2. Copyright © 2002 Career Publishing, Inc. Visual 4-1 Risk Management reduction of the potential for injury

3. Copyright © 2002 Career Publishing, Inc. Visual 4-2 Negligence the failure to give reasonable care or to do what another prudent person with similar experience, knowledge, and background would have done under the same or similar circumstances

4. Copyright © 2002 Career Publishing, Inc. Visual 4-3 Standard of Care the degree of care, skill, and diligence ordinarily exercised by other care givers under the same or similar circumstances

5. Copyright © 2002 Career Publishing, Inc. Visual 4-4 Ethics morals; a set of principles or values that influence behavior

6. Copyright © 2002 Career Publishing, Inc. Visual 4-5 Sixteen-year-old Johnny was participating in a regular basketball practice with the rest of his team when Johnny slipped in a puddle of water during horseplay with another player and hit his head. This blow to his head caused Johnny to lose consciousness. As a result of this injury, he was taken to the emergency room and hospitalized for a period of 24 hours. At the time of the injury, the coach was answering a telephone call in the physical education office, and therefore, was not directly supervising the practice. Was the coach negligent in his responsibility to supervise the team’s practice? From a risk management standpoint, how could the athletic trainer have prevented the problem from occurring? What should he or she do to prevent it in the future?

7. Copyright © 2002 Career Publishing, Inc. Visual 4-6 Some Legal Responsibilities Act as the athlete or client advocate. Provide and maintain safe and effective equipment and facilities. Instruct the athlete or client in safety procedures and methods to minimize injury. Plan an appropriate response for medical emergencies. Take reasonable steps to provide medical assistance when required. Prevent the athlete or client from returning to participation if there is risk of aggravating the injury.

8. Copyright © 2002 Career Publishing, Inc. Visual 4-7 S.A.F.E. Supervise athletes from the locker room to the practice field. Aid the athletes when needed. Facilities must be checked daily for possible hazards. (Fill out written work orders when something must be repaired.) Equipment in facilities must be checked daily.

9. Copyright © 2002 Career Publishing, Inc. Visual 4-8 Stacy, Ridgecrest high school’s overworked athletic trainer, had always felt it was too much work and that it was not her responsibility to give the coaches the medical information cards for away games. She thought the coaches, especially Coach Bordner, would lose them, and then if she needed them for home games she wouldn’t have the information to get the athletes the proper treatment. Megan, a defender for Ridgecrest’s varsity girls soccer, suffered an open compound fracture of both the tibia and fibula in the second period, when she was kicked in the shin by an opposing player. Coach Bordner knew this was a serious situation as soon as he arrived at Megan’s side. He started to activate the emergency action plan for away games only to realize that he had no emergency medical cards at all. When the EMS arrived Coach Bordner was given a choice of two local hospitals to take Megan. He asked the head athletic trainer from the home team for his suggestion, and Megan was off to Saint Michaels. At the hospital they were not able to make immediate contact with the parents because of the lack of an emergency card. Knowing that Megan needed immediate medical treatment, Coach Bordner said he would act as the

10. Copyright © 2002 Career Publishing, Inc. Visual 4-9 guardian and authorized treatment. The surgery required pins, screws, and plates to put Megan’s leg back together. Megan’s parents finally arrived at the hospital and were very happy with the way Coach Bordner handled the situation, except for one thing. The hospital that Megan was brought to was not part of her health maintenance organization. Megan’s parents would have to pay for all the services out of their own pocket. Megan’s parents had supplied all the information on the emergency medical card at the beginning of the season and had the right to sue for damages. They filed a lawsuit against Stacy and the school. Is it Stacy’s job to make sure the coach had the medical information cards? Other than just giving the information cards to the coach, what else could Stacy have done to make sure the coach had the necessary information and maintained her files at the same time? What are some possible outcomes of the trial? Is Stacy guilty of negligence? Why?

11. Copyright © 2002 Career Publishing, Inc. Visual 4-10 A Patient’s Rights 1.The patient has a right to considerate and respectful care. 2.Patients have the right to obtain from their physician complete current information concerning their diagnosis, treatment and prognosis in terms they can be reasonably expected to understand. 3.An informed consent should include knowledge of the proposed procedure, along with its risks and probable duration of incapacitation. In addition, the patient has a right to information regarding medically significant alternatives. 4.The patient has the right to refuse treatment to the extent permitted bylaw, and to be informed of the medical consequences of his action. 5.Case discussion, consultation, examination, and treatment should be conducted discretely. Those not directly involved must have the patient's permission to be present. 6.The patient has the right to expect that all communication and records pertaining to his care should be treated as confidential.

12. Copyright © 2002 Career Publishing, Inc. Visual 4-11 A Patient’s Rights, Cont. 7.The patient has the right to expect the hospital to make a reasonable response to his request for services. The hospital must provide evaluation, service, and referral as indicated by the urgency of the case. 8.The patient has the right to obtain information as to any relationship of his hospital to other healthcare and educational institutions, insofar as his care is concerned. The patient has the right to obtain information as to the existence of any professional relationships among individuals, by name, who are treating him. 9.The patient has the right to be advised if the hospital proposes to engage in or perform human experimentation affecting his care or treatment. The patient has the right to refuse to participate in such research projects. 10.The patient has the right to expect reasonable continuity of care. 11.The patient has the right to examine and receive an explanation of his bill regardless of the source of payment. 12.The patient has the right to know what hospital rules and regulations apply to his conduct as a patient.

13. Copyright © 2002 Career Publishing, Inc. Visual 4-12 Common Causes of Damage or Loss Inadequate supervision of the athlete or client Inadequate training of the athlete or client Improper or inadequate medical treatment by one or more members of the sports medicine team Faulty equipment or facilities Failure to provide safe transportation to a team event Sexual harassment, discrimination, or other inappropriate behavior by one or more members of the sports staff Failure to provide services for which payment has been received

14. Copyright © 2002 Career Publishing, Inc. Visual 4-13 Avoiding Legal Wrong-Doing 1.Do not allow a client or athlete to begin any fitness or training program without obtaining a signed informed consent and liability release. 2.Agree upon fees/costs and put them in writing before the start of services. 3.Make sure adequate facilities are available for women athletes in sports traditionally dominated by men. 4.If possible, avoid being alone in a room with an athlete or client to avoid the suggestion of inappropriate behavior. 5.Keep detailed notes about all your professional activities and those of the team.

15. Copyright © 2002 Career Publishing, Inc. Visual 4-14 Avoiding Legal Wrong-Doing, Cont. 6.Become familiar with the products and supplies you use. Read all dealer’s or manufacturer’s warnings and disclaimers, and make sure your athletes or clients are aware of them. 7.Develop an emergency action plan for every sport. 8.Consider ALL the sports involved in the athletic program, not just the ones that are conducted on a court or field, when developing your emergency action plans. 9.Follow the HOPS procedure in all injury assessments. 10.Assure supervision of all athletes during treatment modalities, whether in the clinic or on the sidelines and make sure those performing the treatment modalities are aware of any health problems or situations the athlete may have.

16. Copyright © 2002 Career Publishing, Inc. Visual 4-15 Avoiding Legal Wrong-Doing, Cont. 11.Make sure your coaches are up-to-date on all training techniques. 12.Conduct pre and post season reviews of past years and seasons, and learn from both the positive and negative events that occurred. 13.Create a daily approach to safety. Make a daily checklist for key items of concern. 14.Create a safety committee. 15.Know your limitations. 16.Be aware of changes in standards of care and any other changes that affect your field of work.

17. Copyright © 2002 Career Publishing, Inc. Visual 4-16 In a New Jersey trial decision, a track athlete was recruited to play football. He had never played organized football before. He was recruited primarily because of his speed and was to be used as a receiver. Unfortunately, he was severely injured while tackling an opposing player after an interception. The athlete sued, contending that the injury was the result of insufficient training, conditioning, and supervision. Investigation showed that he had received only one practice session on tackling. Expert testimony stated that tackling can be an extremely dangerous skill and that proper technique and instruction is paramount to avoiding injury. The jury found the head coach to be 40% negligent and the line coach to be 60% negligent and awarded the plaintiff $6.5 million. The jury emphasized that the injured athlete was a senior who had trained primarily in track and did not receive adequate training and instruction in football. In addition, the jury believed that the attitude of the coaching staff indicated the emphasis was on winning and not on safety. What could the athletic trainer have done to prevent the situation?