(15) Legal Issues and the Dental Radiographer

Do both federal and state government regulate the use of dental x-ray equipment?

yes

Part of the government that controls:

• Safety precautions and requirements for use of dental x-ray machines made and/or sold in USA

• Guidelines for proper maintenance of equipment

The federal government

Which act outlines requirements for the safe use of dental x-ray equipment?

Consumer-Patient Radiation Health and Safety Act

Part of the government that controls:

• Training/certification for radiographers

• DH and DDS don’t need additional certification, but DA do

• Required inspections of equipment every 3 years

State government

Policies and procedures that reduce the chances of the dental office being sued

Risk Management

Informed consent includes:

1. Benefits of x-rays

2. Types of x-rays

3. Risk of NOT taking x-rays

4. Risks involved with taking x-rays

5. Additional diagnostic tools

What do you need to get consent from those younger than 18?

obtaining consent and documentation from the parents

Persons have the legal right to make choices about the treatment received, including the opportunity to consent or to refuse treatment.

Self-determination

The process of informing the patient about the particulars of dental imaging

Disclosure

Consent given by a patient after complete disclosure

Informed consent

When a dental auxiliary performs procedures, legal accountability is presumed to lie with both the supervising dentist and the dental auxiliary.

Liability

Results when the dental practitioner is negligent in the delivery of dental care

Malpractice

What are examples of malpractice?

• Failure to get informed consent

• Taking wrong x-rays

• Taking numerous retakes due to poor technique

• Failure to diagnose from x-rays (DDS only)

Occurs when the diagnosis made or the dental treatment delivered falls below the standard of care

Negligence

The quality of care that is provided by dental practitioners in a similar locality under the same or similar conditions

Standard of care

State laws govern the duration of time within which a patient may bring a malpractice action against the dentist or the auxiliary. This time period is known as what?

Statute of limitations

Does statute of limitations vary state to state?

yes

What is the limit on how long a patient can wait before suing in Indiana?

2 years (5 years for felony)

What should patient records include?

• informed consent (signed and dated)

• Total number of radiographs taken (include retakes)

• Reason for taking radiographs

• Diagnostic information from radiographs - what did DDS find?

What should you never do with records?

Erase or block out an incorrect entry

Are x-rays confidential?

yes

Is it illegal to share x-rays with non privileged individuals?

yes

Can you show other hygienists, assistants, or front desk staff (anyone not involved in the appointment) the radiograph?

no

Can you show your classmates the cool hypercementosis or gnarly cyst on your patients radiographs?

NO that includes you Evan

Who do radiographs belong to?

The dentist

What does the patient pay for when it comes to radiographs?

• equipment

• time

• skills of radiographer

• DDS’s diagnosis

Do radiographs become a part of the patient’s record?

yes

Do patients have the right to a copy of their records?

yes

Can offices charge a fee for making copies?

yes

Can digital copies be sent electronically?

yes, via encrypted email

Does the patient have the right to say no to x-rays?

yes

Can DDS refuse to treat without x-rays?

yes

If you allow your patient to sign saying they’re refusing x-rays to continue treating them, does it hold up in court?

no

Informed consent is based on the concept that a patient receives:

complete disclosure

This process of informing the patient about the particulars of exposing dental images is termed:

disclosure

A dental assistant may have to take an additional certification or licensure examination to expose dental images

true

The right to self-determination means that the patient has the right to consent or to refuse treatment

true

Which person(s) may be liable for the actions of a dental auxiliary

both dental auxiliary and dentist

The improper exposure of dental images may result in:

malpractice

It is best to retain dental records for 6 years

false

The following must be disclosed to the patient before obtaining informed consent:

all of the above

Incomplete disclosure to the patient before obtaining his or her informed consent may:

invalidate the consent

The dental record is a legal document

true