What recourse does a patient have in the event of accidentally false medical records? This story relates to my husband. He's 35 years old and had a vasectomy a few months ago. After the waiting period, he underwent the lab test to check that the procedure was successful. A few days after submitting his sample, he received an email from the urologist's office saying he had new information in his record (online patient portal). To his excessive surprise, the new information was NOT the results of the lab test, but was in fact a record of a cancer diagnosis. Double testicular cancer, to be precise. After a bewildering and frantic hour, he was able to get confirmation from the urologist's office that no, he doesn't actually have testicular cancer. An orchiectomy (testicle removal) had also appeared on his record, although this was clearly false, if only due to the date on the record; the office confirmed that also didn't belong on his record. This was all an accident made by someone in the office, presumably. A few weeks later, after many phone calls and two in-person visits to the office, the cancer diagnosis moved to a classification as a past condition, implying that it had been cured. The patient portal is handled by some other group, and the office claims they don't have the ability to remove records, hence the large volume of phone calls and trying to reach someone who does have that ability. Eventually, one cancer diagnosis was removed, but the other testicular cancer diagnosis and orchiectomy remain. It seems clear that having this appear on his medical record will affect my husband negatively, at the very least in regards to insurance. And, as one can imagine, this has been a traumatic emotional experience for him. So here are my questions: 1. What, if any, law is being broken by the accidental addition of false information to his record? 2. What is the best way to actually enforce removal of the false information? 3. What kind of recompense can we seek, or expect to get, from this situation? (I.e., would it be reasonable to demand that the office reimburse him for the cost of his procedure?)
The relevant legal requirement to have accurate records is 45 CFR 156.526, where An individual has the right to have a covered entity amend protected health information or a record about the individual in a designated record set for as long as the protected health information is maintained in the designated record set. The request can be denied if the record is accurate and complete. A simple and pointed solution is to print that page and circle the section, in a letter requesting an amendment. A somewhat more costly and much more effective solution would be to get a lawyer to write a letter in legalese. It is hard to imagine that the provider would not comply. You will notice that they have 60 days to comply (+30 days extension if requested). If for some reason they insist on leaving the record as is, you have the right to insert rebuttal statements into the record (basically, prove that the record is false). There is no realistic hope of compensation for annoyance, but you can hope for a correction.
IANAL, and I don't live in America, but some of this depends on their intent. If they gave the drugs away by mistake, they probably have not broken any laws. If they were given away deliberately (and you would need to prove this &ndash; which might be hard) then yes, he has broken laws. Either way, I expect you have a right to compensation (i.e. $900) from the physician to "make you whole again." If required necessary you could file for that in your local small claims court: The physician will either come to the party pretty quickly and sort it out, or the court will award you the money you need to buy the replacement meds. (But you will need to evidence the replacement cost, for a start....)
Based solely on what you've described, what the lawyer did is inappropriate if, in fact, it occurred without any prior permissions. However, since you are not the actual client, it may be that you lack pertinent info, because this would be exceedingly rare behavior. Lawyers are allowed to make procedural and "expert"/professional decisions about your case without your consent, and do so all the time. As a general rule: we decide who to depose, what expert(s) are necessary to prove your claim, what questions to ask in discovery, what to say and when to say it when attempting to settle, and what witnesses to call vs. not to call at panel or trial. All of that is in the purview of the attorney's general discretion and work product. However, attorneys cannot diminish, amend, or settle your claim without your permission, unless you've signed a limited representation agreement and/or a prior authorization to do these things with a waiver of consultation on issues relating to settlement. (It is not uncommon for a client to say, "My bottom line is X; hence, you have my permission to settle the case for anything over that amount.") A client may also, subsequently, give verbal consent, saying things like "just do your best and get what you can". Contingency and Total Award Strategies Since you aren't the one having entered into the contract, you may not be privy to the existence of these types of contingencies. Agreements like this are very common when an attorney takes a weaker med mal claim. It may be that the lawyer will only take the case to the extent that they will try to settle, and may even file the case, with the understanding that they will never try the case. It is a way to try to get you as much as possible when all facts come to light, without agreeing to the expense of a trial. This happens a lot. In these situations, when you are trying to settle a claim that ends up being much less valuable than the attorney thought when he took the case, the insurance carrier will often say, "We will pay X on the claim if Doctor Doe is dismissed out," or something like that. Often lawyers intentionally over-file, in hopes there are two carriers (the more insurance the more money to make you go away) that they can try to settle with. When it turns out both docs are covered under one insurance carrier, then the weaker claim will often get dismissed out. It is a strategic decision to add them, and to dismiss them &ndash; and this is very common. Proving malpractice against one doctor is hard enough; trying to prove that you are the victim of double malpractice, back to back, is nearly impossible. All of that said, even if a client has entered into these types of limited or decisional authority-granting agreements, the lawyer still has a duty to keep the client apprised of what's going on. The client may decide later they don't like how little the attorney is stating the claim is worth (despite being forewarned this may happen, it happens all the time that when it actually occurs the client is not happy). In that case, they have the right to find a new lawyer, but that will be very difficult to do for a few reasons: (1) the original attorney is entitled to get paid for the work done under a theory known as “quantum meruit,” so other attorneys will be hesitant to get involved; (2) they will put a lien on any recovery for the amount of time and expenses, to be paid from any settlements or awards (and they get paid first, before the client or the new lawyer); (3) if a client gets angry and says they want to just drop the case rather than have the lawyer make more than the client, even after a year or more of work, all of the costs will still be owed by the client; (4) the potential new attorney will call the one who has the case and ask about whether the client has unreasonable expectations, if their case has any value, etc. Keep mind, if an attorney is doing the things you've described, they probably would suffer no love loss if the case went away. Malpractice in Context It very often happens, especially in medical malpractice cases, that a client will come in and describe the case one way, and then when the medical records arrive and the attorney and/or the paralegal/nurse-para review them, and all the facts get flushed out, it turns out things occurred a bit (or a lot) differently than the client described or recalled in the first place. This is typically not a matter, 99% of the time, of the client lying to the attorney, but rather it is merely the phenomenon of memories being based on their perception of the events/their care, rather than verifiable fact and established medical standards. (This is why eye-witness testimony is so notably unreliable: 10 people can witness the same event and there will inevitably be 10 different descriptions.) One thing all clients should be told by their lawyer (and you should only hire an experienced medical malpractice lawyer for these cases) is that bad outcomes do not equal negligence. Lay people often think that if something bad occurred while under the care of a doctor, this is the case, but it is not the measure of malpractice. Sometimes, even when the doctor does everything according to their specialty/industry standard, bad outcomes happen. Malpractice/negligence only occurs when they have deviated from this standard of care - outcome notwithstanding. The inverse is also true, when it comes to a bad outcome. The doctor may have breached the standard of care, but this cannot be determined by the patient - the law requires expert testimony to establish this. Sometimes bad outcomes are just the risk of the procedure. This is why patients sign (but rarely read) the informed consent forms, that describe in detail, and state the patient is aware, of all the potential bad outcomes that may occur during the procedure. Negligence, or a "breach of the standard of care" occurs when the typical physician (not the best expert in the world, just the normal, typical doctor in that field) would have found the actions to be unreasonable and never acceptable given the totality of the circumstances. Once you prove that, you then still need to prove that is what caused your damages (not the disease, or the ailment itself). Unfortunately, even with the best physicians, bad outcomes happen all the time. It is very common, to the point of being almost predictable, that a medical malpractice claim's value will depart from the original ballpark estimate of value that an attorney tries to "best guess" at the outset. When your attorney tries to value a case, they roughly estimate your "special damages", which consists of medical bills, lost income, lost earning capacity, and other quantifiable sums. Then, they must try to assess the market rate award for pain and suffering for the type injury you've sustained. This is only guesswork, based on jury verdict reports, reported settlements, and the jurisdictional leanings toward large or small verdicts (comparatively). As the case evolves, as facts come to lights, as experts are consulted - this is when these estimates can largely deviate from the original guesstimate based on very limited information. Risks of Contingency Representation At any rate, when a lawyer takes a case on contingency (when they agreed to get paid only if they recover, and not until they recover, aside from out of pocket expenses), they do this because they've relied on the client's account of what happened, as well as their initial assessment of the records, usually prior to hiring an expert (if they even intended to hire one because they agreed to take the case all the way through trial). You must understand that attorneys don't like when a case loses value any more than the client; in fact, probably less as they are the ones who've invested often hundreds of hours in the case at that point. This is how they make their money. Thirty-three percent of a small amount is not the same as that of a large amount. And many, many hours go into these cases. An attorney can make far more than their hourly rate on a great case, but this is balanced by making far, far less on cases whose values plummet as facts come to light. When a case appears to lost much of it's initially estimated value, the attorney will still try to maximize recovery; however, it may not seem that way to the client because after they take their third, and then recoup their expenses (which is on top of the third and is the responsibility of the client win-or-lose), clients can end up with almost nothing. This is because the expense of these cases is enormous and it is the problem with that area of law and the system in general. It is not uncommon for a medical malpractice case to cost, out of pocket, $200,000 or more! This is why so few people are able to get a lawyer to take these cases, and often when they do, it's on the very limited basis I described. Med Malpractice Primer Med Mal cases are some of the hardest cases to win and they are by far some of the most expensive cases to try. This in not accidental. Depending on the state you live in, tort reform (a legislative effort to limit the amount of medical malpractice claims filed and tried overall, as well as limiting their total recovery) can range from limits on damages, to very short windows for statute of limitations, to the requirements (like where I practice) where you must literally try the case twice &ndash; once before a med mal screening panel, who hears all your witnesses just as a jury does, and then decides whether the case should (and in some cases can) go forward. In some states (I happen to practice in one) the findings are admissible in court (not the evidence but the finding). So, if the MMPT screening panel finds the doctor was not negligent, or was, but the damages were within the standard disclosed potential outcomes, so there was no causation, or myriad other things, if you decide (or in some states, if you even still get to go to court) the defense gets to say to the jury that the legislatively enacted Med Mal Pre-trial screening panel found X (no negligence, causation, or damages &ndash; or all three). These panels are usually comprised of a lawyer (75% defense lawyers) or a judge, and two doctors who are biased against these types of cases in the first place). Also, if your expert gets torn apart on an issue during panel phase, anything they admit can be used against them in the trial. I say all this to help you understand that these cases are made, by the legislature, to be very hard to even find a lawyer to take, very hard to win, and exceedingly expensive to litigate. This is based on the (fallacious) theory that medical malpractice claims should be limited to the most serious claims because this litigation is so costly, and so impactful on the rates all citizens pay for insurance, that the legislature has seen fit to make them very difficult to prosecute, thereby weeding out weak claims. Bottom Line If the client truly feels their lawyer did something they did not have permission (either explicitly in writing, or verbally) to do, they need to talk to the attorney, explain their discomfort with the situation, and figure out why it occurred and if it was truly in the best interest of the case and the client. If the lawyer cannot adequately answer those questions, they should get a second opinion. The client can demand that anything the attorney did be undone, if it was the type of thing that is in the client's control. One would need to see the engagement letter and retention agreement, and also be privy to the conversations. It is, unfortunately, not uncommon for a client to say they understand what the lawyer is proposing when they don't. If you find that's the case, you may have them ask that all determinations be put in writing, with an explanation as to why.
You'd have to get technical advice from Dentistry SE or something like that, but it is unlikely that this constitutes malpractice, instead was found to be necessary in the course of the implant. You could hire a lawyer to research the question to see if there is a reasonable probability that you could recover damages from a lawsuit, but the main difficulty would be establishing that you've been harmed. You would need an expert dental witness to establish that there is no reasonable connection between the implant and the frenectomy, and it might be an impossible to find a credible witness to that effect given that there is ample evidence that it can be necessary. If you are really saying that he is denying having performed the procedure, then in addition you would have to prove that he did, maybe with before and after pictures.
&quot;Medical lawyer&quot; is really the wrong focus, this is an issue of civil rights. The question would be, is it a violation of your civil rights to prevent you from taking your baby home; is it legal for the federal government to investigate people who refuse to take a covid test? You can take the question along with pertinent evidence to a civil rights attorney. To pick a non-random hospital's web page, they note that &quot;Any person having surgery or a procedure, including birth, at a Texas Health hospital will be tested for COVID-19 to provide appropriate care for the patient, and for the protection of visitors and the care team&quot;, and &quot;you will need to be tested at admission to help safeguard you and the care team&quot;. In answer to the question whether you can decline testing, they say &quot;Testing is recommended to promote the health of you and your baby. Patients who have COVID-19 can have a weakened immune system and may have inflammatory symptoms that can compromise healing. We encourage you to speak with your provider about the best decision for you&quot;, which doesn't explicitly say &quot;No you may not&quot;, nor &quot;Yes, you may&quot;. However, they cannot literally force you to take the test: at most, they can refuse to treat you. In answer to the question &quot;Will I be separated from my baby if I test positive for COVID-19?&quot;, they say &quot;Texas Health will follow guidelines from the American Academy of Pediatrics, American College of OB/GYN and the Centers for Disease Control for how to keep you and your baby safe during your hospital stay. Ultimately, any decisions about care for you and your baby will be between you and your provider, based on what is best for you both&quot;. This is also not crystal clear. There are three primary legal issues, putting a worst spin on their policy. They say up front that you will be tested prior to admission: the question is whether you can decline to take the test but force them to admit you. Now we are closer to the realm of a medical negligence attorney – they can refuse to treat you, but that might leave them liable. The second question is whether they can temporarily take the infant away, against the mother's wishes (for example, hold the infant in a separate facility while the mother is in the hospital). The third question is whether they have direct authority to take the infant away when you leave the hospital. The third question gets a plain and simple no. The Texas Dept. of Family and Protective Services has some authority in such a matter, but taking a child requires an investigation and a court order.
Insurance fraud But not for the medical part of the form. Almost all procedures in Australia involve some type of insurance (Medicare, private, workers comp. etc.) - the notice is about the part of the form where you are authorizing payment.
A medical practitioner may use whatever methods s/he thinks proper and appropriate, subject to the limits of malpractice law, and to the right of the patient (or patient's parent or guardian for a child) to give informed consent to any procedure or treatment. A patient can not insist on a treatment or method that the doctor or dentist does not wish to perform, having only the right to seek another practitioner. Nor is a practitioner required to use only procedures covered by insurance, unless bound by contract to do so (as may be the case with some &quot;in-network&quot; or HMO agreements). Again, the patient is free to seek treatment elsewhere. So the parent could insist that the dentist not use &quot;conscious sedation&quot; by withholding consent, the dentist may then refuse to treat at all, unless perhaps this was an emergency situation not allowing the parent to seek another treatment venue.
You don't specify what country's law you're interested in, but as you mention precedent, I'll assume you're interested in common-law jurisdictions such as the United States. The short answer is: you won't find any successful lawsuits such as you describe, at least not without some significant additional facts. In order to be subject to liability, a person needs to commit a breach of some duty. In a civil suit, this needs to be a duty to the plaintiff. In order for it to be actionable for the doctor to not answer the phone, the doctor would have to have somehow assumed a duty to answer the phone at that particular time. Giving someone your phone number is not, in and of itself, a promise that you will never take a shower, or go to a movie, or let your battery run down, or for any other reason be unwilling or unable to answer your phone at a moment's notice. In addition, the patient would have to demonstrate that the doctor, by failing to answer the phone, caused some sort of harm. If the patient is having a medical emergency of some sort, the doctor's advice will almost certainly be: "Hang up and dial 911." This is something the patient can do without the doctor's help. Without some more significant and compelling facts, no court is going to impose a duty on a doctor to sit by the phone waiting for a patient's call.