Hospital negligence refers to medical malpractice claims that arise out of substandard medical care provided by hospital employees, including nurses and residents. Residents, or physicians-in-training, play a key role on care of hospitalized patients. However, overworked, fatigued and inexperienced residents can be dangerous to a hospitalized patient’s health.
Residents are doctors-in-training who have graduated medical school but need to demonstrate clinical competency before becoming fully licensed attending physicians. Residents are supervised by attending physicians in the setting of teaching hospitals. In residency programs, there is a chain of command that starts with the intern, who is the first-year resident. The intern will report to a junior resident who, in turn, will report to the senior resident on call. In some instances, fellows, who are obtaining subspecialty training beyond the four-year residency, are in the mix. Ultimately, the attending physician is the captain of the ship and must be included in all important decisionmaking.
Attendings usually round on their patients daily, leaving around-the-clock bedside vigilance to nurses and residents. As bedside caregivers, residents were traditionally worked into the ground, catching sleep here-and-there at the hospital while providing bedside care around-the-clock for days on end. However, it was recognized that adding fatigue to inexperience was a recipe for disaster. Thus, in 2011, the Accreditation Council for Graduate Medical Education (ACGME) set work-hour limits to ensure that residents were not impaired while making life-and-death decisions.
However, a study published in the Journal of the American Medical Association – Surgery (JAMA- Surg) shows that residents are actually fudging their time logs to underreport time spent at the hospital in order to get around the ACGME work-hour limits. In a survey of surgical residents, 20% said that they falsified duty-hour records sometimes, 11% submitted false reports once a week and 4% turned in false reports daily. In response to the survey, one program director reported that “50.1% of surveyed surgical residents under-reported duty hours, 62.1% falsely reported duty hours, and only 32.4% acknowledged complying with the ACGME duty hour rules.”
When mistakes made by fatigued, inexperienced residents cause injury or wrongful death to patients, a potential claim for medical malpractice may exist. It seems unlikely that residents who fudge reports would be honest about doing so. However, in Ohio, an injured patient need not prove that hospital negligence occurred because of fatigue in order to prevail on a medical negligence claim. The patient need only prove that the care fell below accepted standards of medical care.
