R. Austin Wallace, MD
Chairman, President and CEO

Letter from the ChairmanDecember 2018

"We Are Committed to Your Risk Management"

Your West Virginia Mutual Insurance Company strongly values risk management as a means for practitioners to provide quality healthcare and ensure patient safety, thereby avoiding medical liability pitfalls. We have excellent risk management professionals that work every day with the physicians of our area, and practitioners often have the same question: What can I do to prevent a lawsuit? Interestingly, some relatively simple measures can help to avoid the immense future heartache of going through the defense of a medical malpractice lawsuit. First, since our area is at the epicenter of the opioid crisis, always ensure that you prescribe opioids responsibly and that you follow state guidelines, as should be obvious.

Second, it is definitely not a good idea to use single-dose medication vials in a multiple-dose way, as this will come out during the discovery process and will be in a huge hurdle in defending the claim if it involves infection. Third, always document after-hours telephone conversations with a short note, as it is not uncommon that even a simple notation of “go to the ER” can make the defense of the lawsuit much easier and, indeed, make some lawsuits go away completely. Fourth, never keep unlabeled and/or pre-filled syringes in the office, as medication errors are a very significant driver of medical malpractice claims. Fifth, even though it is onerous duty, please ensure that EMR documentation is accurate and that medication and allergy lists are current. Auto-population of electronic health records can be a huge problem, in that allergy lists and medication lists can be dated and no longer accurate leading to therapeutic misadventures. In addition, spurious information can make defending a claim quite difficult.

For example, “normal prostate exam” in a female or “normal pelvic exam” in a male can make the entire medical record very suspect, even if the remainder is truthful and accurate. Furthermore, unless an error or omission is recognized and amended immediately, including a time and date along with an explanation as to why the addendum is necessary, never, ever add a later undated addendum to a medical record after the fact, as this can be considered spoliation of the medical record. This leads to the lawsuit falling outside the medical liability tort reforms that we so vigorously fought for and won, which has the consequence of markedly increased potential damages, including punitive damages that are rarely granted in a medical liability lawsuit. Sixth, please make sure that your medical assistants are adequately trained to their level of allowed responsibility and that you and your staff have an excellent system of test tracking, as ignored tests can lead to extremely adverse health outcomes, which, in turn, lead to lawsuits. Finally, please ensure the security of the health record, as HIPAA claims can be quite expensive. To this end, our compliance specialist, Michael Harmon, can help you, our insureds, in establishing and maintaining proper procedures and protocols.

Our risk management specialists stand ready to assist you in these and other matters impacting patient safety and the quality delivery of health care, and please be assured that your Mutual’s commitment to risk management is unwavering.
We are Physicians Insuring Physicians.

Sincerely,
R. Austin Wallace, M.D.