patient to chart during the case, you can make additions with a chrono-
logical list of progress notes. It doesn't have to include specific times,
but it should contain the sequence of events as they unfolded. In these
kinds of cases, juries want to see that you're taking care of the patient,
and the progress notes will help to show that you acted responsibly.
When a lawsuit finally manifests itself, it might be years after the
fact that you find yourself in a courtroom and someone hands you a
chart, asking you to explain what happened. When that moment
comes, the chart probably won't have all the information you'll need,
and you don't want to go strictly by memory.
After an incident, go home that night and write down every possible
detail about that day and about that case — what you did do, what
you didn't do, even what you wish you had done. In a lawsuit sce-
nario, a private letter to yourself is not discoverable, but you don't
share it with anyone.
What's at stake?
The losses incurred in a malpractice suit inevitably go much further
than the monetary judgments against a defendant. Any clinician who
has ever been named in one of these suits will likely say it affected
them personally just as much as it did professionally. Nothing about a
malpractice suit is pleasant. Being deposed, having to endure a trial,
being put on the stand and having to explain how your actions led to
a most unwanted outcome — these are the kinds of life-changing
experiences that make people want to leave our profession. That's
why we need to do everything in our power to make sure patients
leave our ORs in better shape than when they came in.
OSM
Mr. Landess (william.landess@palmettohealth.org) is the
systems director of anesthesia services for Palmetto Health in Columbia, S.C.
He has practiced defensive medical malpractice.
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