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SM I Chapter 3 Legal and Ethical Issues

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Kembra Mathis

on 12 October 2018

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Transcript of SM I Chapter 3 Legal and Ethical Issues

Chapter 3
Legal and Ethical issues
in Sports Medicine
What are some legal considerations for the
athletic trainers?
Give real life examples of liability,
negligence, torts, and assumption of risks
What measures can be taken to
minimize chances of litigation?
We've come a long way!
What's the difference between
ethical and legal responsibility?
What you should know
and be able to do!
The Big Picture!
What is Product liability
and is it important?
Assumption of risk
Sovereign immunity
Good Samaritan law
Product liability
Statute of limitations
Foreseeability of harm
Practice Act
1._______ A wrongful act committed by a person against another person or that person’s property and a court requires that person to be compensated for the damages.

2.________________ The reasonable anticipation that one might foresee that harm or injury could result from an act, the failure to act, or unmaintained facilities and equipment.

3. ________________A law that protects individuals that attempt to render aid to injured person(s) when the aid is being given in good faith.

4. _________When a person fails to use reasonable care.

5. _________The act of taking responsibility for an action that has caused bodily harm to another person(s).

6.____________Legal guidelines set by state government that stipulates what an individual can and cannot do as a practicing professional. These laws may vary from state to state.

7. ____________ Failure to act when there is a duty to act.

8._____________The legal limit of time allowed to file suit which may vary from state to state.

9._____________ The performance of a lawful act in an improper manner

What about Student athletic
training assitants?
Three elements must be established in every tort of Negligence action.
1. First, the plaintiff must establish that the defendant was under a legal duty to act.
2. The plaintiff must demonstrate that the defendant breached this duty.
3. Finally, the plaintiff must prove that he suffered injury or loss as a direct result of the defendant's breach.
A wrongful act committed by a person against another person
-often results in damages awareded.
When a person fails use ordinary or
reasonable care
Assumptions of Risk
When a person knows that an activity that they are participating in could potentially cause harm to them and they still chose to participate in the activity . Used in defense of Negligence.
The liability of the manufacturer, seller or supplier of goods or equipment to a buyer in the case of injuries that are sustained from defective products.
Lets use it
Not acting at all when you should. ie: Fail to refer
Doing something you Legally shouldn't!
ie:advanced Tx leading to Complications
Performing a legal duty incorrectly.
Statute of Limitations
The legal limit of time allowed to file suit which may vary from state to state.
1-3 years unless a minor!
Foreseability of Harm
The reasonable anticipation that one might foresee that harm or injury could result from an act, the failure to act, or unmaintained facilities and equipment.
1. Work to establish good personal relationships with athletes, parents, patients, clients, and coworkers.
2. Establish specific policies and guidelines for the operation of an athletic training facility or clinic, and
maintain qualified and adequate supervision of the facility.
3. Develop, review annually, and carefully follow an emergency action plan.
4. Become familiar with the health status and
medical history of the individuals under his or her care.
5. Keep factually accurate and timely records that document all injuries and rehabilitation steps,
and set up a record retention policy that allows records to be kept and used in defense of litigation
that may be brought by a patient.
6. Document efforts to create a safe rehabilitation or training environment.
7. Have a detailed job description in writing.
8. Obtain, from parents or guardians when minors are involved, written consent for providing
health care.
9. Maintain the confidentiality of medical records.
10. Exercise extreme caution in the administration, if allowed by law, of nonprescription medications;
athletic trainers may not dispense prescription drugs.
11. Use only those therapeutic methods that he or she is qualified legally to use.
12. Do not use or permit the presence of faulty or hazardous equipment.
13. Work cooperatively with the coach and the team physician in the selection and use of sports
protective equipment.
14. Do not permit injured players to participate unless cleared by the team physician.
15. Develop an understanding with the coaches that an injured patient will not be allowed to
reenter competition until, in the opinion of the team physician or the athletic trainer, he or she
is psychologically and physically able.
16. Follow the express orders of the physician at all times.
17. Purchase professional liability insurance that provides adequate fnancial coverage and be
aware of the limitations of the policy.
18. Know the limitations of his or her expertise as well as the applicable state regulations and restrictions..
19. Use common sense in making decisions about a patient’s health and safety.
Practice Act
Legal guidelines set by state government that stipulates what an individual can and cannot do as a practicing professional. These laws may vary from state to state.
A baseball batter was struck with a pitched ball directly in the orbit of the right eye and fell immediately to the ground. The athletic trainer ran to the player to examine
the eye. There was some immediate swelling and discoloration around the orbit, but the eye appeared to be normal. The player insisted that he was fine and told the athletic trainer he could continue to bat. After the game the athletic trainer told the patient to go back to his room, put ice on his eye, and check in tomorrow. That night the baseball player began to hemorrhage into the anterior chamber of the eye and suffered irreparable damage to his eye. An ophthalmologist stated that if the patient’s eye had been examined immediately after the injury, the bleeding could have been controlled and there would not have
been any damage to his vision.
? If the patient brings a
lawsuit against the athletic
trainer, what must the patient
prove if he is to win a
How should the firstaid
care provided by a
certifi ed athletic trainer
working in a health club
differ from the care
that may be provided by
a lay person?
An athletic trainer is cleaning out a filing
cabinet in a rehabilitation clinic and decides to
throw some older medical files away. Concern
is expressed, however, about how long these files
should be maintained for legal purposes.
What is the statute of
limitations for an adult
patient to file suit?
An athletic trainer who recently
became certified is
planning on working summer
camps for an area high
school before he starts his
full-time employment in the fall.
? What should the athletic
trainer do to protect
himself from liability?
During a state gymnastics meet, a gymnast fell off
the uneven parallel bars and landed on her forearm.
The athletic trainer suspected a fracture and decided
an X-ray was needed. The gymnast’s parents had general
health insurance through a PPO, but, because the gymnast
was in severe pain, she was sent to the nearest emergency
room to be treated. Unfortunately, the emergency facility
was not on the list of preferred providers, and the
insurance company denied the claim. The athletic trainer
assured the parents that the meet organizers would take
care of whatever medical costs were not covered by their
insurance policy.
? Because the PPO denied
the claim, what type
of insurance policy should
the meet organizers carry to
cover the medical costs?
An athletic trainer working in a clinic is
seeking third-party reimbursement for athletic
training services performed. The athletic
trainer is experiencing difficulty obtaining
reimbursement from certain payers because
of uncertainty about the effectiveness of the
treatment program.
? What can the athletic
trainer do to address the
concerns of the thirdparty
1. What are the athletic trainer’s major legal concerns for negligence and for assumption of risk?
2. What measures can an athletic trainer take to minimize the chances of litigation, should an athlete be injured?
3. Discuss what the athletic trainer must do to provide reasonable
and prudent care in dealing with an injured patient.
Review Questions
Apply it!
Insurance info
Every person should have a general
health insurance policy that covers
illness, hospitalization, and emergency
General Health insurance
Most institutions offer secondary insurance coverage
which pays the remaining medical bills once the personal insurance company has made its payment.
It covers accidents that happen on
school grounds while the student
is in attendance or accidents that
occur in the workplace.
Accident Insurance
The purposes:
toprotect against financial loss
from medical and hospital
Encourage an injured patient to receive prompt medical care.
Encourage prompt reporting of injuriesand relieve an institution or a corporation of financial responsibility
Professional Liability Insur.
Protect against damages
that may arise from injuries
occurring on their property.

It covers claims of negligence on
the part of individuals.
Catastrophic insurance
Example NCAA-Benefits begin when
expenses have reached $25,000 and are then
extended for a lifetime. A program at the secondary school level is offered to districts by the National Federation of State High School Associations (NFSHSA). This plan provides medical, rehabilitation, and transportation costs in excess of $10,000 not covered by other insurance benefits.
Has evolved to offset the shotgun approach of lawsuits and to cover
what is not covered
by a general liability
Errors and Omissions
Liability Insurance
The policyholder’s insurance company
reimburses health care professionals
for services performed.
Third Party Reimbursement
Health maintenance organizations (HMOs)
measures and limit
where the individual can receive care.
HMOs generally
pay 100 percent
of the medical
costs as long as
care is rendered
at an HMO facility.
Preferred provider organizations (PPOs) provide
health care but also limit where a person can go for treatment of an illness.
Pay on a fee for service basis
The point of service (POS) plan is
of the HMO and PPO
plans. It is based on an HMO structure,
yet it allows members to go outside the
HMO to obtain services.
The federal health insurance program for the
aged and disabled
A Health insurance program for people
low incomes and limited resources
_________ 1. Tort A. Acknowledgment of hazards in sports
_________ 2. Negligence B. Results in unreasonable risk of harm to others
_________ 3. Copayment C. A legal wrong
_________ 4. Assumption of risk D. Most traditional form of billing for health care
_________ 5. Statue of limitations E.Written guarantee athletic equipment is safe
_________ 6. Exclusions F. Members make a monthly payment
_________ 7. Product liability G. A specific length of time in which an individual

_________ 8. Point of service plan H. A specific amount paid by the policy holder
_________ 9. Capitation I. A combination of HMO and PPO
_________ 10. Deductible J. Treatment not covered by insurance policy
_________ 11. Fee-for-service K. Owed by the insured annually before the
insurance company will pay

Multiple choice
Short Answer
12. Describe the standard of reasonable care.
13. What are the 3 types of torts?
14. Define liability.
15. Explain third-party reimbursement.
16. What is a premium?


LISTING-List the health care systems
designed to contain cost


22-26. Identify, compare and contrast the types of medical insurance available.

27-31. What is negligence and list the things that must be proved in order to claim negligence?

32-36. What are the ways in which athletic trainers avoid litigation?

37-41. You are an athletic trainer at a third division college, how would you file claims for your athletes?

42-45. As an athletic trainer you need to purchase liability insurance, describe the types of policies that are available and describe your major concerns.

Good Samaritan Law
1. Define Liability
2. Define Malfeasance
3-5. Answer the following:
Sovereign Immunity

4. Why is it necessary for an individual to have both general
health insurance and accident insurance?
5. Briefly discuss the various methods of third-party
6. Why should an athletic trainer carry individual liability
7. What are the critical considerations for filing insurance
Government issued identification number for individual health care providers and organizations
Covered health care providers health plans, and health care clearinghouses must use NPI in all administrative and financial transactions according to HIPPA
As of 2007, all electronic transactions (claims, verifications, inquiries) require use of this 10 digit number
National Provider Identifier (NPI)
Standard of reasonable care
Assumes that a person is of ordinary and reasonable prudence

Bring commonsense approach to the situation

Must operate within the appropriate limitations of ones educational background

An athletic trainer at an institution has a duty to provide care to individuals at the institution
May be protected through sovereign immunity

Government cannot be held liable for any
actions taken by its employees.
You cannot be held liable for providing
the same care that anyone else of
your stature and training would have
New law IN PA...
Arkansas Good Samaritan Law
A.C.A. § 17-95-101
a. Any person licensed as a physician or surgeon under the laws of the State
of Arkansas or any other person, who, in good faith, lends emergency
care or assistance without compensation at the place of an emergency or
accident, and who was acting as a reasonable and prudent person would
have acted under the circumstances present at the scene at the time the
services were rendered, shall not be liable for any civil damages for acts
or omissions performed in good faith.
b. Any person who is not a physician, surgeon, nurse, or other person
trained or skilled in the treatment of medical emergencies who is present
at an emergency or accident scene, and who:
1. Believes that the life, health, and safety of an injured person
or a person who is under imminent threat of danger could be
aided by reasonable and accessible emergency procedures
under the circumstances existing at the scene thereof;
2. Proceeds to lend emergency assistance or service in a manner
reasonably calculated to lessen or remove the immediate
threat to the life, health, or safety of such person;
3. Lends only such emergency care or assistance as a
reasonable and prudent person concerned for the immediate
protection of the life, health, and safety of the person for
whom the services were rendered would lend under the
circumstances; shall not be held liable in civil damages in any
action in this state for any harm, injury, or death of any such
person so long as the person rendering such services acted in
good faith and was acting as a reasonable and prudent person
would have acted under the circumstances present at the
scene at the time the services were rendered.
4. No physician or surgeon who in good faith and without
compensation renders voluntary emergency medical
assistance to a participant in a school athletic event or
contest at the site thereof or during transportation to a health
care facility for an injury suffered in the course of the event
or contest shall be liable for any civil damages as a result of
any acts or omissions by that physician or surgeon in
rendering the emergency medical care. The immunity granted
by this subsection shall not apply in the event of an act or
omission constituting gross negligence.
5. For the purposes of this section and any other law of this
state which takes effect on or after January 1, 1994, the term
"physician" shall mean a person licensed by the Arkansas
may sue
This clip is about a young man from LaSalle University. Name the types of negligence you see as well as consider the other issues that come into play.
This is a clip from ER. Determine what actions were illegal and which were considered unethical.
Minors have rights?
Religion and Medicine
Legal or ethical or both?
Organ transplants...
Race, Ethics, and Medicine

Being legally responsible for harm one causes another
Are you ready?
10._______________A doctrine that exempts the government from liability for harm caused by their employees.

11._______________ The performance of an act that should not be performed.

12. ________________ The liability of the manufacturer, seller or supplier of goods or equipment to a buyer in the case of injuries that are sustained from defective products.

13.________________ When a person knows that an activity that they are participating in could potentially cause harm to them and they still chose to participate in the activity and will not be compensated for any injury that they sustain.
Torts May emanate from...
Standards of Reasonable care
Proving Negligence
Not quite
"Crash into me"...Grey's
part 1 Scene 3
We interrupt this moment...
Substance abuse and your job
Relationships at work?
NCAA, NAIANFHSA provide additional coverage to deal with lifetime extensive care.
Primary mechanism of Payment medical services in the US.
Health Maintenance Organization
Preferred Provider Organization
Filing a Claim
Must use codes on standardized forms

Diagnostic: Specifies the injury/condition being treated
Procedural: Specifies treatments/procedures provided.
Full transcript