Healthcare Quality: Medical Errors and Liability

Healthcare quality issues are a typical legal issue. People who emphasize on serving others must address the ethical and social values. Policy makers must lead others in setting standards and, therefore, defining moral or acceptable behavior. Healthcare leaders must act in compliance with these accepted standards as they are the foundation for clinical practice.

Medical Errors

Medical errors are public health problems that require strong attention from policy makers and the legal system. One study estimated that there are 44,000 Americans die each year as a result of hospital-related medical errors; however, another study suggested the number to be as high as 98,000. Causes of medical errors include failing to complete an intended medical course of action, implementing the incorrect course of action, using erroneous equipment or product that can have adverse effects on a course of action, failing to keep abreast of the latest findings and recommendations for clinical practice, and acting negligently. According to a 2006 report from the Institute of Medicine, 1.5 million injuries or deaths occur each year in the United States due to errors in the prescribing, administering, and dispensing of medications.¹ Between 1983 and 1993, fatal medication errors among outpatients doubled. Prescribing mistakes appear in 7.6% of outpatient prescriptions, which added up to 228 million errors in 2004. In 2007, approximately 25% of elderly patients received high-risk medications.²

Medical Liability

Medical negligence fits into the larger legal field of torts.² There are 2 theories involved: one premised on hospitals’ relationship with physicians, which is referred to vicarious liability; and one based on the actions and decisions of hospitals themselves that control the field of hospital liability, which is called corporate liability.¹

Vicarious liability

This type of liability ensures that one party can be legally responsible for the actions of another party and it is based on the type of relationship that exists between 2 parties. As a result of a physician’s malpractice, the hospital is held responsible. This is not because the hospital acted inadequately—it is because the physician is an agent of the hospital. However, most physicians are not formal employees; rather, they are independent contractors. As a result, hospitals are not legally responsible for the illegal actions of these independent contractors.¹

Corporate liability

Corporate liability holds hospitals liable for their own institutional actions that may lead to a patient injury. There are several areas that directly impact patients’ quality of care that include failure to screen out incompetent healthcare providers, failure to keep high-quality standards, failure to take proper action against clinicians who practice below accepted standards, and failure to provide proper equipment and supplies. An example of a corporate liability is the lawsuit of Darling v Charleston Community Memorial Hospital. In the case, 18-year-old Dorrence Darling broke a leg while playing football. He was taken to the emergency department at the Charleston Community Memorial Hospital. Unfortunately, the staff did not construct his leg cast properly, which ended up in cutting off blood circulation that consequently resulted in amputation of his leg below the knee. In this case, the court held the hospital responsible for the improper actions of the emergency room staff. It was clearly evident that the hospital did not maintain a sufficient number of qualified nurses for post-emergency bedside care.¹

Financial Incentives to Encourage Utilization of Electronic Infrastructure

Quality care concerns must be investigated and reduced in order to promote high-quality care. While medical errors can occur regardless of the amount of precautions taken, the use of electronic medical records and electronic health records can reduce medical errors and facilitate managements of costs and support all aspects of health industry. In addition, technology promotes a safe environment for healthcare professionals by reducing negative exposure to risk and liability.

Read the previous article on healthcare quality and the use of health technology.

References

1. Teitelbaum JB, Wilensky SE. (2013). Essentials of health policy and law (2nd ed.). Boston, Mass: Jones & Bartlett Learning.
2. Bodenheimer T, Grumbach K. (2012). Understanding health policy: A clinical approach (6th ed.). New York: McGraw Hill Medical.