Medical

What is ‘risk management’?
Clinical and administrative activities undertaken to identify, evaluate, and reduce the risk of injury to patients, staff, and visitors and the risk of loss to the organization itself. 

How long must a physician retain medical records?
First Professionals recommends that records be kept for at least a 10-year period from the point of last patient contact. For minors, records should be retained for 10 years beyond the last encounter or for four (4) years beyond the age of majority, whichever is greater.

Are e-mails pertaining to a patient part of the medical record?
Yes. All forms of electronic communication and information exchange, when in connection with a patient’s care and treatment, are considered personal health information and thus considered part of the medical record, subject to the same legal requirements and HIPAA privacy provisions as a traditional, hard copy.

Does state or federal law set forth a specific manner in which obsolete patient records must be destroyed?
No. However patient records must be destroyed in a manner that protects patient confidentiality. The best way to dispose of records is by shredding, mutilation or similar protective measures. If arrangements are made with third parties or entities for the destruction of patient records, a written agreement should be obtained clearly obligating the entity to safeguard confidentiality as well as indemnify and hold harmless you and your practice from any breach of confidentiality for which they are responsible. Clarify the timeframes of the specific record retention laws in the state in which you practice.

What basic elements comprise the informed consent process?
1) Proposed treatment or therapy; 2) risks and benefits; 3) likelihood of success; 4) treatment alternatives; and 5) potential outcome with no treatment.  The risk list need not be exhaustive; but rather material to the specific procedure, anesthetic, and patient involved. 

What action should be taken when a medical error is suspected or occurs?
Contact the Risk Management Department for guidance as soon as possible. Make no admissions of liability. Federal and/or state reporting requirements under strict time constraints may apply. Always attempt to discuss the situation with personal counsel or First Professionals before meeting with hospital risk management.

Should professional fees be waived or refunded when a patient is dissatisfied?
Not always. It depends on the particular situation. First, give the patient the opportunity to describe the reason for their dissatisfaction. Attempt to correct the situation, if possible. If the patient demands a refund, waiver of fees, or the issue cannot be remedied, contact the Risk Management Department or personal counsel for specific guidance. What some may interpret as an act of accommodation, others may view as an admission of liability.

Are x-ray films the property of the patient?
No. X-ray films are the property of the originating physician, dentist, or radiology group. By law, the patient may access their films and if requested, be furnished a copy. However, original films should never be released. The patient may be charged the cost of reproducing x-ray films. 

What action should be taken when a summons and complaint is received?
Immediately notify First Professionals by calling the Claims Department at (800) 741-3742, ext. 3047. If you are served, First Professionals only has a limited number of days to assign a defense attorney and prepare a response to be filed on your behalf. It is important that you not discuss the case with the patient, the patient’s attorney or any other parties involved in the care and treatment of the patient. You should gather and secure the patient’s records immediately.

What action should be taken when a 'Notice of Intent' letter is received?
 Immediately notify First Professionals by calling the Claims Department at (800) 741-3742, ext. 3047. First Professionals only has limited a limited number of days to prepare a response to the notice of intent on your behalf and assign a defense attorney, if necessary. It is important that you not discuss the case with the patient, the patient’s attorney or any other parties involved in the care and treatment of the patient. You should gather and secure the patient’s records immediately.  

What action should be taken when a patient is noncompliant or refuses to undergo diagnostic studies, care, or treatment?
Document your recommendations and the patient’s noncompliance. Advise the patient of the potential consequences of their noncompliance or refusal and document your discussion. Confirm the patient’s noncompliance, your subsequent discussion and the potential consequences in a letter to the patient sent certified mail, return receipt requested and send a copy of the letter by regular mail as well. Consider withdrawing from the patient’s care, but first review the language of any managed care contracts that may apply to the situation and seek guidance from our Risk Management Department or personal counsel. If you practice in a group setting, it may be necessary to withdraw on behalf of others in the group and the practice itself.

Does state law pertain to sample medications?
While the law varies from state to state, most state laws view the distribution of sample medications as dispensing medications. The sample medication should dispense the drug in the manufacturer’s labeled package with the practitioner’s name, patient’s name, and date dispensed.

Must a physician sign all progress notes made?
Although state law does not specifically require a signature, Medicare, Medicaid and most HMO’s require such documentation.

What elements should comprise a letter terminating the physician-patient relationship?
1) a statement of the patient’s condition; 2) an offer to render “emergency care only” for the next 30 days; 3) a specific ‘final treatment’ date, beyond which no care will be rendered; 4) a recommendation to immediately find another physician, if appropriate; 5) a description of possible outcomes if no further treatment is obtained; and 6) an offer to furnish the records to the patient or patient’s new physician.  In addition, a referral source for securing another doctor should be provided. Send the letter by both certified and regular mail.

What action should be taken when a patient discharges a physician?
Document the medical record and send written confirmation to the patient specifically indicating the date that your physician-patient relationship was terminated by the patient. If the patient is in the midst of diagnostic work-up, advise the patient and furnish a copy of all lab or diagnostic reports.

Is a specific timeframe set forth when withdrawing professional services to a patient?
No. Although statutes do not specifically set forth the amount of time a patient must be given, managed care contracts and provider agreements may stipulate notice timeframes. Generally, a 30-day notice period is sufficient, however, depending on the circumstances, a lesser time period may be appropriate. If the patient terminates the relationship, there is no further obligation to treat the patient, although First Professionals does recommend that you acknowledge the patient’s termination via a letter.  Always review the language of applicable managed care plans before terminating the physician-patient relationship.

Does the physician-patient relationship end at the time insurance coverage expires or managed care plan terminates?
No. Once established, the physician-patient relationship does not end merely because insurance is no longer available or a change in managed care coverage occurs. A physician’s responsibility to the patient continues unless and until the patient severs the relationship or the physician provides proper notification to the patient of the intent to withdraw from providing further care and treatment. Always seek legal or risk management guidance before terminating the physician-patient relationship.

How many Physician Extenders may be supervised by a physician?
The ratio of physician extenders to supervising physician will vary. While the American Medical Association does not state a specific ratio, it recommends that the appropriate ratio of physicians to physician extenders should be determined by physicians at the practice level, consistent with good medical practice, and state law where relevant. It is important to maintain a ratio consistent with the terms, if any, of your professional liability policy language.

What are the legal differences between a nurse practitioner and a physician assistant?
A nurse practitioner’s (NP) scope of practice varies from state to state. In many states, NPs are allowed to practice independently, without a physician. However, NPs often practice under the guidance of a licensed physician. A physician assistant (PA) is licensed to practice medicine under a physician’s supervision and can practice only under a physician’s license. A PA can conduct physical exams, diagnose and treat illnesses, order and interpret tests and in many states, write prescriptions.

What is an ‘incident report’?
The documentation for any unusual problem, incident, or other situation that is likely to lead to undesirable effects or that varies from established policies and procedures or practices. An incident report may also be referred to as an occurrence report or variance report.

Is the 'Universal Protocol' a requirement or just advice to be considered?
Effective July 1, 2004, compliance with the Universal Protocol For Preventing Wrong Site, Wrong Procedure, Wrong Person Surgery was required of all Joint Commission accredited organizations, to the extent that these requirements are relevant to the services provided by the organization.

What procedures fall within the scope of the Universal Protocol?
This Protocol and its Implementation Guidelines apply to all operative and other invasive procedures that expose patients to more than minimal risk, including procedures done in settings other than the operating room such as a special procedures unit, endoscopy unit, or interventional radiology suite. Certain routine "minor" procedures such as venipuncture, peripheral IV line placement, insertion of NG tube, or Foley catheter insertion are not within the scope of the Protocol. However, most other procedures that involve puncture or incision of the skin, or insertion of an instrument or foreign material into the body, including, but not limited to, percutaneous aspirations, biopsies, cardiac and vascular catheterizations, and endoscopies are within the scope of this Protocol.

Does the American with Disabilities Act (ADA) require that a translator be provided for non-English speaking patients?
No. However, Title VI of the Civil Rights Act does. Title VI of the Civil Rights Act forbids discrimination by any program that receives money from the federal government and requires that health and social service providers give their limited-English-proficient patients meaningful access to their services, which may entail offering translation services. These services must be provided to the patients free of charge.

How does the ADA affect a solo medical practice?
The ADA labor provisions do not affect employment practices for businesses that have less than 15 employees. However, the practice is considered a public accommodation and is generally required to be accessible to disabled patients. Barriers to access must be removed if alterations are “readily achievable”, which is determined by considering factors such as the nature and cost of the action, the owner’s and tenant’s financial resources and the impact of the action on the operation of the business. Such accommodations might include installing a ramp, making curb cuts, widening doorways, and modifying restrooms. Generally, these accommodations are made at the expense of the building owner. In most cases, local commercial building codes require such accommodations and may preempt ADA requirements.

Must a physician supply an interpreter at the request of hearing impaired patient?
Yes, in compliance with the Americans with Disabilities Act. These services must be provided to the patients free of charge.

Dental

What is ‘risk management’?
Clinical and administrative activities undertaken to identify, evaluate, and reduce the risk of injury to patients, staff, and visitors and the risk of loss to the organization itself.

What action should be taken when a patient is noncompliant or refuses to undergo diagnostic studies, care, or treatment?
Document your recommendations and the patient’s noncompliance. Advise the patient of the potential consequences of their noncompliance or refusal and document your discussion. Confirm the patient’s noncompliance, your subsequent discussion and the potential consequences in a letter to the patient sent certified mail, return receipt requested.  Send a copy of the letter by regular mail as well. Consider withdrawing from the patient’s care, but first review the language of any managed care contracts that may apply and seek guidance from the Risk Management Department or personal counsel. If you practice in a group setting, it may be necessary to withdraw on behalf of others in the group and the practice itself. 

Should professional fees be waived or refunded when a patient is dissatisfied?
Not always. It depends on the particular situation. First, give the patient the opportunity to describe the reason for their dissatisfaction. Attempt to correct the situation, if possible. If the patient demands a refund, waiver of fees, or the issue cannot be remedied, contact the Risk Management Department or personal counsel for specific guidance. What some may interpret as an act of accommodation, others may view as an admission of liability.

What action should be taken when a 'Notice of Intent' letter is received?
Immediately notify First Professionals by calling the Claims Department at (800) 741-3742, ext 3047. First Professionals only has a limited number of days to prepare a response to the notice of intent on your behalf and assign a defense attorney, if necessary. It is important that you not discuss the case with the patient, the patient’s attorney or other parties involved in the care and treatment of the patient. You should gather and secure the patient’s records immediately.  

What action should be taken when a summons and complaint is received?
Immediately notify First Professionals by calling the Claims Department at (800) 741-3742, ext. 3047. If you are served, First Professionals only has a limited number of days to assign a defense attorney and prepare a response to be filed on your behalf. It is important to not discuss the case with the patient, the patient’s attorney or other parties involved in the care and treatment of the patient. You should gather and secure the patient’s records immediately.

Does state law pertain to sample medications?
Yes. Most state laws view the distribution of sample medications as dispensing medications. The sample medication should be dispensed in the manufacturer’s labeled package with the practitioner’s name, patient’s name, date dispensed, and administration instructions.

What is the appropriate way to make charting corrections?
Errors in charting should be corrected by drawing a single line through the incorrect portion, initialing, and dating the correction. Additions to the chart should be dated contemporaneously with the entry and when appropriate, an explanation given for the addition.

What procedures should be followed when actual or suspected biological/chemical exposure is encountered?
Dentists should follow current guidelines issued by the Department of Health, Centers for Disease Control, and County Medical Societies. Carefully document in the patient’s chart the severity of symptoms and your clinical examination and findings.

Is a dentist responsible for the negligent acts of an employee?
Yes. Most employers are responsible for the acts of their employees. While specific statutory provisions may hold the employee directly responsible, it is the dentist who is primarily responsible for all delegated procedures. Depending on the allegations made, a dentist may also be held vicariously liable for the acts of others, including the dental practice or professional association. 

Does a dentist have the right to have legal counsel present when being deposed?
Yes. A deponent has the right to legal counsel at the time of deposition. Always contact the Claims Department or Risk Management Department before providing a deposition in order to determine if legal counsel is necessary and  will be assigned to represent you at the deposition.

How long must a dentist retain medical records?
First Professionals recommends that records be kept for at least a 10-year period from the point of last patient contact. For minors, records should be retained for 10 years beyond the last encounter or for four (4) years beyond the age of majority, whichever is greater.

Are x-ray films the property of the patient?
No. X-ray films are the property of the originating physician, dentist, or radiology group. By law, the patient may access their films and if requested, be furnished a copy. However, original films should never be released. The patient may be charged the cost of reproducing x-ray films.

May the dental records of a deceased patient be furnished to the surviving spouse?
Not automatically. Pursuant to most state laws, dental records may only be furnished to the patient or the patient’s “legal personal representative”. In the case of a deceased patient, this requires that the person seeking the record be appointed as the “Personal Representative of the Estate” of the patient. Alternatively, a party seeking production of the decedent’s medical records may obtain a Court Order to produce the records. A standard authorization for release of medical records is sufficient, providing that the requesting party executes the authorization “As personal Representative of the Estate of (patient name), Deceased”.

May a dentist condition providing a copy of the patient records upon the satisfaction of an outstanding bill?
No. A dentist cannot withhold copies of the dental records from a patient with an outstanding balance. The dentist may, however, charge the patient a fee as allowed by law for a copy of the record.

Is a specific timeframe set forth when withdrawing professional services to a patient?
No. Although statutes do not specifically set forth the amount of time a patient must be given, managed care contracts and provider agreements may contain language that does. Generally, a 30-day notice is sufficient, however, depending on the circumstances, a lesser time period may be appropriate. If the patient terminates the professional relationship, there is no further obligation to treat the patient, although First Professionals does recommend that you acknowledge the patient’s termination via a letter. Always review the language of applicable managed care plans before terminating the dentist-patient relationship.

Is the 'Universal Protocol' a requirement or just advice to be considered?
Effective July 1, 2004, compliance with the Universal Protocol For Preventing Wrong Site, Wrong Procedure, Wrong Person Surgery is required of all Joint Commission accredited organizations, to the extent that these requirements are relevant to the services provided by the organization.

What about dental procedures? I understand there have been several cases of extraction of the wrong teeth.
The American Dental Association (ADA) has been very supportive of efforts to eliminate wrong site surgery, including wrong dental extractions. However, the ADA acknowledges that there does not appear to be a practical or reliable method to actually mark the teeth that are intended for extraction. Therefore, dental procedures will be considered exempt from the site marking requirement. In lieu of directly marking the teeth, the ADA recommends—and the Joint Commission concurs with—the following:
        1. Review the dental record including the medical history, laboratory findings, appropriate charts and dental radiographs. Indicate the tooth number(s) or mark the tooth site or surgical site on the diagram or radiograph to be included as part of the patient record.
        2. Ensure that radiographs are properly oriented and visually confirm that the correct teeth or tissues have been charted.
        3. Conduct a "time out" to verify patient, tooth and procedure with assistant present at the time of the extraction (two person rule).

What basic elements comprise the informed consent process?
1) Proposed treatment or therapy; 2) risks and benefits; 3) likelihood of success; 4) treatment alternatives; and 5) potential outcome with no treatment.  The risk list need not be exhaustive; but rather material to the specific procedure, anesthetic, and patient involved.   What elements should comprise a letter terminating the dentist-patient relationship? 1) a statement of the patient’s condition; 2) an offer to render “emergency care only” for the next 30 days; 3) a specific ‘final treatment’ date, beyond which no care will be rendered; 4) a recommendation to immediately find another dentist, if appropriate; 5) a description of possible outcomes if no further treatment is obtained; and 6) an offer to furnish the records to the patient or patient’s new dentist.  In addition, a referral source for securing another dentist should be provided.  Send the letter by both certified and regular mail.

Does the ADA require that a translator be provided for non-English speaking patients?
No. However, title VI of the Civil Rights Act does. Title VI of the Civil Rights Act forbids discrimination by any program that receives money from the federal government and requires that health and social service providers give their limited-English-proficient patients meaningful access to their services, which may entail offering translation services. These services must be provided to the patients free of charge.

How does the ADA affect a solo medical practice?
The ADA labor provisions do not affect employment practices for businesses that have less than 15 employees. However, the practice is considered a public accommodation and is generally required to be accessible to disabled patients. Barriers to access must be removed if alterations are “readily achievable”, which is determined by considering factors such as the nature and cost of the action, the owner’s and tenant’s financial resources and the impact of the action on the operation of the business. Such accommodations might include installing a ramp, making curb cuts, widening doorways, and modifying restroom. Generally, these accommodations are made at the expense of the building owner. In most cases, local commercial building codes require such accommodations and may preempt ADA requirements.

Must a sign language interpreter be certified under ADA requirements?
No. The factor in determining whether effective communication will result is whether the interpreter is qualified, not actually certified by an official licensing body. A qualified interpreter is one who is able to interpret effectively, accurately and impartially, both receptively and expressively.

Must a dentist supply an interpreter at the request of hearing impaired patient?
Yes, in compliance with the ADA. These services must be provided to the patients free of charge.

HIPAA

What is the HIPAA Security Rule?
Security standards that were developed to protect electronic health care information. The Security Rule adopts a set of national standards for safeguards to protect the confidentiality, integrity, and availability of protected health information. 

Do HIPAA privacy regulations set forth Privacy Notice requirements for electronic communications such as websites?
Yes. If you maintain a website that provides information about your professional services, a Privacy Notice must be prominently displayed on the website and made available electronically through the website. The Privacy Notice may be made by e-mail if the patient agrees to electronic notice, however, the patient retains the right to obtain a paper copy as well. 

Do mandatory reporting requirements set forth by Florida statutes pre-empt HIPAA privacy provisions?
Generally, yes. A good example would be FS 381.003 which requires a physician that diagnoses or suspects the existence of a disease of public health significance to immediately report the fact to the Department of Health. However, because the legal waters pertaining to most HIPAA privacy provisions have yet been tested, it is wise to seek legal or risk management guidance first.

Does HIPAA Privacy law or Florida statutes require a physician to obtain the patient's written authorization in order to transfer their medical records at the time of sale or retirement from practice?
No. There are no requirements, under Florida law, to obtain consent when transferring medical records when a medical practice changes ownership per the Florida Medical Association’s "Florida HIPAA Preemption Analysis...."  According to the Federal Register "Health Care Operations:  Changes of Legal Ownership" the "sale, transfer, consolidation or merger" of a covered entity are considered health care operations.  Thus, the "covered entity may use or disclose protected health information in connection with a sale or transfer of assets..." and "transfer records containing PHI as part of the transaction" without the patient's written authorization.

Does HIPAA interfere with patient treatment?
No. Providers can freely share protected health information for treatment purposes without obtaining an authorization. 

Do HIPAA privacy rules impede criminal investigations and proceedings?
No. Hospitals can share information with law enforcement to identify and find criminals while still protecting the privacy of victims. 

Will HIPAA privacy rule compliance cuts patients off from their families and friends?
Patients decide who can be privy to their protected health information. If the patient is incapacitated, doctors can share protected health information when it is in the best interests of the patient.

Will HIPAA prevent others from hospital visits with patients?
Not necessarily. The patient decides whether to provide information for the hospital directory so that callers and visitors have access to their information. 

Do HIPAA privacy rules impede EMT services?
No. Emergency response teams can disclose patient information as needed to quickly find patients and get them to the hospital.

If you get served with a subpoena -- but no court order -- can you still disclose protected health information under HIPAA privacy rules?
Yes, according to the HHS Office of Civil Rights -- as long as you check off one of these criteria:
1. When you are neither a plaintiff nor a defendant in litigation, you may disclose PHI if you have made reasonable efforts to notify the individual whose PHI will be disclosed; or  the party seeking the PHI has made similar efforts --  and provides documentation proving that it provided the individual enough details and time to file objections to the disclosure. Otherwise, qualified protective court orders for the information should be sought. 
2. If you are a party to a legal proceeding, such as a defendant in a malpractice action or a plaintiff in a suit to obtain payment, you may use or disclose PHI as part of your health care operations. However, you must make reasonable efforts to limit such uses and disclosures to the minimum necessary to accomplish the intended purpose. 

If the patient is present and has the capacity to make healthcare decisions, when does HIPAA allow a health care provider to discuss the patient’s health information with the patient’s family, friends, or others involved in the patient’s care or payment for care?
If the patient is present and has the capacity to make healthcare decisions, a health care provider may discuss the patient’s health information with a family member, friend, or other person if the patient agrees or, when given the opportunity, does not object. A healthcare provider also may share information with these persons if, using professional judgment, he or she decides that the patient does not object. In either case, the healthcare provider may share or discuss only the information that the person involved needs to know about the patient’s care or payment for care. 

Under HIPAA privacy rules, may an emergency room doctor discuss a patient’s treatment in front of the patient’s friend?
Yes. Providing that the patient asks that the friend come into the treatment room.

Under HIPAA privacy rules, may a doctor’s office discuss a patient’s bill with the patient’s adult daughter?
Yes. A doctor’s office may discuss a patient’s bill with the patient’s adult daughter who is with the patient at the patient’s medical appointment and has questions about the charges.

Under HIPAA privacy rules, may a doctor discuss the patient’s drugs with a care provider who has accompanied the patient to a medical appointment?
Yes. Providing the patient has provided permission to disclose such information.

Under HIPAA privacy rules may a doctor give information about a patient’s mobility limitations to the patient’s sister who is driving the patient home from the hospital?
Yes. 

Under HIPAA privacy rules, may a nurse discuss a patient’s health status with the patient’s brother if she informs the patient she is going to do so and the patient does not object?
Yes. However, the nurse may not discuss a patient’s condition with the patient’s brother after the patient has stated she does not want her family to know about her condition.

Under HIPAA privacy rules, when a patient is not present or is incapacitated, may a health care provider still share the patient’s health information with family, friends, or others involved in the patient’s care or payment for care?
Yes.  If the patient is not present or is incapacitated, a health care provider may share the patient’s information with family, friends, or others as long as the healthcare provider determines, based on professional judgment, that it is in the best interest of the patient. When someone other than a friend or family member is involved, the healthcare provider must be reasonably sure that the patient asked the person to be involved in his or her care or payment for care. The health care provider may discuss only the information that the person involved needs to know about the patient’s care or payment.

Under HIPAA privacy rules, may a surgeon who performed emergency surgery on a patient tell the patient’s spouse about the patient’s condition while the patient is unconscious? Yes.

Under HIPAA privacy rules, may a pharmacist give a prescription to a patient’s friend?
Yes, providing that the patient sent the friend to pick up the prescription. 

Under HIPAA privacy rules, may a healthcare provider give information regarding a patient’s drug dosage to the patient’s health aide who calls the provider with questions about the particular prescription?
Yes. However, the nurse may not tell a patient’s friend about a past medical problem that is unrelated to the patient’s current condition. A healthcare provider is not required by HIPAA to share a patient’s information when the patient is not present or is incapacitated, and can choose to wait until the patient has an opportunity to agree to the disclosure.

Does HIPAA require that a healthcare provider document a patient’s decision to allow the provider to share his or her health information with a family member, friend, or other person involved in the patient’s care or payment for care?
No. HIPAA does not require that a healthcare provider document the patient’s agreement or lack of objection. However, a health care provider is free to obtain or document the patient’s agreement, or lack of objection, in writing, if he or she prefers. For example, a provider may choose to document a patient’s agreement to share information with a family member with a note in the patient’s medical file.

May a healthcare provider discuss a patient’s health information over the phone with the patient’s family, friends, or others involved in the patient’s care or payment for care?
Yes. Where a healthcare provider is allowed to share a patient’s health information with a person, information may be shared face-to-face, over the phone, or in writing.

If a patient’s family member, friend, or other person involved in the patient’s care or payment for care calls a health care provider to ask about the patient’s condition, does HIPAA require the health care provider to obtain proof of who the person is before speaking with them?
No. If the caller states that he or she is a family member or friend of the patient, or is involved in the patient’s care or payment for care, then HIPAA doesn’t require proof of identity in this case. However, a health care provider may establish his or her own rules for verifying who is on the phone. In addition, when someone other than a friend or family member is involved, the healthcare provider must be reasonably sure that the patient asked the person to be involved in his or her care or payment for care.

What are the penalties for HIPAA privacy rule violations?
Failure to comply with the provisions of the Privacy Rule may result in civil penalties of $100 per violation up to a maximum $25,000 per year for the same violation and criminal penalties of up to $250,000, imprisonment, or both for intentional violations.

Legal

What action should be taken when a summons and complaint is received?
Immediately notify First Professionals by calling the Claims Department at (800) 741-3742, ext 3047. If you are served, First Professionals only has a limited number of days to assign a defense attorney and prepare a response to be filed on your behalf. It is important that you not discuss the case with the patient, the patient’s attorney or any other parties involved in the care and treatment of the patient. You should gather and secure the patient’s records immediately.

What action should be taken when a 'Notice of Intent' letter is received?
Immediately notify First Professionals by calling the Claims Department at (800) 741-3742, ext 3047. First Professionals only has limited a limited number of days to prepare a response on your behalf to the notice of intent and assign a defense attorney, if necessary. It is important that you not discuss the case with the patient, the patient’s attorney or any other parties involved in the care and treatment of the patient. You should gather and secure the patient’s records immediately. 

At what age is a patient considered an ‘adult’?
Generally, a person is considered an adult at 18 years of age. However specific exceptions apply in terms of the age at which a patient may consent to treatment and/or entitled confidentially. For this reason, the patient’s age, medical condition, nature of treatment, and venue must be considered.

What is meant by the term ‘damages’?
A sum of money awarded to a person injured by the tort, or negligence of another.

What are ‘compensatory damages’?
Generally, damages designed to compensate the injured party. Compensatory damages include past, present and future medical bills, lost wages, and other expenses attributed to the negligent act or injury.

What are ‘punitive damages’?
Damages on an increased scale awarded to the plaintiff where the wrong done to him was aggravated by circumstances of violence, oppression, fraud, or wanton and wicked conduct by the defendant. The purpose is to punish the defendant. 

What is a ‘deposition’?
A deposition is testimony given under oath before a court reporter. Depositions are important in the preparation of a case for trial. Depositions also freeze testimony and can be used to impeach your credibility if you deviate from them later. They are used to discover facts of the case and to uncover additional witnesses. Depositions are also used to narrow the issues of the case. Failing to appear for a deposition may potentially subject you to a contempt of court charge. 

What is meant by ‘discovery’?
Pre-trial devices that are used by one party to obtain information about the case. Forms of discovery include depositions, written interrogatories, production of documents or things including medical records and personal records. Discovery can also include physical and mental examinations, requests for admission and information necessary to support a claim for damages.

What is meant by the term ‘direct liability’?
Direct liability may be defined as being responsible for your own acts. If you deviate from the acceptable standard of care, then you are negligent and directly responsible. 

What is ‘vicarious liability?
A term used to describe the imputation of neglect to another person not directly involved in an allegedly negligent act. Generally, the common law test under which vicarious liability is determined is that of direction or control of another’s actions.

What is definition of ‘malpractice’?
Improper or unethical conduct or unreasonable lack of skill by a holder of a professional or official position; often applied to physicians, dentists, lawyers, and public officers to denote negligent or unskillful performance of duties when professional skills are obligatory. Malpractice is a cause of action for which damages are allowed.

What is meant by the term ‘negligence’?
The failure to use such care as a reasonably prudent and careful person would use under similar circumstances, or the doing of some act which a person of ordinary prudence would not have done under similar circumstances.  

What is meant be the term ‘reasonable’?
Fair, proper, just, moderate, suitable under the circumstances.

What is meant by the legal phrase ‘Res Ipsa Loquitur’?
A latin phrase for “the facts speak for themselves.” Res ipsa loquitur is a rule of evidence under which an individual is deemed, under certain specific circumstances, to be negligent by mere occurrence of the incident and where the law presumes that the injury could not have occurred but for negligence. An example of a res ispsa loquitur case would be a retained foreign body claim. 

What does the term ‘respondent superior’ mean?
Respondent superior is a legal doctrine, translated as “let the master answer”. In medical malpractice actions, the doctrine is invoked when a physician is being held liable for the acts of a non-physician whose actions the physician controls, or has the right to control. Depending on the situation, the right to control need not have been exercised to permit invoking the doctrine. 

What is meant by the term ‘standard of care’?
The degree of care a reasonably prudent person should exercise in the same or similar circumstances. 

What is a ‘summary judgment’?
Granting of a judgment in favor of a party prior to trial.  Summary judgment is granted when there is no material issue of fact for a judge or jury to consider and one of the parties is entitled to judgment by law. 

What is the legal definition of ‘supervision’?
The definition of supervision varies greatly in both Florida statutes and Administrative Codes. The scope of collaboration is determined by the context of the clinical setting, patient acuity and medical condition, type of healthcare provider, professional licensure, and even duration of clinical practice and employment.

What is a ‘tort’?
A civil wrong or injury for which the court will provide a remedy in the form of an action for damages.
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