Pathology and Law

A Practical Guide for the Pathologist

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By: Gregory Davis

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Published: 9th January 2004

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Almost all pathologists face legal issues when dealing with the specimens they work with on a day-to-day basis, whether it involves quality control and assurance in handling the specimens, facing the possibility of malpractice suits, or serving as an expert witness in a trial.

Written in an easy to read, conversational tone, with a dose of good humor, this book fills the need for a handbook that discusses the full spectrum of legal issues that many pathologists face, written from a pathologist's point of view. Organized in 12 user-friendly chapters, the book begins with a comparison of Law and Medicine and explains the basics of the American Legal System. It continues with discussions of the impact of law on the practice of pathology, including such topics as specimens with potential legal implications, the controversy of saving organs for teaching, procuring and saving specimens for toxicology testing and DNA confirmation in identity testing. A must-have section on malpractice suits covers reasons why patients sue, what to do if sued, and reducing the chance of being sued. The author addresses expert witness testimony, including how to be an expert witness, conflicts of interest, conduct in a courtroom, what to say and what not to say. Quality control and assurance as it applies to the pathologist is also discussed. Legal implications for the information age, including the use of internet and e-mail with regard to patient confidentiality is discussed in detail. Case samples are scattered throughout the text to illustrate the principles discussed. Every term is defined in the glossary.

Acknowledgments	p. vii
Preface	p. ix
Contributors	p. xi
Introduction	p. 1
On Medicine and Law	p. 1
Similarities	p. 1
Differences	p. 2
The King in His Court	p. 3
Theory and Operation of the American Legal System	p. 5
American Legal Theory	p. 5
American Legal Theory in Operation	p. 7
The Dramatis Personae	p. 7
Types of Trials-Civil and Criminal	p. 15
References	p. 15
Impact of Law on Pathology Practice-Everyday Occurrences	p. 17
Medical Practice	p. 17
The Duty of a Physician	p. 17
Pathologist-Patient Relationship	p. 20
Abandonment	p. 20
Surgical Specimens with Forensic Worth	p. 21
Gross Pathology and the Traumatic Spleen	p. 21
Bullets	p. 23
Chain of Custody	p. 24
Specimens with Civil Implications (Especially Potential Malpractice)	p. 26
Cytology	p. 29
Cervical Preparations	p. 29
Fine Needle Aspirates	p. 30
Autopsies	p. 31
Obtaining Autopsy Consent	p. 34
Performing a Hospital Autopsy	p. 36
Retention of Specimens	p. 43
Routine	p. 43
At Request of an Attorney	p. 43
Anatomical Gifts and Unusual Specimens	p. 46
Clinical Pathology	p. 51
Samples for Toxicology Testing (Ethanol and Drugs of Abuse)	p. 51
Transfusion Medicine	p. 53
Requests for DNA Confirmation	p. 56
Citation of References in Reports	p. 60
Transmitting Information to Clinicians and Clinical Staff	p. 61
Reporting Critical Values	p. 61
What to Do When You Discover that an Error Has Occurred	p. 63
Statute of Limitations	p. 68
Pathology Leadership of The Laboratory	p. 69
Disciplinary Actions	p. 70
Dismissal	p. 71
Confronting a Colleague	p. 72
Consultations and Liability	p. 72
Informal (Curbside) Consults	p. 73
By Clinical Staff of You Concerning an Opinion of Your Partner	p. 74
By a Partner on a Difficult Case	p. 74
Obtained by You from an Outside Expert in a Difficult Case	p. 75
Obtained of You by an Outside Pathologist in a Difficult Case	p. 75
References	p. 75
Impact of Law on Practice of Pathology-Malpractice	p. 77
What Is Malpractice?	p. 77
The Four Pillars of Malpractice	p. 78
The Business of Malpractice Law	p. 81
Patients as Plaintiffs	p. 81
Practice of Medical Malpractice Law	p. 88
Formal Notification of a Malpractice Suit	p. 91
Reaction to a Notice	p. 91
Response to a Notice	p. 93
The Importance of Keeping Your Mouth Shut	p. 93
Parties to Whom You Should Speak after Being Named as a Defendant, and Why	p. 100
Work with the Attorney Assigned to Represent You	p. 101
Signs that You Need a New Attorney	p. 104
Possible Outcomes	p. 110
When the Physician Is Found Guilty of Malpractice	p. 114
When the Physician Is Found Not Guilty of Malpractice	p. 114
Difficulty of Countersuits	p. 115
Reducing the Chance of a Malpractice Suit	p. 115
Indefensible Positions	p. 119
The Impaired Physician	p. 126
Professional Misconduct	p. 127
Criminal Wrongdoing	p. 129
References	p. 129
Expert Witness Testimony	p. 131
Requirements to Be an Expert Witness	p. 131
Reasons to Avoid Becoming an Expert Witness	p. 134
How to Become an Expert Witness	p. 135
Accepting or Refusing a Case	p. 136
Expectations of a Good Expert Witness	p. 137
Equanimity	p. 138
Keeping Track of Prior Testimony	p. 139
Report	p. 140
Competence in Testifying	p. 141
Payment as an Expert Witness	p. 141
What an Expert Witness Is Paid for	p. 142
Setting Expert Witness Fees	p. 142
Getting Stiffed	p. 145
References	p. 148
Natural History of a Legal Suit	p. 149
Preliminary Stages	p. 149
Reviewing the Case with an Attorney	p. 149
Reviewing the Case Yourself	p. 154
Deposition	p. 155
What Is a Deposition?	p. 155
Advantages of a Deposition	p. 156
Conduct at Deposition	p. 157
Outcome of a Deposition	p. 161
Trial	p. 161
Jury Selection	p. 161
Presentation of Evidence	p. 162
Jury Deliberation	p. 163
Mistrials	p. 164
Trial Dates	p. 165
Testifying	p. 166
On Giving a Good Performance	p. 166
On Testifying	p. 168
Legal Ploys Used by Attorneys	p. 176
Unethical Expert Witness Testimony	p. 181
Ethical Expert Witness Testimony	p. 181
Unethical Expert Witness Testimony	p. 181
Lying	p. 181
Willful Failure to Consider Pertinent Medical Evidence	p. 182
Quackery	p. 183
Mechanisms for Handling Unethical Testimony	p. 184
In Court	p. 184
Out of Court	p. 187
Conclusion	p. 189
References	p. 190
Quality Assurance and Record Keeping	p. 191
Definitions and Requirements	p. 191
Importance of Quality Assurance to a Hospital	p. 191
Overlap of Quality Assurance and Risk Management	p. 192
Shortcomings of Quality Assurance Programs	p. 192
Record Keeping	p. 193
Reference	p. 193
When the Time Comes to Be an Activist: Interacting with the Legislature	p. 195
General Overview of the Legislative Process	p. 195
Staying Current with Legislation	p. 196
Communicating with Your Legislators	p. 197
Telephone Calls	p. 197
Facsimiles and E-mail	p. 198
Personal Letters	p. 198
Meeting with Your Legislators	p. 199
Planning the Meeting	p. 199
Common Errors in Interacting with Legislators	p. 199
Conclusion	p. 200
Sources	p. 200
Legal Implications for the Information Age	p. 201
Health Information Portability and Accountability Act	p. 201
Telemedicine	p. 202
Advantages and Disadvantages	p. 202
Legal Matters	p. 203
E-mail	p. 207
References	p. 208
Glossary of Legal Terms	p. 209
Index	p. 215
Table of Contents provided by Publisher. All Rights Reserved.

ISBN: 9780387200354
ISBN-10: 0387200355
Audience: General
Format: Paperback
Language: English
Number Of Pages: 221
Published: 9th January 2004
Publisher: Springer-Verlag New York Inc.
Country of Publication: US
Dimensions (cm): 23.57 x 16.2 x 1.12
Weight (kg): 0.34