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support the claims. The PRO then allows the physician and/or the hospital an additional period of time, not to exceed 5 calendar days from the meeting, to submit the relevant information to the PRO. (v) Within 60 calendar days of receiving the case, the PRO must submit to HCFA a report on the PRO’s findings. HCFA provides copies to the OIG and to the affected physician and/or the affected hospital. The report must contain the name of the physician and/or the hospital, the name of the individual, and the dates and times the individual arrived at and was transferred (or discharged) from the hospital. The report provides expert medical opinion regarding whether the individual involved had an emergency medical condition, whether the individual’s emergency medical condition was stabilized, whether the individual was transferred appropriately, and whether there were any medical utilization or quality of care issues involved in the case. (vi) The report required under paragraph (g)(2)(v) of this section should not state an opinion or conclusion as to whether section 1867 of the Act or § 489.24 has been violated. (3) If a delay would jeopardize the health or safety of individuals or when there was no screening examination, the PRO review described in this section is not required before the OIG may impose civil monetary penalties or an exclusion in accordance with section 1867(d)(1) of the Act and 42 CFR part 1003 of this title. (4) If the PRO determines after a preliminary review that there was an appropriate medical screening examination and the individual did not have an emergency medical condition, as defined by paragraph (b) of this section, then the PRO may, at its discretion, return the case to HCFA and not meet the requirements of paragraph (g) except for those in paragraph (g)(2)(v). (h) Release of PRO assessments. Upon request, HCFA may release a PRO assessment to the physician and/or hospital, or the affected individual, or his or her representative. The PRO physician’s identity is confidential unless he or she consents to its release (see §§ 476.132 and 476.133 of this chapter). Source: Reprinted from 42 C.F.R., Section 1395dd, 1999. K. References - Physician Patient Relationship 1. General Barratt K. Avoid patient abandonment—how to properly end a relationship with your patient. Wis Med J. 1996;95:875– 877. Barton HM. Creation of the physician–patient relationship. Tex Med. 1994;90:39–42. Barton HM. Terminating the physician–patient relationship. Tex Med. 1994;90:46– 49. 269
Berlin L. Communication of the significant but not urgent finding. AJR. 1997;168:329–331. Borowitz SM, Wyatt JC. The origin, content, and workload of e-mail consultations. JAMA. 1998;280:1321–1324. DuVal G. Liability of ethics consultants: a case analysis. Camb Q Healthc Ethics. 1997;6:269–281. Epstein RM. Communication between primary care physicians and consultants. Arch Fam Med. 1995;4:403–409. Eser A. The role of law in the patient–physician relationship. Forensic Sci Int. 1994;69:269–277. Eyers K, Brodaty H, Parker G, et al. If the referral fits: bridging the gap between patient and referrer requirements in a tertiary referral unit. Aust NZ J Psychiatry. 1996;30:332–336. Eysenbach G, Diepgen TL. Responses to unsolicited patient e- mail requests for medical advice on the World Wide Web. JAMA. 1998;280:1333–1335. Finkelstein D, Wu AW, Holtzman NA, Smith MK. When a physician harms a patient by a medical error: ethical, legal, and risk- management considerations. J Clin Ethics. 1997;8:330–335. Fox BC, Siegel ML, Weinstein RA. “Curbside” consultation and informal communication in medical practice: a medicolegal perspective. Clin Infect Dis. 1996;23:616–622. Gallagher TH, Lo B, Chesney M, Christensen K. How do physicians respond to patient’s requests for costly, unindicated services? J Gen Intern Med. 1997;12:663– 668. Garrick TR, Weinstock R. Liability of psychiatric consultants. Psychosomatics. 1994;35:474–484. Golden GA, Brennan M. Managing erotic feelings in the physician–patient relationship. CMAJ. 1995;153:1241–1245. Grana WA. An essay on managed care and the patient–physician relationship. J Okla State Med Assoc. 1997;90:450– 452. Haney C. Guidelines for the physician–patient relationship. J Med Assoc Ga. 1992;81:607–609. Kelly CE. Bringing homophobia out of the closet: antigay bias within the patient– physician relationship. Pharos. 1992;55:2–8. Larsen JH, Risor O. Telephone consultations at the emergency service, Copenhagen County: analysis of doctor–patient communication patterns. Fam Pract. 1997;14:387–393. 270
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Public Health Law Map - Beta 5.7 I.
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1942.] The English statutory and co
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health or individual health officer
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actions through the district attorn
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3. The Judicial Branch The federal
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consumer protection, such as requir
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With these exceptions, most litigat
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the court in Los Angeles might allo
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subject matter and may also have in
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2. Implementing ADR The major benef
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III. Tort Claims against Private Pa
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cannot be proved, but it is clear t
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uterus, triggering a miscarriage. T
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first were passed immediately after
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years. If the practitioner violates
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defendant’s conduct or (for the d
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proving a case against a physician
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e important for their adult medical
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emoving the plantar wart. This emph
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Blake BL. Sgt. Friday, Dr. Welby, a
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Walter C, Richards EP. Keeping junk
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earning capacity. b) Medical Expens
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simple as installing wheelchair ram
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cases do not give rise to injury-re
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medical costs from the lawsuit. Som
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compilation of legal principles. It
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traditional sense. Fetal heart moni
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oxygen saturation. When saturation
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1993;56:12-14. King JY. Practice gu
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are handled through an administrati
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U.S.C. § 1491. As such, the Court
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waiving immunity provide the only m
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against the United States in federa
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A discretionary function is an act
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deviant sexual conduct by an Air Fo
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The government can be liable under
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decision of the hospital officials
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constitutional rights have been vio
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case basis. The critical element in
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allegedly defective product was a m
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that state law is displaced if it i
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adopted. Therefore, Congress may au
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alleged. The “color of state law
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Importantly, the DeShaney analysis
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In the context of public health, on
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Also, immunity from suit is preserv
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The mere fact a private corporation
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1. Absolute Immunity Absolute immun
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prisoners were infected with HIV an
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against physicians who sold prescri
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The key distinction between crimina
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it almost impossible for practition
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forced to give hair samples, blood
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medical care practitioner does not
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assume that a hospital has an incen
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fined not more than $25,000 or impr
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charitable, religious, or philanthr
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(2) The Everyone-Does-It Defense De
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automatically invoke attorney-clien
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The Federal government, and several
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e of no benefit to the community, t
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activities of the large professiona
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Some of these provisions, such as t
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not support the scheme to reduce ho
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(1) Sentencing Guideline Standards
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did not provide full information ab
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5. If an employee chooses not to re
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documents until the court had made
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Frech HE III, Danger KL. Exclusive
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1998;29:16-18. Stahl DA. Consolidat
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tampering. b) Search Warrants If th
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defense lawyers to fight claims tha
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a) Service of Process One distressi
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provide as little speculation from
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place for the deposition. Each part
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should include a signed release by
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juries will disregard scientific ev
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the jury may be out of the room for
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entered the patient’s description
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the information being presented is
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are situations where what is genera
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test so generously that it also gav
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defendant’s failure to render the
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fees may be construed as attempting
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Fish R, Rosen P. Physicians should
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$150,000 to fight a case that could
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case; rather, it encourages the att
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were below the acceptable standard
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A. Establishing Agencies For its fi
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local level because the employees a
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dispute before the court. The lawye
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c) The Goldberg Rights Persons whos
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the cost of butter. A public intere
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standards and who agree to complian
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a) Agency Interpretation of Law All
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Johnson JA. Court limits board of m
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persons—business law, constitutio
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5. Corporate Employers and Institut
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prohibited the attorney from asking
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supervising the work. A more fundam
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medical problems. Whether it is can
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for buying insurance is that it pay
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Lawyers working on a contingency do
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Review deposition summary: 30 Novem
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of an effective preventive law plan
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ibes were in the form of consulting
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detailed summaries of important doc
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A very important part of the invest
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cases. Houston Bar Assoc. 1996;34:2
Page 219 and 220: state civil rights laws and health
Page 221 and 222: must carry out these actions correc
Page 223 and 224: c) Informal Consultations One of th
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Page 227 and 228: The manufacturers of emergency kits
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Page 231 and 232: any differences of opinion between
Page 233 and 234: to refer a patient to such an insti
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Page 237 and 238: diagnostic interest to the physicia
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Page 243 and 244: to find a specialist willing to see
Page 245 and 246: physicians, a recent U.S. Supreme C
Page 247 and 248: The law requires a physician to pro
Page 249 and 250: proper diagnosis. The physician los
Page 251 and 252: possible, the letter should be sent
Page 253 and 254: states than in others.) The best ra
Page 255 and 256: Medical licensing agencies and medi
Page 257 and 258: If there is a physician-patient rel
Page 259 and 260: (1) In general If any individual (w
Page 261 and 262: subject to a civil money penalty of
Page 263 and 264: condition described in paragraph (1
Page 265 and 266: (A) Placing the health of the indiv
Page 267 and 268: may not transfer the individual unl
Page 269: sent by certified mail, return rece
Page 273 and 274: evaluation of distance medicine tec
Page 275 and 276: consent: reducing conflicts with pa
Page 277 and 278: ) Children in the Emergency Room A
Page 279 and 280: such as cancer should be withheld f
Page 281 and 282: eing challenged over their good- fa
Page 283 and 284: would not require that the risk be
Page 285 and 286: usual in the community, and in othe
Page 287 and 288: consent to risks of the treatment b
Page 289 and 290: ) Reasonable-Patient Standard This
Page 291 and 292: candidates for treatment if their u
Page 293 and 294: prospective reimbursement systems r
Page 295 and 296: The child’s legal status should b
Page 297 and 298: litigation. Most states allow a phy
Page 299 and 300: should be reported to the child pro
Page 301 and 302: mental suffering and injury. 5. No
Page 303 and 304: ensure that all other participants
Page 305 and 306: (1) The research involves no more t
Page 307 and 308: different dialects but with differe
Page 309 and 310: to consent to medical care. Convers
Page 311 and 312: person. The power of attorney may b
Page 313 and 314: eligious reasons. Parents may refus
Page 315 and 316: life-support technologies, patients
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Page 319 and 320: decision? The court found that Miss
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Cruzan really dead? Justice Rehnqui
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discussed in terms of the patient
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) Following the Patient’s Wishes
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Few termination of life-support cas
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than any element of human behaviora
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Law Policy. 1997;361. Brody, H. Com
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Furthermore, a physician who withdr
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Cunningham N. Fear and informed con
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Invest Radiol. 1996;31:109-113. Nic
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interests test. J Leg Med. 1991;12:
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esearch subjects: proposed guidelin
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1994;8:19-27. Silverman HJ. Ethical
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Insurance Portability and Accountab
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physician, just as the records of c
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and if the patient is the victim of
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Disabilities Act (ADA) limits an em
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that is part of routine medical car
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A description of each purpose of th
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services to the medical care provid
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Access to the records is subject to
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Use appropriate safeguards to preve
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when they were designing research s
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such as an antitrust or false claim
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contain, the potential for harm in
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identification of abnormal findings
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Anything that indicates special tre
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put in the chart to document that t
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keep personal notes, and often the
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night unless she has a serious conc
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difficult to authenticate, unless t
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225. Smith J. Good medical records
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The legal consequences of the corpo
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to set up their own practices or wo
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California. Independent Contractor:
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physician fail to obtain a proper i
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When a physician recommends unneces
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Because employers attempt to limit
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utilization review organization den
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to influence a treating doctor’s
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important if the employee injures a
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these rules vary greatly from state
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If, as frequently happens, the pati
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eviewed completely by the supervisi
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protocols become generic documentat
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the physician is directly supervisi
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a. Penicillin V potassium 250 mg q.
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they hospitalize or refer a patient
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patient’s right of privacy should
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Medical students are often enthusia
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unauthorized practice of medicine.
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staff knows that the orders are onl
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is injured by a fellow workers’ n
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limited due process restrictions on
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agreeing to reimburse the MCO for a
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collective action, a close reading
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Med Soc. 1996;148:341-343. Maurer W
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Fiesta J. Delegation, downsizing an
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XIV. Peer Review and Deselection HI
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the development of new legal theori
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juror’s perspective, peer review
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to deal fairly with citizens, these
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5. There is an overriding national
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a) Notice of a Right to a Hearing T
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equest, to the physician or practit
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subchapter. Information about malpr
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the standards set forth in the Act,
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2. The Problem of Bias Until recent
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from general disclosure, but it sho
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do cost-cutting that the physicians
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Med. 1997;18:521-538. Maguire D. Te
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Introduction All medical care pract
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we are due for another worldwide ep
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include nurses, dentists, veterinar
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marital disharmony. In the classic
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criticisms of the cost of contact t
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diseases such as the Marburg or Ebo
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organized, powerful political lobby
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homosexual activists and the religi
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eligion or conscience. Thus, he can
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high, amounting to several dollars
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1. Birth Certificates Normally the
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caused or contributed to by infecti
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D. Law Enforcement Reporting Every
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campus police. The campus police de
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the law enforcement authorities are
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when they are acting as officers of
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eporting practices. J Emerg Med. 19
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Starr P, Starr S. Reinventing vital
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October;51:132]. J Am Med Womens As
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laws governing air and water pollut
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the widespread occurrence of tooth
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within the power of the judiciary t
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[specify fluoridation measure at is
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Still other arguments center on all
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(Wash. 1955); Rogowski v. City of D
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adverse effects would occur was arb
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Kaul v. City of Chehalis, 277 P.2d
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Introduction There are special cons
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Under no circumstances should medic
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patients about high-risk behavior a
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arrier method that is only 70% effe
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injectable contraceptive that lasts
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that HIV is less of a threat than a
Page 527 and 528:
for procedures affecting reproducti
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funded services to coerce a person
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The person who obtains the consent;
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The recognition of personal privacy
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medically necessary: On their face,
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Although abortion is still a surgic
Page 539 and 540:
The presumption of legitimacy was a
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Unfitness is also narrowly defined
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consistent with public health and s
Page 545 and 546:
constitutional protections or feder
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information in violation of confide
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Mary Sue’s ova were successfully
Page 551 and 552:
But the rule does not contemplate t
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as not to violate this prohibition.
Page 555 and 556:
committed before she knows the stre
Page 557 and 558:
1. Adoption 2. Family Planning and
Page 559 and 560:
Soderberg H, Andersson C, Janzon L,
Page 561 and 562:
Hum Reprod. 1992;7:1029-1033. Snowd
Page 563 and 564:
condition. This conflict can take t
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eaching a level of 1 per 11 births
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who has finally conceived after thr
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should be sure that she understands
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The treatment of infertility poses
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disorder should not be helped to co
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Choosing a sperm donor can be legal
Page 577 and 578:
prevent the spread of disease, and
Page 579 and 580:
problems before they cause accident
Page 581 and 582:
Beyond a structured prenatal care s
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patient’s decisions. The patient
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covered in signs that ask women if
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decisions not to use medical interv
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lifesaving care. Many physicians ig
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profound differences in the underly
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midwife’s skills and judgment, as
Page 595 and 596:
who might sue on her behalf or on t
Page 597 and 598:
contraception, but contraception ha
Page 599 and 600:
One example has been the developmen
Page 601 and 602:
Marshall BM. Ethical issues in assi
Page 603 and 604:
1995;115:39-43. Greely HT. Genetic
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3. General Obstetrics Abrams FR. Co
Page 607 and 608:
King NM. Informed consent and the p
Page 609 and 610:
XIX. Occupational Medicine and Disa
Page 611 and 612:
and balances inherent in having gen
Page 613 and 614:
putative illness, requesting an exc
Page 615 and 616:
compensation system. The company ma
Page 617 and 618:
In some circumstances, the union ma
Page 619 and 620:
ethical obligations concerning the
Page 621 and 622:
Records concerning voluntary employ
Page 623 and 624:
employee’s health status.” In t
Page 625 and 626:
films shall be preserved in their o
Page 627 and 628:
Employees may also have a financial
Page 629 and 630:
available information on the proper
Page 631 and 632:
lood tests that are medically neces
Page 633 and 634:
hospital. Both the medical care pro
Page 635 and 636:
Section 504 was a remedial statute
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or recurrent, that the key word was
Page 639 and 640:
government officials investigating
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incorrect, so this area of the law
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is to ensure that patients have eno
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problems. The Court also reiterated
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the medical problems have affected
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normal eyes and kidneys and no peri
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not constitute a disability. The pa
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workplace, their legal status is no
Page 655 and 656:
hepatitis A, the onset of the disea
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(2) The nature and severity of the
Page 659 and 660:
Many diseases are spread by insects
Page 661 and 662:
eporting duties that apply to the c
Page 663 and 664:
9. Bloodborne Pathogens All workpla
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this includes all types of medical
Page 667 and 668:
clinics or home health visits. An i
Page 669 and 670:
Purtilo RB. Ethical issues in the h
Page 671 and 672:
Disabilities Act: a decision analys
Page 673 and 674:
occupational accidents and diseases
Page 675 and 676:
1998;13:241-272. Pollack R. Update
Page 677 and 678:
legislation, set minimum standards
Page 679 and 680:
hearing seems to be rooted in the l
Page 681 and 682:
ates among drug addicts. Beyond the
Page 683 and 684:
Team physicians’ duties are to th
Page 685 and 686:
first aid and training programs are
Page 687 and 688:
equired by the school is not accept
Page 689 and 690:
interfere with getting the child pr
Page 691 and 692:
4. Handicapped Children Handicapped
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1996;35:237-242. Cheng TL, Savageau
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Med Sci Law. 1995;35:45-47. Mitten
Page 697 and 698:
handling prisoners in a burns unit.
Page 699 and 700:
legislation. The FDA, DHHS, HCFA, a
Page 701 and 702:
of a lower court to a higher, appel
Page 703 and 704:
assaulted will bring a legal action
Page 705 and 706:
anesthesiologists and nurses with i
Page 707 and 708:
Negligence to consider the plaintif
Page 709 and 710:
declaratory judgments about the con
Page 711 and 712:
Durable Power of Attorney ensurance
Page 713 and 714:
fiduciary relationship, as is the r
Page 715 and 716:
Hearsay Rule Testimony of what anot
Page 717 and 718:
In Loco Parentis Literally, in the
Page 719 and 720:
to dangerous products such as drugs
Page 721 and 722:
filing of all official documents. I
Page 723 and 724:
Perjury The willful act of giving f
Page 725 and 726:
had that reasonable person been in
Page 727 and 728:
RICO The common abbreviation for st
Page 729 and 730:
person seeks damages or other legal
Page 731 and 732:
appropriateness. Vacate When a cour
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