Medical Malpractice Cases
Sanjay Adhia, M.D. | Forensic Psychiatry
The four legal elements of medical malpractice include:
- a professional duty owed to the patient
- deviation from the standard of care
- resulting damage to the patient
- as a direct result of the deviation from the standard of care
These four elements have to be proved by a “preponderance of evidence”.
The law considers two basic types of error:
- errors of fact
- errors of judgment
Common causes of mental health malpractice include:
- medication errors
- inappropriate relationships with patients
- improper documentation
Dr. Adhia revisits a few medical malpractice cases.
Crossing the Line
Was a Patient Sexually Exploited by His Treater?
A man with a psychiatric disorder was admitted to a private psychiatric hospital. He alleged his treater exploited him sexually and introduced him to addictive substances. The man had a successful professional career and he alleged the impact on his work and family was destructive. He is now on psychiatric disability.
I evaluated the Plaintiff at the request of his counsel. I considered complex records, given the circumstances under which he was admitted to the hospital and later outcomes before issuing my conclusions.
Double the Dose
There was an elderly patient with history of psychosis admitted to a psychiatric hospital. This hospital was transitioning from handwritten records to an electronic medical record system. This patient was ordered one dose of a long acting antipsychotic medication that last several weeks in the system. The administration of this medication was improperly documented.
In error, another nurse administered the medication again. In essence, it is as if he received double the intended dose daily for about a month. The patient developed severe body stiffness and was sent to the emergency room.
He was diagnosed with Neuroleptic Malignant Syndrome (NMS). The symptoms of NMS include increased body temperature, delirium, sweating and an imbalance of the autonomic nervous system. Some of the complications include respiratory failure and rhabdomyolysis (muscle breakdown) which could lead to kidney failure.
This patient developed respiratory failure which required intubation with mechanical ventilation. He developed complications and ultimately was sent to a skilled nursing facility. Six months later he passed away. The medical expert witness opined his cause of death was linked to the respiratory failure which was caused by the medication error in the psychiatric hospital.
Medication Malpractice: Forensic cases
Some of Dr. Adhia’s Forensic cases.
Medication error in psychiatric hospital causing complications resulting in death of elderly male.
Medical doctor refusing to continue psychiatric medication in jail resulting in severe withdrawals (DTs) which was not treated appropriately resulting in hospitalization.
Elderly woman (former nurse) held illegally against her will in a psychiatric hospital
Polypharmacy in patient with obstructive sleep apnea resulting in death in a psychiatric hospital in South Carolina.
Of interest, Psychopharmacology Discussion on Expertise page.