How Does a Medical Expert Explain the Applicable Standard of Care During Surgery?
In the medical field, doctors, surgeons, nurses, and all other applicable staff deal with a wide range of situations. Some, such as helping a patient find relief from a common cold or stitching up a minor cut, are fairly straightforward. Others, such as administering life-saving medications to the terminally ill or performing emergency surgeries to repair traumatic wounds, are a bit more complicated.
In any case, there is a lot of room for something to go wrong, and unfortunately, that can often mean the difference between a full recovery in record time, and an untimely death that was avoidable.
Medical staff isn’t let off the hook for the mistakes they make, and their mistakes have some pretty serious consequences. So, they use a system known as the Standard of Care to minimize mistakes and ensure that there is a protocol enforcing the safety and reliability of treatment across all medical operations.
Today, we want to explain the standard of care for one of the medical field’s most serious branches; the surgical field. A lot of lethal or highly traumatic mistakes can occur when professionals don’t follow the standard of care during surgery. So, we’re going to make sure you understand what it is, why it exists, and what things surgeons typically have to do to ensure they’re following it.
Let’s get started.
What is the Standard of Care?
The standard of care isn’t a law or anything like that. It’s an agreed-upon standard that was developed and is continually updated, by the medical industry’s top-performing specialists. The standard of care essentially dictates what actions are acceptable for handling different types of situations, which ones are too risky or too out of the ordinary to be worth attempting, and generally how a medical professional should go about treatment without potentially making a mistake or making things worse.
For example, let’s say a patient has a penetration that would be affecting their lung. Those types of injuries are more common than you think, and there is plenty of data on that type of injury to tell doctors what is most likely going to have the most profound result without causing undue damage to the patient’s chances of surviving and subsequent quality of life. If the doctor follows the standard of care, the patient will have a higher chance of being properly treated.
Who is the Standard of Care Meant to Protect?
The standard for care is two-sided. First, by ensuring that doctors are relying on an established and agreed-upon standard, it protects patients. The agreed-upon standard is there to make sure that the methods used provide a solid, tangible, balance of risk and reward, and that naturally helps ensure that treatment can be administered without doctors doing anything reckless that can cause unnecessary risk.
However, in the same way, it protects medical professionals. While medical treatments are never guaranteed, and even a patient given optimal care can experience adverse effects, medical professionals can be sued and lose their licenses to practice if they’re found guilty of malpractice.
Malpractice is when a medical professional intentionally or unintentionally does something that was riskier than it needed to be, or otherwise makes a mistake, that results in harm to the patient. After all, they take an oath to do no harm. By following the standard of care to ensure risks are balanced against the rewards of treatment, medical professionals can protect their careers from the threat of malpractice allegations and charges.
How is the Standard of Care Used?
The standard of care is used in two situations.
First, medical professionals use it any time they’re treating a patient; unless they’re actively going against it, which isn’t in their best interest. When defining a treatment plan, medical professionals will refer to the standard of care to guide their decision-making process, find suitable treatment plans, and execute an optimal treatment plan with as little room for error as possible. This is how it is most commonly used since it’s ideally a part of every patient’s care plan.
However, it comes up in other situations, too. Namely, when something goes wrong.
Let’s say that a surgeon operates on a patient’s heart, and resolves the problem, but the patient suffers from severe pain in their chest that doesn’t go away months after the surgery. The patient decides to seek an examination, and it is discovered that a foreign object was left in the patient’s body during the surgery; that’s determined to be causing the patient’s pain. The patient can then file for malpractice against the surgeon. During the investigation to prove the patient’s claim and find out what happened, the investigating team will go through the standard of care to determine if it was followed properly. If not, the surgeon will likely have a very weak defense in their case. If they did, they might be able to prove their innocence. Of course, the example we used is a fairly extreme example that does not happen often, but the same concept applies to far more common situations such as inappropriately applying anesthesia, prescribing inappropriate medications, and similar occurrences that can be just as dangerous and damaging to the patient.
How is the Standard of Care Developed?
The standard of care varies dramatically depending on the type of treatment being issued. So, there isn’t just one standard that can be applied to everything.
How is the standard of care developed, then? Well, it is typically developed for individual situations in one of two ways.
First, it can develop over time. For example, when AIDS was first identified, there wasn’t a standard of care to go off of. Doctors and other medical professionals had never dealt with it. Therefore, there was no way to draw up an appropriate benchmark or group of guidelines to determine what medical professionals should do while treating it. For a while, this adversely affected patients, and the sector dealing with the AIDS epidemic was a bit of a wild west situation. However, over the course of a couple of decades, medical professionals made advancements in the treatment of AIDS, data regarding what was safe and what wasn’t was collected, and a standard of care for treating patients with HIV and AIDS was developed. Now, that standard of care helps protect patients suffering from AIDS on a daily basis, and it helps protect doctors from making mistakes that can end their careers.
Then, there’s the clinical trial route. The medical field often sets up clinical trials that compensate individuals who meet certain conditions for allowing medical professionals to try new treatments or collect data on the illness or injury that they might be suffering from. This data is gathered in a controlled environment and is typically done soon after a condition is discovered to help medical professionals get an understanding of it before it can become rampant; leaving patients in a “wild west” of treatments that might or might not work with varying risk levels. Once the trial is completed, the data can be gathered, organized, and used to develop a standard of care for that specific situation.
Regardless of which method is used, establishing a standard of care is something that takes time. Data must be collected and experience in the massive variety of various medical situations must be gained before medical professionals can commonly agree upon which practices are acceptable and which ones are not.
The Standard of Care and Litigation
The standard of care might be used on a daily basis by good medical professionals, but as a patient, there’s really only one situation you’re likely to hear anything about it; when something goes wrong that shouldn’t have.
The standard of care is typically talked about the most when it’s time for a malpractice lawsuit. The medical professional –the defendant- and the wronged patient –the plaintiff- use it in very different ways, though.
Here is a basic rundown of how the standard of care is implemented in litigation.
Identifying the Standard of Care:
First things first, the standard of care isn’t written down or formed into a law or concrete guideline. So, legal professionals can’t simply bring up a copy and start cross-examining the medical professional’s performance against solid, defined rules.
Instead, it’s sort of unofficial.
When a malpractice case is presented to the court, both legal teams will typically seek out “expert witnesses”. An expert witness is a professional in a field relevant to the case. In this situation, an expert witness would likely be a medical professional at the top of their field who specializes in the type of treatment under trial. The court will consult those expert witnesses to determine what they believe the standard for care is in the relevant situation, how the situation should have been handled, and if any parts of the patient’s treatment did or did not align with the standard of care.
However, both legal teams will approach this situation differently.
Using the Standard of Care as a Defendant:
In a malpractice case, the defendant is the medical professional being accused of malpractice; in other words, they are defending themselves against allegations that they strayed from the industry standard and their decisions resulted in unnecessary harm to the patient that could have been avoided, and the patient is seeking compensation, or in some cases, justice in the form of having the medical professional’s license revoked to prevent others from experiencing the same thing.
Because of this, the defense will use the standard of care differently from the plaintiff.
The medical professional’s legal team will attempt to find an expert witness that is likely to prove that the client followed the standard of care in as reasonable a way as possible and that the unfortunate injury or death was not their fault. Their entire case will be built around proving that the doctor in fact did everything they were supposed to and were not reckless in any way that wasn’t justified by the immediate needs of the patient.
Using the Standard of Care as a Plaintiff:
In a malpractice case, the plaintiff is typically the patient who suffered undue harm due to their caregiver’s negligence, or the family of a patient who unfortunately passed away, allegedly, due to their care provider’s negligence. The way their legal team will use the standard of care is a direct contrast to the way the defense’s team will use the standard of care.
First, the plaintiff will seek an expert witness that aligns with their client’s claim that the accused in fact failed to follow the standard of care and caused the issue the patient suffered from. This can be difficult because, as we stated earlier, bad things can happen even if the standard of care is followed, and just because something went wrong, the doctor might not be responsible. That’s just an unfortunate part of the medical field.
However, when there is reason to believe there was wrongdoing involved, the legal team will seek to question the expert witness in a way that exposes the wrongdoing. This mistake might be something small such as providing medication without performing all necessary examinations and tests first, or it might be something major such as failing to take precautions against shock or blood loss during emergency surgery.
In either case, the plaintiff’s expert witness will go over everything that should have been done, and the legal team will look for actions that don’t align with that to prove their case.
How the Findings are Used:
Once both expert witnesses describe the standard of care, and the legal teams have ample opportunity to examine each witness, the court will determine if the standard of care was properly followed. If so, the case might be dismissed. If something wasn’t done properly, or the professional was negligent, they will have to face the consequences of the malpractice suit; which might involve large financial settlements and a loss of license.
Get the Right Expert Witness for Your Trial
If you find yourself in a malpractice lawsuit, whether as a medical professional who did their best or as a patient who has suffered at the hands of a negligent medical professional, contact Litigation Legal Insight to find the right expert witness to defend your case and help you receive justice.