3 million dollar lawsuit verdict

  1. http://post-gazette.com/pg/07328/836466-85.stm
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  2. 9 Comments

  3. by   pickledpepperRN
    This was a PA not an NP.
    If the agreement or licensure required the physician to see every patient treated by the PA and did not it is am error.

    What is the scope of practice of a PA in that state?

    Terribly sad.
  4. by   caliotter3
    Very sad indeed. If those in the office had been following their own procedure of each patient being seen by the doctor, perhaps the doctor would have caught this and prevented all this heartache and suffering. They are wrong for not following their own procedure.
  5. by   heartrn35
    This is why doctors and any medical professional are leaving Pennsylvania in record numbers. I'm not saying that the PA was right, but from this report there is a lot of room for interpritation. The woman had a infection in her brain, if they would have started her on abx immediately would she still have suffered some of the affects? we will not know from this report, but it would be nice to know where the truth is.What I'm trying to say is if my patient is complaining of a headache with some nasal discharge, and lives in western Pennsylvania (lots of plants) I'm thinking allergies or a cold. I'm not thinking brain infection. I don't know about you folks but I wouldn't even think to test the drainage for csf, or any other more appropriate test. It's easy to look back at the circumstances and see what went wrong, but would any of us done something different?
  6. by   Jolie
    Quote from caliotter3
    They are wrong for not following their own procedure.
    Truer words have never been written (in regards to healthcare anyway).

    Failure to follow existing policy and procedure, whether in a doctor's office, out-patient setting or hospital is suicide in terms of trying to defend against allegations of malpractice.
  7. by   caldje
    i got this in my email and am curious as well. There is a lot missing in this story. It is very strange for a doc to see every patient a PA sees. I also wonder if the PA said "if things aren't better in a few days come back and see me." It is very common for rhinosinusitis to be viral and one of the key difinitive factors is length of symptoms. If symptoms had only been present for 3 days then it most likely would have been viral and an antibiotic is not indicated.

    The real issue in this story is the steroid. I can't figure out why on earth you would hand someone a steroid in this situation??

    Either way, the PA messed up in one way or another.. they didnt document enough, they gave a steroid when some afrin would have been fine.. they didnt say return to the office if worse or no better... whatever it was.. it was the PA's fault, not the docs.. This is a case of some folks trying to get as much as they could and by suing everyone in the office (TWO docs and a PA) they managed to do so. We'll see what the appeal says.
  8. by   Jolie
    caldje,

    You make some interesting points. But it is my understanding that PAs are not licensed to practice independently of physicians, so in effect, the physician is liable for errors the PA may make.

    While working in NICU, I cared for a preemie born at about 28 weeks gestation who suffered serious complications and was likely to have life-long health needs. Her mother had called the OB office c/o symptoms of a UTI (which are often similar to those of pre-term labor). She spoke to the office assistant (not the RN) who stated she would relay the information to the MD. Well, she apparently forgot to do so. At the end of the day, the patient called back, stating that she had not heard from the physician. The assistant told her that he had called in a prescription for an antibiotic to the pharmacy, and she should let the office know if she was not feeling better in a day or two. The assistant called in the script herself. After a day of antibiotics, and not feeling better, the patient called the office back, at which time, the assistant's actions came to light. The patient was in labor, too far along to stop, and delivered a severely preterm baby.

    The patient and her husband sued the MD for damages to help cover their child's lifelong medical expenses. They stated that they felt bad doing so, since he had no knowledge of the assistant's actions, but they needed revenue to care for their child, and he was ultimately responsible for his employee's actions.

    I realize that the deliberate actions of this assistant are not the equivalent of a PA's mistake, but practice agreements and licensing requirements make the physician responsible for the actions of his employees.
  9. by   caldje
    Quote from Jolie
    caldje,

    You make some interesting points. But it is my understanding that PAs are not licensed to practice independently of physicians, so in effect, the physician is liable for errors the PA may make.

    I realize that the deliberate actions of this assistant are not the equivalent of a PA's mistake, but practice agreements and licensing requirements make the physician responsible for the actions of his employees.
    If the supervision agreement stated that the doc would see every patient the PA saw (far from necessary and not required by law in penn.) then yes the doctor is liable because he was not following his own agreement. However, if a PA makes a mistake completely independent of a doc's input the PA is the one who is liable. PAs are licensed to practice medicine under the supervision of a physician.

    The question is, why did the PA give steroids? Were they NASAL steroids? and if so, was the PA even that wrong or did the patient just not follow up appropriately. Then, beyond that, had the doctor's actually agreed to see every patient the PA saw or is that a misinterpretation.

    In regards to your story, the assistant was an unlicensed medical person so they could not be held responsible for their own medical decisions. They COULD be put in jail for practicing medicine without a license though.

    Thanks for sharing your story, we all learn a lot from (hopefully) other people's mistakes.
  10. by   NursingAgainstdaOdds
    Quote from Jolie
    caldje,
    While working in NICU, I cared for a preemie born at about 28 weeks gestation who suffered serious complications and was likely to have life-long health needs. Her mother had called the OB office c/o symptoms of a UTI (which are often similar to those of pre-term labor). She spoke to the office assistant (not the RN) who stated she would relay the information to the MD. Well, she apparently forgot to do so. At the end of the day, the patient called back, stating that she had not heard from the physician. The assistant told her that he had called in a prescription for an antibiotic to the pharmacy, and she should let the office know if she was not feeling better in a day or two. The assistant called in the script herself. After a day of antibiotics, and not feeling better, the patient called the office back, at which time, the assistant's actions came to light. The patient was in labor, too far along to stop, and delivered a severely preterm baby.
    Such a sad story. Issues like this are precisely why I get so upset when a receptionist attempts to exert decision-making over my family's (or my own) health care. It's unfortunate but commonplace in this system. Also, the example you provided illustrates how a universal health care system and a less litigious society go hand-in-hand.
  11. by   oramar
    Quote from caldje
    If the supervision agreement stated that the doc would see every patient the PA saw (far from necessary and not required by law in penn.) then yes the doctor is liable because he was not following his own agreement. However, if a PA makes a mistake completely independent of a doc's input the PA is the one who is liable. PAs are licensed to practice medicine under the supervision of a physician.

    The question is, why did the PA give steroids? Were they NASAL steroids? and if so, was the PA even that wrong or did the patient just not follow up appropriately. Then, beyond that, had the doctor's actually agreed to see every patient the PA saw or is that a misinterpretation.

    In regards to your story, the assistant was an unlicensed medical person so they could not be held responsible for their own medical decisions. They COULD be put in jail for practicing medicine without a license though.

    Thanks for sharing your story, we all learn a lot from (hopefully) other people's mistakes.
    You bring up a good point. It is hard to trust these stories sometimes because people's qualifacations are so often misstated. They identify everyone from dietary aides, to pharmacy tech's as well as N.A.s as nurses. They could easily say a medical assistant is a PA, Lord knows they frequently refer to them as nurses. They really don't know the difference between PAs and NPs that is for sure.

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