Infection Prevention and Control Strategies for Managing Reusable Medical/Dental Instruments and Devices in Ambulatory Care Settings

Ambulatory healthcare facilities — such as clinics, surgery centers, medical offices, and dental offices — must make concerted efforts to prevent and control the spread of infectious diseases and outbreaks. As more patient care services have shifted from inpatient to outpatient settings, the importance of infection prevention and control (IPC) has become more pronounced — and, in the wake of the COVID-19 pandemic, concerns about IPC have reached new heights.

CASE STUDY: Failure to Identify Sepsis and Initiate Treatment Leads to Patient Death

The patient in this case was a 49-year-old female who had a significant medical history, including chronic obstructive pulmonary disease (COPD), coronary artery disease, hypertension, and hyperlipidemia. Her surgical history included placement of two coronary stents and vascular surgery on her left leg.

Inadequate Informed Consent Process for Orthopaedic Surgery Complicates Malpractice Defense

Residents performing surgeries and procedures under the supervision of experienced physicians is an integral component of the medical educational process. At the same time, disclosing to patients which providers will be involved in their care is an essential component of the informed consent process, which recognizes patients' rights to make informed decisions about their care.

In this case, the patient was a 66-year-old male with a long history of arthritic and orthopaedic problems in his right knee. His medical history included one arthroscopy and one high tibial osteotomy. Continued evaluation of the knee resulted in the recommendation that he have a total knee replacement, to which he consented. The patient was aware that a resident would be assisting in his surgery. In actuality, though, an orthopaedic resident (Dr. A) performed the procedure with an attending surgeon (Dr. B) assisting.

Accountability for Informed Consent in Healthcare: Considering Shinal v. Toms

Issues related to informed consent are a persistent area of concern in healthcare and a source of liability exposure. MedPro Group malpractice claims data show that more than one-fourth (27 percent) of all communication-related malpractice claims involve allegations associated with informed consent.¹ Of these allegations, the majority are related to inadequate consent processes and failure to manage patient expectations.

Addressing Racial Disparity in Maternal Health

One of the key challenges in addressing maternal mortality is the racial disparity that exists. Among high-resource countries, the United States has the highest rate of maternal mortality, and the risk is three to four times higher for black women, according to the Institute for Healthcare Improvement.¹

Some contributing factors to the racial disparity include unconscious biases — both institutional and structural racism — and lack of insurance.

CASE STUDY: Patient Aspirates Foreign Material During Dental Restoration Procedure

The patient presented to Dr. J, a general dentist, for four uncomplicated restorations. After Dr. J obtained and reviewed the patient's history and physical information and received appropriate informed consent to treat, she started the procedure. Shortly after entering the patient's oral cavity, the burr dislodged from the handpiece, struck the back of the patient's mouth, and the patient aspirated it.

The patient was having some respiratory distress, so the office contacted emergency medical services (EMS). At the local hospital, an X-ray indicated the burr was in the base of the patient's lung. An otolaryngologist was unsuccessful in reaching the burr endoscopically; ultimately, a thoracic surgeon removed it.

CASE STUDY: Failure to Follow Protocols, Poor Documentation, and Inadequate Postmortem Investigation Worsens Liability

This case study discusses how multiple missteps can play a role in an adverse outcome and increase the risk of liability. As such, the case study focuses on a healthcare providers' involvement with a patient from a two-phase perspective: clinical care provided to the patient during the patient's hospitalization and compliance with hospital protocols prior to and following the patient's death.

CASE STUDY: Failures in Communication and Management of Care Result in Poor Patient Outcome

The patient, a 66-year-old Hispanic male who did not speak English, was referred to a MedPro-insured ophthalmologist (Dr. A) by his regular optometrist (Dr. B) for evaluation of early cataracts. During the patient's appointment, Dr. A relied on her very limited Spanish proficiency to communicate with the patient instead of using an interpreter.