Page 68 - OB Risks - Delivering the Goods (Part One)

SVMIC Obstetrics Risks: Delivering the Goods

appointment could not be accommodated. This failure resulted

in two phone calls from the patient without referral to the
physician. Although both calls were documented in the medical

record, neither referenced consultation with a clinical advice
protocol or instructions from a physician to have the patient wait

10 days after the second call before coming into the office. A
clinical advice protocol would have included clarifying questions

that would provide necessary details to the patient’s complaints
and given staff guidance to discuss the situation with the

physician.

This lack of appreciation by the staff for the patient’s complaints
of pain and other symptoms compounded the patient’s

perception that the physician and his office were uncaring and
unconcerned. As a result of the systems failures outlined in this

situation, there was no recourse but to compromise this claim.

The benefit of written protocols to assist the staff when

scheduling appointments or handling patient questions
cannot be overstated. In the following example, the absence

of protocols created significant challenges with defending this
physician.

C A S E S T U DY

A 37-year-old gravida 6, para 1, with a history of multiple

miscarriages, gestational diabetes, obesity, and a
congenital heart defect was followed closely by her

obstetrician with regularly scheduled non-stress tests. At
39 weeks, she was admitted to the hospital with complaints

of chest pain. After a comprehensive cardiac workup,
she was discharged the following day and scheduled for

a follow-up appointment at her obstetrician’s office in

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