Institutional Negligence: Looking Beyond the Medicine in a Medical Malpractice Case

Medical malpractice is associated with errors made by individual healthcare providers, but these errors are not typically caused by a single careless act; rather, they stem from systemic failures within healthcare facilities. Healthcare facilities are not just responsible for employing qualified professionals – they have an independent duty to provide environments for safe patient care. The medical malpractice team at Brooks Law Partners specializes in looking beyond the medicine and holding healthcare facilities responsible for their independent duty to keep patients safe.

Claims of institutional liability can be based on failures such as

1. Staffing errors – overscheduled and fatigued physicians or unsafe nurse-to-patient ratios, leading to medication errors, patient falls, or inability to provide thorough monitoring
2. Negligent credentialing – granting hospital privileges to physicians without properly verifying their training, competence, or history of medical errors or malpractice claims
3. Technology and equipment – failing to inspect or maintain medical equipment, having outdated equipment, or not having an electronic medical records system that enables necessary communication or critical value alerts
4. Policies and procedures – failing to have, communicate or enforce clinical and operational policies for patient safety
5. Training and oversight of medical staff – failing to ensure the facility’s healthcare providers are complying with patient safety standards 
6. Communications breakdowns – in person or electronically, leading to diagnostic delays and treatment errors

Finding the WHY

When filing a medical malpractice claim, the lawyer already knows WHAT happened. Establishing institutional negligence requires the lawyer to determine WHY it happened. This develops through the discovery process, but the lawyer has to know what questions to ask and what documents are relevant to the issues. Each case presents different facts, but documents that are typically useful include:

1. Policies and procedures (start with an index of all policies relevant to the issues/facility unit and narrow it down to those that are relevant to the case)
2. Patient census documents
3. Patient assignment logs
4. Staffing sheets 
5. Healthcare provider schedules
6. Healthcare provider training and education files 
7. Complete audit trail (through the date of the request, not limited to the dates of treatment) 

The information gathered from the facility’s documents can then be used to question healthcare providers and the facility’s corporate representative. An institutional expert can be used to tie the evidence together and explain how the system failed.

Why institutional negligence claims are important 

1. Medical issues are complex. Institutional failures are simpler for the average juror to understand.
2. Medical malpractice claims typically become a “battle of the experts.” An institutional expert’s testimony stays outside the ring.
3. People generally like and trust healthcare providers. Jurors are more inclined to hold an institution liable for its failures than individual healthcare providers. 
4. Institutional negligence affects everyone. Jurors might not identify with the circumstances of the case at hand, but if the entire system is broken, jurors can see that they might also be affected.
5. Exposing safety failures can lead to meaningful reforms.

The healthcare industry is in the business of making money. When corners are cut to maximize profits, patients get hurt. Institutional negligence holds healthcare organizations accountable when unsafe policies, inadequate oversight, or cost-driven decisions place patients at risk. Holding institutions accountable not only compensates injured patients but also helps create safer a healthcare system for everyone.