Legal Issues in Phlebotomy Chapter 19

What is statutory law? Created by a legislative body At federal level it consists of: Congress – made up of the Senate & House of Representatives State legislative bodies vary from state to state but usually follow the federal mode

Case law State courts rule on state laws Federal courts rule on federal laws U.S. Supreme court rules both State and Federal laws

Administrative law IRS OSHA

Public law When violated leads to criminal action Prosecuted by public (district attorney) Can be a felony or misdemeanor

Phlebotomist and public law Drawing without consent Forcing a patient to comply with a draw Assault – unjustifiable attempt to touch another person, or the threat to do so Battery – intentional touching of another person without consent

Battery Using a dirty needle Damaging nerves from improper drawing technique Not correctly identifying the patient ( pt received wrong test results) Death caused by wrong ID of patient and improper care can lead to charging the phlebotomist with murder or manslaughter

Private law Can lead to civil action in which the defendant is sued in civil court by the plantiff Tort- an injury to one person for which another person who caused the injury is legally responsible. (can be intentional or unintentional) Most medical malpractice suits are unintentional torts

Examples of civil action Damaged nerve Reusing needles Careless probing for a vein Accidental artery stick Drawing samples not requested by the MD Releasing test results to someone not authorized to receive them

Liable Legally responsible for an action and can be held accountable for its consequences. NEVER perform a procedure for which you have not received training Standard of care- ex: phlebotomist are only allowed to make two unsuccessful attempts at routine Venipuncture before seeking assistance.

Medical Malpractice Delivery of substandard care that results in harm to a patient. Sometimes called medical professional liability The burden of proof is on the plaintiff to show the four elements of negligence

Four elements of negligence Duty Phlebotomist has a requisition for a patient and was expected by his or her supervisors to draw blood

Four elements of negligence Dereliction Phlebotomist mislabeled a sample specified on the requisition

Four elements of negligence Injury Timed draw for a therapeutic drug monitoring sample was written incorrectly, and the patient received too much medication as a result, the patient may be able to prove injury.

Four elements of negligence Direct Cause Overmedication can be shown to be a direct result of mislabeling, direct cause is demonstrated

Do NOT Attempt a draw over 2 times without calling for assistance Place a phlebotomy tray on the patients bed Leave a bed rail down after a blood draw

Defense against malpractice Practice good standard of care Document clear and complete Shows what was done When it was done And by whom it was done Whenever an unusual incident occurs during a phlebotomy procedure, report it to your supervisor immediately and fill out an incident report

Liability insurance Phlebotomist are usually covered by their institutions liability insurance, although some phlebotomist also obtain their own.

HIPAA Health Insurance Portability and Accountability Act of 1996 Phlebotomist are both legally and ethically bound in the area of confidentiality.

PHI Protected health information Information is a pt’s health record Information that ID’s the pt Test results Pt name Pt address

Never!!!!!!!! Discuss a pt’s condition, tests, or financial information in public place. Discuss information concerning a patient with someone not directly involved that patients care. Release information without authorization Leave patient record out where other can see