Civil liability is a significant legal concern for healthcare providers. Medical malpractice, otherwise known as clinical negligence, can result in costly civil lawsuits, harming your reputation. The risk of a civil liability case is higher than you might think: a 2022 report from the American Medical Association found that 31.2 percent of physicians had been sued at least once in their careers.
To protect yourself and your practice from these costly and stressful lawsuits, it’s key to understand both how civil liability works as well as what your responsibilities are as a medical professional. In civil litigation, one party seeks compensation for damages suffered at the hands of another party.
Also, civil law has a lower standard of proof than criminal cases, meaning it is easier to be found “liable” in a civil case than “guilty” in a criminal one.
In this article, we'll define civil liability, break down the legal process for civil cases, and explain how civil liability standards can affect healthcare providers.
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So what does civil liability mean? When a person suffers a "tort," or a civil wrong, they can take legal action to address this wrong. The defendant is responsible for paying monetary damages or taking other court-mandated action to right this wrong. This is sometimes also called “tort liability.”
Torts are harmful actions that generally do not rise to the level of crimes, such as negligence or breach of contract. In most cases, the plaintiff files a lawsuit against the defendant seeking financial compensation for the harm experienced. However, some civil court cases also seek injunctions to stop harmful behaviors.
There are several different types of cases that are litigated, and perhaps tried, in civil court. These include:
These are just a few of many instances where someone could face civil liability. Civil courts also handle marriage and family disputes, financial disputes, labor issues, and civil rights violations.
Defendants in civil and criminal cases both face legal liability. However, civil and criminal courts are structured very differently, with different possible outcomes for the defendant and the injured party.
In general, civil law focuses on torts or contract disputes against a specific person or organization, while criminal law covers crimes against society. Civil cases are brought forward by private parties and their legal teams, while criminal cases are initiated by government prosecutors. Many criminal cases respond to violent conduct, such as murder, assault, robbery, or rape.
When comparing the process and trial of civil vs. criminal liabilities, the biggest difference is the burden of proof. In a criminal case, the prosecution must prove that the defendant is guilty beyond a reasonable doubt and the case is worked up to meet that burden of proof.
However, in a civil case, the prosecution only needs to prove that it's more likely than not that the defendant was responsible for the damages suffered.
The burden of proof is higher for a criminal conviction because of the possible consequences for the defendant. In most criminal cases, the defendant will face jail time if they are found guilty. This is often necessary to prevent future crimes against society.
However, defendants in civil cases usually do not face jail time. Instead, they are responsible for paying monetary damages and complying with injunctions and other court orders.
It's possible to have both civil and criminal liability for the same offense. For example, domestic violence cases are criminal, because they violate laws against physical assault. They can also be civil, because the assault causes harm to a specific individual that requires remediation.
Medical malpractice is a type of civil liability, meaning if a medical provider is negligent, causing harm to a patient, they are liable for the damages related to the incident.
For example, if a general practice physician is negligent in failing to properly work up a patient with cancer and the patient loses the opportunity of a better outcome, then the physician could be held responsible for damages in civil court.
Similarly, if a pharmacist makes medication errors that cause a patient illness or injury, the provider could be held responsible for that injury in civil court. In both instances, the provider may need to pay the patient's related medical bills, cover any lost wages, or even provide compensation for pain and suffering, emotional distress, or the loss of enjoyment of life.
Medical negligence is also a type of civil liability that can affect healthcare providers. Negligence happens when a provider fails to take appropriate action, such as ordering specific tests or obtaining informed consent.
All forms of civil liability are designed to compensate a party who has suffered a civil wrong and to deter people from causing harm to others. In the medical field, civil liability provides added incentive for healthcare providers to meet or exceed the standard of care for their patients.
Standard of care is the level of care that a medical provider is expected to provide based on what would typically be expected by a similar provider in that same practice. Essentially, medical providers must offer appropriate treatment based on current industry standards.
In the United States, standard of care is outlined by agencies like the American Medical Association and state medical boards. It is also defined by state laws as well as precedent established in previous medical malpractice cases.
If a medical provider fails to meet the standard of care, they could be found in breach of duty and face civil liability in a medical malpractice lawsuit.
For example, if a doctor fails to work up a patient and provide an appropriate diagnosis that is consistent with what is reasonably expected for a similar doctor in the same medical specialty, then they wouldn't meet the established standard of care. This could lead to a failure to timely diagnose lawsuit in which the provider would be responsible for damages. Those damages may include any relevant medical expenses, lost wages, and other expenses the patient had suffered because they did not have an appropriate diagnosis, as well as compensation for any pain and suffering caused as a result.
Informed consent is the process of providing patients with information about their treatment options. This includes risks, benefits, what to expect during the procedure, and any alternative treatment options, if available.
Medical providers must receive informed consent from their patients before providing treatment. This ensures that patients maintain autonomy and can make decisions about their own care based on their personal beliefs, preferences, and goals.
If a physician fails to obtain informed consent before treatment and the patient experiences harm, they could be found liable for medical malpractice.
There are some instances where informed consent is not necessary. For example, if the patient is in an emergency situation that could result in serious harm or death, the medical provider has an obligation to provide treatment.
In the medical field, there are many people and entities that can face civil liability. These include:
There are four legal elements present in medical malpractice cases:
All four elements must be present for a provider to be held liable for damages.
If a healthcare provider is found liable for medical malpractice, they may be required to pay the following types of damages to the plaintiff.
Read everything you need to know about the current rise in “nuclear verdicts” here!
There are four key steps in a civil liability case: pleadings, discovery, trial, and appeal.
Beyond liability for one’s own actions, there are times when a healthcare provider may be liable for the actions of another. This is typically called “vicarious” liability. With vicarious liability, you are held responsible for the actions of another party, even if you didn't directly cause harm to the plaintiff.
For example, a hospital could be found “vicariously” liable for the actions of their employees, as the company had a responsibility to supervise employee actions. Similarly, a supervising physician could be “vicariously” liable for a more junior healthcare provider working under his or her direction or control.
Medical providers aren't always liable for the malpractice cases brought against them. Here are some of the defense strategies that legal teams use in these situations to win civil cases.
A frequent defense in civil negligence cases for healthcare providers is that the defendant met the appropriate standard of care, with no breach of duty during the alleged incident. Not every injury or bad outcome is the result of negligence. Often, an injury can occur in the normal course and the risk of injury is what’s known as a “risk of the procedure.” This is why a patient typically signs an informed consent document before the procedure begins.
The accepted standard of care in the healthcare industry is somewhat subjective and can change based on new research and best practices. For this defense to be successful, the team must prove that the healthcare provider acted in a way that another reasonably competent professional would, or could have acted in the same situation.
The medical malpractice statute of limitations varies from state to state, but is usually between two and four years. If the injured party fails to file their lawsuit before the statute of limitations is up, the defense team can use this to have the case dismissed.
Another common defense in such cases is that the healthcare provider's actions did not directly cause the patient's injury. For example, the patient may have had a pre-existing condition that contributed to the outcome.
Causation is an essential component of any medical malpractice case. If the prosecution cannot establish clear causation, the defendant should not be held liable.
A comparative negligence defense states that the patient's behavior contributed to their injury. For example, if a patient doesn't take certain actions before having surgery, that could contribute to a poor outcome.
In cases of comparative negligence, the defendant may still be held liable, but the total damages will be reduced. For example, the judge or the jury may find that the patient was 10% at fault for the incident and lower the total damage amount accordingly.
Health insurance companies often have an interest in civil liability cases against medical providers. If a patient receives damages or a settlement in a medical malpractice case, their insurance company may request subrogation for related services they've covered.
With subrogation, the insurance company will take a percentage of the total settlement amount. Subrogation rights are outlined in health insurance policy documents, and not all insurance policies have them.
Both the legal and medical fields are changing rapidly due to the advent of AI technology. 79% of legal professionals now use AI in some capacity, and this technology is likely to support future civil liability cases.
Alternatively, it’s likely we’ll see civil liability cases in the future where plaintiffs allege harm caused by AI systems. Right now, these cases are judged using tort law in the US, but this could change in the future if more specific legislation is passed.
For medical providers, AI can also help reduce the risk of medical malpractice. AI can assess your current operations and identify risk, giving you time to address the problem before an incident happens and you are held liable.
Are we in a hard insurance market today? Is it getting worse? Find out!
So what is civil liability? In the medical field, it means that you could be held responsible for damages in a medical malpractice or negligence case. These cases are handled in civil court between two private parties, rather than criminal court. Healthcare providers need to be prepared for these cases to avoid financial strain and reputational damage.
Indigo offers malpractice coverage tailored to your needs, with a tech-driven quoting process and access to legal specialists. Get a quote today to see if Indigo is right for your practice.
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