Chapter 7 Standard of Care and its Breach

imissyou419's version from 2017-11-28 20:54


Question Answer
The greatest majority of claims against health professions are based onNegligence and most of these cases turn on whether the professional breached the standard of care.
The court typically undertakes a detailed review of the specific facts of the case in determining if the standard of care has been breached


Question Answer
What is the standard of care expected of general practitioners?a reasonable, competent general practitioner in all of the circumstances of the case. These practitioners are expected to know their own limits and when they should refer patients to those with greater expertise
GP and rural physicians are not responsible for what but they are held accountable for what?not responsible for a lack of medical facilities and specialists in their communities, but are accountable for the treatment and care they choose to provide
Locality rulebeen greatly narrowed due to modern communications and publishing technologies. All physicians are expected to keep abreast of developments in their fields of practice (before rural physicians working alone w/o specialist and comprehensive hospital services could not be held to the same standard as their urban colleagues)
In Canada, can doctors be held liable for advices they give in "corridor consultations" even if they are not paid?Yes
Residents medical school graduates can no longer serve as general practitioner after 1 year internship but rather must enter a residency program. Residents are expected to know their own limits
Can organizations be held vicariously liable for the wrongful acts of volunteers, students and trainees?Yes, even though they are not employees
What kind of liability will administrators and professional staff be held by for negligently screening, hiring, placing, training, and supervising volunteers, students and trainees?personally liable
What standard of care do volunteers, students, and trainees need to meet?not expected to meet the standard of care of professional staff, but are expected to have the knowledge, skills, and training to competently perform their assigned duties. Know their own limits and seek assistance


Question Answer
T/F, all health professionals have an affirmative duty in negligence to obtain an informed consent to proposed treatment, counselling and careT
What are the 2 key issues in informed consent cases?1. whether health professional breached the required standard of disclosure in informing the patient,
2. whether this breach was a cause of the patient's injuries (in effect, the failure to inform must have induced the plaintiff to have a treatment that he/she would not have otherwise had AND that treatment must have caused the plaintiff's loss)
Objective/subjective test of causationIn addition to proving he/she would not have had the proposed treatment if adequately informed, plaintiff must prove that a reasonable person in his/her position would have forgone the treatment
Material riskboth a very low possibility of death or other serious harm, i.e. 4% chance of death and 10% chance of paralysis, and a moderate possibility of minor harm i.e. 35% risk of minor infection. Thus, the materiality of a risk is based on both its severity and probability
Non-material riskhealth practitioners must inform patients of non-material risks that they know, or ought to know, would be a particular concern to a patient i.e. 15% risk of minor shoulder stiffness from surgery may be no concern to 60-year old accountant but concern to 20 year old professional tennis player
Disclosing errors in eyes of courtcourts have increasingly SUGGESTED that practitioners have a common law and fiduciary duty to inform patients of errors that have occurred in their treatment
CPSO require what?disclosure of HARM to the patient or his/her SDM. This arises from physician's fiduciary duty to the patient and in part of the physician's obligation to provide professional and ethnical health care
Regulation 965 of the Public Hospital Act require what?hospital administrators are required to establish a system for disclosure of "critical incidents" to the patient or his/her SDM.
Critical incident includes serious, unintended, or unexpected adverse events that are not primarily related to the patient's conditions
Apology Act 2009An apology is defined as an expression of sympathy or regret, whether or not it implies liability or fault.
The Act states that an apology does not, in law, constitute an express or implied admission of fault or liability, cannot void insurance coverage.
An apology is not admissible in civil, administrative, or arbitration proceedings as evidence of fault or liability, but this does NOT apply to statements made while testifying