Failure to supervise residents and interns or other members of the healthcare team may result in a lack of follow through in elements of a patient’s care; someone drops the ball. And the root cause is often poor communication between the healthcare team members. The result? The patient suffers dire consequences and members of the healthcare team end up in court. Unfortunately, this scenario is all too familiar…

There has been a trend toward team-based care and delegation of duties within the medical team. This can pose increased legal risks for physicians who supervise physician and non-physician team members if the supervision is faulty.

According to James W. Saxton, an attorney and chair of the Healthcare Litigation and Risk Management Group at Stevens & Lee in Pennsylvania, “Each year, there are more claims where the supervision is not as tight as it should be. Often there’s a claim [against physicians] for failure to supervise members of the team.”

Root Causes of Sentinel Events

According to The Joint Commission Sentinel Event Data, between 2001 and 2013, human factors, leadership, and communication were the top three root causes of sentinel events. Root cause means the fundamental reason for failure or inefficiency of one of more processes.

A sentinel event is defined on The Joint Commission website as:

“An unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. Serious injury specifically includes loss of limb or function. The phrase, “or the risk thereof” includes any process variation for which a recurrence would carry a significant chance of a serious adverse outcome. Such events are called “sentinel” because they signal the need for immediate investigation and response.”

Healthcare Supervision Responsibility

Ultimately, it is the responsibility of the supervising physician to know what’s going on with his/her patient. Failure to supervise is a common allegation when there is a failure in the healthcare team’s care of the patient.

A physician may delegate a patient’s care to a non-physician healthcare professional such as an advanced practice nurse or physician’s assistant. If the patient suffers a poor outcome, the physician can be sued for failure to properly oversee the patient’s care…even if he or she has never seen the patient.

According to Martin Kern, executive director of Academic Group, a healthcare risk management firm in NY, “If you were the attending physician or you were the supervisor, you are going to be at blame or more at blame than those under your supervision.”

Vicarious liability and administrative negligence may also be claims that can be made in a medical malpractice case. Employers may be sued for the actions, or inaction, of their employees. If a supervisor fails to review, develop, or refine healthcare policies and procedures, he may be sued.

Medical malpractice attorneys need to carefully consider the potential defendants in a malpractice claim. Expert witnesses should evaluate the potential liability of the people involved in the patient’s care and consider the supervision responsibilities.

Med League provides medical expert witnesses to trial lawyers. Please call us at (908)788-8227 or contact us today to discuss your next case.

Jane Heron

Jane D. Heron, RN, BSN, MBA, LNCC is a legal nurse consultant at Med League.