Posts Tagged ‘Nancy Collins’

Three Common Reasons You Might Get Sued

Friday, August 11th, 2017

Nancy Collins, PhD, RDN, LD, FAPWCA, FAND

Patients often sue for reasons that have nothing to do with the quality of the medical care rendered, but rather for the human care that is perceived as lacking.

Three Common Reasons You Might Get Sued

 

The last few weeks were very difficult for my family and friends in the medical sense. I had one family member in an intensive care unit on the West Coast, one friend’s father in a rehab facility on the East Coast, and one friend’s son having problems in the outpatient setting in the Midwest. These patients are male and female, young and old, and have very different medical histories, but they all have one thing in common. They all want to sue about their medical care or lack thereof. These cases illustrate three common reasons you might get sued. Let’s take a closer look at what has gone wrong for each patient.

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Nutrition and Wounds: The View From Both Sides

Friday, July 14th, 2017

Nancy Collins, PhD, RDN, LD, FAPWCA, FAND

Nutrition is frequently conjoined to wound care lawsuits because patients often lose weight, so it is important to thoroughly document nutrition interventions and education.

 Nutrition and Wounds

 

Most pressure injury lawsuits begin as just that—a lawsuit initiated because of an acquired pressure injury. Usually the wound in question never healed to closure, became infected, led to an amputation, or otherwise caused the patient suffering. During the legal discovery process, all sorts of other care issues come to light, and the scope of the lawsuit grows. One of the most common additional issues is the patient’s nutritional status. Let’s look at it from both sides.

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Truth or Consequences: Admitting Your Wound Care Program Needs Improvement

Friday, June 9th, 2017

Nancy Collins, PhD, RDN, LD, FAPWCA, FAND

Some healthcare providers are working in underperforming facilities, and they need to discuss how to improve outcomes before it becomes a matter of legal record.

Truth or Consequences: Admitting Your Wound Care Program Needs Improvement

 

“I didn’t have any special training in wounds. No one else wanted to do it, so I said okay.”

“The weekends were really bad. We only had a few people working weekends.”

“I know some of the patients didn’t get turned all day.”

“We always were running out of supplies, so I improvised.”

All of these confessions, or truths, are from real life depositions of nurses who were working in facilities that patients were suing because they developed wounds. These nurses were not trying to hurt their facility in any way or stymie the defense team, but were simply telling the truth in their opinion.

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Nine Wound Care Documentation Pitfalls to Avoid

Friday, May 12th, 2017

Nancy Collins, PhD, RDN, LD, FAPWCA, FAND

Lawsuits often are settled out of court because the medical record documentation is not defensible. Incomplete, illogical, and inconsistent records are far too common, so it is important to avoid the common pitfalls.

9 Wound Care Documentation Pitfalls to Avoid

 

After reviewing hundreds of medical charts involved in litigation, I noticed many of the same problems occurring in the wound care documentation over and over again. From New York to Florida to California, it is remarkable how the same inconsistencies, errors, and oversights tend to stymie the defense of a case. The goal of every healthcare practitioner is to have complete, accurate, and timely documentation of the medical care given to each and every patient. Here are nine wound care documentation pitfalls to avoid.

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The Great (Legal) Debate About Turn and Reposition Documentation

Friday, April 7th, 2017

Nancy Collins, PhD, RDN, LD, FAPWCA, FAND

Documentation of turning and repositioning often leads to legal problems as some healthcare providers chart by exception and others chart at the point of care.

The Great (Legal) Debate About Turn and Reposition Documentation

 

“The hospital never turned the patient, and therefore the patient suffered a serious pressure injury,” declared the plaintiff attorney. The defense team shot back, “Whoa. Slow down. Never is long time, and of course we turned the patient.” How can a basic care intervention such as turning and repositioning have two totally opposing views?

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Disappointed by Debridement

Friday, March 3rd, 2017

Nancy Collins, PhD, RDN, LD, FAPWCA, FAND

Plaintiffs often express shock and disbelief after eschar is removed, which often leaves a wound larger than the original size of the eschar.

Disappointed by Debridement

Wound photo: “Stage 4 decubitus displaying the Gluteus medius muscle attached to the crest of the ilium” by Bobjgalindo is licensed under CC BY 2.0

 

“We were in shock and couldn’t believe our eyes. It was like half her foot was gone.”

“My husband and I were horrified when we saw what they did.”

“My sister and I looked at each other, and I just kept asking why?”

“I had to leave the room and go the bathroom to cry when I saw what they did to my mother.”

You might think these quotes are from people who have witnessed a shocking crime or some sort of violence, but they are not. These are quotes from family members, now plaintiffs, who are suing for poor medical care related to a chronic wound. Their shock all had one thing in common—it came after seeing a wound that was surgically debrided.

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When Your Patient Refuses to Be Turned and Repositioned—And Then Sues!

Friday, February 3rd, 2017

Nancy Collins, PhD, RDN, LD, FAPWCA, FAND

The battle between optimal medical care and patient rights is one to fight with empathy and finesse to keep it out of the courtroom.

When Your Patient Refuses to Be Turned and Repositioned—And Then Sues!

 

I recently reviewed a lawsuit filed by the family of a patient* with a spinal cord injury. The patient was involved in a car accident and sustained multiple traumatic injuries. The medical team worked tirelessly over the course of many weeks to stabilize him. Because of this catastrophic accident, the patient was understandably quite devastated and depressed. He refused all physical therapy and spent most days lying in bed on his back, despite encouragement from his medical team and pleading from his family. He frequently stated that he wished he was dead and that he wanted everyone to leave him alone, often escalating things to the point of screaming.

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Intake + Output = Big Documentation Problems

Friday, October 7th, 2016

Nancy Collins, PhD, RDN, LDN, FAPWCA, FAND

Inaccurate and incomplete intake and output (I&O) records pose a problem in litigation, as well as a risk to the patient who requires monitoring of fluid balance for medical reasons. 

Intake + Output = Big Documentation Problems

 

“Would you agree that the nurses did not know how to do basic arithmetic?”

Of course nurses know how to add and subtract, yet I was asked this question in a very challenging manner by a plaintiff attorney. He had just showed me 3 weeks of I&O tables excerpted from the medical chart of the deceased plaintiff, and almost every shift was incomplete. The plaintiff attorney was reducing the problem to poor math skills, implying that not a single day was complete because the nurses who cared for this patient lacked the skills to add a column of numbers. He knew I would disagree because I was not going to say these nurses lacked basic math skills. But he also knew his follow-up question was the real reason for this math ploy.

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Your Patient Died: Should You Send the Family a Card?

Friday, September 9th, 2016

Nancy Collins, PhD, RDN, LD, FAPWCA, FAND

Bereavement care is part of the job, no matter how difficult it is to talk about death and deal with grieving family members.

Your Patient Died: Should You Send the Family a Card?

 

“Callous disregard.” These two little emotionally loaded words are how the plaintiff complaint summed up the following story from a grieving daughter named Sally.* In her deposition, Sally recounted how nice and welcoming everyone was at the nursing home when she toured it 3 years ago prior to moving her mom in. It seemed like a good place where the staff could provide the care her mom needed; care Sally was no longer able to provide for her at home as her mom’s physical and mental condition continued to worsen. Those feel-good sentiments were replaced by anger, sadness, and ultimately litigation after her mom died. When Sally was asked why she was suing, she replied that no one at the nursing home cared about her mother.

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Great Expectations Unmet: The Real Reason Patients Sue

Friday, August 5th, 2016

Nancy Collins, PhD, RDN, LD, FAPWCA, FAND

Most lawsuits start not because of poor medical care but because families believe promises were made and broken and they are angry.

 

Great Expectations Unmet: The Real Reason Patients Sue

 

If you speak to any health care attorney about the proliferation of lawsuits against hospitals, nursing homes, and health care providers (HCPs) over the last decade or so, you will engage in a conversation peppered with a variety of legal terms. These may include breach of duty, negligence, malpractice, wrongful death, statutory standard of care, or even criminal culpability. It is important to understand that these are formal words with specific legal meanings, and at least a few of them appear on every plaintiff complaint as the reason for the lawsuit.

This is in sharp contrast to every deposition I have ever read from a plaintiff—usually the surviving spouse or child/children of the deceased. These family members never use legal jargon. Instead, they use emotional terms that reveal the true reason they are suing. Unless the family member works in the medical field, they rarely criticize the actual medical care but rather express great sadness with the personal care and the way they were treated. Plaintiffs frequently remark about the lack of caring they felt in health care. It is these words that we must focus on if we are to understand the patient perspective and thereby improve patient satisfaction.

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