Civil Topics

Topics of relevance as identified by the
American Board of Psychiatry & Neurology Board Certification Examination Content Outline.

Learn Forensic Psychiatry is not affiliated with nor endorsed by ABPN.

Professional Liability

Medical Errors

How Common Are Medical Errors?

  • Medical errors are common, but they don’t always result in harm.

  • Some of the most common types of medical errors are related to diagnosis and prescribing. In psychiatry, claims related to suicide are among the most common.

  • Most patients who experience medical errors don’t take legal action. Of those who do, only a fraction of cases proceed to trial, and an even smaller amount are found in favor of the plaintiff.

  • Psychiatrists have one of the lowest malpractice rates when compared to other medical specialties

Preventing & Disclosing Medical Errors

  • Prevention

    • A systems-based approach to medical error involves viewing errors as systems-level failures rather than pointing blame at specific individuals.

  • Disclosure

    • Typically encouraged by professional medical ethics.

    • Many states have apology statutes which provide immunity for healthcare professionals in disclosing medical errors.

      • Condolences may not be used as evidence of negligence in legal proceedings, but statements of fault often aren’t protected.

Medical Malpractice

Basics of Malpractice

  • Medical malpractice falls under tort law (civil)

  • The 4 D’s of Medical Malpractice

    • Duty (Doctor-patient relationship)

    • Dereliction of duty (deviation from the standard of care due to negligence)

    • Damages (actual harm or injury occurred)

    • Direct cause

    • The burden of proof is on the plaintiff (patient) to demonstrate that a doctor-patient relationship, and thus a duty of care, existed; that a deviation from the standard of care occurred; and that negligent care was the direct and proximate cause of damages.

    • The standard of proof is preponderance of the evidence, meaning it’s more likely than not that malpractice occurred.

  • Standard of Care

    • Physicians have a duty to provide the standard of care- the level and type of care that a reasonable, competent physician of the same specialty would’ve provided under similar circumstances.

    • The standard of care may be established using professional society guidelines, policies, or expert witness testimony.

  • Types of Negligence

    • Comparative Negligence: both parties are at fault. Plaintiff may recover damages depending on their percentage of fault.

      • Ex: car accident where both parties played a role.

    • Contributory Fault: if the plaintiff is at all at fault, they may not recover damages.

      • Ex: pedestrian hit while jay-walking.

    • Negligence Per Se: violation of a statute or law is automatically considered negligent if someone protected by that law is harmed.

      • Ex. hitting a pedestrian while driving over the speed limit.

    • Gross Negligence: Severe, reckless disregard for the safety and wellbeing of others.

      • Ex: operating while intoxicated.

  • Types of Causation

    • Cause in Fact (Actual Cause)

      • Would the damage have occurred “but-for” the negligent act?

    • Proximate Cause (Legal Cause)

      • Was the damage reasonably foreseeable- in other words, a natural and probable- outcome of the negligent act?

  • Types of Damages

    • Compensatory damages aim to make the patient whole, compensating for losses suffered as a result of the malpractice. They may include economic damages (such as medical bills or loss of income), and non-economic damages (such as pain and suffering, loss of quality of life, or loss of consortium)

      • Many states limit non-economic damages.

    • Punitive damages serve to punish the defendant and serve as a deterrent. They are generally awarded when conduct was reckless or malicious.

  • Professional Liability Insurance

    • Occurrence-Based Policies cover claims that arise from events that occurred during the policy period, regardless of when the claim is filed.

    • Claims-Made Policies only cover claims filed during the policy period- if the event occurred while the policy was active, but the claim isn’t filed until after the policy is terminated, it wouldn’t be covered.

    • With the latter, Tail Coverage may be required to ensure continuous coverage for claims filed after the policy ends.

    • Liability insurance generally doesn’t cover punitive damages, nor claims unrelated to malpractice (such as sexual misconduct).

Personal Injury Basics

Key Legal Principles

  • “Eggshell” Plaintiffs

    • In personal injury cases, plaintiffs are taken “as-is”, meaning that a defendant is still liable for damages even if the plaintiff had pre-existing conditions which made them more vulnerable to, or predisposed them to, injury.

  • Bystander Recovery

    • Bystanders may be able to recover damages due to emotional distress if they witness injury to another, even if they weren’t directly injured. Rules vary by jurisdiction.

      • Impact Rule: Damages cannot be recovered for emotional distress without physical impact

      • Zone of Danger: Bystander was at immediate risk of harm due to physical proximity

      • Dillon Rule/ Foreseeability Test - Dillon v. Legg, 1968

        • Proximity to scene of accident

        • Emotional impact from direct observation

        • Close relationship to victim

Workplace Issues

Worker’s Compensation

  • State and federal programs that provide compensation, in the form of medical and financial benefits, to workers for work-related injuries, regardless of fault.

    • Typically includes a percentage of lost wages during recovery and medical costs at the employer’s expense.

  • Requires a nexus (causal link) between the injury and employment- “injury arises out of and in the course of employment.”

    • Employee was at greater risk for injury than during everyday life because of employment.

    • Occurred on the employer’s premises while performing work-related duties (some exceptions)

  • Typically serves as an exclusive remedy, meaning workers cannot also sue their employer for negligence.

  • Psychiatric Workers’ Compensation Claims

    • Physical-Mental: physical injury leads to a mental condition.

    • Mental-Physical: psychological trauma leads to a physical disorder.

    • Mental-Mental: psychological trauma leads to mental condition.

Social Security Disability Insurance (SSDI)

  • SSDI provides replacement income to disabled workers and dependents who have contributed to Social Security via FICA tax on earnings.

  • State’s Disability Determination Service (DDS) makes the initial determination based upon 5 questions:

    • Are they engaged in substantial gainful activity?

    • Is there severe impairment that limits ability to work?

    • Does the condition meet or equal a listed impairment?

    • Can they perform relevant past work?

    • Can they do any other type of gainful activity?

  • Substantial Gainful Activity (SGA)

    • Any productive work performed for renumeration or profit, whether or not profit is made, involving significant physical and/or mental duties.

    • Includes part-time work and work unrelated to past employment.

    • If earning above a certain threshold, generally not considered to be disabled and disqualified.

  • Total Disability

    • Inability to engage in any SGA due to a medically-determinable physical or mental impairment which is expected to result in death or which has, or can be expected to, last for a continuous period of no less than 12 months.

Supplemental Security Income (SSI)

  • SSI provides a minimum income to those with limited income and blindness, disability, or age 65+.

  • Uses the same 5 qualifying questions for determining disability as SSDI.

Discrimination at Work

  • Title VII of the 1964 Civil Rights Act (CRA) prohibits discrimination on the basis of sex, race, color, religion, or national origin.

    • Enforced by the Equal Employment Opportunity Commission (EEOC)

  • Hostile Work Environment

    • Defined by the CRA as unwelcome conduct (uninvited and offensive) that’s:

      • Based on a protected class

      • Severe or pervasive enough that a reasonable person would find intimidating, hostile, or abusive

      • Perceived by the victim as hostile or abusive

      • Affects employment

  • Same Sex Harassment

    • Defined by the CRA as unfair treatment, harassment, or being subject to a hostile work environment on the basis of sex by someone of the same sex.

      • Includes biological sex, gender identity, sexual orientation, and sex-based stereotypes.

Americans with Disabilities Act (ADA) - 1990

  • Federal civil rights law that prohibits discrimination on the basis of disability.

  • Disability: a physical or mental impairment that substantially limits one or more major life activities, having a record of such impairment, or being regarded as having such impairment.

    • If this definition is not met, the impairment isn’t considered a disability under ADA.

  • Titles of ADA:

    • Title I: Employment

      • Employers are required to provide reasonable accommodations as long as they don’t present undue hardship.

      • Employers aren’t required to:

        • Retain employees who are unable to perform essential job functions with reasonable accommodations.

        • Accommodate employees who pose a direct threat, even if related to disability.

    • Title II: Public Services

      • Prohibits discrimination and exclusion from participation in services, programs, or activities of a public entity on the basis of disability.

      • Generally requires that services be provided in the most integrated setting.

      • Reasonable modifications must be made when necessary to avoid discrimination, unless the public entity demonstrates that the modifications would fundamentally alter the nature of the service, program, or activity.

    • Title III: Accommodations required by private entitites

    • Title IV: Telecommunications services

    • Title V: Miscellaneous provisions & Specific Exclusions

ADA Amendments Act of 2008 (ADAAA)

  • Expanded the definition of disability to include those previously excluded by strict interpretations.

  • Broadened the definition of major life activities, including adding bodily functions.

  • Broadened the “regarded as” category

    • Clarified that employer accommodations are not required for those who are regarded as, but not actually, disabled.

  • Mitigating measures were no longer considered for disability determinations.

Fitness for Duty Evaluations

  • An evaluation aimed at determining whether an employee is psychologically and emotionally capable of safely and effectively performing their job duties.

  • Often requested in context of performance issues, behavioral concerns, incidents at work, or safety concerns.

  • Referrals should be based on both performance issues and known or suspected mental impairment.

Guardianship

Guardian

  • An adult with formal court-appointed authority to manage the property and personal interests of another individual (the ward).

  • Holds a fiduciary responsibility (must act in ward’s best interest)

Types of Guardianships:

  • General Guardian: appointed to provide for the personal needs of the ward due to global incompetence.

    • Burden of proof is on petitioner to demonstrate clear and convincing evidence of substantial impairment in ability to manage property or inability to care for themselves due to a specific disability.

    • Guardian has broad authority to make decisions about most aspects of wards’ life.

  • Conservator/ Limited Guardian: appointed to manage the ward’s financial affairs

    • Doesn’t require global incompetence of ward.

    • Guardian has limited authority; ward retains ability to make decisions in other aspects of life.

    • Guardian doesn’t have legal decision making capacity (such as consenting to treatment)

  • Guardian ad litem: appointed to protect the interests of a minor or incompetent individual in a legal proceeding.

  • Testamentary Guardian: appointed for a minor child in a will, responsible for child and their estate until age of majority.

Testamentary Capacity

  • The capacity of an individual to make a valid and enforceable will.

  • Testamentary capacity is presumed.

  • Elements

    • Requires ability to know and understand:

      • Nature of the act (making a will)

      • Nature and extent of property and natural beneficiaries (who would typically inherit property)

    • Must be of sound mind and free of undue influence (coercion)

  • Insane Delusion

    • Ex.. testator’s delusional belief that spouse is having an affair

    • May potentially invalidate a will if it had a direct impact on testator’s decisions while making the will.

      • May invalidate the entire will, or just a part of it