Patient Abandonment and the Dental Malpractice Risk Involved Read about the medical malpractice risk related to patient abandonment. In a medical malpractice case medical peer review may be used to prove negligence.
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Healthcare providers have to be constantly aware of medical negligence and consequent malpractice litigation. This article looks at a particular type of malpractice or medical negligence risk a physician could face, namely, patient abandonment. Any medical malpractice case requires collecting the claimant’s medical records, medical record organization, and detailed review to find evidence of malpractice. Patient abandonment issues arise when a physician terminates the doctor – patient relationship without a logical excuse or reasonable notice and fails to provide the patient with an opportunity to find a qualified replacement physician or healthcare provider.
In this article, we consider the issue of patient abandonment and the malpractice risk it lays on dentists. We are going through a period of health emergency created by COVID-19 and dental practices, just as other physician practices, have temporarily stopped the provision of routine care to patients. This is of course with a view to prevent the spread of the dangerous virus in keeping with state directives and CDC recommendations.
However, dentists are obliged to either
remain available to “patients of record” (patients who have undergone a complete dental evaluation performed by a licensed dentist)who need emergency dental treatment, or arrange coverage for any emergencies with another dentist. Charges of negligence and patient abandonment could arise if dentists fail to communicate with patients, fail to treat them, or refer them for treatment. During the present health crisis when patient treatment is restricted (though temporarily) to emergent care only, it is important to have clear protocols to communicate with patients and provide them emergency treatment, including patient screening and proper use of PPE or personal protective equipment for the dentist as well as the dental staff. Here are some important points dentists can consider to avoid liability in the midst of the pandemic, as outlined by the CDA (California Dental Association.) These are useful recommendations any dental professional can adopt. •
Patients of record must understand how the dental office is handling appointments and emergencies amid “stay-at-home” orders issued by individual states and other county/local orders related to practicing social
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distancing and limiting travel to essential purposes only (e.g. for groceries, emergency healthcare, medicine). o The CDA has published announcements dentists can use on their websites, social media pages, and on the dental practice’s front door. o A dental office that is not handling patient emergencies must make sure to provide their patients with the contact name and phone number of the dentist who is handling the office’s emergencies. o Patients who call the dental office, and get connected to the dentist or other staff working remotely or even the voicemail, must receive the proper message and contact details of the dentist handling dental emergencies such as severe pain, trauma, heavy bleeding, and cellulitis. Dentists should use their clinical judgment to determine whether the patient has a real dental emergency. •
Dental practices should have a clear protocol for staff regarding when and how emergency patients will receive care and what personal protective equipment will be used.
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Dental offices that are open must continue to screen emergency patients for COVID-19 via a telehealth platform/phone before the patient enters the office. Patients who pass the screening should not be referred to a hospital ER.
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Use at least a face shield and level 3 surgical mask for non-aerosolproducing care for a COVID-19 -negative patient.
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Dentists must be extremely cautious when determining if a patient is a “patient of record.” If the minimum required PPE is not available, the dentists should request the same from their colleagues or local Medical and Health Operational Area Coordinator.
In a medical/dental malpractice case, medical peer review would focus on establishing negligence by finding evidence that the treating dentist’s actions deviated from the standard of care required. In the face of unanticipated events, negligence or malpractice concerns can be avoided if the medical or dental professional had advised the patient of the possibility of such events and recommended the proper conduct in such instances. Intentional or willful patient
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abandonment will lead to litigation against a dentist or physician under specific circumstances. To prove willful abandonment, there should be evidence that the dental professional has knowledge the patient is suffering from the actions of the dental professional. Even with that understanding the dental professional did not take any action to ensure that the patient was treated, or in the absence of immediate treatment the dental professional took no action to ensure the patient had access to other dental professionals. This access may be either written information provided to the patient after a surgery, or actual statements made by the dental professionals or their staff to the patient. The dentist’s priority must be to avoid liability. To ensure this, they can make sure that patients of record are able to communicate their dental needs with a dentist to find out whether emergency care is warranted. Dentists can also give directions to patients regarding maintaining good oral health.
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