Medical Malpractice Attorneys :Suicide Risk and Poor Documentation

2007-03-08 10:33:40

( Legal )



Although psychiatrists are less often the targets of litigation by medical malpractice attorneys, their numbers are increasing.

The reasons are many, but suicide is the greatest cause.

Your greatest defense in a suicide case is good documentation. This does not substitute good care – but rather a combination of both protects you from medical malpractice attorneys.

The standard of documentation will often be the reason why medical malpractice attorneys accept a malpractice suicide case.

The main issue in a suicide case is whether the suicide risk was properly evaluated and whether it was “predictable”.

This predictable risk depends on factors like:
- Clinical treatment plans
- Decisions to hospitalize
- Using ECT
- Treating the patient as an out-patient

When medical malpractice attorneys file a suit, they try to find out how precise the psychiatrist was in assessing the risk. They do this by studying the medical records. There is nothing that deters them more than good documentation. Legally speaking- if you didn’t write it down, it didn’t happen. So don’t be persuaded that good documentation is too time-consuming.

Good Documentation – Not Simply Defensive.

Good documentation is not important simply because it deters litigation, but more importantly because it prevents suicide

Good Medical Records:

- Help other physicians make better decisions
- Can make you assess your own work more thoroughly.

When should your records indicate suicide assessment?

When investigating malpractice related to suicide, attorneys want to know if you made an assessment at each critical stage:

- Initial visit
- Emergency room
- Outpatient psychotherapy
- Medical checks
- Before a pass

Discharge from:
- The outpatient unit
- Rehabilitation centre

- When the observation level of a patient in hospital is changed.


What do you need to document?

- Asking rote questions like “ Are you suicidal?” is inadequate in you defense.
- Instead you need to document all positive and negative findings as well as intervention plans and reasons why you don’t choose alternative intervention
- Not only do you have to evaluate the present suicidal planning and intervention of the patient but you need to have a proper history as well

Documenting as a record for other Care-givers

The importance of keeping good documentation is because a “team” of caregivers will need to rely on your information.

Patient Reliability

Patients have many reasons for providing unreliable information
- Cognitive deficits
- Psychosis
- Desire to be discharged sooner
- Inability to judge their own actions
- Desire to kill themselves without interference

Other sources of information are much more reliable

- Old records
- Previous care-givers
- Family members


When you offer hospitalization to the patient, the jury will want to know:

- Whether the patient was competent to refuse
- Whether he should have been hospitalized against his will
- Whether the psychiatrist suggested hospitalization convincingly
- Whether you got family support for your decision.


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