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Errors and Omissions
Insurance Case Study:
Wrongful Death
By
Laura McCormick
December, 2002
The
following is a claim scenario involving teleservices companies, based on
combining fact from actual claims made against the ATSI Professional Liability
plan. Following the scenario are some helpful suggestions on how
your company can avoid such claims.
A
medical telemessaging company held responsible for a patient death:
A telemessaging company performed call answering and forwarding for a
group of physicians. The company
had handled this account for many years and while there were originally
written instructions that all calls received for a specific doctor were to be
directed to either a medical center or to a designated on-call physician,
whose identity was supplied each day by telephone, this documentation hadn't
been seen in years, nor had it been reviewed or updated.
A
call came in one evening for a specific doctor and the company tried, without
success, to get through to the medical center.
The company then paged the originally specified doctor, rather than the
on-call doctor. A delay occurred
before the original doctor answered the page.
Ultimately, the patient died and a lawsuit was filed, alleging that the
delay caused or contributed to the patient's death.
The telemessaging company was defended by its
insurance provider. The company
could not get out of the lawsuit on a summary judgment motion, because the
court found there was a question as to whether the delay was a cause or
contributing factor to the patient's death.
There was also a question about whether paging the originally specified
doctor was in accordance with applicable legal and contractual standards for
medical telemessaging companies. Ultimately,
a settlement was reached, with the teleservices company contributing a
substantial percentage of the total settlement amount.
How
this claim could have been avoided or mitigated: The medical teleservices company had a written set of
instructions from its client on how to deal with certain situations.
This is a good and necessary practice, which is strongly recommended.
However, perhaps because of a lack of training, inexperience, or a lack
of communication to the agents on duty, these instructions were not followed
by the agents. Further, the
general instructions about the on-call physician were nowhere to be found, nor
had they been reviewed or updated by either the client or the telemessaging
company. This made it harder and
more expensive to show what protocols the company followed or attempted to
follow.
Written checklists, changed every day to meet
the specific needs and instructions of each client, cannot only prevent errors
from occurring, but can also furnish documentary proof that a telemessaging
company performed its work in accordance with applicable standards of care.
Continued training of agents is important, and it is strongly
recommended that all contracts, instructions, lists, and protocols for each
client should be discussed, reviewed, and updated periodically.
Further, these reviews should be acknowledged in writing by the client,
including confirmation that the instructions and procedures are correct and
approved by the client.
For
more information contact Laura McCormick or Chris Jones at 866-303-4297 or visit https://atsi.haysaffinity.com.
For
more E & O Case Studies, see Laura's previous
and subsequent article.
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