Doctor’s liability -Criminal liability ,Civil liability , Contractual liability

Presented by

Dr. S.M.Kantikar

National Consumer Disputes Redressal Commission New Delhi

[www.ncdrc.nic.in]

26 March 2022 at Jabalpur (MP)

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Doctor’s liability

Criminal liability

Civil liability

Contractual

CPA,2019 PRB

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To succeed to claim, the C/o has to prove

1. Duty towards patient

2. Deficiency in duty (breach)

3. Directly results- injury (causa causans ) 4. Damage which may be physical, mental or

financial loss to patient or relatives.

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 “It reflects and creates excellence in medical care.”  StandardsofCare:

Documentation is legal protection for both patient and physician in the dispute over care.

Failure to document important details can lead to adverse patient outcomes and malpractice suits.

 Ethical issues :

Assures patient confidentiality and ensures that standards of care are met.

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 Many physicians complain that they do not have the time to write sufficient records!

 “Would you rather spend the time in court for 12 weeks, 5 days a week,

from 9 am to 5pm ”

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 what is important to document

 when to document

 how to document

 how to maintain/destroy

 who owns the medical record,

 the significance of the transition to the

electronic medical record,

 problems and pitfalls when using the

electronic medical record

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 Use of decorative letter head  Over description of doctor’s

qualification /competence (publicity)

 Handwriting – wrong dispensing

 Explaining to patient

 Over prescription of certain drugs (steroid)  Abbreviations

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 Both are separate and distinct concepts.

 Consent is generally recognized as a patient

signing a name to a form, or verbally

agreeing to a treatment plan or a procedure.  Informed consent is a communication

process that leads to shared decision-making

by the physician and patient.

 Physicians are required to obtain informed

consent from patients prior to treatment.

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 Signatureondottedlines…!!!

“ Patient’s signature goes a long way toward

mitigating the legal problems of the doctor.”

 ItinvolvesDegreeofdisclosure

Reasonable disclosure Adequate disclosure Complete disclosure

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Informed consent accommodates both patient autonomy and the physician’s responsibility

Benefits of treatment

Risks of treatment

Alternatives (other treatment options) No treatment (risks of)

Documentation + signature ( Pt+Dr+Witns)

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Neatness and legibility Medical transcription

Handwritten notes ▪ Blue ink

▪ Highlight specific items such as allergies ▪ Make corrections properly

Accuracy

 Check information carefully

 Never guess or assume

 Double-check accuracy findings and instructions

 Make sure most recent information is recorded

 shows list of abbreviations and acronyms used.

 MR folder should be clipped or stapled  If amendment made- it should be

rewritten by the physician and reason for rewriting should be specified along with signature.

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 Correct mistakes immediately

 Draw a line through the original information

 Document why correction was made

 Date, time, & initial correction  Insert correct information

 Hv a witness,if possible

Client’s words Clarity Completeness Conciseness Chronological Order Confidentiality

Neat, Legible,Timely,Accurate, with Professional tone

Referral Note Discharge Note

Confidential Correcting MR

Tampering Destruction

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1.3 : Maintenance of Medical Records:

 Section 1.3.1 – 3 years from commencement of treatment (IP).

 Section 1.3.2- issued within 72 hours of request – to patient or authorized representative

 Issue register – date, time, identity

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• Referringapatientisnotanegligence • Remember Having a

“second pair of eyes and ears”

help you out of litigation.

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 Issuing Medical Certificate in Good Faith  Advertisement / Unfair trade Practice

 Shortcuts; illegible prescription,

 Vague reports, Abbreviations

 Maintenance/Tampering of Record

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 Hon’ble Ms Justice Indu Malhotra of Supreme Court of India advises doctors to do „robust documentation‟

 Violation of Ethical Regulations 1.3, 7.2 related to Medical Record constitute Gross Professional Misconduct and Deficiency in Service:

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