Documentation is best protection against litigation

CHICAGO — Meticulous documentation of patient encounters is the best defense against lawsuits stemming from retinal detachments, said Marvin F. Kraushar, MD.

During a free paper session at the American Academy of Ophthalmology meeting, Dr. Kraushar outlined a number of risk-prevention strategies surgeons can employ to prevent being named in a lawsuit brought by a patient with a retinal detachment.

“This is a high-risk diagnosis for both the patient and for the ophthalmologist,” Dr. Kraushar said. “If there is any possibility of a retinal tear or detachment, be extremely careful.”

Clearly identifying the risks of surgery preoperatively and ensuring the patient’s comprehension of the risks is important, Dr. Kraushar said.

“Don’t think of informed consent as a legal obligation. It is a powerful opportunity for risk prevention,” he said.

Likewise, informed refusal should be documented, Dr. Kraushar said. He called it the physician’s “duty to disclose the risks of non-treatment.”

The physician should document every communication with the patient, he advised. This will help create a complete record of interaction with the patient.

“Every record you write is a potential legal document,” he said.

The physician can even be sued by a patient he has never seen, Dr. Kraushar said. For instance, he said, a person might call to make an appointment complaining of flashes and floaters, but not be given a timely appointment. If, subsequently, a retinal detachment occurs, the practice could be at risk for legal action.

“Instruct your staff about emergency symptoms,” he suggested.

Patients can also sue physicians for “vicarious liability,” such as for mistakes other physicians, fellows or residents made while covering for the primary physician.

“Choose competent, reliable physicians to treat your patients,” he said. “And treat other physicians’ patients as you would treat your own.”