Medical Legal Implications When Providing Emergency Care on a Commercial Flight

INTRODUCTION: U.S. airlines often request a healthcare professional to volunteer to assist an ill passenger. Litigation from a Good Samaritans care of an in-flight medical emergency (IME) is considered improbable. The 1998 Aviation Medical Assistance Act (AMAA) encourages health care professionals to volunteer with indemnity for standard and good medical care. It does not offer legal or financial assistance. Our review explored the legal support malpractice companies and U.S. airlines provide if litigation is initiated for IME care. Malpractice insurance policies can differ on IME coverage. We found most private practice physicians policies include IME. Medical institutions may have policies restricting their physicians coverage to the institutions location. Those without malpractice coverage will need to retain and pay for a legal defense to demonstrate no gross negligence and no willful misconduct. The physicians, airline crews, and on-ground IME documentation support should be retained by the Good Samaritan especially for a pediatric or adolescent ill passenger. U.S. airlines consider a Good Samaritan medical volunteer as a passenger and do not extend legal assistance. This contrasts with some foreign airlines that do provide liability protection. Knowledge of the malpractice policy IME coverage is essential prior to traveling by air. After completing care for an ill passenger, physicians should generate their medical documentation and request the IME documentation generated by the airline and on-ground medical expert. We also believe U.S. airlines should assume responsibility to provide legal assistance to a Good Samaritan physician in the event of IME litigation.de Caprariis PJ, Di Maio A. Medical legal implications when providing emergency care on a commercial flight. Aerosp Med Hum Perform. 2021; 92(7):588592.

Applying Human Factors Methods to Improve Healthcare Risk Management Tools

The Healthcare Insurance Reciprocal of Canada (HIROC) is a not-for-profit medical malpractice insurance reciprocal that has a vision of partnering to create the safest healthcare system. Each year, patients die from preventable patient safety incidents in Canada. A proactive focus on risk management and embedding safety into healthcare systems is key to improving patient safety. HIROC conducted semi-structured interviews to help identify usability areas of interest for two primary risk management tools: The Risk Assessment Checklist and the Risk Register. A total of 16 participants from HIROC Subscribers, all with experience in risk management, quality improvement or patient safety, volunteered to partake in the semi-structured interviews. A thematic analysis of the data collected informed usability improvements. For the Risk Assessment Checklist, participants indicated that the tool is informative as it helps create risk management awareness across their organizations. Participants found the Risk Assessment Checklist interface easy to use and are pleased that submitting their self-assessments is a streamlined process. For the Risk Register, participants reported that the tool is simple and easy to use. Specifically, they find value in having an electronic system that keeps them organized and provides a way for them to track and trend their progress. Participants identified some usability concerns that the research team addressed with proposed design reflections informed by Jakob’s Ten Usability Heuristics (Nielsen, 1994).

The Hidden Epidemic: The Harvard Medical Practice

Malpractice! The word strikes terror in doctors’ hearts—and with good reason. All doctors are at risk of being sued when things go wrong, and most doctors are in fact sued at some time in their career, whether or not they did anything wrong. For some high-risk specialties, including neurosurgery, vascular surgery, and cardiology, the percentage sued is very high, and multiple suits are not uncommon. For all doctors, the cost of malpractice insurance is substantial.

Effect of Increasing Malpractice Insurance Cost and Subsequent Practice of Defensive Medicine on Out-of-Hospital Birth Rates in the United States

Background Across the United States, the burden of malpractice litigation has influenced obstetricians and obstetric institutions to avoid high-risk patients, favor cesarean delivery, and decrease availability of trial of labor after cesarean. Recently, the United States has experienced an increase in out-of-hospital (OOH) births. Objective The main purpose of this article is to investigate the association between malpractice insurance premium (MIP) and OOH births in the United States from 2000 to 2014. Study Design We analyzed changes in OOH birth rates and MIP from 2000 to 2014 using birth data from the National Vital Statistics System and Medical Liability Monitor's annual survey, respectively. The change in OOH birth rates was then compared with the change in MIP. Results Between 2000 and 2014, there has been approximately 60% increase in MIP from national average of $40,949 to $65,210 (p < 0.05). OOH births increased 57% from 39,398 births to 59,674 births (p < 0.05). There was a significant positive correlation between increase in MIP and increase in OOH births (p < 0.05, R 2 = 0.14). Conclusion MIP and OOH birth rates have a significantly associated increase from 2000 to 2014. Given that malpractice climate affects other aspects of obstetric practice, we cautiously propose that increasing MIP may be associated with an increase in OOH births.