Massachusetts Hospitals Pilot Apology Program

A group of six healthcare organizations announced on April 18th, 2012, that the new “Disclosure, Apology and Offer” process will be piloted this year in seven Massachusetts hospitals. This process will require disclosure to patients when a medical error is made during the course of the patient's care. Once the error is investigated, an apology is issued and financial settlement is offered in lieu of legal action.

“This idea that you have to wait for five years (for a suit) to play itself out in the legal system before you can get an explanation that you need to heal, I think it’s unacceptable,” says Dr. Ashley Yeats, chief medical officer of Beth Israel Deaconess Hospital-Milton. “ It takes precious time away from patients, it takes time away from physicians, and it ultimately takes good people, I think, out of the health care system.”

While more transparency among health care providers is a good thing, it is cause for concern when the entire process can be controlled by the hospital itself. If it is decided that malpractice has occurred, the hospital then apologizes and makes an offer to the patient. In accepting that offer, the patient signs away all of their legal rights - even if the patient requires future medical treatment that the settlement did not account for.

The hospitals say that patients will be “encouraged” to hire their own counsel to evaluate whether an offer is fair, however counsel is not required. And since the overall goal of the program is to prevent any litigation, a representative from the hospital would most likely offer a settlement that would be keeping in line with the hospital’s need to lower medical malpractice costs. How could the average person be capable of making a fair minded decision as to whether the amount in the settlement is a reasonable number without the assistance of an attorney that is looking out for your best interests?

Suffolk University Law professor Gabriel H. Teninbaum reviewed apology programs across the country and wrote this about the University of Michigan hospital system (UMHS) on which the Massachusetts apology program is based:

“Patients need an advocate because programs like UMHS have attorneys whose primary obligation is to protect the assets of their organization. This dynamic results in what is, in actuality, an adversarial environment that simply uses collaborative language. Without legal advice of their own, patients who take part in apology programs must trust that risk managers would violate their obligation to their own employer (of keeping overall costs low), in order to give them an appropriate settlement. There is simply no evidence that this has, or will, occur and no program has released any data to that effect…

In other words, it has not been made public whether patients with valid claims for malpractice are giving up some compensation to which they are entitled in exchange for the warm discussions UMHS provides. If the small glimpse provided by [one anecdotal] case isrepresentative of what UMHS does, then the organization derives significant financial benefits by paying less money to patients injured by medical errors.”

If an “apology” is accepted by the patient, an apology protection provision would be included that would prevent a litigant from “parroting back” a physician's acknowledgment of error while in a lawsuit. Even though these systems allow the involvement of an attorney, they should require it. It should be certain that all victims of medical malpractice are fully aware of their options. And while honesty is the best policy, in this instance it comes with a caveat - your legal rights.

It cannot be emphasized enough that people need legal counsel when making important financial decisions. Considering settlement of a personal injury claim - medical malpractice or otherwise - is an important financial decision. In addition to surrendering certain legal rights the decision will impact your life for years to come. Getting legal counsel in advance can help insure that you make the right decision and protect your legal rights.

Keep Your Property Safe for Foreseen and Unforeseen Visitors

When you invite a guest into your home, whether it’s for a dinner party or to do repairs, you are accepting responsibility for any injuries that could occur on your property due to unsafe conditions. Even in the instance a trespasser is injured, you bear some responsibility so it’s best to keep your property safe, at least for the sake of the unknown.

There are three different classifications of people that can come onto your property. The first is an invitee. When a homeowner invites someone to enter the premises, the home owner is taking on the duty of keep the area safe so that the person doesn’t injure themselves. Contractors or your satellite installation person are typically considered an invitee.

The second classification is a licensee. A licensee is a person that has no contractual relation to the property owner but is allowed to be on the property, this is typically a social guest. The home owner has no duty to the licensee for obvious conditions, but rather conditions that are concealed. However, a condition that is obvious during the day time becomes impossible to see at night.

The third is classification is a trespasser. It is surprising to many home owners that they have a duty to protect these people as well considering they were not invited on to the property. The home owner has no duty to prevent the trespasser from harm until the homeowner is aware of the uninvited person. Only then does the property owner have a duty to avoid injuring the trespasser. Also, the homeowner is not allowed to intentionally inflict harm on the trespasser by preparing traps or pitfalls. Mot home owners take out coverage on their Insurance policy to protect themselves from this type of legal trouble. There is an exception to the trespasser rule, if the property owner has reason to believe that children will trespass on their land the owner must take special care to protect the children and prevent injury. There are criminal fines and penalties for trespassing in certain circumstances.

Under Maine law the owner of property has duty to an invitee to exercise due care to have its premises in reasonable safe condition and to give warning of latent or concealed perils. An invitee on property has the right to rely to some extent upon the owner's discharge of the duty owed to invitees that they would not be exposed in their use of the property to an unreasonable risk of harm. An invitee is not bound to anticipate negligent conduct on the part of the owner in the maintenance of the property, but the invitee has the right to assume that the premises are reasonably safe for their use.

Steps should be taken to eliminate dangers to visitors on your property:

• Inadequate Outdoor Lighting can lead to a person being injured on a sidewalk or in a parking lot. The property owner can be held responsible if they knew or should have known about the dangerous situation but failed to fix it. 
• Flooring problems can result in slip-and-fall accidents. A property owner’s oversight for providing adequate signs for wet areas, failure to provide proper barriers, floor waxing in excess among other scenarios can all lead to a slip and fall accident. 
• Store owners are liable for their patrons. People visit a store to primarily benefit the store owner by purchasing products and services. It is the store owner’s duty to keep they premises reasonably safe. For instance, if it has been raining for a several days straight, and the owner makes an effort to keep his floors reasonably dry and free of water, there may not be a way to keep the floors completely devoid of water. However, if it rained several days prior and the floor still has puddles, then the store owner may hold some liability. 

The reasonable foreseeability of injury to others from one's acts or from one's failure to act raises a duty under the law to proceed in the exercise of reasonable care and do what needs to be done to keep people safe. It is not necessary that the precise type of injury be foreseen nor the specific person injured.

It would be wise to walk around your property with a sharp eye just to be sure you are keeping your business or home safe for anyone that might visit it, invited or not.