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Healthcare Risk Management

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  • Severe Hypoxia During Delivery Results in Permanent Brain Damage, $15 Million Verdict

    This case presents a multitude of breaches of the standard of care that cumulatively gave rise to the liability and significant verdict in this matter. In the complaint, the patient alleged the physicians breached their duty of care on multiple factual bases, including by failing to disclose all the risks associated with VBAC, violating the hospital’s standard operating procedure, failing to monitor the fetal heart rate continuously, allowing the patient to ambulate, and failing to identify early signs of fetal hypoxia.

  • Causation Difficult for Plaintiff in ED Malpractice Claim

    Generally, plaintiff attorneys find some aspect of care that was arguably beneath the standard of care. Likewise, they can show the ED provider was acting in the scope of his or her employment. However, causation often is a difficult problem.

  • Patient Selection, Standardization Can Reduce Surgical Liability

    One-quarter of all malpractice claims in a recent closed claim study involved surgical allegations, second only to diagnosis-related allegations. The authors of the study said standardization and practice contribute to successful outcomes. Routine and rigor also are vitally important.

  • Fall Prevention Always Is a Concern; Innovative Products Help

    There has been progress in fall prevention, but there is much more room for improvement. Some organizations are finding success with innovative products that can help reduce falls.

  • Medical Record Retention Requires Good Policies, Strict Compliance

    Records retention is a critical issue for risk managers, as the loss of important patient records and other documents could compromise litigation defense and threaten ongoing care. Healthcare organizations must create clear records retention policies and follow them closely, experts say.

  • HHS, CMS Easing Some Abuse Rules, Will Reduce Compliance Burden

    The Department of Health and Human Services and the Centers for Medicare & Medicaid Services are trying to reduce regulatory burdens on healthcare organizations with rule changes that would protect some activities from anti-kickback allegations. The changes are intended to promote value-based care.

  • Surgeon Sues Health System for ‘Forced Referrals’

    A Florida health system is facing a whistleblower lawsuit from a surgeon alleging the system violated federal law by requiring him to perform surgery and refer patients within its own facilities. The surgeon claims the health system fired him for not complying with the policy. The mandatory self-referrals violate the Physician Self-Referral Law and other statutes, the lawsuit claims.

  • Wrong Person Receives Bill, OCR Secures $2.175 Million Fine

    Sentara Hospitals in Virginia and North Carolina agreed to take corrective actions and pay $2.175 million to settle potential HIPAA violations stemming from a complaint alleging the organization sent a bill to an individual containing another patient’s PHI. OCR determined Sentara mailed 577 patients’ PHI to wrong addresses.

  • HIPAA Settlements Hold Lessons on Right of Access, Breach Reporting

    The Office for Civil Rights (OCR) recently announced two HIPAA settlements that offer lessons for covered entities regarding right of access and failure to notify after a breach. In early 2019, OCR announced it would take steps to enforce the rights of patients to receive copies of their medical records timely and at a reasonable cost. This led to the introduction of the HIPAA Right of Access Initiative.

  • Expect More High-Tech Breaches, Attorney General Audits This Year

    The trend for HIPAA compliance is toward more breaches and complex breaches than seen in earlier years of efforts to follow the privacy rule, say some experts. A sharp increase in cyberattacks also may be coming this year.