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demonstrating textbook symptoms of pregnancy-induced hyperten- sion. This patient presents to, and is discharged from, the hospital with these symptoms by a resident on 2 separate occasions, before arriving for a scheduled induction a week after the symptoms began. Before being admitted, the woman is placed in a waiting area for more than 14 hours. During this time, her symptoms continue to progress and she develops preeclampsia. The woman dies due to complications after an emergency Cesarean section. In the wake of her death, the hospital tries to disentangle itself from a finding of corporate negligence by arguing that it had no notice of the woman's situation. The court, however, upholds the finding of corporate negligence, saying that the situation was so blatant that even if the hospi- tal didn't know, it still should be held responsible because it should have known, either from reporting through the nursing chain of command or through appropriate supervision. Courts have held that if there is a failure to report changes in a patient's condition, or to question a physician's orders that are not in accordance to standard medical practice, the facility itself will be liable for corporate negligence. Have a chain of command for passing along important patient information, and ensure that staff is trained in how to communicate using this chain. Enforce adequate rules and policies When it comes to malpractice, facility liability starts and ends with policies and procedures. Constantly review and revise them. When you update a policy, don't just change it in your manuals and new-hire hand- outs — work with staff to put your policies into practice on a daily basis. An example of where this basis for liability against a hospital was called into question involved a man who developed a staph infection, allegedly due to the length of time the hospital let his 4 Medical Malpractice MM 4 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • O C T O B E R 2 0 1 6