. Responding to the review in a HIPAA compliant fashion could have put a period at the end of this encounter.
Vengeance and bearing false witness are poor character traits to put it lightly. We all have bad days, and we all sin, so I pass no judgement. Doc had poor judgment that day, and her decisions may cost her her license. The TMB is vicious and they work behind their own shroud of secrecy. When you have a bad day, there is only one way: mea culpa, mea culpa, mea maxima culpa. Thanks
It’s my understanding that the Dr. in question has been exonerated by the TMB from all of the baseless accusations Mr. Cahill fabricated.