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Communication Is Key

November 2019  |  Jeff Williams, JD

In the practice of pediatric medicine, physicians care for arguably the most innocent and vulnerable subset of our population, children. When a child suffers an adverse outcome while under the care of a physician and other caregivers, it has a profound effect on the family, the medical providers, and, often, ...

No Perfect Cases

October 2019  |  John T. Ryman, JD

On June 1, a 24-year-old obese female patient at 11 weeks gestation presented to the OB-GYN clinic to see Dr. Smith.[1] She had been treated at the clinic for her three prior pregnancies. At the patient’s visit on September 3, Dr. Smith scheduled the patient for a three-hour glucose tolerance test (GTT)...

Who's In Your Net?

September 2019  |  Tim Rector, JD, MBA

In military communications parlance, your “net” is defined as several people on the same radio frequency channel as you. An axiom followed by leaders in the United States Army in order to win on the battlefield is, “Shoot, move, and communicate.” Timely and effective communication is t...

Details Matter - Take the Time to Do It Right

August 2019  |  Stephanie Deupree, JD, BSN

The Taylor1 family had a history of prostate cancer throughout the last couple of generations of their family tree. When Moses Taylor, age 63, received his prostate cancer diagnosis, he finally convinced his brother Malachi, age 59, and his son Martin, age 42, to see the local family medicine physician for a ...

Throwing Stones

July 2019  |  Tim Behan, JD

Words matter. Words may matter even more in the medical profession. Health care providers work in glass houses. What is said, how it is said, and most importantly, how it is interpreted by the listener, can lead to serious and time-consuming consequences. You may think your words are benign or comforting, but...

Shoulda, Coulda, Woulda

June 2019  |  Zynthia T. Howse, JD

"Shoulda, Coulda, Woulda. It's so easy in the past tense." - Sarah Dessen Contrary to popular belief, all medical negligence claims do not start and end with a physician or even a licensed healthcare provider. You may be thinking – “what are you talking about? Only a physician or healthcare provi...

Know Your Medical Devices

May 2019  |  Jamie Wyatt, JD

The United States is the largest medical device market in the world, generating over $180 billion in annual revenue. [1] An area of growing concern for some in the healthcare community, but often unknown to patients, is the role of medical device sales representatives in patient care. Among these concerns are...

Don't Just Assume...Or You May End Up As a Defendant

April 2019  |  Kathleen W. Smith, JD

Bear with me, but I presume you are familiar with the colorful colloquial saying about what happens to us when we assume. (If not, just Google it. I will spare you the quote itself, in an effort to maintain some level of decorum.) Despite this “advice,” we make assumptions daily. We assume that ev...

Communication is in the Eye of the Beholder

March 2019  |  J. Baugh, JD, CPA

Over the years, SVMIC has emphasized the importance of effective communication as it relates to providing medical care. The physician should attempt to effectively communicate with patients as well as with other healthcare providers. Patients sometimes claim after the fact that they didn’t really unders...

Practice Makes Perfect

February 2019  |  Matthew Bauer, JD

Physicians often feel anxious and fearful when faced with a medical malpractice lawsuit, even when they have rendered appropriate medical care and committed no medical mistake. This anxiety and fear likely stems from physicians’ belief that they have little or no control over the outcome of their case. ...

Only a Phone Call Away

January 2019  |  Stephanie C. Hatchett, JD

Tommy Waddell,* a 55 year-old truck driver, finally sought care from neurosurgeon Andrew Lewis when his back pain became disabling. Waddell’s history included spinal stenosis, prior disc surgery, DVTs (for which he took warfarin), diabetes, obesity, and other health issues. Physical therapy provided lit...

Self-Inflicted Wounds

November 2018  |  Jeff Williams, JD

Lisa Owens was a sixty-year-old female.[1] By most standards, she had a good life. Mrs. Owens had a loving husband, adult-aged children and young grandchildren. Mrs. Owens and her husband were both at the twilight of their respective careers and were looking forward to retirement, which meant spending more ti...

Judge a Man by His Questions Rather Than by His Answers

October 2018  |  Jamie Wyatt, JD

Communication is one of the most important facets of human life and interaction. The ability to exchange information is a skill learned early on in our lives. Yet, despite our early introduction to communication and the vital role it continues to play in our lives as we mature, it is frequently underestimated...

Know Your Medical Record

September 2018  |  Tim Behan, JD

Know your medical record. It’s an obvious statement. It’s a simple statement. On the face of it, it shouldn’t even be a necessary topic of discussion because it is presumed that we in fact do know our records. But that presumption is rebutted each and every day by reality. The reality of a s...

Perception Can Be Everything

August 2018  |  Zynthia T. Howse, JD

“It takes a lifetime to build a good reputation, but you can lose it in a minute.” - Will Rogers In general, physicians are widely respected. They are perceived as “healers” with good intentions. Physicians are members of society with remarkable abilities to help others. Statisti...

Through the Retrospectroscope: When Connecting the Dots to Diagnosis Comes Too Late

July 2018  |  Kathleen W. Smith, JD

Most of the time, diagnosing a patient’s medical problem is a straightforward process. The patient’s symptoms are recognizable, and the solution becomes clear to the clinician after formulating a list of differential diagnoses. On rare occasions, a clinician will encounter a confounding constellat...

Who Can Go the Distance? We'll Find Out in the Long Run

June 2018  |  John T. Ryman, JD

On a hot summer day in 2002, 55-year-old Mr. Adams[1] was working on his farm. When dismounting from the back of his truck, Mr. Adams fell and injured his left leg. He presented to the local ER later that day with complaints of left knee and ankle pain. Mr. Adams had a history of bilateral knee replacements. ...

A Time-out that Did Not Save the Day

May 2018  |  Dan Himmelberg, JD

Jim Logan,[1] a 54-year-old attorney and outdoorsman, had seen various providers over several years with occasional complaints of pain in one or both knees. In 2011, he injured his left knee while fishing. An MRI showed degenerative changes. Mr. Logan was initially treated with NSAIDS and pain medication. Six...

Back to the Basics: The Importance of Good Communication and Documentation in a Complex Case

April 2018  |  Stephanie Deupree, JD, BSN

Tony Green[1], a 29-year-old construction worker, presented to the emergency department of a small, regional hospital complaining of lower and upper back pain over two days after lifting some flooring at a worksite. He described the pain as worsening with movement and radiating through to his chest. He was ab...

When Instincts are Ignored

March 2018  |  William "Mike" J. Johnson, JD

Our instincts of self-preservation and “common sense” protect us from many hazards.  This article illustrates what can happen when those instincts are absent or ignored. The plaintiff, a middle-aged diabetic female, presented to a family practice physician for the primary purpose of obtainin...

If You Order a Test, Follow Up On It

February 2018  |  Judy King Reneau, JD, BSN

Peggy Sue White* was a busy lady. At 73 years of age, she was described by her husband of 57 years as his “whole world.” They had seven children together, 19 grandchildren and 11 great-grandchildren. She took care of him due to his poor health, made his doctor appointments and attended the appoint...

The Long Road of Litigation

January 2018  |  Alisa Wamble, JD

This Tennessee case involved the alleged wrongful death of a 42-year-old male who presented to the ER in early 2008 complaining of lower abdominal pain, fever, nausea, diarrhea, anxiety and severe distress. The patient had a four- to five-year history of diverticulitis, which was managed by diet. Dr. Long[1] ...

An Illusion of Communication

November 2017  |  J. Baugh, JD, CPA

“The single biggest problem in communication is the illusion that it has taken place.” - George Bernard Shaw SVMIC has written articles and given seminars over the years about the importance of communication as it relates to providing medical care to patients.  This article focuses on a case...

The Rest of the Story

October 2017  |  Kenneth W. Rucker, JD

“The memories of men are too frail a thread to hang history from.” John Still Paul Smith[1], a 52-year-old male, presented to the emergency room in a small community-based hospital with complaints of chest pain, shortness of breath, and nausea. Mr. Smith was quickly triaged and shortly thereafter...

Importance of Effective Communication

September 2017  |  Jamie Wyatt, JD

 “A time comes when silence is betrayal.”  -  Martin Luther King, Jr., The Time to Break Silence, 1967 We are bombarded with reminders of the importance of effective communication skills in our daily lives, whether the setting is professional or personal.  The importance ...

Who's On First, and Who's On Second?

August 2017  |  Stephanie C. Hatchett, JD

Who is ultimately responsible for notifying the patient of important test results?  If the ordering physician fails to do so, does any responsibility flow to the next provider in line, for example, the physician’s nurse practitioner?  Does responsibility flow outward to other providers who wer...

"We Are Sorry to Have to Inform You"

July 2017  |  Jim Howell, JD

All seemed well at a busy pediatric practice until a routine audit conducted by the Vaccine for Children program (VFC). When the VFC auditor reviewed the temperature log for the practice’s vaccine storage unit, numerous temperatures were noted to be out of conformity with guidelines. Non-conforming temp...

The Patient Who Cried Wolf

June 2017  |  Tim Behan, JD

We are all familiar with Aesop’s fable wherein a lonely shepherd boy seeks attention by crying out wolf. This trick brings villagers rushing to his side to protect the flock of sheep from an attack. But there is no wolf the first few times the boy shouts out this false alarm. When a real wolf does appea...

Putting the Cart Before the Horse?

May 2017  |  Zynthia T. Howse, JD

In life, and certainly in documentation, there is a right and wrong way to do things. Order is everything. It is a well-known fact that a complete, accurate medical record will foster quality of care. Most importantly, it is the footprint that guides the course of the patient’s medical care and provide...

Discontinuity of Care: Two Physicians, One Practice and One Patient's Tragedy

April 2017  |  Kathleen W. Smith, JD

“Continuity of care.”  We often think about this concept involving physicians in different specialties or groups, such as the doctor who treats the patient after us or the doctor who referred the patient to us.  However, when stripped down, the concept of “continuity of care”...

Summary Judgment Saves the Day

March 2017  |  Tim Rector, JD, MBA

Mary is a 60-year-old female who brought suit against a cardiologist alleging he failed to timely diagnose and treat her retroperitoneal hemorrhage following a cardiac catheterization.  Unfortunately, for Mary, this alleged failure to diagnose and treat her resulted in a cascade of multiple medical/surgi...

Sometimes, Action Is Required

February 2017  |  John T. Ryman, JD

Mr. Smith was 72, with a long history of various medical issues including coronary artery disease, carotid artery stenosis, chronic obstructive pulmonary disease, and peripheral vascular disease, when he was referred to cardiovascular surgeon, Dr. Jones.  The referral to Dr. Jones was by Mr. Smith’...

Successful Defense of Surgical Judgment

January 2017  |  Dan Himmelberg, JD

Mr. Gamgee1 was a 70 year-old male who was a smoker and slightly overweight.  He had a history of back pain and of a skin cancer removed 20 years before.  His hypertension had been treated over many years with various medications but was not well controlled. He presented to the Emergency Depart...

Indefensible Medicine

November 2016  |  Stephanie Deupree, JD, BSN

Nathan Brown,[1] a 55 year-old man, fell from a 6 foot ladder outside his home while working on a home improvement project. Mr. Brown was able to get up and ambulate after the fall. The fall caused pain from his left shoulder blade down to his rib cage and coccyx. He took over-the-counter medication for pain....

Your Adversary in a Lawsuit: It's Not Always the Plaintiff

October 2016  |  William "Mike" J. Johnson, JD

Debbie[i], a woman in her fifties, presented to the emergency department on a Saturday with left chest pain, left arm numbness, shortness of breath, nausea and vomiting; she had been experiencing vomiting for two days.  The ED physician, Dr. Smith, noticed that she had slightly elevated blood pressure an...

Everything Is Not As It Seems

September 2016  |  Judy King Reneau, JD, BSN

It was a warm day on a long July 4th holiday weekend when 39-year-old William[i], his wife, Carrie, and their two sons decided to go hiking on the family’s property where they intended to build a new home.  The site was undeveloped and mostly flat except for a steep ravine on the rear side of the p...

Hoof Beats in Medicine

August 2016  |  Alisa Wamble, JD

Occasionally the sound of hoof beats should lead a medical provider to consider a zebra – instead of a horse – when evaluating a complex medical presentation. This obstetrical case involved a 24 year old female who was pregnant with her first child. Megan[1] had no previous medical problems and h...

Tracking Matters

July 2016  |  J. Baugh, JD, CPA

Henry Jackson[1], a 50-year-old male patient, presented to the ER at a hospital near his home where he was seen for cold symptoms and progressively worsening headaches that were not responding to medication.  The ER physician ordered a CT scan for Mr. Jackson.  The scan showed sinusitis in the ethmo...

No Good Deed Goes Unpunished...Or Not?

June 2016  |  Kenneth W. Rucker, JD

A physician, even if approaching a situation with the best of intentions, must be careful not to go outside the bounds of his/her training and expertise. Samantha Smith[1] had struggled with back pain and muscle spasms through her teenage years due to the development of extremely large breasts.  This le...

Nice Guys Don't Always Finish Last

May 2016  |  Stephanie C. Hatchett, JD

As her gurney clattered toward the delivery room, Heather Carr[1] was excited about the birth of her second baby despite the need for a C-section.   Her husband would be at her side during surgery, she was healthy, in a major hospital attended by her own obstetrician, and thus she had no fear. ...

Documentation

April 2016  |  Jim Howell, JD

The possibility of developing breast cancer is a haunting concern for most women. A perceived delay in diagnosis is one of the leading causes of malpractice litigation in the United States. Juries can be expected to sympathize with breast cancer victims, and these cases can be very challenging to defend. None...

Leave No Stone Unturned

March 2016  |  Tim Rector, JD, MBA

The wise old saying “leave no stone unturned” is said to mean that one should do everything possible to find something or to solve a problem.  Well, we will see in the following claim that is very wise advice.  This case involved a 45-year-old male who underwent routine treatment for a ...

Compartment Syndrome

February 2016  |  Stephanie C. Hatchett, JD

The crowd cheered, the football snapped, and helmets clashed as players piled onto the running back.  A more ominous snap was heard, and 16-year-old running back, Jason[1], did not get up from the field.  The teenager was admitted to orthopedics via the ED, where studies revealed a comminuted close...

Glass Houses

January 2016  |  Jim Howell, JD

The adage about “people who live in glass houses” still holds true. This claim involved an obese 45-year-old-male who presented to his general surgeon with a ventral hernia. History included multiple abdominal surgeries and known adhesive disease. The patient was admitted to the local hospital, a...

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