Chapter 3: Legal Concerns and Insurance Issues
Overview
The athletic trainer needs to be familiar with the legal issues surrounding the profession and is responsible for providing care according to the standards of reasonable care. It is important to know and understand the various legal terms and make every attempt to avoid litigation.
Along with understanding the legalities involved, it is important to have a clear understanding of insurance requirements. Not only is the athlete's health insurance necessary, but liability insurance for the school/university and the athletic trainer are crucial. A clear understanding of the terminology and facts about insurance coverage are essential to provide good care to the athletic population.
Learning Objectives
· After completing this chapter, the student will be able to:
· Analyze the legal considerations for the athletic trainer acting as a healthcare provider.
· Define the legal concepts of torts, negligence, and assumption of risk.
· Identify measures that the athletic trainer can take to minimize the chances of litigation.
· Explain product liability.
· Categorize the essential insurance requirements for the protection of the patient.
· Classify the types of insurance necessary to protect the athletic trainer who is acting as a health care provider.
Visit connect.mcgraw-hill.com for further exercises:
· Clinical application scenarios covering chances of litigation, legal considerations, and insurance
· Click and drag questions covering legal considerations and insurance nomenclature
· Multiple choice questions covering legal concepts and considerations, litigation, and insurance
· Selection questions covering chances of litigation
Key Terminology
Liability - The state of legal responsibility for the harm one person causes another.
Negligence - The failure to use ordinary or reasonable care.
Duty of Care- Part of an official job description
Tort - Legal wrongs committed against a person.
Nonfeasance - When an individual fails to perform a legal duty
Malfeasance - An individual commits an act that is not legally his to perform.
Misfeasance - An individual who improperly does something he or she has the legal right to do
Sovereign immunity - Neither the government nor any individual who is employed by the government can be held liable for negligence.
Good Samaritan law - Provides limited protection against legal liability to any person who voluntarily chooses to provide first aid.
Assumption of risk - The individual, through express or implied agreement, assumes that some risk of danger will be involved in the particular undertaking.
Other Terms
Statute of Limitation - A specific length of time that individuals may sue for damages from negligence.
General health insurance - A policy that covers illness, hospitalization, and emergency care
Secondary insurance - Pays the remaining medical bills once the personal insurance company has made its payment
Family health insurance - Insurance provided by an individual through a family member
Extended Lecture Outline
· Legal Concerns of the Coach and Athletic Trainer
§ Liability: Being legally responsible for the harm one causes another person
o Standard of Reasonable Care – an individual is neither exceptionally skillful nor extraordinarily cautious, but is a person of reasonable and ordinary prudence. An athletic trainer will act according to the standard of care of an individual with similar educational background or training
§ Negligence: Failure to use ordinary or reasonable care
§ Negligence is alleged if an individual does something a reasonably prudent person would not do or fails to do something a reasonably prudent person would do in similar circumstances
§ Three things needed to establish negligence: Duty of care, Conduct of defendant fell short of that duty or care and resultant damages.
o Tort: Legal wrongs committed against the person or property of another
§ Nonfeasance: (act of omission) An individual fails to perform a legal duty; failure to refer an injured athlete to MD
§ Malfeasance (act of commission) An individual performs an act that is not legally his to perform; An athletic trainer suturing a laceration
§ Misfeasance: An individual improperly does something they have the legal right to do; Fitting an athlete with a helmet that is too large for them, leading to serious injury
§ Negligence
§ Negligence is alleged if an individual does something that a reasonably prudent person would not do, or fails to do something that a reasonably prudent person would do under the circumstances similar to those shown by the evidence
§ To prove negligence must prove that the athletic trainer had a duty to exercise reasonable care, that the athletic trainer breached that duty by failing to use reasonable care and that there is a reasonable connection between the failure to use reasonable care and the injury the individual suffered, or that the athletic trainers action made the injury worse
§ Sovereign Immunity: Legal document that states that neither the government nor any individual who is employed by the government can be held liable for negligence – level of protection from sovereign immunity varies from state to state
§ Good Samaritan Law: Provides limited protection against legal liability to any individual who voluntarily chooses to provide first aid, should something go wrong
o Statutes of Limitation: Plaintiffs have between 1-3 years to file a suit of negligence, either from time of incident/omission or from the time of discovery of injury caused by the negligent act or omission.
o Assumption of Risk
§ Athlete assumes risk of participating in an activity
§ Subject to varied interpretations by courts, especially when a minor is involved
o Reducing the Risk of Litigation
§ Work to establish good personal relationships
§ Establish policy and procedures
§ Develop emergency action plan
§ Become familiar with medial history of athletes
§ Keep accurate records and document injuries and rehabilitation
§ Have detailed job description in writing
§ Obtain written consent from minors parents or guardians
§ Maintain confidential medical records
§ Exercise precaution in dispensing non-prescription drugs
§ Use only therapeutic methods qualified to use
§ Do not allow faulty or hazardous equipment to be used
§ Work w/ coach and MD on selection of sports protective equipment
§ Do not permit injured players to participate unless cleared by MD
§ Do not allow an injured player to reenter competition until he/she is psychologically and physically able
§ 15. Follow orders from team MD at all times
§ 16. Purchase professional liability insurance
§ 17. Know limitations of expertise and know state regulations and restrictions to scope of practice
§ 18. Use common sense in making decisions about a patient’s health and safety
o Product Liability
§ Manufacturers have a duty to design and produce athletic equipment that will not cause injury as long as it is used as intended
§ If an athletic trainer alters equipment in anyway, it invalidates the warranty
§ NOCSAE establishes minimum standards for football helmets to ensure safety