So something did not turn out as planned and you worry you may get sued...

Q. Should you remain in contact with the patient/family? 
A. Yes, do not avoid the patient/family during this time, they are likely distraught and may feel isolated and abandoned, by keeping a positive connection with the family/patient, you can help them through the process. This may also help you work through complex emotions that are likely to arise following an adverse event. If contact grows contentious or meetings become difficult to manage seek an impartial party to serve as a mediator or keeper of the facts. Do not enter in to meetings where your communication is not witnessed by parties other than the patient or family.
 
Q. At what point do you need an attorney? 
A. If you have concerns following an incident or event, please do not hesitate to call KMRRRG risk management. We are here to guide you through the process and to provide advice on next steps, up to and including engaging an attorney.
 
Q. When do you need defense counsel with you? 
A. Any calls from legal counsel (defense or plaintiff), request for depositions, subpoenas, or other potential legal matters can be addressed by our office. We can help you by offering some guidelines on how to address the request or advise you when you should have an attorney present. We will also help by assigning counsel to you from a panel of KMRRRG legal counsel.
 
Q. When should you call risk management? 
A. Anytime! Even if it was a no harm no foul situation, risk management may be able to derive a lesson from a near miss and apply that lesson to future situations to help you or others avoid it down the road.

Q. What should you do if a patient (or family) says they are going to sue?
A. We can help you respond to this type of situation. It is important to acknowledge that the patient/family may be angry, be careful not to act defensively or respond in anger when confronted by this situation... and call risk management immediately. You may advise them that any of their concerns will be evaluated in detail and they can expect a response within 30 days.
 
Q. What is a "joint defense?"
A. A joint defense is when all those named in a medical malpractice lawsuit meet and agree to present as a unified front against the claims of negligence.  All defendants may even be insured by the same RRG and may assign one defense counsel to represent all defendants if no conflicts are noted. This course of action may be changed anytime during the litigation process if a conflict arises.
 
Q. Why is a "joint defense" important?
A. If each person named in the claim acts only to defend themselves, a jury may be led to believe that there was negligence and it is only a matter of who to assign blame, rather than to determine if negligence happened in the first place.
 
Q. But... what if a joint defense is not possible because I have concerns about another provider's actions or care?
A. Share your concerns with your attorney and/or risk management. There are ways to present a unified front, stay focused on the facts of the care, while not pointing fingers at others during the litigation process.
 
Let's take a look a case dramatization where a physician blames another physician during deposition... There goes a joint defense!

CASE STUDY: Emotional Responses and Demeanor Damage Credibility

After treatment for an upper respiratory infection, a 34-year-old patient returned to her family physician's office reporting that, despite completing the prescribed course of antibiotics, she still had intermittent sensations of "losing her breath." After conducting a physical examination, the family physician ordered a chest X-ray that demonstrated a suspicious lesion in the lower left lung. A CT scan confirmed that the suspicious lesion was a pulmonary mass that warranted further clinical investigation.

Consequently, the physician referred her to a thoracic surgeon at an academic medical center, who performed a wedge biopsy of the mass and sent the excised tissue to the pathology department for frozen section diagnosis. While the patient was still anesthetized, the pathologist returned a preliminary diagnosis of "Probable pulmonary blastoma." Given the aggressive nature of that diagnosis, the surgeon determined that immediate resection of the lower left lobe could spare the patient a second surgical procedure.

Three days after the surgeon removed the lower left lobe, the final pathology report concluded that the patient's lung mass was not malignant, but a pulmonary endometrioma that, on frozen section, closely resembled a pulmonary blastoma.

The patient sued the surgeon, alleging that she had negligently failed to obtain an adequate pathology consultation to confirm the frozen section diagnosis; and hastily proceeded, without sufficient clinical indication or the patient's consent, to unnecessarily remove her lower left lobe.

ANALYSIS:

During deposition] The plaintiff's attorney may use a variety of tactics in an attempt to subtly or overtly coerce a physician into making statements that will later harm his/her defense or the defense of an involved colleague or organization. For this reason, emotions should be kept in check, and a physician should refrain from any form of speculation, whether it be in regard to the conduct of another provider or in reference to an event of which he/she has no first-hand knowledge or experience. A jury will likely be unmoved by a physician's emotional profession of the grandeur of his/her professionalism. If the plaintiff's attorney succeeds in eliciting an inappropriately emotional response from a physician, he/she has succeeded in making the physician an unfavorable witness to the jury. Juries generally do not want to believe that physicians are uncaring or careless but may be influenced to change their perceptions by thoughtless, overzealous or self-promoting statements.
 
In general, it is imperative that a physician defendant refrain from speculating, in any case scenario, about the motivations of a colleague, patient, or any involved person's reasons or thoughts. It is within acceptable bounds to simply reply, "I will not speculate," to a question of this nature.