Page 56 - OB Risks - Delivering the Goods (Part One)
P. 56
SVMIC Obstetrics Risks: Delivering the Goods
In the event of a medical malpractice lawsuit, the medical
record becomes a legal document and may be one of the most
powerful, objective, and persuasive pieces of evidence proving
the physician met the applicable standard of care. It should
also be emphasized that a well‐documented, legible medical
record may prevent the filing of a lawsuit. One of the first things
an experienced malpractice attorney evaluating a malpractice
case will do is review the medical record looking for evidence
to support the claims of liability. If the attorney finds a clear,
complete, and accurate record to the extent that even creative
interpretation will not support a finding of liability, the attorney
may decline to proceed further. Keeping accurate records and
consulting them prior to beginning or continuing treatment is
integral to good medical practice – failure to do so results in
medical malpractice cases being more difficult to defend and
may result in a plaintiff’s verdict.
The medical record is evidence of the course of a patient’s
medical evaluation or workup, treatment, and condition.
Hospitals, professional review organizations, accreditation
bodies, third‐party payers, governmental agencies, medical
licensing boards, and juries may use these records to judge the
quality of patient care.
The ideal medical record contains the following:
Page 56
