Hospital negligence occurs when a hospital employee, such as a nurse or resident physician, fails to comply with accepted standards of medical care. Residents make important decisions in many patients’ care, even though they are not fully trained physicians. Many mistakes by residents occur as a result of fatigue, inexperience or misplaced arrogance. Since residents are usually employed by the hospital in which they work, the hospital will be liable for injuries caused by a resident’s negligence.
Residents are physicians-in-training who are subject to supervision. Residency starts after graduation from medical school and usually lasts for four years. A first-year resident is referred to as an intern. Interns rotate through various specialties of medicine, such as surgery and emergency care, in order to get exposure to the inner workings of a hospital. As their training progresses, residents choose a specialty of medicine to focus on.
Newer residents are called junior residents. They then become senior residents. Senior residents in their last year of training are called chief residents. Upon completion of residency and other licensing requirements, a resident becomes an attending physician, who may see patients without supervision. Some physicians, called fellows, obtain further specialty training after residency.
Residency begins in July of every year. As new, inexperienced interns pour into hospitals, mistakes occur. This is the so-called “July effect.” The risk of malpractice is particularly high given the many distractions that occur during summer months. One study showed that even the risk of infection in a hospital increases in July.
The hospital is organized such that inexperienced residents have support for decisionmaking. The first line of support is the nursing staff. Experienced nurses perform an unofficial and unheralded role in training young doctors. However, some young doctors look down on nurses and refuse their help. This type of arrogance can compromise patient safety.
When a patient’s condition deteriorates, nurses are trained to contact the service of the attending in charge. Often, the first physician to respond to such notification is the intern. Interns are so inexperienced that they may not have the judgment to seek help from experienced caregivers. This is another source of trouble.
Residents work long hours. It is well-recognized in every aspect of human endeavor that fatigue impacts safety. Medicine is no exception. Despite efforts to set safe hours for residents, studies show that they remain unsafe. The Journal of the American Medical Association (JAMA) published an article recently that correlates overscheduling with an increase in medical errors.
As you might expect, it is difficult to prove that a resident was tired, unprepared or too arrogant to ask for help. However, under Ohio law, you need not prove the root cause of hospital negligence to prevail in a lawsuit. Instead, you must show that a resident’s care fell below acceptable standards through the testimony of a qualified expert.
