Dr. Shyam P Lohani

It has been estimated that unsafe healthcare results in 2.6 million deaths annually in low-and middle-income countries (WHO, 2019). Johns Hopkins researchers (2016) ranked medical malpractice as the third leading cause of death in the United States after heart disease and cancer. However, it is still unknown how many deaths result from malpractice worldwide every year. As per the constitution of most of the countries around the world, it is the right of any individual to get the best available healthcare services. The safety of patients’ health is the duty of the hospital and healthcare professionals. Therefore, a hospital or healthcare professional is expected to provide a certain standard of care.

Negligence
Medical malpractice arises when a healthcare professional or provider neglects to avail appropriate treatments, omits to take appropriate action, and deviates from standards in their profession, thereby causing harm, injury, or death to a patient. The errors in diagnosis, treatment, and aftercare or health management may arise due to negligence.
Any act of medical malpractice should consist of three fundamental characteristics. First, it must be proven that the treatment has not been consistent with the standard of care accepted and recognised by the profession. Second, it must be proven that the patient has suffered some kind of harm, injury, or death due to negligence. However, an injury without negligence or an act of negligence without causing any injury cannot be considered a malpractice. Third, it must be proven that the injury resulted in significant damages such as disability, unusual pain, suffering, hardship, and loss of income, or a significant burden of medical bills.

There are several cases where an error or negligence could lead to a lawsuit include misdiagnosis or failure to diagnose, unnecessary or incorrect surgery, premature discharge, failure to order appropriate tests or to act on results, not following up, prescribing and/or dispensing the wrong dosage or the wrong medication, leaving objects inside the patient’s body after surgery, operating on the wrong part of the body, the patient experiencing persistent pain after surgery, potentially fatal infections acquired in the hospital, pressure ulcers, or bedsores. Fires in hospitals and patients committing suicide while in the care of health staff have also been sued for malpractice.
Obtaining informed consent is considered fundamental to prior treatment in order to avoid litigation against medical malpractice. It is the duty of a healthcare provider and/or hospital to obtain informed consent to a medical procedure. Without informed consent, if the procedure results in harm or injury, even if it was carried out perfectly, a health care professional may be liable for medical malpractice.

The medical malpractice law is different in different countries and usually under the jurisdiction of the federal government. The allegation of medical negligence must be filed in time. Once it is established that negligence led to harm, injury, or death, the court gives verdicts on monetary damages resulting due to malpractice. Damages usually compensated for actual economic loss such as lost income and cost of future medical care, as well as noneconomic losses, such as pain and suffering. Healthcare providers generally have medical malpractice insurance to protect themselves against medical negligence and unintentional injury. In some instances, a hospital or a medical group running hospitals pay the damages.

Pharmaceutical drugs can work wonders if used prudently both in the long term and short term. However, mistakes made by pharmacists and pharmacy assistants can even results fatal outcome. Dispensing the wrong medication is the most common type of pharmacy error. Dispensing incorrect drugs can include giving a patient a prescription with a similar name, mixing up patient prescriptions, or misreading the prescription. Distraction, multitasking, or mixed up prescriptions during dispensing could lead to medical malpractice.

Placing incorrect directions on a medication label or failing to provide instructions can result in complications. Pharmacists should always check new drug labels. Sometimes a pharmacist may dispense correct drug but in wrong dosage. Incorrect dosage can cause serious side effects or even death. Nurses are the front liner of patient healthcare. They handle everything from everyday care to special procedures such as surgeries. Mistakes made by nurses make them liable for medical malpractice. This is because nurses have a duty of care owed to a patient and the breach of that duty causes personal injuries. Usually, a hospital employing nurses has insurance coverage for the damages caused by such negligence in developed countries.
It is estimated that at least 70 per cent of all medical decisions are based on the results of common diagnostic tests, such as those conducted in a laboratory setting. Laboratory technicians are liable for malpractice if their work results in a physician making the wrong diagnosis or delivering a treatment harmful to a patient. Even lab technicians do not intend to harm the patient, and never even saw the patient, lab or technicians are liable for malpractice.

Amendments
It is important to have cooperation and coordination between physicians, pharmacists, and nurses for better healthcare services. The proper recognition and utilisation of the expertise of those healthcare professionals as a team both in private or public healthcare facilities have yet not been realised in many countries. The existing act on medical malpractice needs amendment and all the stakeholders should be consulted prior to any amendments. The appropriate legislatures help victims to get justice in time which not only ensures their fundamental rights but also compensates for the loss they incurred. At the same time, unnecessary hooliganism and litigations against the providers and hospitals can be avoided.

(Prof. Lohani is the founder and academic director at Nobel College. lohanis@gmail.com)