International Health Certificates—Do You Know the ... - AVMA PLIT

WINTER 2008
Volume 27, Number 1
International Health Certificates—Do You Know the Current
Guidelines and Regulations
for six months at an expense of $10,400. Dr.
A had relied on the guidelines previously used
for export requirements. Dr. A consented to
settle the matter and Dr. A’s PLIT-sponsored
insurance carrier has offered to pay the owner
$10,400 for the quarantine expense.
A Report for
PLIT-sponsored
Professional
Liability
Program
Participants
Contents
International
Health Certificates
Open Claims
Report
PLIT Personal
Insurance
Calendar of Events
Inside the
PLIT
Self-audit Your
Records
Closed Claims
Report
Produced by Hub International
Midwest Limited
The PLIT frequently reviews malpractice claims
that involve international health certificates. The
responsibility is on the veterinarian to research
and follow current international guidelines and
regulations. Here are three claims where the
veterinarian breached the standard of care by not
being aware of international travel regulations.
Client Quarantines Pets Overseas
Dr. A was presented with two cats who were
being moved overseas. The owner requested
that Dr. A ensure that the animals were
compliant with export requirements. The cats
were current on vaccinations (including rabies)
so Dr. A performed the required microchip
placement. One month later, Dr. A did the
rabies titers. Six month after this, Dr. A wrote
the certificates of veterinary inspection.
The owner and pets moved overseas. Upon
arrival, the certificates of inspection were
denied because the micro-chipping needed
to precede a rabies vaccination (even if the
pet was current on rabies). Consequently, the
owner was required to quarantine the pets
International Health Certificate
Rejected
Dr. X was presented a cat for an international
health certificate. Dr. X inserted the microchip
and then drew blood for the rabies titers. No
vaccinations were given because the cat was
current. When the owner moved overseas, the
health certificate was rejected as a result of
improper vaccination protocol. The cat was
quarantined for six months, and the owner
demanded compensation. Dr. X consented to
settle the claim and Dr. X’s PLIT-sponsored
carrier reimbursed the owner $4,867 for the sixmonth
quarantine expense.
Dr. Y Found Liable for Not
Researching Export Requirements
Dr. Y was presented four cats for examination,
rabies testing, and microchip placement. The
owner and cats were moving abroad. Dr. Y
performed the procedures and then advised the
client to investigate if anything else was needed
for the cats to move overseas. Just before the
move, the owner discovered that the cats did not
meet the international vaccination requirements.
To still move on time, the owner was required to
quarantine the cats for six months upon arrival.
The owner contended that it was Dr. Y’s responsibility
to follow the correct protocol, while Dr.
Y believed it was the owner’s responsibility to
research the requirements. A claims investigation
determined that Dr. Y did not meet the standard
of care and that Dr. Y was the responsible party
to research export requirements. Dr. Y’s insurance
carrier reimbursed the owner $7,679 for
the six-month quarantine expense.

Open Claims Report:
Rabid Kitten Identified Too
Late
Dr. B was presented a nine-week-old
kitten that had been attacked and
injured by an unknown animal. The
kitten was hospitalized for treatment.
Eighteen days later, the cat presented to
an associate for distemper and leukemia
vaccinations. The injuries were checked
and looked well. Forty-five days after
the kitten’s initial attack, the kitten was
re-presented for lethargy. A physical
exam was normal except for pain on
palpation of the hips and lumbar
region. No neurologic, orthopedic, or
blood work abnormalities were noted.
Radiographs revealed two large fecal
balls in the colon and before an enema
was attempted, the kitten defecated and
appeared to feel better. The kitten was
hospitalized overnight.
The following morning, the cat was
observed doing flips and acting erratic
in the cage. This behavior was attributed
to the fact that the cat was an outdoor
kitten and did not like the cage. After
a consultation with an associate, Dr. B
released the patient with a laxative gel
to help prevent constipation. When the
owner was transporting the kitten into
the car, the kitten’s behavior intensified.
Before the owner returned home, the
kitten had attacked and bitten several
people and appeared to have lost use of
its hind legs.
PLIT Personal Insurance Carrier Eliminates
Animal Affidavit for Dogs
Liberty Mutual, the insurance carrier for PLIT-sponsored personal insurance, recently
discontinued the use of the animal affidavit. Dog owners who apply for or renew their
homeowners insurance can expect a simpler process by answering a few basic questions
concerning the dog’s home (both in and out of doors), training, vaccination history, and
temperament. Liberty Mutual does not deny coverage based on breed and views each
situation as unique. For more information or for a coverage evaluation of your homeowners
or personal automobile insurance, call Liberty Mutual at 800-459-3759.
The owner returned to the clinic where
an exam revealed the kitten to be
ataxic and aggressive. Dr. B consulted
with the practice owner and the state
veterinarian’s office. It was decided to
euthanize the kitten for rabies testing.
Between the owner, the owner’s family
and friends, and the veterinary staff,
a total of eight people were bitten or
scratched by the cat. All were advised
to seek immediate medical treatment.
The rabies test returned positive and all
exposed parties were notified.
After a claims investigation, the PLITsponsored
insurance carrier determined
that the standard of care was not met due
to the kitten being discharged despite
its behavior. The owner and other
exposed parties are still being treated
and have advised that a demand will be
forthcoming.
Health Department Rejects
Tissue for Rabies Testing
Dr. C was presented three puppies
that had been exposed to a skunk for
euthanasia and rabies testing. One
pup exhibited neurological signs when
presented. The brains were removed,
cooled, and triple packed. During the
final packaging for transport, the freeze
pack was omitted. The lab called the
following day to advise that all three
brains had autolysis severe enough to
prohibit rabies testing. The state health
department called the dog’s owners to
advise the same. In total, ten people
(friends and family of the owner) had
been exposed to the puppies. Dr. C
consented to settle the matter and Dr.
C’s insurance carrier has paid more than
$2,700 to date on rabies prophylaxis.
The exposed parties are still undergoing
treatment.
PLIT Calendar of Events
American Association of Swine Veterinarians,
March 8-11, San Diego, California; technical
table
SAVMA Symposium, March 20-22, Auburn
and Tuskegee Universities, Alabama
American Animal Hospital Association,
March 27-30, Tampa, Florida; booth 216
Central Veterinary Conference (East), April
18-21, Baltimore, Maryland; booth 205

INSIDE THE PLIT:
Your Business Insurance Sales Team at
Hub International Midwest Limited
Six insurance professionals work with practice owners and managers seeking PLIT-sponsored
workers’ compensation and business insurance for their practices and mobile clinics. Pictured
from left to right: Maranda Haluska, Annie Sanders, Will Sundwall [top], Cindy White,
Michelle Page, and Iven Kiser have a combined total of 50 years of experience working with
veterinarians. This sales team helps veterinarians apply for coverage over the phone and then
works with the insurance carriers to provide comprehensive and competitively priced products.
One important fact to remember is that as the PLIT insurance broker, Hub International
functions to represent you, the buyer, as opposed to an agent who works for the insurance
carrier. You can count on the PLIT and Hub International to represent your best interests and to
enhance your work life through our business, professional, and personal insurance solutions.
Closed Claims continued from page 4
barium was unsuccessful, so Dr. Z passed
a tube and the barium was delivered.
The first radiograph revealed a significant
amount of barium in the right caudal lung
lobe. The dog remained BAR with a good
CRT, pulse oximetry, and moderate cough.
As the barium series continued, it was
believed a foreign body was in the dog’s
stomach. Dr. Z consulted with specialists
regarding treatment of barium in the lungs
and instituted maintenance therapy with
IV fluids. When the dog became increasingly
dyspneic, Dr. Z recommended a
referral. At the referral clinic, the suspicion
of a foreign body was confirmed. A
lobectomy of the lung was also performed.
The dog faced some initial post-operative
complications and then fully recovered.
The Outcome
Dr. Z consented to settle the matter and
Dr. Z’s insurance company paid for the
medical expenses related to the delivery
of barium into the dog’s lungs, a total of
$33,301.
The sales team (along with the PLIT Trust Representatives and other Hub team members) also
represents the PLIT at fifteen veterinary conferences each year.
Self-audit Both Your AVMA and PLIT Records
Ensure that your professional activity is recorded correctly by checking it
annually with both the AVMA and the PLIT. The PLIT uses four class
codes to determine your insurance rating: predominantly equine
(70% or more), food animal, mixed practice with 70% to 89% small
animal, and small animal exclusive. The AVMA Membership and Field
Services Division also tracks your professional activity to study trends in
the profession. Each office operates independently and maintains separate
client databases. Cross-audits are performed between the AVMA and PLIT
databases. Please keep your insurance and membership records accurate.
AVMA PLIT: www.avmplit.com or 800-228-PLIT (7548)
AVMA: www.avma.org/membshp/member_records/default.asp
or 800-248-2862, ext 6631

The outcome of claims reported to the PLIT office may not be known for months or even years; however, the following claims were recently resolved.
‘Open’ Alpaca Aborts Fetus
Dr. W was presented an alpaca for a pregnancy check. Dr.
W performed a transabdominal and a rectal ultrasound,
diagnosed the alpaca as open, and then administered
prostaglandin. A few days later, the alpaca aborted a
fetus. The alpaca’s owner demanded compensation for
the abortion. Dr. W agreed to settle the
matter and Dr. W’s insurance carrier
reimbursed the owner for the market
value of the lost alpaca.
Pre-surgical Blood Count
Missed by Dr. X
Dr. X was presented a nine-year-old dog for
a dental and mass removal. Pre-surgical blood
work was performed, but Dr. X misinterpreted the
results. Believing the results were within normal
ranges, Dr. X proceeded with the surgery. After
the dog was released, the surgical site was swollen
and oozing blood. The dog re-presented to Dr.
X’s associate who discovered that the original
blood work revealed a low platelet count. On a
re-review of the test results, Dr. X confirmed
the low count was missed prior to the surgery.
Dr. X referred the dog to an emergency clinic
for treatment. The dog later expired. The
owner demanded reimbursement of the
emergency clinic’s expenses.
The Outcome
Dr. X consented to settle the matter and
Dr. X’s PLIT-sponsored insurance carrier reimbursed the owner
a total of $9,424 for the dog’s medical expenses.
Dropped Dog Never Recovers
Dr. Y’s staff member was presented a dog for grooming. When
the dog was taken out of the tub, it was accidentally
dropped. Radiographs revealed the dog’s left front
elbow had fractured. Dr. Y referred the dog to an
orthopedist for further care. The dog required a
total of three surgeries due to complications with
the repair and was given a guarded prognosis. After
nearly six months of infection and treatment related to
the incident, the owner decided to euthanize the dog.
The Outcome
Dr. Y consented to settle the matter and Dr. Y’s
insurance company paid for the medical expenses
and the market value of the dog, a total of
$15,994.
Dog Requires Lobectomy After
Intubation
Dr. Z was presented a five-year-old dog for
vomiting, lethargy, and poor appetite. The
owners opted for a conservative treatment plan
of famotidine and a bland diet. Several weeks
later, the dog re-presented for continued vomiting.
The owners elected to pursue a barium
study. Syringe administration of the
Closed Claims continued on page 3
P.O. Box 1629
Chicago, IL 60690-1629
Phone 800-228-PLIT (7548)
Fax 888-PLIT-FAX (754-8329)
Fax-on-Demand 888-740-PLIT
Email info@avmaplit.com
www.avmaplit.com
Trust Broker and Consultant since 1962:
Hub International Midwest Limited
Hub International Midwest Insurance Agency (CA)
This newsletter contains only a general
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this newsletter will form the contract between
the insured and the insurance company.
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