CORPORATE NEGLIGENCE

Corporate negligence

The theory of corporate liability is typically applied in cases involving hospitals and their staff physicians. Hospitals have independent duty to their patients to investigate adequacy and review the competence of staff physicians.

This theory is based on the principle that hospitals are in a far better position than their patients to supervise a physician’s performance and provide quality control. This legal theory has been used to attack the allegedly negligent selection, retention, or supervision of its participating physicians, that is negligent credentialing.

It is the failure of those persons who are responsible for providing the accommodation, facilities and treatment to follow the established standard of conduct. Corporate negligence occurs when the hospital provides defective equipment or drugs, selects or retains incompetent employees, or fails in some other manner to meet the accepted standard of care, and such failure results in injury to a patient to whom the hospital owes a duty.

In the corporate sector (hospital, nursing home, etc.)., where more than one person in more than one level fails to render appropriate service to the patient, may result in some damage to patient. Here the treating doctor and also other category of persons who were negligent will be held responsible.

If a hospital knows or should have known, that one of the patients is likely to be a victim of professional corporate negligence by a doctor on its staff, the hospital is liable, even though that doctor is an independent with staff privilege at the hospital.

If the doctor is employed by a patient in his private capacity, and the hospital only provides facilities for treatment, the doctor alone is held responsible for any corporate negligence.

ETHICAL Corporate negligence

Ethical negligence is the violation of the Code of Medical Ethics. In this, no financial compensation is payable unless there is also civil Corporate negligence, If a complaint is made and the facts proved, the name of the doctor may be erased from the Medical Register. This term should be better avoided.

Precautions against corporate negligence: To prove that reasonable care and skill has been exercised, the following precautions should be taken.

(1) Obtain informed consent of the patient.

(2) Establish good rapport (relationship or communication) with the patient.

(3) Keep full and accurate and legible medical records.

(4) Employ ordinary skill and care at all times.

(5) Confirm diagnosis by laboratory tests.

(6) Take skiagrams in bone or joint injuries, or when diagnosis is doubtful.

(7) Immunization should be done whenever necessary, particularly for tetanus.

(8) Sensitivity tests should be done before injecting preparations which are likely to produce anaphylactic shock.

(9) In suspected cases of cancer, all laboratory investigations should be done without delay to establish early diagnosis.

(10) No female patient should be examined unless a third person is present.

(11) Keep yourself informed of technical advances and use standard procedures of treatment.

(12) Seek consultation where appropriate.

(13) Do not criticize or condemn the professional ability of another doctor, especially in the presence of the patient.

(14) Do not make a statement admitting fault on your part.

(15) Do not exaggerate nor minimize the gravity of the patient’s condition. Avoid from overconfident prognoses and promising too much to patient.

(16) Never guarantee a cure.

(17) Do not fail to exercise care in the selection of assistants and allotting duties to them.

(18) The patient must not be abandoned.

(19) Do not leave patient unattended during labor.

(20) Inform the patient of any intended absence from practice, or recommend or make available, a qualified substitute.

(21) Transfer the patient if facilities are inadequate to handle his problem.

(22) Do not order a prescription over telephone because of possibility of misunderstanding as to the drugs or their dosage.

(23) The drug should be identified before being injected or used otherwise.

(24) Obtain consent for an operation or giving anesthesia and to use discretion in obscure cases.

(25) Frequently check the condition of equipment, and use available safety installations.

(26) In a criminal wounding, operation should not be performed unless it is absolutely necessary.

(27) Proper instructions should be given to the patient, and proper postoperative care should be taken.

(28) In the case of death from an anesthesia or during operation, the matter should be reported to the police authorities for holding a public inquiry.

(29) Anesthesia should be given by a qualified person. Only generally accepted anesthesia should be given after clinical and laboratory examinations of the patient. The patient should be watched until he fully recovers from its effect.

(30) No experimental method should be adopted without the consent of the patient.

(31) No procedure should be undertaken beyond one’s skill.

(32) Do not fail to secure the consent of both husband and wife, if an operation on either is likely to result in sterility.

Defenses against corporate negligence:

(1) No duty owed to the plaintiff.

(2) Duty discharged according to prevailing standards.

(3) Misadventure.

(4) Error of judgement.

(5) Contributory Corporate negligence.

(6) Res judicata (S. 300, Cr.P.C.). If a question of corporate negligence against a doctor has already been decided by a Court in a dispute between the doctor and his patient, the patient will not be allowed to contest the same question in another proceeding between himself and the doctor. Only appeal can be made.

(7) Limitation. A suit for damages for corporate negligence against the doctor should be filed within two years from the date of alleged negligence. A suit filed after two years will be dismissed as being beyond the period of limitation. Where breach of duty to provide care as per a contract between a patient and a doctor is committed, legal action can be initiated up to three years from the date of alleged corporate negligence.

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