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The peer review process is indispensable to promotion of quality in medical facilities. A major component of the process is honesty; without open investigation and discussion of adverse events and their causes, meaningful reforms for avoiding the same occurrences again are less likely to be made. To ensure open discourse, nearly every state has enacted laws protecting the confidentiality of peer review proceedings. However, federal law may not always be so deferent to the privacy concerns of the peer review committee. In certain circumstances, what most participants thought would be a closed record under state law might be opened by competing federal law enacted to protect the disabled.
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It is now common knowledge that the Centers for Disease Control and the American Medical Association consider obesity to be a high-priority medical problem. To combat the growing epidemic, bariatric surgery, which is indicated for 'severely' or 'morbidly' obese patients ' generally defined as a body mass index (BMI) over 40 (a 'normal' BMI is 19-25) ' has become increasingly popular. Surgery may also be indicated for patients with a BMI between 35 and 40, if there are significant co-morbid conditions.
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Modern understanding of medical malpractice is based upon the presence of a physician-patient relationship. This specific relationship gives rise to a special duty on the part of the physician, the breach of which is one of the requirements for finding professional negligence. Although this consensual relationship is often discussed and thought of in terms of an express contract ' that the relationship is created when professional medical services are 'offered' voluntarily and those services are 'accepted' voluntarily by another ' most courts have held that the creation of the relationship need not satisfy the formalities of a contract.
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Recent rulings of interest to you and your practice.
As we have discussed in Parts One and Two, there are many well-understood reasons medical mistakes are made ' lack of communication between providers and patients, inattention to detail, placing profit above patient care, and so forth.If we examine all these reasons for medical negligence while looking specifically at health care providers ' why a particular practitioner makes a mistake ' I find that mistakes often happen because doctors, nurses and others in the medical professions 'are' who they are, as people. It is a 'people phenomenon' ' a function of personality that manifests itself in the way a person works.
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On Jan. 18, 2006, the U.S. Food and Drug Administration (FDA) issued a final rule to revise the required format of prescription drug labels so as to enable physicians to find the information they need more readily. New features include a section called 'Highlights' and a Table of Contents. According to the FDA's press release, this is the first time in 25 years that the labeling requirements have undergone a major revision.
The Health Insurance Portability and Accountability Act (HIPAA) (42 U.S.C.A ' 1320d) was enacted by Congress in 1996 and took effect on April 14, 2003. Although it was originally intended to increase access to health care by expanding insurance portability and renewability, privacy issues evolved due to developing technology that provided easy access to health information. As a result, Congress added additional safeguards to the seemingly innocuous Act. Such procedural safeguards have spawned a debate on whether HIPAA preempts state privacy laws, and if so, whether it prohibits ex parte communications between a plaintiff's treating physicians and defense counsel. Therefore, it's important for counsel to be aware of the various state and federal court decisions on the subject and the issues raised by both plaintiffs and defendants in this amorphous area of law.
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