Medical Malpractice Resource Guide
We trust physicians with some of our most precious assets, our health, and our personal information. When a health care provider or health care facility violates a patient’s trust or puts their health on the line, the patient has the right to stand up and advocate for themselves. You may feel vulnerable, but you are not powerless.
Patients are entitled to make a formal complaint about poor care, service, or a breach of trust. If a health care provider’s care is reckless or negligent, a patient may even have the grounds for a medical malpractice claim.
At Spiros Law, P.C. we want to provide patients with this helpful guide to get them started on the road to becoming more proactive and involved in their healthcare options. If you need help advocating for yourself, turn to the experienced legal team at Spiros Law, P.C. for help by calling (815) 929-9292. We even offer a free case evaluation to get you started.
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Table of Contents
Types of Medical Malpractice Claims
Medical malpractice is defined as an incident or series of incidents perpetrated by a health care professional or health care institution that neglects to provide a patient with appropriate medical treatment or provides a patient with a substandard level of care. For a claim to rise beyond a mistake and be eligible for a potential medical malpractice claim, at least three conditions must be met, they include:
- The institution or practitioner violated the standard of care
- Negligence caused an injury to the patient
- The injury resulted in damage or further injury to the patient
When negligence is at the core of a medical error, a victim may be able to seek compensation through a medical malpractice claim. While there are a wide variety of circumstances that can result in a medical malpractice suit, some of the most common types of malpractice claims include:
Failure to Properly Diagnose
A failure to accurately diagnose is uncovered by asking a relatively simple question. Would another reasonably trained and competent physician draw the same conclusion under similar circumstances?
The follow-up question is always, would there have been a better outcome for the patient? If key clues were missed or reasonable tests not performed and a serious diagnosis was overlooked, a victim may be entitled to compensation when the result is a misdiagnosis or a delayed diagnosis.
Improper or Inaccurate Treatment
Physicians and health care providers have a duty to provide appropriate and accurate treatment options to patients. Providing wildly inappropriate or inaccurate treatments can compromise the health and safety of a patient.
The same question is posed in this situation as above, would a similarly trained and educated physician make the same decision, in the same set of circumstances? If the answer is no, a patient may have a medical malpractice claim on their hands.
Failure to Inform
Health care professionals have a duty to inform all patients of the known risks and side effects of any medication, course of treatment, or surgical procedure. Informing a patient of these risks is also known as the “duty of informed consent.” Patients cannot make decisions on their health care with fractured or partial information.
Negligence of Care
Negligence of care is a broad term that encompasses a wide variety of circumstances that may be considered medical malpractice, some of these situations include:
- Performing surgery on the wrong body part or limb
- Performing surgery on the wrong patient
- Mixing up an infant with another
- Birth injuries to a mother or infant
- Prescribing or administering the wrong medication
- Prescribing or administering the wrong dosage of medication
- Failure to obtain consent for a procedure
Mistakes Happen, But You Have the Power to Change That
Not all mistakes rise to the level of medical malpractice, but that doesn’t mean that patients are helpless or voiceless. Mistakes are worth reporting. When someone knows that have made an error, they can take steps to correct that behavior and ensure that it never happens again to another patient. Keeping a record of mistakes also helps keep health care providers accountable.
As a patient, you should never feel intimidated or embarrassed about filing a complaint against a health care provider or institution that made a mistake in your treatment, billing, or the handling of your personal information. Taking charge of your health care can be empowering, unfortunately, the process can be intimidating, and many patients don’t know where to start. Consider the following a guide to help get you started down the path of advocating for yourself and standing up for your rights.
Requesting Medical Records
Keeping a copy of your medical records is important for helping you keep track of your medical care. You can review your treatment, double-check that your medical information is accurate, and notice patterns in the notations that a physician makes in your chart.
Inappropriate notations, unprofessional language, or inaccuracies in the documentation are all red flags. A hard copy of these red flags in your possession strengthens the validity of a complaint or medical malpractice claim.
As a patient you are legally allowed to obtain copies of your medical data, Illinois state law allows anyone to request a copy of their personal medical records. The process for obtaining your information may vary by provider, but generally, providers have information on their websites directing patients on how to request their medical records.
This typically includes requiring a patient to complete a simple series of paperwork and then submitting it to the appropriate medical records division of the provider’s office. Privacy laws such as HIPAA stipulate that medical records may only be obtained by the patient. Minors may have their parents submit a request and those declared legally incompetent may have an authorized executor or guardian submit a form on their behalf.
Filing a Complaint Against a Health Care Provider
The state of Illinois gives patients the power to file a complaint against a physician or health care provider. The Illinois Department of Public Health takes complaints seriously and may investigate facilities or physicians if they feel that there are quality issues, serious errors, or the potential for other patients to be harmed.
To build the most effective and impactful complaint possible it is important to stick to the facts and be as specific about the incident as possible. You may be feeling vulnerable and angry about your situation, but it is always best to try and keep emotion out of your complaint and use concise language. Being as accurate as possible lay out what happened, the circumstances of the incident, and list all those involved. It is also helpful to include witness names as well.
Those wishing to make a formal complaint may do so by phone, mail, and fax. Forms can be found on the Illinois Department of Public Health website.
Phone: 1- 800-252-4343
Mail:
Illinois Department of Public Health
Office of Health Care Regulation
Central Complaint Registry
525 W. Jefferson St., Ground Floor
Springfield, IL 62761-0001
Fax: 217-524-8885
Filing a HIPAA Complaint
Your medical information is your own, it is private. Many times, patients are rushed into filling out paperwork at their physician’s office and blindly sign their name to the form saying that they’ve been made aware of their HIPAA rights. This is a mistake. It is supremely important that all patients take the time to review HIPAA standards and understand what HIPAA means when it comes to their information.
HIPAA stands for Health Insurance Portability and Accountability Act. In 1996, the act became federal law and required medical providers to protect a patient’s private health information. This means that a patient’s medical information and history cannot be disclosed to anyone without the patient’s consent or knowledge. Medical and insurance providers may not disclose health information, billing information, treatments, or medical history. Some of the most common complaints associated with HIPAA violations include:
- Personnel accessing records for reasons other than medical care or “snooping” on other patients
- Personnel leaving records or electronic devices unattended
- Removing medical documents or paperwork from a healthcare facility that leaves them open to exposure
- Releasing patient information to unauthorized individuals
- Releasing patient information without proper authorization
- Providing other individuals or providers with unauthorized access to medical records
- Downloading patient information onto unauthorized devices
- Improper disposal of medical records or information
- Disclosing medical information to an unauthorized third-party or company
- Failing to manage security risks to patient’s data
- Denying patients access to copies of their health records
If you believe you have been the victim of a HIPAA violation you can report the incident. A HIPAA complaint may be filed online, in writing by mail or e-mail, by fax, or through the Complaint Portal. When filing a complaint by sure to keep the information simple and factual.
While it can be a sensitive and emotionally charged topic, try to keep your complaint to the point, accurate, and as detailed as possible. Be sure to include the full names of those involved and the facility that work at.
Filing a Billing Complaint
Billing issues are some of the most complex and confusing issues a patient will encounter. Between medical costs and insurance costs and everything in between things are not always black and white. It is always important to request an itemized bill, that way you can see exactly what you are paying for and how much you are being charged. Hidden costs can be missed when you receive a bill with one total on it and don’t know how they came to that number.
Review the bill line by line and make sure you actually received everything they said you did. It’s ok to contact the billing department and ask questions or dispute inaccurate charges. You may even ask for a discount in exchange for a one-time, lump-sum payment. If you feel like you are hitting a brick wall or have insurance-related or billing issues, complaints may be filed with the Illinois Department of Insurance.
Consult with an Experienced Medical Malpractice Attorney Today
If medical negligence has caused your further damage or injury, it may be time to consult with an experienced medical malpractice attorney. These types of claims can be very complicated, and it takes a skilled attorney to help victims navigate the complex legal and medical framework.
Fortunately, the Illinois medical malpractice lawyers at Spiros Law, P.C. have the knowledge and experience to recover the compensation you deserve if you’ve been the victim of medical malpractice.
For a free medical malpractice consultation, contact the team at Spiros Law, P.C. today by calling (815) 929-9292.
