Practice Guidelines in Medical Malpractice Litigation

Every field has laws and regulations including the health sector. Regulations are even stricter in healthcare because of the delicate nature of services offered. Both federal and state governments have a responsibility to formulate and implement existing guidelines.

Medical malpractice is a serious offense and punishable by law. Medical professionals who are found to have caused harm to patients due to negligence or failure to follow the stipulated procedures often find themselves in trouble with the law. Mistakes sometimes happen. Medical practitioners need to explore the best legal options when they are caught in such situations.

Role of Practice Guidelines in Medical Malpractice

Clinical practice guidelines (CPGs) play a two-fold role in medical malpractice claims. The guidelines can be used by an accused medical professional in litigation as well as patients accusing doctors of breaching their professional code of conduct. Determining a breach in medical professional conduct is vital when it comes to litigating medical malpractice claims.

It is usually the responsibility of the accused doctor or medical practitioner to prove that they complied with the existing code of conduct. The victim (plaintiff) must also prove that the acceptable standard of care was not followed.

Although CPGs may offer doctors the necessary direction and consensus depending on clinical evidence, the use of CPGs in medical malpractice lawsuits mainly relies on state rulings and evidentiary practices. Despite the fact that CPGs are designed to promote standardized practices in the medical sector, they are likely to restrict physician autonomy and flexibility.

In the past two decades, most states have established their own medical codes of conduct based on the medical malpractice lawsuits filed. It has become evident that some of the medical guidelines adopted before appear counterproductive to effective medication administration. This is what has largely prompted both the federal government and state authorities to review their previous guidelines.

The Evolution of Clinical Practice Guideline (CPGs)

Practice guidelines came about as a way of improving the quality of medical care. This was done by trying to close the gap between variations in clinical practice, balancing underuse and overuse of medical services and offering a means of communication for medical practitioners.

But CPGs have rapidly proliferated over the years. They are being applied by most organizations in the healthcare sector such as professional and medical societies, state and federal governments, insurance companies, managed care groups and other healthcare providers.

The Cost of Medical Malpractice

It is a fact that medical malpractice increases the cost of healthcare both directly and indirectly. Direct costs may include things like damage expenses, insurance premiums and legal fees. Indirect costs may include the practice of what is referred to as “defensive medicine” where medical practitioners offer unnecessary procedures and tests to caution themselves from any liability.

Another factor driving the cost of medical malpractice is the increase in the number of lawsuits related to medical malpractice. Unlike in the past, many people today are aware of their rights and can file negligence charges for minor mistakes made by physicians. For example, it is estimated that ten percent of the cost of medical services is directly linked to defensive medicine practices and medical malpractice litigation.

Trends and Variations

When looking at testimonies backed by CPGs, judges often consider factors like the sources of the guideline, the type of case, and expert witness testimonies among other factors. Courts may also exercise their own discretion with regard to the relevance, quality and reliability of the health guidelines in use. They have a right to reject health guidelines that they see as prejudicial or those that failed the impartiality test.

There is also a growing trend where clinical practice guidelines admissibility are used as an affirmative defense in malpractice lawsuits. This is contrary to what used to happen in most states in the country.

For instance, a patient visited a cardiologist complaining of chest pains and the cardiologist asked him to conduct a chest X-ray, rest and do some exercise. The doctor concludes that there’s no need for the patient to be admitted to the hospital. Three hours later, the patient dies from a cardiopulmonary arrest. The widow of the deceased later filed a medical malpractice lawsuit claiming the cardiologist went against the standard of care.

The trial court found the cardiologist not guilty based on the guidelines formulated by the American College of Cardiology as well as the American Heart Association. The widow appealed but the appellate court upheld the trial court’s decision. The appellate court affirmed that the guidelines used by the cardiologist were supported by a majority of experts as the standard code of the profession. The judges concluded the case by saying that the CPGs used were relevant and served as substantial evidence in the malpractice lawsuit.

Malpractice Tort Reforms

As the use of Clinical practice guidelines continues to grow, there are a number of tort reforms have been introduced. This include:

  • The use of contracts by insurance companies to bind patients and physicians to CGGs as a means of creating the standard of care for the sake of future malpractice claims.
  • Another tort is the judicial notice where the court offers an impartial medical expert to create the right set of guidelines that can be used as the standard of care in a particular case.
  • The use of compliance with CPGs in form of an affirmative defense.

The results of these reforms have been great. Experts in the medical sector admit a significant decrease in medical malpractice lawsuits. Besides, wider tor reforms offer a safe haven for medical practitioners and encourage more accountability.

Future Trends

The Patient Protection and Affordable Care Act that became law in 2010 failed to address the issue of medical liability reform or even the role of CPGs. However, it did authorize approximately $50 million to be used in demonstrative projects to determine alternative medical liability systems. But limitations of the law and the proposed demonstrative projects have been criticized sharply.

In a nutshell, the use of practice guidelines in medical malpractice have drastically changed over the past few years. Physicians at the moment need the best legal options to be able to defend themselves against medical malpractice lawsuits.

Christopher Stern

Christopher Stern is a Washington-based reporter. Chris spent many years covering tech policy as a business reporter for renowned publications. He has extensive experience covering Congress, the Federal Communications Commission, and the Federal Trade Commissions. He is a graduate of Middlebury College. Email:[email protected]

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