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    How patient obesity can impact malpractice litigation

    Lawsuit involving obese woman’s tricky stone surgery illustrates potential pitfalls

     

    Obesity-related documentation critical

    A general rule of thumb is that good documentation is helpful to a defense. In the event that a patient’s course of medical or surgical treatment is being dictated by the condition of obesity, it is critical for a provider to document this. If there is any question in litigation that treatment or management did not comport with the standard of care, one or more notes in the chart detailing why a certain test or procedure could not be done due to body habitus, or similar, would be helpful to a malpractice defense.

    Also from Brianne Goodwin, JD, RN: How spoliation of evidence can cost you in court

    If surgical complications are expected to be greater for the obese patient than for a patient with a BMI of less than 25, a preoperative note educating the patient as to the increased risks related to obesity would be similarly helpful.

    Of course, at the root of documenting these conversations is actually having the conversation. A number of factors inhibit providers from discussing a patient’s obesity frankly and openly with him or her, according to The Doctors Company. Weight bias and discrimination are present in society, and the stigma associated with obesity can lead to decreased health care utilization (Am J Public Health 2010; 100:1019-28). Still, it is in a provider’s best interest to address obesity as a health condition the same way one might address other chronic conditions such as diabetes or hypertension. It is equally as important that these sensitive conversations make their way into the medical chart to best protect yourself should a suit be filed.

    Addendum: Obesity is not only timely and relevant at this stage of the calendar year, but also in the news and academic domain. A New York Times article from Dec. 12, 2016 discusses current obesity research and how more than 25 genes have been identified that may contribute to at least 59 types of obesity. It is an interesting read with anecdotal narratives that has provoked a long thread of commentary and provides some additional “food” for thought.

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    Brianne Goodwin, JD, RN
    Ms. Goodwin is manager of clinical risk and patient safety at Cambridge Health Alliance, Cambridge, MA.

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