Hospitals constantly face the threat of lawsuits. In fact, right here in Saint Lucia, the Owen King European Union Hospital (OKEU) spends nearly $600,000 on malpractice insurance – that’s on a yearly basis.
Chief Executive Officer of the Millennium Heights Medical Complex (MHMC) Dr. Dexter James said this much recently, when speaking to reporters at a press briefing.
In cases where family members or patients are unhappy with the services they’ve received, litigation can be pursued. But that does not guarantee a win, patients must note, and moreover, family members and patients should remember that nurses and doctors are fallible like everyone else.
When a patient or a family member has accused a hospital of negligence, the hospital has to ensure that it gets to the bottom of that situation. How then does it proceed?
As James puts it: “healthcare workers are humans, this is why we have to purchase malpractice insurance to protect the institution. When incidents take place at the hospital these incidents are logged and investigations are carried out.”
“These investigations are conducted by a quality department, usually a risk officer, and they are required to conduct root cause analysis so we know what the truth is,” he added.
Ultimately, James explained, “a decision is taken as to whether we were liable or not. Where we are liable we say to the public we didn’t do as well as we should and this is what we’re doing to improve it. Some persons go on the litigious side and we ask our attorneys to sort that out, accept liability and see how we could settle out of court. In cases where our investigation proves otherwise we’re prepared to defend it.”
However, he noted, it cannot be a self-serving arrangement “because if it goes to court the institution would look silly. This has to be an independent kind of work that transcends whether you’re an employee or otherwise the facts of the incident must stand on its own, we’re not fearful of it.”
MHMC is determined to create a just culture and has made it clear to staff that “things can go wrong; when it does happen, don’t be fearful , report it because when you report it we could take the appropriate action to prevent it from becoming catastrophic,” James said, adding that “we would rate the incidents as to whether we believe it will cause grave harm, injury or death to the patient and do a root cause analysis.”
OKEU has adopted ISO 31000 as its framework for risk management as it is tailor-made for any organization seeking clear guidance on risk management.
According to the International Organization for Standardization (ISO), using ISO 31000 can help organizations improve identification opportunities and threats and effectively allocate and use resources for risk treatment.
In the Caribbean, laws governing medical malpractice claims are as varied as the jurisdictions, a 2021 article on kennedyslaw.com noted.
For instance, ‘Kennedy’s Law’ stated, the US Virgin Islands (USVI) has a per incident cap of US$250,000 on all medical malpractice claims and routes all claims through a medical malpractice administrative body before reaching the courts.
In the Commonwealth Caribbean jurisdictions of Barbados and Jamaica, there is no such cap on damages and there has been a noted increase in the litigiousness in both jurisdictions in recent decades, the site indicated. Further, claimants in these countries can bring a lawsuit in court without going through an administrative body.
“It can however, take the courts several years to resolve these claims, sometimes taking up to six years in Jamaica (by comparison, averaging three to four years in USVI courts). However, alternative dispute resolution may be available and can greatly reduce the time for resolution of a claim,” ‘Kennedy’s Law’ stated.
The most common medical malpractice claims include misdiagnosis, childbirth injuries, medication errors, and surgical errors. However, any situation where a medical professional’s negligence injures a patient could warrant a medical malpractice claim, law firm Friendman & Simon noted in an online post.
In cases where patients accuse medical personnel of covering up an incident, James (in a 2023) said, “the issue of cover up I’ve heard of it, but I can give the public the assurance that this department is duty bound to investigate all incidents that occur at the hospital; those that are of an adverse nature , we do a root cause analysis immediately. That involves retrieving the file, doing an audit of the care and treatment provided to the patient and interviewing persons who have been directly or indirectly involved in the case and putting together a comprehensive report.”