Legal Definitions & BIll of Rights (1100)

ethics

science of human behavior to systemize principles of morally correct conduct

liability

an obligation one has incurred or might incur through any act or failure to act in which responsibility for conduct falling below a certain standard which is the casual connection of the plaintiff's injury

plaintiff

the party who brings a civil suit seeking damages or other legal relief (wants to get paid or justice)

defendant (in a criminal case)

the person accused of committing a crime

defendant (in a civil suit)

the party against whom the suit is brought

respondeat

aka appellee the person who argues against a petition or appeal, generally the person who prevailed in the lower court

respondeat superior

the employer is responsible for the legal consequences of the acts of the service or employee while he acts within the scope of his employment

"Let the master answer" refers to what?

respondeat superior

risk management

the process of avoiding or controlling risk of financial loss to the radiographers and hospital or medical center in which it is a matter of patient safety that will identify actual and potential that causes patient accidents and will implement programs to eliminate or reduce these occurrences

res ipsa loquitur

a doctrine of law applicable to cases where the defendant had exclusive control of the thing which caused the harm that ordinarily could not have occurred without negligent conduct

Normally, the plaintiff must prove the defendant's liability, but when this doctrine is found to apply, the defendant must prove himself not responsible for the harm

"The thing speaks for itself" refers to what?

res ipsa loquitor

torts

the type of laws that governs the rights between individuals in non-criminal actions (or personal injury law in short)

intentional torts: civil assault

threat of touching in an injurious way (with words)

intentional torts: civil battery

touching a person without permission as the willful act to harm or provoke (THINK: hit them with a bat)

false imprisonment

an issue when a patient wishes to leave and is not allowed to do so (I.e. restraints)

invasion of privacy

results when confidentiality of information has not been maintained, or when the patient's body has been improperly or unnecessarily exposed

libel and slander

refers to malicious spreading of information that results in defamation of character or loss of reputation

libel

refers to written information that is malicious spreading of information that results in defamation of character or loss of reputation

slander

malicious spreading of information that results in defamation of character or loss of reputation which is done verbally

A breach of confidentiality is not only unethical but what can happen to an RT?

may also cause the RT to be sued for slander

Unintentional Misconduct

negligence

neglect or omission of reasonable care or caution

What is the standard of reasonable care based on?

"doctrine of reasonably prudent person"

What does the "doctrine of reasonably prudent person" standard require?

that a person perform as any reasonable person would perform under similar circumstances

gross negligence

negligent acts that involve "reckless disregard for life or limb" which carries a higher degree of negligence than ordinary negligence and results in more serious penalties (i.e. drinking and driving or leaving siderails down of a patient when supposed to be up)

contributory negligence

acts of negligence in which the behavior of the injured party contributed to the injurious outcome (i.e. heavy patient wants to get up from stretcher even when side rails are up and slides down at the end causing the stretcher to tip and fall on patient)

What are happening with malpractice lawsuits each year?What then happens to insurance coverage for hospital and physicians?

increasing malpractice lawsuits causing increasing insurance coverage

Legally, to establish claim of malpractice, a claimant must prove to the court's satisfaction in which the 4 conditions are true:

1. the person or institution being sued had a duty to provide reasonable care to the patient

2. the patient has sustained some loss (even loss of time) or injury

3. the person or institution being sued is the responsible party for the loss

4. the loss is attributable to negligence or improper practice

Accordingly, a patient may sustain some loss, but for the patient to collect damages, what needs to happen?

the court must be convinced that the loss has resulted from negligence in professional care

The 7 C's of malpractice prevention:

1. communication

2. courtesy

3. compliance

4. competency

5. charting

6. carefulness

7. confidentiality

Good Samaritan Laws

main purpose was to encourage citizens to assist their fellow man by rendering emergency medical aid to injured persons

Why were the Good Samaritan Laws passed?

to protect the same citizens who render aid from criminal liability or civil liability for any acts or omissions resulting from attempts to give emergency medical aid

advance directive

document in which a person either states choices for medical treatment or designates who should make treatment choices if the person should lose decision making capacity

Example of an advance directive documents in healthcare is:

Living Will or Durable Power of Attorney, though the patient may possess another form of advance directive

Living Will

written document voluntarily executed by the patient directing that should the patient have a terminal condition, life sustaining measures be withheld or withdrawn

Durable Power of Attorney for Healthcare (DPOA)

a written document in which an individual names someone else to make healthcare decisions in the event that the individual becomes unable to make them himself/herself which can also include instructions about specific possible choices to be made

What are the 3 branches of responsibility?

1. clinical

2. ethical

3. legal

clinical responsibility

take care of the patients medical needs

ethical responsibility

to do what is morally correct

legal responsibility

to do what is right under law

"The goal is to protect and promote the health of individuals and the community" refers to what?

3 branches of responsibility

What is intended to cover all claims against the hospital arising out of alleged negligence of any member of the physician staff and/or employees?

hospital liability and malpractice insurance or patient liability insurance

In some states, operation of a clinic or hospital owned by a physician makes who liable for the acts of the physician as well as the conduct of the employees of the clinic or emergency care centers?

the physician himself

Is a RT licensed to draw blood?

no, unless an appropriate phlebotomist certification is on file with the State Department of Health Services

Many radiographers working in doctor owned clinics and/or offices have indicated that as long as the physician gives permission to perform duties that are beyond the scope and practice it is permissible. Is this okay since the doctor allows it?

no, any duty out of the scope and practice of licensure is illegal

What are hospital employees instructed to do after any injury to a patient?

report said injury to administration via the department manager, which in turn should report it immediately to the insurance carrier

If hospital employees fail to give any notice after any injury to a patient, what may happen?

may be a good reason to disclaim the policy and may make it easier to award damages to the injured party in a legal case

The medical records of a patient is the:

written account of what has happened to the patient during a special time

What is required of the patient's report/record to contain?

sufficient information to justify diagnosis, course of illness, management, and treatment in which it contains only facts and not conclusions

Grady's medical records is contained within:

EPIC

The functions of the patient's medical records is:

- It is a source of accurate information between health professionals and other legitimate or appropriate persons or agencies

- It is an official document, it is a confidential document and is the physical property of the hospital, doctor's office, or agency

- It serves as a data base for planning individual care and clinical data

- It serves as an objective witness to certain events that occurred in a health care setting

The standards of the Joint Commission for the Accreditation of Hospitals recommends the following policies for radiology service in the hospital:

- The radiology services in the hospital/medical center be directed by a qualified radiologist who is recognized by the American Board of Radiology

- There shall be adequate numbers of technical staff to conduct radiology services

- There shall be sufficient space, equipment, and supplies for the performance of radiology services

- There shall be written policies and procedures governing radiology services

What should a consent form contain?

a signature by the patient or guardian, witnessed and dated

A record of the patient's medical care that is used to transmit information about the patient from one healthcare worker to another that should be kept in confidence is known as:

charts (or for Grady, EPIC)

All contradictory information must be check out by a physician is known as:

request or requisition

Who is the only one that has authority over his/her body as long he/she is conscious and competent?

the patient upon whom the procedure is to be performed

When is the consent invalid for a patient?

if the patient is intoxicated, under the influence of narcotics, delirious, and/or irrational

What is essential when it comes to an individual's right to make his/her own decisions?

to respect the patient's decision for themself

What should be done if the patient is mentally incompetent?

consent must be obtained from a person legally authorized to give consent for the patient (i.e. an elderly or infirm person may have had to foresight to authorize a power of attorney designated a child or relative to act on their behalf)

When should a spouse's consent be obtained for a patient?

only in case of an emergency

At what age do most states consider a minor to be the age of majority and no longer under the jurisdiction of their parents?

18 years

When are minors allowed to consent for his/her own care?

if they are married, emancipated, pregnant, suffering from venereal disease, or in need of psychological or psychiatric care

What does emancipated mean when talking about obtaining consent for minors?

the individual is allowed to consent for themselves as the individual is no longer under the control of another as the minor is working and responsible for one's own support and necessities

implied consent

consent which is not expressly granted by a person, but rather implicitly granted by a person's actions and the facts and circumstances of a particular situation (or in some cases, by a person's silence or inaction)

Patient's Bill of RIghts, Radiology Services & Forensic Radiology

Patient's Bill of Rights consist of:

The patient has the right to:

- proper care

- information on diagnosis, treatment, and prognosis

- names of people treating him/her

- refuse treatment

- privacy

- confidentiality

- expect the hospital to make reasonable response to a request for services

- information on affiliated healthcare institutions

- advised of human experimentation affecting his/her care

- expect reasonable continuity of care

- examine and receive an explanation of his/her bill

- know hospital rules and regulations

What MUST be maintained in terms of a knowing a patient's medical details, consultation, and treatment?

strict confidentiality

What are medical charts? What is documented in them?

recordings of medical care that are maintained for every patient in which they document all patient visits, treatments, medications, and medical procedures (such as radiology reports) whether it be electronic or on paper

TRUE/FALSE: Medical charts contain only facts and not conclusions

true

What is the purpose of a hospital medical chart?

to transmit information about the patient from one health worker to another

What do medical charts protect and provide?

health workers, the patient from medical error, and provide data for medical research

Medical charts also act as what?

legal record that may be subpoenaed into a court of law as evidence

TRUE/FALSE: All information included in a medical chart is confidential

true

TRUE/FALSE: If the RT needs to consult a patient's chart, he may disclose its content to anyone not directly responsible for that patient's care

false, he may NOT disclose such content to anyone

Policy of Ownership

The American College of Radiology has adopted the following statement regarding ownership of images for the guidance of hospitals and physicians:

- Images should be used for best interest of the patient

- Images are the legal property of the radiologist, physician, or hospital in which they are made

- It should be the policy of the radiologist to make the images available to the attending physician with a copy of the report

- If the referring physician or the patient, on behalf of the referring physician, wishes to take the images away from the office or hospital, it should be clearly understood the are "on loan" and are the physical property of the hospital

- If the patient dismisses the referring physician and goes to another physician, the images and report should be made available to the new physician

The American College of Radiology has adopted the following statement regarding ownership of images for the guidance of hospitals and physicians (continued):

- If the referring physician, on being dismissed from the patient, objects to the images being sent to the second physician the radiologist/physician must send the images/reports in spite of the objection

- All images should be diagnostic and permanently marked, identified, and dated

- When medico legal situations exist, the radiologist has the right to refuse to release the images for his own protection, except when the images/reports are subpoenaed by the court

Medico Legal Use of Radiographs: Who is the only person that may diagnose a patient according to their images?

the radiologist

Images (radiographs) taken in a hospital, clinic, or emergency center are the property of (or owned by) who?

the property of the facility

The patient and physician are entitled to what in terms of radiographs?

the report, but not the images

TRUE/FALSE: Patients are unusually perceptive to the conversations surrounding them. Overhearing talk concerning another patient's illness or treatment may be misinterpreted.

true

TRUE/FALSE: Loud talking, laughing or joking has a place in the radiology department and represent a sense of responsibility and sincerity to the patient

false, it has no place as it represents more of an irresponsibility and lack of sincerity to the patient

health care team

consists of a large group of people with varied skills and responsibilities and organized to form a chain of command as the radiographer is an important member of this team with significant responsibilities to the patient and the team

Chain of Command for Radiology

- medical director

- chief radiologist

- staff radiologist

- resident radiologist

- administrative director

- administrative technologist

- supervising technologist

- technologist in charge

- student technologists

The use of forensic radiology is to:

determine whether bones are actually present whether they are human, and to determine basic features such as age, sex, and stature

Forensic radiology compares what two sets of images?

ante-mortem versus post-mortem views

ante-mortem

before death

post-mortem

after death

What are some ways to identify bodies after death?

dental and skeletal images (teeth and bones), old injuries, and foreign bodies (i.e. bullets or shrapnel)

X-ray imaging techniques are helpful in determining what?

cause of death

Death can be easily determined with x-ray images and can show death caused by:

a penetrating wound, strangulation, drowning, electrical shock, metallic poison, and/or blast injuries

TRUE/FALSE: In multiple injury cases, images will enable the radiologist to discover which wound was fatal

true, imaging can determine which wound was fatal in multiple injury cases

Forensic Deaths

In a court of law, what can radiographic images be introduced as? Who typically introduces the radiographic images?

evidence presented by a physician who requested the radiographs or by the radiographer who took them for identification purposes

Radiographic images are valueless as legal evidence unless there is complete proof of the patient's identity. What should always be permanently imprinted on a patient's image?

patient's name or MRN, x-ray number (right or left markers), date of service and the place where the images were taken

Battered Child Syndrome

radiologic appearance of bizarre and unusual injuries of the bone in affected children (i.e. EX: fractures of different ages in the same child, not just a scrapped knee)

Battered Child Syndrome is also known as:

Non-Accidental Trauma (NAT)