Negligence= Conduct lacking in DUE CARE.  Carelessness.  Doing something a reasonable person would not do. 

Malpractice=More specific term.  Failure of a PROFESSIONAL person to act in accordance with the prevailing standard, or failing to forsee. 

1-Duty owed the pt

2-Breach of the duty owed the pt

3-Foreseeability

4-Causation

5-Injury

6-Damages

Failing to report a change in a pt's status is considered what element of malpractice?

Duty owed the pt

Breach of the duty owed the pt

Foreseeability

Causation

Injury

Damages

Failing to report another health care workers incompetence is an example of:

Duty owed the pt

Breach of the duty owed the pt

Foreseeability

Causation

Injury

Damages

1- Cause in fact

2- But-for-test

3- Substantial Factor test

4- Alternate causes

The following is an example of which test for causation?

"Could somethin have been done to prevent the injury?"

1- Cause in fact

2- But-for-test

3- Substantial Factor test

4- Alternate causes

The following is an example of which test for causation?

"Did the defendants action cause or contribute to the injury?"

1- Cause in fact

2- But-for-test

3- Substantial Factor test

4- Alternate causes

General

Special

Emotional

Punitive or exemplary

What type of damage?

"Pain, suffering(past, present and future), permanent disability or disfigurement"

What type of damage?

"Losses and expenses incurred as a result of the injury"

What type of damage?

"Lost wages, medical bills, future medical costs"

What type of damage?

"rare event usually accompanied by physical harm"

What type of damage?

"awareded for malicious, willful or wanton conduct"

What type of damage?

"Plaintiff shows that the defendent acted with a conscious disregard for the plaintiffs safety"

Usually occurs when the injured party is was

unconscious

in surgery

an infant

This occurs when a plaintiff is injured but connot prove how the injury happened or who was responsible

This occurs when a plaintiff is injured but connot prove how the injury happened or who was responsible

1.  accident must be the kind that doesn't normally occur in the absence of negligence.

 2.  The accident must be caused by an agency or intrumentality within exclusive control of the defendant.

3.  Cannot be due to any voluntary action by the plaintiff

Comparative negligence=% of damages the pt is responsible for.

Contributory negligence= If the pt actions contribute towards their own lack of health then they arent entitled to any damages.

If the pt actions contribute towards their own lack of health then they arent entitled to any damages this is considered to be:

Contributory or Comparative negligence?

Does KS practice comparative or contributory negligence?

How does it work?

Modified Comparative

If pt found to be >50% responsible, then there is no cause of action

What is the difference between intentional and quasi intentional torts?

What are the 2 types of quasi torts?

With quasi the intent is missing. 

Invasion of privacy

Defamation

Things connected to the pt

a single touch is sufficient

no harm or injury need occur

pt doesnt have to be aware

Metally ill, threat to self or others

Contagious disease that would be threat to society

Refusing to allow pt's to leave against medical advice is an example of?

Handing a mother her stillborn child in a gallon of formaldehyde is an example of?

Why?

Intentional infliction of emotional distress

because the conduct goes beyond that allowed by society, calculated, causes mental distress

Conversion of property

1- intrude on others land

2- fails to leave when requested

3- puts something on property

4- causes third party to enter property

With intentional torts do damages need to be proven?

What are the types of consent?

What are they used for?

Written, oral, apparent, implied by law

Used as defense against intentional torts

What is apparent consent?

Example?

What a reasonable person would infer from the pt's conduct that consent was given.

Ex: Pt rolls up L sleeve when asked which arm they prefer the shot in.

What is implied consent?

When a person is unable of giving or denying consent.

What is necessity?

Allows what?

What are the restrictions?

Defense used against intentional torts

Allows nurses to interfere with the pt's property rights to avoid threatened injury.

Can only search property if there is a reason

What type of defense should be used?

A pt comes into the ER with a knife..

1- adversely affect a persons rep

2- concerns a living person

3- has to be a witness

Truth- the whole statement must be true

Privilege- disclosure may be allowable to protect or further public interests recognized by law

1-  Benefits greatly outweigh risks

2-  Risks cannot be eliminated

3-  No safer products exist

Must state that an offense has been filed, but not required to specify

-dollar amount claimed

KS=20days

MO=30days

Please state each diagnosis you considered on __ when you saw mrs jons in your office. Please state whether sepsis was in your diff diagnosis for mrs jones. 

These are examples from what discovery process?

^{Gives yes or no question.}

What is the most important aspect of litigation?

why?

Depositions of the Parties

Because the vast majority of cases don't end up in court

    3)         To get admission regarding others.

What is Voir Dire ?

What does it mean?

Jury selection

means to speak, process where the attorneys ask them questions.  To widdle down impartial jury. 

Who has the burden of proof?

-  find out someone did something wrong, like juror did research on internet.

THIS WOULD BE GROUNDS FOR?

What is JNOV?

Is this an objective or subjective informed consent standard?

What is

Subjective patient standard?

Requires full disclosure of information.  Answer any questions the pt has. 

Most of the time we us this

What does the latin term in loco parentis mean?

the ability of a person or state to stand in the place of parents. 

Who may consent in the absence of parents

What is self determination?

2 concepts:

A. Involves the right of individuals to determine what happens to their   bodies.

      B. Competent patients can refuse treatments provided the State does not have overriding interests.

Instructional

Proxy directive

What are the types of instructional advance directives?

What are the problems with each?

Living will- problem is that it is difficult to enforce with it's broad language and little direction.

National Death Acts- legal version of living will, may need to be reexamined reguarly, some states don't recognize if out-of-state, only useful if the person qualifies as terminal. 

What is the most common type of proxy directive?

How does it work?

Things the appointed person can do:  ?

Durable Power of Attorney for Health Care

Patient Self-Determination act was signed in ___?

became effective in_____?

1990

1991

A.        Requires of all Medicare and Medicaid institutional providers:

                                    1. Provide written information to inpatients upon admission about                                                           their rights to make health care decisions.

                                    2. Document in the medical record a person’s advance directive

                                    3. Not discriminate based on advance directive

                                    4. Ensure compliance with state laws

                                    5. Provide advance directive education

What are the stipulations for assisted suicide?

In Oreg

1. Pt has less than six months to live agreed to by attending and consulting                                        physician

                  2. Pt must make both oral and written requests followed by a second oral                                        request after 15 days

                  3. If depression is suspected then counseling must be done

                  4. Must wait 48 hours after the third request

                  5. Physician writes lethal drug prescription

a.  draw single line through

c.           date and initial words “mistaken entry”           

Document as stated

Read the order back to the MD

Use V.O or T.O.

Follow this with MD name and your name and status

What is the proper way to write your name?

Sign at bottom of the page

On the next page write date/time and "continous from previous page"

What do you do if a patient asks to view their record?

What are the common elements of insurance policies?

1.      Provides payment for a lawyer to represent the insured nurse

2.      Sets limits of legal liability

3.      Pay settlements or jury awards

Occurence based

Clamis made

A. Occurrence based:  cover the cost of any injuries that are your fault that occurred during the time the policy was in effect.  Was the insurance in effect when the claim occurred? 

What is claims based insurance?

B. Claims based:  provide coverage only if an injury occurs and the claim is reported to the insurance company during the active period during an uninterrupted extension of that policy period. 

: involves insuring a group of similarly licensed professionals in the same fashion as an individual policy usually for less money.

What type of insurance?

Doesn't cover non-work r/t activity

employer calls the shots

Declarations

1.      Policy holders name

2.      Covered professional occupation

3.      Covered time period

4.      Limits of liability

5.      Additional State requirements for information that may modify policy

What do the EMTALA regulations say?

Medical screening for all pt's to see if serious

Treat and stabilize before xfer

Transfer is for medical reason

xfer is consented to by pt

Who are alleged violations reported to?  -

Who investigates the alleged violations? -