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Legal Issues in the Case Study
The provided claim against a physical therapist raises legal issues pertaining to the case scenario and the prevalence of malpractice issues in healthcare. One of the legal issues is whether it is legal for the PT to leave the patient to get out of the recumbent bike alone. Can the PT be sued for negligence? Was it legal for the student PT to assist the patient and push him during the clearance from the bike? Was the student PT insured? Should the PT and the student PT be held liable for causing injury to the patient? The physical injury has caused damage to the client and can no longer ambulate without discomfort. There are also legal concerns associated with the outpatient clinic’s rules and responsibilities regarding patient safety. The patient sustained injuries while in hospital, and the PT did not provide the patient with a gait belt when using the bike. Furthermore, the patient has received permanent disability rating and cannot resume former employment, should the hospital be held liable?
The case scenario also raises questions regarding ethical concerns in healthcare. The ethical issues raised require a course of action regarding patient safety in hospital. In this case, the PT ought to be protected from fraudulent activities where patients frame patients with an intention of being compensated. There is a need to consider consequential ethics entails the outcomes of actions (Hosukler et al., 2022). The ethical theory of utilitarianism deals with making decisions that increase the happiness or maximize the satisfaction of stakeholders. In this case, there is a need to determine if the physician was acting in the best interest of the patient or not.
Medical Malpractice
Based on the facts of the case, the patient could sue both the PT for negligence and the outpatient clinic for malpractice. The PT sustained injuries and permanent disability in the presence of PT who was standing at the wrong side of the bike. The fact that the PT failed to act or was at the wrong side of the bike indicates that the PT acted negligently and could have prevented the fall. Additionally, the outpatient clinic is responsible for failing to ensure the safety of patients. In this case, the clinic could have made sure that the PT had all the resources required, including the gait belt that could have prevented the accident.
Legal Standard of Proof
Healthcare malpractices are common. According to Pozgar (2020), healthcare malpractices account for a significant number of deaths and disabilities in patients in the United States. Despite the increasing number of physicians sued for malpractice, Pozgar and Santucci (2019) explained that there is a need for proof of evidence that the physician acted negligently when handling the patient. This negligence can be investigated and proved through preponderance, which Pozgar (2019) defines as the presentation of credible evidence. Pozgar (2019, p. 170) defined credible evidence as one that can be believed both in light of reason and common sense. The patient ought to provide convincing evidence that the PT acted negligently and did not follow due process of care when evaluating and allowing the patient to use the recumbent bike.
The Need for an Expert
Legal issues in healthcare malpractices can be complex, creating a need for one to consult an expert in the area of concern. Pozgar (2020, p. 171) explained that consulting an expert can help in providing expert testimony to refute the plaintiff’s claims. Furthermore, consulting an expert in this case will provide the causation link between the injury suffered by the patient and the medical event. The expert can also conduct independent examination of medical records and prove beyond reasonable doubt that the defendant was not reasonable for the injury incurred by the patient. When considering an expert, there are several factors that the insurer ought to look for in the type of expert to be consulted.
One of the factors is the experience of the expert in the PT profession and qualifications in handling such cases. The importance of considering a person with experience in the field is that the expert will provide unbiased assistance and help the PT make an informed decision. An experienced PT can provide unbiased judgment in the case and testify against the plaintiff when the case is brought before jurors. An expert in the field of physical therapy can be considered a valuable resource in this case. However, there is a need to investigate and only choose an expert who is registered with the medical board of a member of the medical profession and has other certifications in the area of physical therapy to gather sufficient evidence to be used in the case. The goal of obtaining the credentials of an expert is to determine if he is capable of providing additional evidence and making an independent decision without bias. The goal of involving an expert is to see if it is possible to have the case settled without facing a jury, considering the potential impact of the case on the PTs career and reputation.
Recommendations
As an insurer, I would advise the PT and the insurance company to settle the case without proceeding to the jury. The primary goal of an insurer is to settle the case at the least amount of money possible or deny any settlement when it is evident that the PT did not act in negligence. I would advise the insurance company not to deny the claim and consider settling the case as soon as possible. I would also consider damages and costs that could be incurred in settling the case before jurors. Dumas (2019) explained that defendants ought to consider when to lose and when to win before making decisions regarding insurance indemnities. It would be better to bargain with the plaintiff and have the case settled at about $150,000 or less instead of allowing the case to proceed to the jurors.
The advantage of avoiding the jurors is that they may make a biased decision because they do not understand the facts related to the case. Jurors may also make a wrong judgment when they are carried by emotions to make decisions, rather than approaching it from a practical point of view and the facts presented in the case. Jurors may also consume time and resources before settling the case. Despite the limitations associated with involving the jury in the process, jurors can provide a common sense perspective to the case. Jurors can also be unbiased and impartial when considering the medical event in question.
Ethical Issues Raised
One of the ethical issues that affect the presented case is the goal of the insurer having vested interests in the case. In this case, the insurer has put personal interests of reducing the costs of settlement, instead of seeking justice and having the jurors conclude the case. The impact of this approach is that it creates room for future medical events if the PT is not allowed to face the jurors. The decision to put the economic costs of the case over justice is that it breaches the trust that the insured has in the insurer. The insurer does not want to incur additional costs, even when the outcomes of the case could have been different. Furthermore, the insurer puts pressure on the insured to accept responsibility for the medical event, even when the PT believes that they are innocent. It is evident from the case scenario that the PT can be judged innocent when allowed to face the jurors. However, due to halving personal financial interests in the case, the insurer does not want to incur additional costs in pursuit of justice for the PT.
When the PT and the outpatient clinic accept liability for the mistake they did not commit, there is room for future patients framing physicians, knowing that they will easily get away with fraudulent activities (Bach-Golecka, 2021). This is unethical both to the PT and the healthcare industry at large. Additionally, if the insurer has a habit of settling cases without pursuing justice, it indicates that the insurer is not willing for the rights of the insured as seen in this case.
The American Physical Therapy Association (APTA) (2019) provides some guidance on the issue of patient advocacy and insurance indemnities. APTA advises PTs that not all risk exposures can be covered by insurance providers. In this case, PTs are encouraged to research and only do what one can perform within the professional area of practice. PTs are encouraged to seek guidance of attorneys or other professionals, including discussing with the insurance provider to make sure that all risks are covered.
References
American Physical Therapy Association (2019). Malpractice/Professional Liability in Provision of Fitness Services. Web.
American Physical Therapy Association (n.d.). Standards of practice for physical therapy. Web.
Bach-Golecka, D. (2021). Compensation schemes and extra-judicial solutions in case of medical malpractice. a commentary on contemporary arrangements. Compensation Schemes for Damages Caused by Healthcare and Alternatives to Court Proceedings: Comparative Law Perspectives, 1-39.
Dumas, T. L. (2019). When do the losers win? Appellate court reversals of civil jury verdicts. In Research Handbook on Law and Courts (pp. 308-319). Edward Elgar Publishing.
Hosukler, E., Hosukler, B., & Uzun, I. (2022). Medical malpractice claims against physical therapy and rehabilitation physicians. Journal of Physical Medicine & Rehabilitation Sciences, 25(3).
Pozgar, G. D. (2019). Legal and ethical issues for health professionals. Jones & Bartlett Learning.
Pozgar, G. D. (2020). Legal and ethical essentials of health care administration. Jones & Bartlett Learning.
Pozgar, G. D., & Santucci, N. M. (2019). Legal aspects of health care administration. Jones and Bartlett Publishers.
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