Archived Works

Hashmi-Alikhan v. Staples (Fla. 5th DCA March 29, 2018)

Gutierrez v. Vargus (Fla, March 22, 2018)

McCall and Kalitan: The Elimination of Non-Economic Damage Caps in FL Medical Malpractice Claims (Oct 2017) American Bar Association Health Law Litigation (Must be a member of ABA to view article)

Patient Representation in Communication and Resolution Programs: What is the Best Model? (Nov 2016)
Healthcare Professional Liability Review Journal Article

Tips for Managing the “MEGA-MEDIATION” (Sep 2016)
Healthcare Professional Liability Review Journal Article

What a Healthcare Provider Needs to Know About E-Discovery (Sep 2016)
Healthcare Professional Liability Review Journal Article

Angeli v. Kluka (Fla. 1st DCA 2016)

No-fault compensation for ventilator-dependent children (Aug 2016)
A reasonable settlement value for lifetime attendant care

Last Issue of Risk Rx: Announcement of a New Peer-Reviewed Journal (Jul-Sep 2015)
Risk Rx has had a long and distinguished run. Numerous published articles reviewed by experts in their respective fields were made available to all those served by SIP to increase their knowledge of opportunities to reduce risk of professional liability and to enhance patient safety.

Palliative Care:  A specialty that has come into its own (Jul-Sep 2015)
Palliative care is a relatively new medical specialty rapidly expanding over the past decade.  Since the year 2000, the number of hospitals with inpatient palliative care teams has increased by nearly 148%, including 66% of all hospitals over 50 beds 1.

Advance Directives: A Short Primer (Jul-Sep 2015)
As health care providers expand the availability of hospice services and palliative care services to assist severely or terminally ill patients in transitioning to end-of-life care, there is a concurrent need to encourage and expand conversations on advance directives, the important role they play, and impact they can have not only on end-of-life care, but also on unexpected medical care episodes.

Starting a Medical Practice (Jul-Sep 2015)
Starting a new business is not for the faint of heart, but starting a new medical practice can certainly be a daunting task.

Transitions of Care: The need for a more effective approach to continuing patient care (Apr-Jun 2015)
This paper is the first of many planned communications that will report on new developments from The Joint Commission enterprise about work underway to address the problems related to transitions of care.

The Handoff: A Critical Point of Vulnerability (Apr-Jun 2015)
Dr. Landrigan is Director of the Sleep and Patient Safety Program, Division of Sleep Medicine and Brigham and Women’s Hospital (Boston); Research and Fellowship Director, Inpatient Pediatrics Service at Children’s Hospital Boston; and an Assistant Professor of Pediatrics and Medicine at Harvard Medical School.

Fixing Fumbled Handoffs: Let’s not drop the ball! (Apr-Jun 2015)
The University of Florida has had a prize football team since 1906.  The bronze statues of our Heisman trophy winners outside of the Swamp are a tribute to our best. John Heisman’s famous quotes talk about how a football should never be fumbled.

Keeping Up with HIPAA (Apr-Jun 2015)
The Department of Health & Human Services (HHS) released the HIPAA Omnibus Rule in January 2013 which modified the HIPAA Privacy, Security, Breach Notification, and Enforcement Rules.

Small-Scale Grant Awards Programs: Professional Liability Insurance Partnerships with Providers Aim to Reduce Claims and Improve Patient Safety (Mar 2015)
In growing numbers, medical professional liability (MPL) insurers are tapping into a wealth of expertise, innovation, and energy by awarding small grants to fund patient safety, claims reduction, and loss prevention initiatives that are developed by the healthcare providers they insure, with promising results.

NICA – Florida’s Innovative Alternative to Costly Litigation (Jan-Mar 2015)
It has been 25 years since The Florida Birth-Related Neurological Injury Compensation Association (NICA) was established to help curtail the unpredictable cost of covering certain catastrophic birth injuries in the tort system.

Small-Scale Grant Awards Programs (Jan-Mar 2015)
Professional Liability Insurance Partnerships with Providers Aim to Reduce Claims and Improve Patient Safety.

Exploring the Benefits and Risk of Using Presuit Voluntary Binding Arbitration as an Alternative Dispute Resolution Process in Medical Malpractice Cases (Dec 2014)

I’ve Been Set for Deposition! (Dec 2014)
Can We Talk? (Must be a member of FDLA to view article)

Communication Tips in the Trauma Setting (Oct-Dec 2014)
Even under ideal conditions, communication in the health care setting, whether among providers or between providers and their patients, continues to be a challenge from a patient safety and customer service standpoint.

The Pivotal Role of Communication in Healthcare Reform and Risk Reduction (Oct-Dec 2014)
It’s all about communication! Despite having superbly trained healthcare providers, state-of-the-art medical technology, and well-established therapies at provider’s fingertips, the American healthcare industry remains beleaguered by unacceptable numbers of preventable medical and surgical mistakes.

Optimizing Physician-Nurse Communication in the Emergency Department (Oct-Dec 2014)
Strategies for Minimizing Diagnosis-related Errors.

Veterinary Medicine and the Law: How to Provide Good Care and Protect Yourself in the Process (Jul-Sep 2014)
Part III: Veterinary Records.

Surgical Team Debriefing and Follow-Up: Creating an Efficient, Positive Operating Room Environment to Improve Patient Safety (Jul-Sep 2014)
Experience from the Memorial Healthcare System, Florida.

Minimizing Diagnostic Error: 10 Things You Could Do Tomorrow Lists for physicians, patients, and healthcare organizations (Jul-Sep 2014)
Despite its obvious importance, diagnostic error has to a great extent been ignored in the world of patient safety.

Veterinary Medicine and the Law: How to Provide Good Care and Protect Yourself in the Process. (Apr-Jun 2014)
Part II:  Medical Records.

Tips on Being an Effective Witness at Deposition (Oct-Dec 2014)
A lawsuit consists of snapshots, often taken out of context, in the day in the life of a health care provider. It is focused on one patient to the exclusion of all other patients with whom that health care provider interacted.

The Good Samaritan Act (May 2014)
“Immunity” in the Emergent Care Setting.

Florida Fine Tunes its Definition of “Expert.” (Apr-Jun 2014)
Expert witnesses.  What comes to mind?  Medical and legal analysts?  Talking heads on various news channels?

Veterinary Medicine & The Law – Part III (Mar 2014)
How to Provide Good Care and Protect Yourself in The Process, Part III: Veterinary Malpractice Litigation.

Medical Malpractice Defense E-lert — Caps on ‘Pain and Suffering’ Damages in Medical Malpractice Death Cases Ruled Unconstitutional (March 2014)

The Amendment 7 Decade (Mar 2014)
Ten Years of Living With a “Patient’s Right to Know” in Florida.

Veterinary Medicine and the Law: How to Provide Good Care and Protect Yourself in the Process. (Jan-Mar 2014)
Part I: Informed Consent.

Correcting Errors In the Electronic Medical Record (Jan-Mar 2014)
Despite all of the benefits that electronic health records (EHR) offer, there remain opportunities for incorrect data entry due to problems with system design and or user error. Errors caused by system problems (e.g., a confusing screen design, etc.) can be prevented by working with your vendor to reset user preferences as needed.

Managing Behavior and Eliminating Harm: Moving Towards a Just and Safe Culture (Jan-Mar 2014)
Patient Safety focuses on protecting patients from harm by learning methods of preventing adverse avoidable events due to latent, often unidentified flaws in complex medical care systems.

Veterinary Medicine and the Law – Part II (Jan 2014)
How to Provide Good Care & Protect Yourself in the Process Part II: Medical Records.

Mandatory Presuit Mediation (Jan 2014)
5-year results of a medical malpractice resolution program.

Grant Award Program Partnerships With Your Professional Liability Insurance Carrier (Jan 2014)
An innovative approach to loss prevention and improved patient safety.

Intimidation and Retaliation: The Challenge to get Resident Physicians to Report Medical Errors (Oct-Dec 2013)
Resident physicians, being the first responders for patient care, have several daily patient interactions, and work closely with nurses, physicians, and other allied health disciplines.

Integrity of the Healthcare Record: Best Practices for EHR Documentation (Oct-Dec 2013)
Electronic documentation tools offer many features that are designed to increase both the quality and the utility of clinical documentation, enhancing communication between all healthcare providers.

Coping with a Medical Malpractice Suit (Jul-Sep 2013)
In this article, we discuss how and why physicians react to an accusation of malpractice and the range of strategies they use to diminish the emotional disequilibrium that accompanies this experience. Information presented here is based on survey and interview studies and extensive clinical experience.

The July Effect (Jul-Sep 2013)
Everybody knows it exists, right? In July with all the new housestaff in a teaching hospital, patients admitted to the teaching hospital or cared for in its clinics are much more likely to be exposed to physicians who don’t possess the appropriate skills or experience to provide optimal care.

Veterinary Medicine & The Law – Part I (May 2013)
How to Provide Good Care and Protect Yourself in the Process, Part I: Informed Consent.

The Team Concept: Who’s Got Your Back? (Apr-Jun 2013)
Do you feel part of a cohesive, tight knit healthcare team who routinely looks out for each other’s back? You may respond with an unequivocal “yes” or you may be thinking team dynamics could be a whole lot better.

Florida Supreme Court Prohibits Physician Discussions with Attorneys (Apr-Jun 2013)
This involved a medical malpractice action by Ramsey Hasan (Ramsey Hasan, v. Lanny Garvar, D.M.D., et all, Respondents. No. SC10‐1361– December 2012) against his dentist, Lanny Garvar, D.M.D., and his dental practice, alleging he failed to diagnose and treat dental issues and a bone infection, resulting in significant damages.

Conflict in the Healthcare Workplace (Apr-Jun 2013)
Managing conflict in the workplace is a time consuming but necessary task for the physician leader.  Conflicts may exist between physicians, between physicians and staff, and between the staff or the health care team and the patient or patient’s family.

Use of Pre-suit Voluntary Binding Arbitration as an Alternative Dispute Resolution Process in Medical Malpractice Cases 1 (Jan-Mar 2013)
Litigation of malpractice cases is very costly, not only in monetary terms, but also because of the substantial emotional drain experienced by the litigants during the protracted timeline to finality.

How Is Your Bedside Manner? (Jan-Mar 2013)
College of Medicine Jacksonville campus.

Second Victims: To Forgive, Divine (Oct-Dec 2012)
Alexander Pope, an 18th-century English poet, wrote in part, “To err is human; to forgive, divine.” Forgiveness can come from very many different sources, but the ability to forgive oneself is often the hardest to come by. Mistakes are a human inevitability.

Potential Long Lasting Repercussions of Medicaid Audits (Oct-Dec 2012)
In the past, a Medicaid audit was annoying, intrusive, costly, and frustrating. While the procedure for Medicaid audits have not eased any of those issues, newly implemented statutes and changes to the Florida Medical Practice Act have added a new and significant complexity to defending Medicaid and Medicare audits.

How the Good Samaritan Act Can Minimize the Potential for Claims in the Emergency Room (Jul-Sep 2012)
In order to recover damages against a healthcare provider for actionable negligence, a plaintiff must establish that the healthcare provider had a legal duty to provide care and breached that duty.

Mandatory Pre‐Suit Mediation: Local Malpractice Reform Benefiting; Patients and Healthcare Providers (Jul-Sep 2012)
This article outlines the systematic process and early success of the Florida Patient Safety and Pre-Suit Mediation Program (FLPSMP) as a pro-patient and pro-provider solution to the high costs, lengthy delays, and uncertainty plaguing the existing medical malpractice litigation process.

University of Florida Board of Trustees v. Stone (Jun 2012)

Outcomes of Medical Malpractice Litigation Against US Physicians (Jun 2012)

Operating Room Or Concert Hall? (Apr-Jun 2012)
Senior surgeons remember the days when an operation began with the surgical resident helping the anesthesiologist induce the depth of slumber that would enable effective operative intervention. The “help” usually involved keeping a finger on the patient’s pulse to assure it stayed there!

Medical Malpractice- When Does it Become a Crime? A Historical Review (Apr-Jun 2012)
In November 2011, Dr. Conrad Murray was tried and convicted of involuntary manslaughter for providing Michael Jackson with propofol; he is serving a four year sentence in prison.

The Disclosure of Unanticipated Outcomes of Care and Medical Errors: What Does This Mean for Anesthesiologists? (Mar 2012)

NICA CARES (Jan-Mar 2012)
As over 61,000 bills were sent out to licensed physicians recently I had the opportunity to field many phone calls, some supportive, some inquiring, and a few outright hostile about paying $250 a year to help fund the Florida Birth-Related Neurological Injury Compensation Association (NICA).

In the Shadows of Patient Safety Addressing Diagnostic Errors in Clinical Practice: Heuristics and Cognitive Dispositions to Respond (Jan-Mar 2012)
Real solutions to the role of cognitive error in medical misdiagnosis are a challenge to identify; therefore, strategies for improving patient safety tend to focus on more easily attainable objectives related to the more familiar issues regarding medical errors.

Reducing Liability in Complex Cases (Oct-Dec 2011)
Most medical errors are attributed to system errors– not faulty medical judgment. System failures increase with medical complexity and the number of physicians involved even when involvement is tangential.

Relevant DOH Disciplinary Actions Concerning Dentists (Oct-Dec 2011)
In the most recent edition of Risk Review, we considered prevalent disciplinary actions concerning allopathic and osteopathic physicians. Presently, we explore disciplinary actions that are common to Florida dentists.

University of Florida Proton Therapy Institute: A Unique Cancer Treatment and Research Center (Jul-Sep 2011)
The largest medical device in use today deploys one of the smallest particles known to man to effectively treat cancer patients. The device is a particle accelerator. The particle is the positively charged part of an atom called a proton. The cancer treatment is proton therapy.

Formula for Improved Patient Care: Teamwork + Communication (Jul-Sep 2011)
Providing patients with the highest quality of care in a safe and effective manner is not a new concept in medicine. Nonmaleficence, which derives from the maxim, “Primum non nocere” or “First, do no harm” is one of the principal precepts of medical ethics.

DOH: Prevalent Disciplinary Actions for Allopathic and Osteopathic Physicians (Jul-Sep 2011)
It is always interesting to consider trends in medicine, not only as they relate to the advancements made in medical technology, but also as they also pertain to the unfortunate continuing struggles faced by medical professionals.

Communicating Adverse Events: The Art of Apologizing Without Admitting Liability (Apr-Jun 2011)
When a serious adverse event occurs, it is distressing to the physician, to the patient and to the patient’s family.

The Power of the Partnership: Engage, Enlighten and Empower (Apr-Jun 2011)
We are constantly reminded of how medicine is changing; new therapies, new communication tools, new roles emerging.

The Three “P”’s: A Common Liability Problem (Apr-Jun 2011)
Failure to follow, lack of, and inadequate Policies, Procedures and Protocols (the three “P”’s) are a common cause for citations and fines in regulatory surveys as well as a frequent liability in hospital and provider negligence claims.

A View from the Trenches: Discovery Issues with Electronic Medical Records (Jan-Mar 2011)
Until about five years ago, if I asked a client to preserve & copy a patient’s original medical record, it would be as simple as going to the file room, pulling the manila folder off the shelf, and having a file clerk copy each document completely, and then putting the original chart into a “legal lockdown” area, where access would be restricted to just a few individuals.  But if I were to make this request now, it may not be as simple to produce and preserve the patient’s information.

The Electronic Health Record: Keeping the Illegible From Becoming the Illogical (Jan-Mar 2011)
In November 1999, the Institute of Medicine released “To Err is Human” in which it reported that approximately 98,000 unexpected deaths occur every year in American hospitals.

For Doctors’ Scrawl, Handwriting’s on the Wall (Oct-Dec 2010)
Physicians’ handwriting has long been a joke. However, poor handwriting among healthcare providers is increasingly being diagnosed as a threat to patients.

The Radiation Overdose Sentinel Event (Oct-Dec 2010)
The Joint Commission has defined a radiation overdose sentinel event to be a patient peak skin dose of 15 Gy from fluoroscopic procedures within a 6-to-12 month period.

Three Strikes Rule: It Has Been Almost Six Years: Is There Any Discernable Impact of its Passage (Oct-Dec 2010)
As many recall, Amendment 8, more commonly known as the “Three Strikes Rule,” was implemented by the Florida legislature in Senate Bill 940 after the Florida electorate overwhelmingly approved the proposed amendment to the Florida constitution in November 2004.

Mandatory Presuit Mediation (Oct 2010)
Local malpractice reform benefiting patients and healthcare providers.

Overcoming Prescribing Errors Not a Bitter Pill (Jul-Sep 2010)

Breaches of Unsecured PHI after HITECH: A Suggested Framework for Investigation (Jul-Sep 2010)
The Health Information Technology for Economic and Clinical Health Act (“HITECH Act”), enacted by Congress as a part of the American Recovery and Reinvestment Act of 2009, places a duty on covered entities to notify patients, the Secretary of the Federal Department of Health and Human Services (“HHS”) and, in some cases, the media, of any breach of unsecured protected health information (“PHI”).

The Journey from Patient to Plaintiff (Apr-Jun 2010)
Risk factors that jeopardize trust and confidence between physicians and patients are those internal and external influences that impact negatively upon the physician-patient relationship, often launching patients on an adversarial course towards litigation.

Infection Prevention in 2010 (Jan-Mar 2010)
Government Response to Public Concern about Healthcare Associated Infections.

Robotic Surgery (Jan-Mar 2010)
The minimally invasive surgical revolution began in the late 1980’s with the advent of video-chip technology.

HIPAA – Privacy Regulatory Updates (Oct-Dec 2009)
The Department of Health and Human Services (HHS) issued rules related to breach notification requirements for providers, health plans, and other entities covered under the Health Insurance Portability and Accountability Act (HIPAA).

Legal Case Study: Florida Department of Corrections v. Lisa M. Abril (Fla. 2007) (Oct-Dec 2009)
The enactment of the Health Insurance Portability and Accountability Act (HIPAA) in 1996 brought national focus on the issue of patient confidentiality.

Preventing Medical Identity Theft (Oct-Dec 2009)
As telemedicine and electronic patient records (EHR) become more commonplace, so does the threat and incidence of security breaches by hackers and attackers.

A Malpractice Lawsuit Simulation: Critical Care Providers Learn as Participants in a Mock Trial (Aug 2009)
Critical Care Nurse, Vol 29, Number 4.

Patient Non-Compliance — A Powerful Legal Defense (Jul-Sep 2009)
This article is reprinted with permission from Healthcare Risk Manager, a publication of MAG Mutual Insurance Company’s Risk Management/Patient Safety Department, Vol. 15, Number 1.

Sovereign Immunity – A Primer For The UF Health Care Provider (Jul-Sep 2009)
This article published in the April-June 2006 edition is being reprinted for the benefit of  new faculty and residents.

Telemedicine and its Liability Implications (Jul-Sep 2009)
While the concept of telemedicine has emerged well over the last decade, its application has only slowly been interpreted and analyzed by medical boards, national associations and courts across the nation.

Cyber Doctors (Apr-Jun 2009)
This article, published in the March 2009 issue of Compliance Today, appears here with permission from the Health Care Compliance Association (HCCA).  For reprints, call HCCA at 888-580-8373.

Fundamentals of the Marchman Act (Apr-Jun 2009)
In the early 1970’s, the federal government enacted laws creating formula grants for states to develop continuums of care for individuals and families affected by substance abuse. The laws resulted in separate funding streams and requirements for alcoholism and drug abuse. In response to the laws, the Florida Legislature enacted Chapter 396 (alcohol) and Chapter 397 (drug abuse) of the Florida Statutes (F.S.).

WHO and the Surgical Care Outcomes Assessment Program Surgical Checklist (Apr-Jun 2009)
Checklists as tools for safety have demonstrated value in complex systems and thus have been mandatory in the aviation industry. Until recently, they were missing from medicine, save the anesthesia pre-induction checklist.

Credentialing for New Procedures (Jan-Mar 2009)
New technology creates challenges for many in the healthcare field. Prior to granting privileges to perform a new procedure or use new technology, The Joint Commission requires hospitals to have a process to determine whether sufficient space, equipment, staffing, and financial resources are in place to support each requested privilege.

Frequent Board of Medicine Disciplinary Actions (Jan-Mar 2009)
For many physicians, the experience of opening a letter from the Department of Health inspires pangs of anxiety and concern, generating the oft asked questions.

Preventing Wrong Site Surgery (Jan-Mar 2009)
In its December, 2008 report, the Florida Board of Medicine addressed four cases of wrong site surgery that had just been reviewed and adjudicated.

Partnering with Patients (Oct-Dec 2008)
The ten year anniversary of the Institute of Medicine report, To Err is Human: Building a Safer Health System is almost upon us.

Following the Patient Rights of Medication Administration: Are These Enough to Guarantee Patient Safety? (Oct-Dec 2008)
According to the Institute of Medicine of the National Academies, the most common medical errors are medication errors and annually account for injuries to approximately 1.5 million Individuals.

Minimizing the Legal Risk with ‘Curbside’ Consultation (Oct-Dec 2008)
“Curbside consultations” – in which a physician obtains insights on a medical case from another physician who has not seen the patient or reviewed the record – can yield advantages to the requesting physician.

Case Reviews involving Restraints and Seclusion of Involuntarily Committed Patients (Jul-Sep 2008)
On December 8, 2006, the Centers for Medicare and Medicaid Services (CMS) finalized the Patients’ Rights Conditions of Participation applicable to all Medicare and Medicaid hospitals.

Exercising Restraint (Jul-Sep 2008)
Health care organizations around the world continue to make strides in the reduction of the use of restraints. In the United States, both the Centers for Medicaid Services (CMS) and the Joint Commission recently revised and tightened the standards for restraint use and seclusion in health care.

Baker Act Basics (Jul-Sep 2008)
Patients found to have the capacity to consent are encouraged to seek psychiatric examination and treatment on a voluntary basis.

Bohannon v. Shands Teaching Hospital and Clinics Inc. (Jun 2008)

Good Care, Bad Documentation (Apr-Jun 2008)
Charting is a fact of life for providers; an integral part of the daily responsibilities of providing patient care.

The Florida Supreme Court Rules on Amendment 7 (Apr-Jun 2008)
Last month, the Florida Supreme Court issued an opinion relating to the constitutionality of legislation that implemented and clarified the “Patients’ Right to Know about Adverse Medical Incidents,” a constitutional amendment approved by the voters in the November 2004 general election.

The Physician’s Best Defense Against Malpractice (Apr-Jun 2008)
When questioned regarding the most important challenges facing physicians today, one third of responding physicians cited medical malpractice insurance/claims, according to a study published in the New England Journal of Medicine.

Legal Case Review: The Disruptive Physician (Jan-Mar 2008)
“The disruptive practitioner is by definition contentious, threatening, unreachable, insulting and frequently litigious. He will not, or cannot, play by the rules, nor is he able to relate to or work well with others ….”

ARNP and PA Scope of Practice (Jan-Mar 2008)
Frequently there are issues that arise concerning the scope of services that can be performed by a Physician Assistant (“PA”) and Advanced Registered Nurse Practitioner (“ARNP”).

Falls in the Acute Care Setting (Jan-Mar 2008)
Falls are one of the most common adverse events leading to injury in hospitals (Krauss et al., 2007). Fall rates in acute care hospitals range from 2.3 to 13 falls per 1000 patient days.

Innovative Teaching for Health Law: A Case Study of a Hospital Medical Malpractice Lawsuit Simulation (Dec 2007)
Journal of Health Administration Education, Vol 24, Number 1 (Must be a member of JHAE to view article).

Dunn v. Shands Teaching Hospital and Clinics Inc. (Nov 2007)

About NICA (Oct-Dec 2007)
In 1988 the Florida Legislature created the Florida Birth‐Related Neurological Injury Compensation Association (NICA) in Florida Statute Chapter 88‐1, Laws of Florida. The Act addresses medical malpractice issues by setting up a no‐fault plan for hospitals and doctors that covers specific birth‐ related neurological injuries typically among the most costly in tort settlements. It was hoped that a no‐fault system limited to this type of injury would be manageable and funding levels could be statistically predicted.

What’s in your Emails? (Oct-Dec 2007)
Over the last several years, Email has begun to change the health care industry by providing health care providers a convenient and cost effective method to facilitate communication with patients and other business associates.

Learn How to Mitigate Hospital and Personal Risk by Participation in a Simulated Negligence Lawsuit (Jul-Sep 2007)
The Joint Commission and healthcare facilities recognize that the failure to improve patient safety will expose organizations to significant human and financial loss.

Chart Documentation of Patients Leaving Without Being Seen or Against Medical Advice (Jul-Sep 2007)
Despite improvements in patient flow, the creation of “fast track” services and other quality initiatives, a significant number of patients choose to leave hospital emergency departments prior to being seen by a physician or receiving treatment.

Clinical Care and the Chain of Command (Jul-Sep 2007)
Whether a medical student, resident, nurse or physician extender, or attending or practicing clinician, we have all been faced with the questions of “Do I call?”…and “When should I call?”

Legal Case Review: Case Summary: St. Anthony Hospital v. U.S. D. H. H. S., (10th Cir. 2002) (Apr-Jun 2007)
This is a case involving “reverse dumping” under EMTALA.  Reverse dumping occurs when a hospital emergency room inappropriately refuses to accept transfer of a patient who requires the specialized capabilities of a hospital.

Starting a Medical Practice (Apr-Jun 2007)
Starting a new business is certainly not for the faint of heart, but starting a new medical practice can certainly be a daunting task.

Medication Safety-High Priority (Jan-Mar 2007)
Efforts to reduce adverse drug events have steadily intensified over the last several years.

Consent Issues for Minors in Florida (Jan-Mar 2007)
A 17-year-old University of Florida student is rushed to the Shands emergency room with acute lower, abdominal pain.

Amendment 7 Update (Oct-Dec 2006)
As you will recall, in the general election of November 2, 2004, Florida voters overwhelmingly approved a constitutional amendment entitled “Patients’ Right to Know about Adverse Medical Incidents,” commonly known as “Amendment 7.”

Florida’s Good Samaritan Act: A Little Protection is Better Than None (Oct-Dec 2006)
Dr. Smith is driving down the road, happily going home from a busy day in the OR. Suddenly, a truck pulls out in front of an on-coming car. While Dr. Smith successfully avoids being in the wreck, and does call 911, does she risk a lawsuit if she stops to render assistance?

Shands Teaching Hospital and Clinics, Inc. v. Sidky, et al. (Aug 2006)

Legal Case Review: Nardone v. Reynolds: The effect of fraudulent concealment on the medical malpractice statute of limitations. (Jul-Sep 2006)
Case Summary:  Nardone v. Reynolds: The effect of fraudulent concealment on the medical malpractice statute of limitations.

License Not Required to Practice Risk Management (Jul-Sep 2006)
Risk management is one of the few professions health care staff on all levels can practice without a license.

Amendment 8: Its Impact Still Unknown (Jul-Sep 2006)
Amendment 8, more commonly known as the “three-strikes rule” was implemented by the Florida legislature in Senate Bill 940 after the Florida electorate overwhelmingly approved the proposed amendment to the Florida constitution.

Risk Reduction Strategies (Apr-Jun 2006)
It is important to know the state law regarding medical futility and/or the withholding and withdrawal of life-sustaining procedures.

Legal Case Review: In the Matter of Baby “K” (4th Cir. 1994) (Apr-Jun 2006)
While this case involves a patient complaint brought under EMTALA, it is also recognized as having a subtext addressing the issue of “medical futility.”

Sovereign Immunity – A Primer For The UF Health Care Provider (Apr-Jun 2006)
The doctrine of sovereign immunity, also referred to as “Crown immunity,” is grounded in the English common law concept that “the king can do no wrong,” and was not, therefore, subject to claims and suits by his countrymen.

Simulation Team Training- A Proactive Approach to Risk Reduction (Jan-Mar 2006)
Simulation in health care training has been used for decades. Since the late 60’s and early 70’s, the use of full body manikins for CPR and obstructed airway procedures have allowed skills and techniques to be taught to all levels of care providers.

Universal Protocol Compliance Q&A’s (Jan-Mar 2006)
JCAHO compliance with the Universal Protocol for Preventing Wrong Site, Wrong Procedure, Wrong Person Surgery became effective July 1, 2004.

Critical Processes for Preventing Wrong Site Surgery (Jan-Mar 2006)
Modern surgical practice is based on a growing knowledge of the biology of disease and on the continued evolution of sophisticated operative techniques.

Legal Case Review: Case Summary:  Emergency Restriction of the License of Arnaldo Carmouze, PA, by the Department of Health (Oct-Dec 2005)
This was an administrative case involving a licensed physician assistant, who was employed as a PA at the Weems Hospital Emergency Department in Apalachicola but whose supervising physician was 500 miles away in Miami.

Resident Tips: Applying for Hospital Staff Privileges (Oct-Dec 2005)
The Medical Staff Office (MSO) is the entity responsible for credentialing of physicians and allied health professionals.

Strategies for Shift Handoff (Oct-Dec 2005)
Shift handoff is a basic health care practice designed to provide continuity of patient care from one health care team to another. The omission or ineffective handover of essential transfer information can lead to delays in treatment, missed treatment, or the wrong treatment. Shift handoff may also result in longer response time to patient requests if the handoff is not conducted in a timely manner.

Legal Case Review: Jeanette Wright v. Johns Hopkins Health Systems Corporation et. al (728 A.2d 166  Md. 1999) (Jul-Sep 2005)
On July 18, 1994, Robert Lee Wright Jr. was admitted to the medicine service of Johns Hopkins Hospital, suffering from acute renal failure secondary to AIDS.

The SKINny on Pressure Ulcer Prevention (Jul-Sep 2005)
Pressure ulcers remain a common problem in all health care settings. It is estimated that 1.3 million to 3 million adults develop pressure ulcers with an estimated cost of $500 to $40,000 to heal each ulcer.1 Failure to prevent or heal avoidable pressure ulcers can also result in costly litigation.

Legal Implications and Ethical Considerations of “Do Not Resuscitate” (Jul-Sep 2005)
A DNR order is a physician order that instructs health care professionals that a patient is not to receive any, or only limited, resuscitative efforts in the event the patient’s heart stops beating or the patient stops breathing.

Legal Case Review: John Insinga v. Michelle LaBella, et al. (Fla S. Ct. 1989) (Apr-Jun 2005)
In this case, the Florida Supreme Court ruled, for the first time, that the doctrine of corporate negligence was applicable to a hospital for failure to properly credential a physician on its staff.

Golden Rules of Chart Documentation (Apr-Jun 2005)
For those who have worked in health care a few decades, reflecting over the past often lends credence to the old saying that “the more things change the more they stay the same.”

“What We’ve Got Here is a Failure to Communicate.” (Apr-Jun 2005)
Besides being one of the most recognized movie lines of all time, it is a perennial truth for physicians and their patients.

HIPAA Final Security Regulations (Apr-Jun 2005)
The final Security Standards under the Health Insurance Portability and Accountability Act (HIPAA), published in February 2003, become effective on April 20, 2005.

Legal Case Review: Fernando Jimenez M.D. v. Department of Professional Regulation Board of Medicine (4th Cir. 1990) (Jan-Mar 2005)
This case involves an appeal by the above physician, of a disciplinary penalty imposed by the Board of Medicine that was more severe than the penalty recommended by the Administrative Hearing Officer of the Division of Administrative Hearing.

Florida Cares & C.A.P. (Jan-Mar 2005)
In 1997, the University Of Florida College of Medicine, developed an assessment center for physicians and physician assistants to aid hospitals and regulatory boards in the assessment of professional competency.

Saying “Goodbye” To A Patient Without Saying “Hello” To A Lawsuit: A Primer On Patient Dismissal (Jan-Mar 2005)
Although infrequent, there can come a point in a physician-patient relationship when the physician, due to any number of good and sufficient reasons, no longer wishes to continue treating a patient.

How Is Your Bedside Manner? (Jan-Mar 2005)
Each of these scenarios represents a combination of good and bad.  Physicians today are overwhelmed by increasing administrative stress, decreasing levels of reimbursement, and a variety of other factors, all of which compete effectively for the most valuable asset any physician possesses – his or her time.

Managing Disclosure Of Adverse Events (Jan-Mar 2005)
There are two groups affected by adverse medical incidents, and historically, we have not done a good job of helping either. The first group is patients and their families; the second is the health care providers involved in the incident.

Legal Case Review: Anne Marie Nolen v. Boca Raton Community Hospital, Inc. Et al., 373 F.3d 1151 (11th Cir. 2004) (Oct-Dec 2004)
Case Summary: Anne Marie Nolen v. Boca Raton Community Hospital, Inc. Et al., 373 F.3d 1151 (11th Cir. 2004).

Tips on Being an Effective Witness at Deposition (Apr-Jun 2004)
A lawsuit consists of snapshots, often taken out of context, in the day in the life of a health care provider.

DOH Practitioner Investigation – What to Expect (Oct-Dec 2004)
In order to practice medicine in the state of Florida, a physician must be licensed to practice medicine by either the Florida Board of Medicine or the Florida Board of Osteopathic Medicine (collectively, the “Boards”).

Editor’s Welcome (Oct-Dec 2004)
Welcome to the first edition of Risk Rx!

Medical Malpractice: A New Treatment for an Old Illness (Sep-Nov 1988)
Florida State University Law Review: Review of Florida Legislation, Vol 16, Number 3.

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Please feel free to contact her for any questions or recommendations regarding page content.