LEGAL MEDICINE

TOPIC: Medical Negligence and Medical Malpractice

Hippocratic Oath (Modern version)

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

ConceptMedical Malpractice

Malpractice refers to negligence or misconduct by a professional person, such as a lawyer, a doctor, a dentist, or an accountant. The failure to meet a standard of care or standard of conduct that is recognized by a profession reaches the level of malpractice when a client or patient is injured or damaged because of error.

Medical malpractice has been defined as the failure of physician to exercise that degree of care and skill ordinarily employed by the medical profession under similar conditions and circumstances.

In its simplest terms, it is that type of claim which a victim has available to him or her to redress a wrong committed by a medical professional which has caused bodily harm.

Are Doctors Hospital Employees?

Whether a doctor is a hospital employee depends on the nature of his or her relationship with the hospital. Though some doctors are hospital employees, most doctors are not. Non-employee doctors are independent contractors, which means that the hospital cannot be held responsible for the doctor's medical malpractice, even if the malpractice happened in the hospital. A doctor is more likely to be an employee (rather than an independent contractor) if: the hospital controls the doctor's working hours and vacation time, or the hospital sets the fees the doctor can charge.

Exceptions: When Hospitals Are Liable for Non-Employee Doctors' Actions- Even if a hospital would generally not be liable for an independent contractor doctor's malpractice, a hospital may be held responsible in certain situations.

Hospital Appeared to be the Doctor's Employer- If the hospital does not make it clear to a patient that the doctor is not an employee, the patient can sue the hospital for the doctor's malpractice. Hospitals attempt to avoid this problem by informing patients in the admission forms that the doctor is not a hospital employee. The situation is different for patients injured in an emergency room. Usually, the hospital does not have an opportunity to inform emergency room patients that a doctor is not an employee. This means that ER patients can often sue the hospital for a doctor's medical malpractice. There are also a few states that say a hospital can be sued for emergency room malpractice regardless of what the patient believed or was told.

Medical Malpractice in the Philippines

Per PRC Board of Medicine August 2002 data, there are 585 docketed cases with 176 malpractice or gross negligence cases Center for People’s Health Watch documented 53 cases of medical malpractice from 1992 to 1996 in Visayas alone. Does not include deaths from missed diagnoses or medical negligence that occurred in clinics, private doctors' offices, or other treatment facilities

  In most cases, patients who suffer at the hands of a negligent doctor have

available to them a civil action for damages under: Article 2176 of the Civil Code Article 365 of the Revised Penal Code

The existing policies is inadequate in meeting this needs. Under the current

system, victims find it very difficult to obtain justice because doctors, understandably, do not want to testify against their colleagues.

  Penal and Civil Code of the Philippines (civil action for damages under Article

2176 of the Civil Code and a criminal case, under Article 365 of the Penal Code with which the civil action for damages is impliedly instituted) are unable to find expert witnesses to redress their real grievances. Code of Ethics and Guidelines of the Professional Regulatory Commission The maximum penalty would be revocation of license but up to date, not a single doctor has been penalized.

SENATE BILLS

SB-03 Magna Carta of Patient’s Rights and Obligations. Bill introduced by Sen. Juan M. Flavier. SB-121 An Act to reduce medical mistakes and medical related errors. Introduced by Senator

Luisa “Loi” P. Ejercito Estrada. SB-588 An Act declaring the rights of patients and prescribing penalties for violations

thereof. Bill introduced by Sen. Manuel B. Villar.

SB-743 An Act Punishing the malpractice of any medical practitioner in the Philippines and for other purposes. Introduced by Senator Manuel B. Villar.

SB-1720 An Act to Protect against medical malpractice, punishing the malpractice of any

medical practitioner and requiring them to secure malpractice insurance and for other purposes. Introduced by Senator S. R. Osmeña III

SB-191 Health Maintenance Organizations Act of 2004. Sen. Luisa P. Ejercito Estrada sponsored the Senate Bill.

SB - 1701 An act to improve emergency medical services and trauma. Introduced by Senator

Defensor Santiago House of Representatives Bill

H B 4955 An act punishing the malpractice of any medical practitioner in the Philippines and for other purposes. Introduced by Representative Oscar S. Rodriguez.

Health Maintenance Act (HMO) of 2005. The proponents of the bill are Rep. Emilio C. Macias,

Rodriguez D. Davidas and Nanette Castello-Daza.

Malpractice - What To Do When A Doctor Gets It Wrong

Not every medical error is preventable.  And despite taking every available precaution, you may still be exposed to medical error.  In the event you are harmed by a medical error, you may be concerned for your health, frightened by the possible consequences, angry at the mistake, or any combination of these and other powerful emotions.  In this state, you may not know what to do next or how to report the incident.  In the following article, InjuryBoard provides you with an easy to understand guide explaining what to do when you’re injured by a doctor’s mistake and how you can help prevent others from suffering in the same way.

Seek Medical Help Immediately- Your safety and health should always be your first priority in any medical decision you make.  If you have already been injured by a doctor’s negligence or mistake, report the problem to your doctor immediately and seek immediate medical treatment from a different physician.  If you identify problems early, another physician may be able to improve the medical error. Seek out an appropriate specialist who can treat your specific injury.  Give the doctor your full medical history, including the circumstances surrounding the recent medical error.  Remember that medical records are the most important factors when determining a doctor’s error.  Make sure you give the new doctor enough correct and thorough information to ensure that the charts accurately record your state of health following the medical error.  To make sure your doctor fully understands your present condition and that these facts are properly recorded, be sure to share the “complete picture” by explaining what your health was like before, during, and after the accident, as well as your current condition.  Make sure your new doctor has access to any medical records that may impact his/her diagnosis and plan for treatment.

Know Your Injuries- Although knowing how to identify a medical mistake may seem like common sense, you should familiarize yourself with common medical errors.  If you know the types of medical mistakes that give rise to medical malpractice, you may be better equipped to decide whether you should report the incident. Generally, medical malpractice cases fall into several categories: Doctor Mistake, No Injury to Patient – Not all medical errors cause injury to the patient.  For example, a doctor may prescribe the incorrect dosage of medication.  The patient then takes the wrong dose, has a temporary reaction, and reports it to the doctor or pharmacist.  If the error is caught before the patient suffers any serious or lasting injuries, then this would be considered a mistake on the doctor’s fault but would not be considered medical malpractice.  The lack of harm to the patient does not erase the fact that the doctor made a serious mistake.  In this situation, however, this would not be considered medical malpractice by the doctor because there is no lasting harm to the patient.

Doctor Mistake, Injury is Minor – This category encompasses situations in which a doctor misdiagnoses an injury (perhaps an ankle sprain) and then quickly corrects the misdiagnosis.  Like the no-injury scenario described above, the patient would not have a case for medical malpractice against the doctor.  Because the doctor quickly corrected the mistake, the patient suffered no damage.

Doctor Mistake, Serious Injury – Despite significant harm to the patient, sometimes it is impossible to prove a case of medical malpractice against a physician.  For example, an older patient with a heart condition may die after receiving the wrong medication.  After an investigation, experts may determine that although the physician prescribed the wrong medication, the incorrectly prescribed drug had the intended effect on the patient.  In this case, there is physician negligence (for prescribing the incorrect medication), but no causation (the mistake did not cause the harm to the patient).

Doctor Liability, Damages Are Small – Some states have enacted tort reforms that apply caps to the amount of money an injured patient can recover from a medical malpractice claim.  Under these caps, a patient may only be entitled to a $250,000 verdict.  While this amount of money may seem large, the patient must share that money with expert witnesses, investigators, and attorneys.  In the end, the patient’s financial recovery may be slight.  Attorneys may hesitate to take a case if it seems like the recovery will be negligible.  However, some patients are more concerned with filing suit as a matter of principle than as a means of financial recovery.  Sometimes lawyers are willing to take a case to help the client make such a statement.

Doctor Liability, Damages – In this category of cases the patient can prove that the doctor was negligent, and that negligence was the cause of the patient’s injury.  These are the situations most likely to end favorably for the injured party.  Attorneys are more likely to take cases they believe will be easy to prove.  When attorneys can easily prove physician liability, costs are lower and the client will receive more of the damage award.  In other words, less money will be deducted from the patient’s award.

File a Report An average person does not know how to correctly file a report against a doctor who has committed medical malpractice.  Further

complicating matters is the fact that each state has its own procedure for filing complaints against physicians.  Generally, you should file the complaint with your state’s medical board.  Each state has its own medical board and its own forms and requirements for filing complaints against doctors.

The act of filing a complaint against a physician triggers a state medical board investigation of the physician for possible disciplinary action.  Realistically, there is only an extremely small chance that your complaint will result in disciplinary action against the physician.  Because state medical boards are composed of doctors, they likely feel a personal and professional kinship with the people they regulate and may be hesitant to discipline another member of their own profession.

However, you should still file a complaint.  Complaints may alert future patients to the doctor of his suspect practices.  By making future customers aware of potential unsafe practices, you may save someone else from falling victim to medical malpractice.

In addition to filing a formal complaint, you may also rate your physician’s performance at RateMD.com. This site allows users to browse rated doctors, search for specific doctor ratings, and rate your own doctor.  It is a helpful resource

in researching potential physicians. Remember that a complaint does not initiate a law suit.  If you wish to take legal action against your doctor, you should consult

with a medical malpractice attorney who can evaluate your situation and provide legal advice.  If you feel that your doctor’s actions rose to the level of criminal behavior, contact the district attorney in the jurisdiction where your physician practices. 

Hire an Attorney As we explained in the Know Your Injury section, an attorney is not necessary for every potential medical malpractice situation. 

In some cases, the patient is unharmed, unable to prove causation, or incapable of receiving a large enough damage award to make a law suit worthwhile. 

However, an attorney may be able to help you file a law suit against the negligent physician.  When seeking your legal expert, the single most important factor is the attorney’s reputation.  If you hire an attorney that is notorious for settling claims for less than they’re worth, you are less likely to receive the money you deserve.  For more information on attorneys and the legal processes involved in medical malpractice law suits, please read our article Medical Malpractice and the Legal Process

To recover in a cause of action for medical malpractice, the plaintiff must prove:

1. The existence of a duty, owed by the defendant to the plaintiff, to conform to a recognized standard of professional care;

2. A breach of that duty;

3. An injury that is causally related to the breach of the duty;

4. Legally recognizable damage.

DOCTRINES

RES IPSA LOQUITOR; WHAT IS THIS?

Res Ipsa Loquitor is a legal doctrine that essentially means, "The thing speaks for itself." Res ipsa loquitor is often asserted in negligence actions when there is no other way that the injury could have occurred unless it was caused by the defendant's negligence. This is often the case in medical malpractice suits because of a number of reasons which include the medical professional's expertise in dealing with the matter; the availability and awareness of the patients previous medical history including allergies, prior treatment, etc; and often the sedation of the patient at the time that the medical malpractice occurs.  Although these examples are inclusive they are not exclusive and there are other factors.  Due to the fact that it is more probable than not that the medical professional is in full control of the instrumentalities of a medical procedure the doctrine of res ipsa loquitor is often used by the plaintiff in these medical negligence cases.

“Contributory negligence” is used to describe the actions of an injured person that may have also caused or contribute For example, if you were hit by a bike while crossing the street, but you jumped into the street without looking first then your carelessness will be taken into consideration and any money that you receive may be discounted because of your own carelessness. If you are found to have contributed to your own injury, the rules in some states will prevent you from collecting any money. 

Proximate cause is the primary cause of an injury. It is not necessarily the closest cause in time or space nor the first event that sets in motion a sequence of events leading to an injury. Proximate cause produces particular, foreseeable consequences without the intervention of any independent or unforeseeable cause. It is also known as legal cause. To help determine the proximate cause of an injury in Negligence or other TORT cases, courts have devised the "but for" or "sine qua non" rule, which considers whether the injury would not have occurred but for the defendant's negligent act. A finding that an injury would not have occurred but for a defendant's act establishes that the particular act or omission is the proximate cause of the harm, but it does not necessarily establish liability since a variety of other factors can come into play in tort actions.

There is also a legal doctrine of hospitals’ corporate negligence. Under this legal precept, since hospitals act only through medical practitioners, the corporate entity that owns and operates said hospital must be held liable for their acts, omissions and negligence. Hospitals are the ones who hired them, supervised them and have powers of control and dismissal over them. If doctors do their jobs well, hospitals do succeed and gain patronage and profit financially. Where negligence mars the quality of medical services, hospitals should not be allowed to escape liability. These are the pronouncements of the highest court of the land. There are many hospitals in the country, in Manila specifically, and  in Cebu. Management should take these words very seriously.

EXAMPLES OF MEDICAL MALPRACTICE CASES

The examples below are general instances where medical malpractice might have occurred. This is certainly not a complete list of all medical mistakes or errors, but is very useful in providing a level as to what constitutes breach of medical care.

Anesthesia- A patient underwent surgery with a certain anesthetic, even though they had previously had a problem with that anesthetic. The patient suffered greatly or died from the effects of the anesthetic. An anesthesiologist runs out of oxygen in the middle of an operation and the patient has a cardiac arrest.

Angiography- An angiography (a test of the arteries) is performed incorrectly and the patient suffers brain damage. 

Bone Fractures- A patient experiences one or multiple fractures. The physician is periodically monitoring them, but the patient is allowed to walk. The X-rays come back and indicate that the patient should not be walking and they suffer permanent damage to the body. A patient experiences a bone fracture that is then improperly set. The result is permanent damage or disability to their arm, leg, etc.

Burn Therapy- A patient with severe burns receives inadequate "burn therapy" and continues to suffer horribly, both from a pain and aesthetic perspective.

Delayed Treatment- A physician does not properly detect the existence of a condition, and because of this, the person is not admitted to the hospital. The condition becomes worse but the hospital does not admit them. By the time they receive appropriate treatment it is too late to save them.

Delivery of Children- A woman experiences complications during delivery. She requires a C-section but the attending physician delays this step. The baby develops Cerebral Palsy as a direct result. A baby with a metabolic disorder suffers some degree of brain damage after they are misdiagnosed and/or monitored during the delivery process. The healthcare personnel fail to detect that a child was born with a blood problem- Rh incompatibility-antibodies (which destroy the blood in the baby).

Diet- A patient has just undergone an operation for a head injury. Despite a physician’s orders that a patient is to receive no food orally, the physician’s assistant nonetheless feeds them by mouth. This error results in serious brain damage.

Drug Addiction- A patient has an operation that turns out to be unnecessary. Following the operation, the patient becomes addicted to painkillers, drugs, etc.

Drug Reaction- A patient is given the wrong medication, despite the fact that the proper medication is on the chart. The patient suffers a serious drug reaction that causes permanent damage to the patient.

Experimental Therapy- An experimental therapy is undertaken with the purpose of providing relief from a medical malady. The operation or therapy results instead in a serious disability, neurological problem, or permanent damage to the brain.

Heart Surgery- A patient undergoes a heart procedure that ultimately proves to be unnecessary. The surgery results in improper valve function, a blood clot, etc., which causes long-term health problems for the victim.

Hemorrhaging- A hospital patient hemorrhages either from an injury or after a surgical procedure. The hemorrhaging goes undetected and inadequate reaction and treatment by hospital staff results in the patient’s death or permanent damage.

Hysterectomy- A patient undergoes a routine hysterectomy that goes awry and results in a severance of the ureters. This is not detected and it causes the loss of the patient’s kidney. A woman’s hysterectomy results in severe bleeding. The result is additional surgeries and costly and time-consuming complications.

Inadequate Medication- A patient with a severe health condition is prescribed medication that turns out to be grossly inadequate. The condition worsens, yet the doctor does not make the appropriate changes to their medication. The result is long-term damage or death.

Infections- A surgical procedure is performed that results in an unnoticed infection. When it is finally discovered, the treatment is delayed and a further surgery is needed. The result is permanent damage or disability to the patient.

Lab Errors- The results of a laboratory test indicate a benign condition when, in fact, the results indicate something much more serious. By the time the mistake is discovered, there has been permanent damage done to an individual.

Misdiagnoses- The physician failed to properly diagnose a patient’s cancer. The patient therefore does not take the necessary steps to cure the cancer and eventually succumbs to the disease. A patient has appendicitis that is not diagnosed by their physician. The appendix ruptures and kills the patient. A patient ingests a poisonous substance without knowing it. The physician incorrectly diagnoses the problem and the patient experiences permanent damage or dies. A physician informs a patient that their condition is much less severe than it turns out to be. By the time the severity of the problem is known there has been permanent injury. A young child swallows a metal object that goes undetected by the doctor and the child dies. An eye doctor diagnoses an eye condition without properly examining a patient. The misdiagnosis eventually leads to the patient losing their eyesight.

Priapism- A patient is given a diagnostic spinal tap, causing him to experience priapism (an extended and painful erection of the penis). The treatment does not occur promptly and afterwards the condition causes a degree of impotency and/or impairs the ability to urinate. 

Spinal Surgery- A patient undergoes spinal surgery to remove a disc. During the operation, nerve damage occurs that, despite additional surgeries, is unable to be cured. The patient therefore has to live with back pain. During back surgery, the spinal canal is accidentally punctured and the patient either suffers a serious disability or long-term pain. A patient undergoes back surgery, but a tear in the covering of the spinal cord is not detected. The patient develops spinal meningitis and dies.

Stomach Surgery- A patient has an operation to remove a section of their stomach. Complications ensue and further surgeries are required that end up causing permanent health issues and/or disability. A patient undergoes an unnecessary operation. The result is additional operations that lead to a prolonged period of disability.

Transferred without Consent- A patient is transferred from one hospital to another without consent of the attending physician. While the transfer is occurring, they suffer a serious complication or brain damage.

Uncontrolled Diabetes- As a result of the physician’s failure to control the diabetes and/or deficiencies in potassium, the patient dies.

What can patients do to lessen the likelihood that they’ll experience

medical malpractice?

Being proactive about medical care is undoubtedly the best step. Patients should do research to understand their health condition, and document their symptoms. They should ask health-care providers a written list of questions that they feel are important, and expect—indeed, demand—full and complete answers.

It’s also critical not to allow yourself to be intimidated by the medical system. Speak up and advocate for your own well-being. If patients sense that something is wrong, they should tell—or ask—their health-care providers. Although it’s important to trust your doctor or nurse, it’s also important to listen to your body and use common sense. Also advisable: have a family member or friend accompany you on important visits to health-care providers. Don’t be afraid to get a second opinion. And don’t be afraid to find a new doctor if you don’t feel that you’re receiving proper medical care. Your health is too important to place in the hands of a provider who hasn’t earned your confidence, isn’t answering questions or isn’t giving you—or your condition—adequate time and attention.

Are Hospitals liable for doctors' negligence?

The Supreme Court, in at least two decisions, has declared that when a patient dies or suffers serious injuries due to the medical malpractice, gross negligence or fault of an attending physician, surgeon, anesthesiologist and other medical and para-medical service providers, those practitioners may be held liable for damages.

They may even lose their license for such negligence or fault may be held as a medical malpractice. The hospitals too, cannot escape liability by merely alleging that the doctors are not their employees but are allegedly, independent practitioners of medicine and surgery. The hospitals’ liability is based on the legal doctrine of “RESPONDEAT SUPERIOR’’, and other principle in the Civil Code on damages. 

In one case, (Ramos vs CA, GR 124354, 29 Dec 1999, 321 SCRA 584), a lady who entered a hospital walking, ended up comatose with serious brain injury, secondary to some palpable mistakes in the administration of anesthesia. In another case, (PSI vs CA, GR 126297, GR 121467, GR 127590, 02 Feb 2010), some surgeons left two pieces of gauzes inside the body of a patient and closed the incision in a surgical operation. The patient had to go to the US to undergo a corrective medical procedure. In the Ramos case, the doctors and the hospital were held solidarily liable for actual damages of 1.352 million plus 8 thousand pesos every month for the entire lifetime of the comatose victim, moral damages of 2 million, temperate damages of 1.5 million, exemplary damages of 100 thousand, and attorneys’ fees and cost of litigation. In the PSI case, a huge amount was also awarded as damages.

The Supreme Court, in both cases, admonishes hospitals to exercise utmost care in undertaking one of mankind’s most important and delicate endeavors, the practice of medicine and surgery, because no matter how technical, complex, and esoteric, the services of doctors and surgeons are, the standards of care and diligence must be raised to the level commensurate with that extremely vital task of preserving health and lives.

In holding hospitals liable for their doctors’ negligence, the High Tribunal cited Article 2176 of the Civil Code, which provides that whoever, by act or omission, causes damage to another, there being fault or negligence, is obliged to pay for the damage done. That is for the doctors to pay. For the hospitals, Article 2180 of the same Code provides that the obligation is demandable not only for one’s own acts or omissions but also for the fault or negligence  of one’s employees and agents.

The hospital, as principal, is bound by the acts of its doctors with the apparent authority which the hospital management knowingly permits them to assume. The question in every case is: did the Hospital, as principal by its act, placed the agent in such situation, where the public is justified to presume that the  doctor has authority  and the competence to undertake the action which ultimately became the proximate cause of the damage suffered by the patient? This is what the law considers as agency by implication or agency by estoppel, as provided in Article 1869 of the Civil Code. When the hospital publicly displays in its lobby the names and specialization of the doctors, said hospital is deemed to have guaranteed their skills and competence. The hospital thus is estopped from passing all the blame to the doctors. And the absence of employer-employee relationship is not a valid defense to free the hospital from liability.

The Court stressed that hospitals have three specific responsibilities. First, in choosing doctors, they must assure the public that they have all the qualifications, training, experience, residency, accreditation, diplomate, and fellowships. Second, hospitals must exercise control and supervision over their doctors, not only as the results of their tasks but the manner of achieving the expected results. Third, hospital management must provide all the needed manpower and facilities, supplies and equipment and must closely monitor and oversee the treatment administered by all physicians practicing in its premises. The Hippocratic Oath mandates physicians to give primordial consideration to their patients and to exercise extraordinary diligence in performing their tasks. Failing in which, they are liable for damages. And in cases of fault and negligence, the hospitals are solidarily liable with them.

Medical Malpractice: When Can Patients Sue a Hospital for Negligence?

If you are injured when receiving treatment in a hospital, can you sue the hospital for negligence or medical malpractice? Though hospitals are often on the hook for incompetent care provided by employees like paramedics, nurses, and medical technicians, they often are not responsible for a doctor's medical malpractice. Here's a primer on when a hospital is, and is not, responsible for medical malpractice committed by its employees and staff doctors.

Hospitals Are Liable for Employee Actions- If someone is an

employee of a hospital, the hospital is responsible (liable) if that employee hurts a patient by acting incompetently. In other words, if the employee is negligent (is not reasonably cautious when treating or dealing with a patient), the hospital is on the hook for any resulting injuries to the patient. (Keep in mind that not every mistake or unfortunate event that happens in a hospital rises to the level of negligence. 

Typically, nurses, medical technicians, and paramedics are hospital employees. As long as the employee was doing something job related when he or she injured the patient, the patient can sue the hospital. For example, if a paramedic employed by the hospital injects the wrong solution into the patient on the way to the hospital, particularly if the medical situation is not life threatening, then the hospital is liable for the paramedic's mistake.

However, if a doctor makes a mistake and injures a patient while working in the hospital, the hospital will not be liable for the doctor's mistake unless the doctor is an employee (which is unlikely -- see below).

Also, if a hospital employee commits malpractice while under a doctor's supervision, the patient can sue the doctor, but the hospital may be off the hook. Whether an employee is under the supervision of the doctor when the misdeed occurs depends on:

1) whether the doctor was present, and 2) whether the doctor had control to prevent the employee's negligence.

For example, a surgeon may be liable if an attending nurse miscounts the surgical sponges, leading the surgeon to leave a sponge in the patient. 

Hospital Keeps an Incompetent Doctor on Staff- A number of states hold the hospital responsible if it gives staff privileges to an incompetent or dangerous doctor, even if the doctor is an independent contractor. The hospital is also responsible if it should have known that a previously safe doctor had become incompetent or dangerous. For example, if a doctor becomes severely addicted to drugs and the hospital management knew about it, or it was so obvious they should have known about it, a patient injured by that doctor can sue the hospital.

Getting Help- It's often essential to get advice or representation from a lawyer because medical malpractice law is highly regulated by a complex body of rules, which vary considerably from state to state.

Surgeons must be very carefulWhen they take the knife!

Underneath their fine incisionsStirs the Culprit - Life!

~Emily Dickinson