LEGAL IMPLICATIONS

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LEGAL IMPLICATIONS

• LAW THE HEALTH
• FIELD

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• Peculiar to healthcare organizations is the
  fact that patients are often helpless and at the
  mercy of others. They are far too often places
  where the morally weak and mentally deficient
  prey on the physically and sometimes mentally
  helpless. The very place meant to make people
  feel well and safe can sometimes provide a
  setting for criminal conduct.
• Legal and Ethical Issues, Pozgar, George 2005.

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Advanced Level Radiography

• More complex, additional responsibilities,
  possibly make person more vulnerable to legal
  action
• 3 major areas to protect themselves
• Knowledge
• Careful attention to details
• documentation

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Advanced Studies follow same general procedures

• Strict confidentiality
• Pre- exam consultation
• Drug awareness
• Signed/ witnessed informed consent
• Prepared equipment
• Proper documentation
• Patient instruction/ pre- exam care

• Intra- exam care
• Contrast admin/ filming/ interventional treatment
• Post-exam care/ instructions
• Awareness of risks assoc. w/ catherization, etc.
• Patient discharge

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Criminal law Civil Law

• Protects community against certain acts
• Felony
• 1000.00 and more than one yr in jail
• Misdemeanor
• Less serious nature of crime
• Fine or lt1000 and lt than one year in jail

• Persons private legal rights are violated
• Violator pays sum of money or repair damages
  (Judge Judy!)

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Terms you should know

• Gross negligence- reckless disregard for life
  or limb
• Contributory negligence- behavior of injured
  party added to injury
• Res Ipsa Loquitur - the thing speaks for
  itself
• Respondeat Superior- master speaks for the
  servant
• Tort Law- patient feels injury for which they
  should receive damages
• Intentional Torts- wrong committed intentionally

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Ethical Principles

• Autonomy
• Beneficence
• Nonmaleficence
• Justice
• Paternalism
• Veracity

• Provide a framework to analyze particular ethical
  situation
• Help in making behavioral choices

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The use of foreign objects and foreign substances
in angiography/interventional radiography, CT or
MRI mandates the need for patient information and
informed consent.
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Name some possible reactions to contrast media.
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Informed Consent

• Necessary anytime there is a procedure that
  involves substantial risk
• Informed and ?s answered
• Expressed verbal or written
• Implied- non- verbal, suggested by actions
• Emergency situations
• Inadequate- consent given w/o adequate information

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Informed consentPhysicians should

• Explain procedure in advance
• nature of procedure (techniques used)
• anticipated outcome
• risks and benefits/alternative procedures and
  risks and benefits of these procedures

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Consent form

• Signed by patient
• Witnessed by impartial bystander
• SHOULD NOT BE WITNESSED BY RADIOGRAPHER

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THE CONSENT FORM
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THE CONSENT FORM SHOULD HAVE

• Written in language patient understands
• Authorization clause- facility and personnel
  involved
• Disclosure statement- risks, benefits, nature,
  purpose, alternatives to procedure
• Statement that info explained and pt. consents
• Signature of patient
• Signature of disinterested party

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In cardiovascular interventional studies, the
physician should obtain the written consent.
However it may become the responsibility of the
interventional technologist
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PROPER DOCUMENTATION AND RECORD KEEPING IS
VITAL!!!!
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PROCEDURE DATA FORM

• Is completed by?
• Name the info that should be noted on the
  procedure data form during an interventional
  study

• Pt info
• vitals (B.D.A.)
• Personnel
• type/amount of contrast
• other meds
• fluoro time
• size and number of exposures
• other notes

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Complication/incident report

• What was complication/incident
• Treatment/course of action
• follow-up procedure
• given to risk management
• Not considered part of pts medical record

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PROTOCOL AND PROCEDURES MANUAL

• Written document to ensure consistency in
  procedures
• Includes protocol from scheduling through
  dismissal
• Easily accessible
• all new employees should be given one to
  familiarize themselves with department
• should be reviewed and revised as needed

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LEGAL LIABILITY
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BURDEN OF PROOF FALLS ON THE PATIENT

• Duty of care
• Breach of duty
• Injury
• Causation

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Intentional Torts- harm done deliberately

• Assault- intent to do harm
• Battery- touched inappropriately/wrong exam
• False Imprisonment-restraints w/o permission
• Defamation of character- slander
• Causing extreme emotional distress by outrageous
  or shocking conduct resulting in illness

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Res Ipsa Loquitur ( patient care- Ehrlich)

• the thing speaks for itself
• How a patient is injured through no fault of his
  or her own while under the complete control of
  another

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Respondeat Superior

• Master speaks for the servant
• Facility and/or physician is held responsible for
  negligent act
• However, the technologist is responsible for his
  or her actions IF named in a lawsuit
• Good Samaritan laws
• Malpractice Insurance

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CR/PACS/Teleradiography

• How is this affecting the legal climate of the
  medical institution?
• HIPAA- Health Insurance Portability and
  Accountability Act (1996)
• Protects privacy and security of information
• Applies to electronic and transmitted images
• Restricts access, disclosure and training
  requirements and enforcement