Professional Liability
Insurance
Insurance
Presented By Karen M Wernette, DVM Presented By Karen M Wernette, DVM
Professional Liability Insurance
Responds to allegations of Responds to allegations of professional malpractice. professional malpractice.
1. defends veterinarians
2. pays the costs veterinarians are legally responsible for due to allegations of professional negligence
3. educates veterinarians about avoiding claims.veterinarians about avoiding claims.
Professional Liability
Insurance
Allegations of Negligence
Allegations of Negligence
Allegations of Negligence
Allegations of Negligence
What is Malpractice ???
Failure to use such reasonable skill and diligence Failure to use such reasonable skill and diligence as are ordinarily expected of careful, skillful, and as are ordinarily expected of careful, skillful, and trustworthy persons in his or her profession trustworthy persons in his or her profession
Below the standard of care or Below the standard of care or negligencenegligence
What is the Standard of Care?What is the Standard of Care?
SOC is determined to be what a reasonable SOC is determined to be what a reasonable veterinarian would do in a particular situation. veterinarian would do in a particular situation.
SOC may be different in different geographical SOC may be different in different geographical areas.
areas.
Malpractice
Can you avoid claims of
Can you avoid claims of
malpractice?
malpractice?
Malpractice/Board Complaints
MiscommunicationMiscommunication Adverse events & unfortunate outcomesAdverse events & unfortunate outcomes
NegligenceNegligence
NegligenceNegligence
Human injuryHuman injury
Economic lossEconomic loss
CollectionCollection
PLIT’s Interest in Communication
in Veterinary Medicine
Proven connection to complaintsProven connection to complaints
“Communication” is one of the more recent “Communication” is one of the more recent hot topics
hot topics hot topics hot topics
Can be found at most CE meetingsCan be found at most CE meetings
PLIT PLIT –– better communication better communication
Reduced claims=reduced defense costs, Reduced claims=reduced defense costs, reduced claim handling costs, stable premiums reduced claim handling costs, stable premiums
Effective Communication Reduces
Malpractice Risk
Estimated that 60% of all claims are related Estimated that 60% of all claims are related to some breakdown in communications to some breakdown in communications
What can you do?What can you do?
What can you do?What can you do?
Communicate Effectively
ClientsClients StaffStaff ColleaguesColleagues ColleaguesColleaguesMalpractice due
Miscommunications
Lack of consentLack of consent
Failure to inform or risks, prognosis or Failure to inform or risks, prognosis or options
options options options
Failure to inform of costsFailure to inform of costs
Failure to give complete written and verbal Failure to give complete written and verbal discharge instructions
discharge instructions
Failure to listen or to be availableFailure to listen or to be available
Give Estimates
Update estimates during treatmentUpdate estimates during treatment
Dosage errors
Human errorHuman error
OverdoseOverdose--decimal point moveddecimal point moved li i
li i
Insulin syringesInsulin syringes
Drug mixDrug mix--up up
Zyrtec OTC and owner got Zyrtec DZyrtec OTC and owner got Zyrtec D
Zyrtec D contains pseudoephedrine Zyrtec D contains pseudoephedrine
History
Obtain pertinent recordsObtain pertinent records
Ask what medications has animal been Ask what medications has animal been given given given given
Identify animals
Note the procedure that the animal is Note the procedure that the animal is admitted for
admitted for
Document, Document, DocumentDocument, Document, Document Keep Good Medical Records Keep Good Medical Records
Records
EstimatesEstimates
Provides dxs/txs/ and PROGNOSISProvides dxs/txs/ and PROGNOSIS
Provides updates, alternative txs, Provides updates, alternative txs, P id id f li ’ P id id f li ’
Provides evidence of client’s Provides evidence of client’s acceptance or refusal of txs. acceptance or refusal of txs.
Note phone conversationsNote phone conversations
All records subject to subpoenaAll records subject to subpoena--all all communications, billing, clinical communications, billing, clinical care.
care.
Adverse
Events Happen
Mistakes will occurMistakes will occur
British Veterinary Defense Society British Veterinary Defense Society
reported that 78% of first year reported that 78% of first year reported that 78% of first year reported that 78% of first year veterinarians made a mistake veterinarians made a mistake
What do you do when it happens?What do you do when it happens?
What Does A Client Want To
Know If An Error Was Made?
1.
1.
What Happened? (Tell THE
What Happened? (Tell THE
TRUTH!)
TRUTH!)
Wh t H
N t?
Wh t H
N t?
2.
2.
What Happens Next?
What Happens Next?
(Recommend what is in the best
(Recommend what is in the best
interest of the animal)
interest of the animal)
3.
3.
What will you do to prevent this
What will you do to prevent this
from happening again
from happening again
4.
Recommend a necropsy when the
cause of death is in question.
AVMA PLIT
– 49 years of serviceThe PLIT’s mission is to provide
valuable services that protect the assets and reputations of program participants and enhance the image of the
veterinary profession.
Veterinarians Serving
Veterinarians
Veterinarians are Trust Representatives
1. Review EVERY malpractice claim submitted 2. Identify expert witnesses
2. Identify expert witnesses
3. Available to discuss claim and practice situations via toll-free phone call every business day
Owner’s Injury
Human injury claims represent 1%
Human injury claims represent 1%
of all claims and 4.8 % of the total
of all claims and 4.8 % of the total
dollars paid
dollars paid
Cat Bites Owner
Outcome
-Serious infection/tenosynovitisof the hand - permanent disability $80,000 indemnity payment $6,738 in legal defense costs
More PLIT Benefits
Protects you wherever you legally practiceProtects you wherever you legally practice
Consent to settle clause Consent to settle clause ––no claim settled w/out no claim settled w/out your written consent or a court order
your written consent or a court order y
y
Network of attorneysNetwork of attorneys
Court costs & fees for attorneys Court costs & fees for attorneys
Program’s experience Program’s experience –– covers over 55,000 covers over 55,000 veterinarians
Eligible for professional liability
insurance
AVMA MembersAVMA Members
SAVMA MembersSAVMA Members
Important Point
Individual premiums never go up no Individual premiums never go up no matter how many claims submitted matter how many claims submitted
AVMA Professional
Liability Insurance Trust
Professional LiabilityProfessional Liability
Animal BaileeAnimal Bailee
Student Professional Student Professional
Li bilit Li bilit
Mobile Practice Mobile Practice
coverage coverage Employment Employment Liability Liability
Veterinary License Veterinary License
Defense Defense
Business Owners Business Owners
Package Package Worker’s Worker’s Compensation Compensation Practices Liability Practices Liability Personal Personal Lines(Home, Auto) Lines(Home, Auto)
Embryo and Semen Embryo and Semen
Transfer Services Transfer Services
Negligence
Harm to patient Or client
COMPLAINT
Civil court system Licensing Board
Veterinary License
Defense
Endorsement to your PLIT
Endorsement to your PLIT
professional liability policy
professional liability policy
$69
l
i
$69
l
i
$69 annual premium
$69 annual premium
Up to $25,000 per year in legal
Up to $25,000 per year in legal
fees to defend complaints against
fees to defend complaints against
your license
your license
AVMA PLIT
License Defense
responds to complaints against your license provides legal expenses including fees
i t d ith i l tt
associated with preparing a response letter, conferencing with the licensing agency, and attending hearings.
The professional liability premiums vary The professional liability premiums vary
by class. Each class represents a by class. Each class represents a particular animal type:
particular animal type:
AVMA PLIT
Professional Liability
particular animal type: particular animal type:
•• Class I Class I –– Equine Equine
•• Class II Class II –– Food Animal Food Animal
•• Class III Class III –– Mixed Practice Mixed Practice
•• Class IV Class IV –– Small Animal Small Animal
AVMA PLIT
Professional Excess
additional professional liability limits for additional professional liability limits for practitioners that purchase the highest practitioners that purchase the highest professional liability coverage plan and would professional liability coverage plan and would
p y g p
p y g p
like even more protection. like even more protection.
Excess coverage is available up to five million Excess coverage is available up to five million dollars per year (in one million dollar
dollars per year (in one million dollar increments).
increments).
AVMA PLIT
Professional Extension (Bailee)
Covers damage to animals in your care, custody, and control, resulting from: Fire Wind Theft Theft Escape Flood Vandalism
Attack from other animals
Many other perils not related to treatment.
This is an endorsement to the PLIT-sponsored professional liability policy.
AVMA PLIT
Embryo/Semen Storage provides coverage limits for loss of embryo/semen while in storage or transit
storage or transit
This is an endorsement to the PLIT-sponsored professional liability policy.
Adverse Results
Total Truth to Client
Total Truth to Client
Empathy
Empathy---
p
p
y
y
---Sympathy
Sympathy
y p
y p
y
y
Best Interest of the Patient
Best Interest of the Patient
Continue Communication if Possible
Continue Communication if Possible
Situations That Prompt Claims
N
egligence
Collection
Communication
Economic Loss
Claim Reviews
Negligence?Negligence?
Inherent Risk?Inherent Risk?
What other information do you need to determine What other information do you need to determine Standard of Care?
Standard of Care?
Wh d ? Wh d i h ?
Wh d ? Wh d i h ?
What was done wrong? What was done right?What was done wrong? What was done right?
What could have been done better?What could have been done better?
What do you tell the owner?What do you tell the owner?
Who tells the owner? Who is present?Who tells the owner? Who is present?
What do you recommend at this point?What do you recommend at this point?
Give owner’s perspective as well as DVM’s Give owner’s perspective as well as DVM’s perspective
perspective
Most Common Types of SA
Claims
Miscommunication (informed consent) Miscommunication (informed consent) Misidentification (patient or body part) Misidentification (patient or body part) Sx Complications Sx Complications Anesthetic Complications Anesthetic Complications Dentals Dentals Thermal Burns Thermal Burns
Mis Dx (foreign body, metabolic disease) Mis Dx (foreign body, metabolic disease) Lack of Referral Lack of Referral Bandage/Cast complications Bandage/Cast complications Post op radiographs Post op radiographs
Urethral tears (during sx, castrations, FUS) Urethral tears (during sx, castrations, FUS) Medication complications (NSAIDS) Medication complications (NSAIDS)
