Liability for Premises an Personnel房屋与人员的责任

1、liability for premises and personnelinjuries to patients while on the premises of a practitioner is a relatively stable cause of liability claims.the patients of health care practitioners are legally termed invitees. one in possession of land owes a duty to invitees to protect them from: dangers tha

2、t the one in possession is aware of; and dangers that the one in possession should have discovered with reasonable diligencethis legal protection to invitees extends to the “area of invitation”, which includes the office, areas of ingress and egress, furniture, equipment, and any other items that ma

3、y present a hazard or cause injury.“slip and fall” injuriesare the most common cause of liability claimsarising from premises.a patient who used a crutch because of an injured leg went to an ophthalmologists office, and his pupils were dilated as part of the examination. when the visit was concluded

4、 the patient left the office and entered the hallway, where his crutch slipped on a spot mopped minutes before by a janitor, causing him to fall and injure his other leg. there was no sign or other warning that the flooring was wet. he sued the janitorial service and the landlord, and they were both

5、 held to be liable for his injuries.thus an optometrist is obligated to: warn the patient of dangers of which the optometrist is aware inspect the premises for patent defects that could cause injury or for latent defects that are discoverable with reasonable diligence take reasonable precautions to

6、protect the patient against dangers that are foreseeabledilation of the pupil may contribute to an injury on the premises, particularly a slip and fall.for this reason, elderly patients or individuals with infirmities may need to be assisted after pupillary dilation, and care should be taken to ensu

7、re that they receive mydriatic spectacles.dilated (and cyclopleged) uncorrected hyperopes may also require assistance.example case: “slip and fall” on the office premises elderly patient is given dilating drops by a staff member after the exam, the patient is allowed to leave the office without mydr

8、iatic spectacles and unattended the bright light outside strikes his eyes as he starts down the office steps he falls and breaks his hip, with ensuing disability from complicationsin this case, the lawyer uses the fact that the doctor does not know what was said or done by staff, and that the staff

9、members cannot remember the exact details because of the passage of time, to virtually eliminate their defense.clap traps it only takes seconds to document that a dilated patient was warnedjust do it! patients should either have their own sunglasses or receive mydriatic spectacles at a minimum, offe

10、r to assist elderly or impaired patients through areas of office ingress and egressoptometrists have a duty to inspect their equipment, and the standard of care required of doctors is generally stated as follows: if a defect is apparent to ordinary observation, and, even if not, if it should have be

11、en discoverable through a reasonable inspection, then the doctor will be held liable for any injury suffered by the patient as a result of the defect. only when there is a latent defect that is not discoverable is the doctor held not to be liable for a failure to conduct the inspection.a patient wit

12、h a preexisting lower back condition sought an eye examination from an optometrist. as part of pre-testing he was taken to a room for non-contact tonometry (nct) to be performed by a technician. he was seated on a stool, instructed to keep his eyes on the fixation target, and told that he would feel

13、 a puff of air against his eye. when the air puff discharged he was so startled that he jerked backward, falling off the stool onto the floor and significantly injuring his back. he subsequently sued the optometrist for his injuries, alleging that a seat with a back rather than a stool should have b

14、een used to prevent him from accidentally losing his balance and falling. he failed to win damages.if an optometrist or the assistants suspect that an instrument or a piece of equipment is defective, it should be removed from service immediately and repaired. continuing to use a defective instrument

15、 or piece of equipment that can cause injury creates certain liability.whenever equipment is used in a negligent manner, liability will be imposed for the negligence.a young physician who was attempting to measure the intraocular pressure of a patient used a schiotz tonometer immediately after it ha

16、s been sterilized. instead of allowing it to cool properly, the doctor merely waved the instrument in the air for a couple of minutes: he did not determine the temperature of the instrument foot plate, which was later estimated to be 475 degrees fahrenheit when the doctor applied it to the patients

17、eye. the patient was awarded substantial damages for the resulting loss of vision.syncope (fainting) by a patient can be a cause of liability for the practitioner if the patient can show that: the syncope was foreseeable and results in injury the most common causes of syncope in an optometry office

18、are tonometry, instilling drops for dilation, and having an elderly patient stand up quickly.an assistant must act reasonably in performing duties delegated by an employer, and negligence that causes injury to a patient can be imputed to the employer under vicarious liability law. thus optometrists

19、are responsible for the acts or omissions of assistants that occur in the line and scope of the assistants duties. one of the most likely duties to result in a liability claim is scheduling of patients requiring urgent care.an assistant is held to a standard of reasonable care, and if the employee f

20、ails to do what a reasonable assistant would have done under the same or similar circumstances, the doctor is responsible for resulting injury to the patient. this does not include acts that are outside the scope of an assistants care.on a friday afternoon, while the doctor was away attending a cont

21、inuing education meeting, a patient who had been fitted with daily wear soft lenses by the optometrist stopped by the office, complaining about discomfort from one of her lenses. the contact lens technician examined the lens and cleaned it, and the patient seemed satisfied. on monday morning the pat

22、ient returned to the office, however, with a red, painful eye. it was found that she had suffered a corneal abrasion, but despite all efforts the patient developed complications that ultimately resulted in loss of acuity. she sued the optometrist for negligence, alleging that he was responsible for

23、the assistants failure to recognize that a referral should have been made to an eyecare practitioner. the optometrist defended the claim on the basis that the technician had not been given the authority to manage contact lens complications and that she had acted outside the line and scope of her dut

24、ies in so doing. the patient received damages.there are four areas of practice in which assistants are most vulnerable to negligence claims: inaccurate recordkeeping (a “fail-safe” system is needed to double check that essential record entries have been made by doctor and assistants) guarantees and

25、warranties (especially important for spectacle lenses, because verbal guarantees are binding) dispensing of spectacles (assistants must ensure that patients receive the appropriate lens materials and frames) contact lens services (assistants should be careful not to exceed their level of skill)the r

26、esponsibility of assistants for the fitting, training, and monitoring of contact lens patients is essential, and involves the delegation of numerous duties. thus the education of assistants is a constant obligation for practitioners.an important responsibility that may be assumed by assistants is to

27、 organize office procedures appropriately to reduce the opportunity for inadvertence or mistake.a patients daily wear soft lenses needed to be rinsed with saline, and a contact lens technician was given the lenses for this purpose. when she returned the lenses to the patient, immediately following i

28、nsertion he began to experience pain, tearing, and redness. the lenses were removed, and slit lamp examination revealed a severe chemical injury to the patients corneas. it was then discovered that the lenses had been soaked with a cleaning solution. the containers for both the saline solution and the cleaning solution were kept in the same area of the office, in containers that were of the same color, and the assistant had inadvertently used the wrong one. the patient sued the optometri