| Accident |
An event or occurrence that is unforeseen or unintended |
| Actionable |
An event or circumstance which may be remedied by a lawsuit |
| Ad Litem |
For purposes of litigation, an individual who has been given the authority to act on behalf of another, i.e., a lawyer acting ad litem on behalf of a minor child in litigation |
| Advance Directive |
A general term for advanced-care documents in which patients direct the medical care or intervention they want, or do not want when, they are no longer competent. These documents include living wills, medical directives, or durable powers of attorney for health care. |
| Adverse Event |
A general term for harm or death, whether by nature or by acts or omissions |
| Assault |
Any willful attempt or threat to inflict injury upon the person of another, when coupled with an apparent present ability to do so, and any intentional display of force, such as would give the victim reason to fear or expect immediate bodily harm, constitutes assault. An assault may be committed without actually touching, striking, or doing bodily harm to the person of another. |
| Battery |
The touching of one person by another without permission |
| Brief |
A written document, prepared by counsel, stating the law involved in a case and its application in support of a particular position in that case |
| Causation |
The legal concept of cause and effect |
| Child Abuse |
A condition in which a child has sustained a wound, injury, disability, or physical or mental condition caused by brutality, abuse, or neglect. Severe child abuse means the knowing exposure of a child to, or the knowing failure to protect a child from, conditions of brutality, abuse, or neglect that are likely to cause great bodily harm or death, and the knowing use of force on a child that is likely to cause great bodily harm or death, severe psychosis, severe neurotic disorder, severe depression, severe developmental delay or retardation, or severe impairment of the child's ability to function adequately in his/her environment, and the knowing failure to protect a child from such conduct. |
| Child Neglect |
An act by parent, guardian, or custodian in which that individual neglects or refuses to provide necessary medical, surgical, institutional, or hospital care for a child |
| Child Sexual Abbuse |
The commission of any act involving unlawful sexual abuse, molestation, fondling, or carnal knowledge of the child under the age of 13, including aggravated rape, rape, aggravated sexual battery, assault with intent to commit rape, crimes against nature, incest, use of a minor for obscene purposes, or the promotion of performance of sexual conduct by minors. For children between the ages of 13 and 17, if the above-named acts are committed against the child by a parent, guardian, relative, person residing in the child's home, or person responsible for the care and custody of the child, this also constitutes child sexual abuse. |
| Claim |
When a person makes a demand for compensation against a person or an institution, usually precipitated by an accident or injury |
| CMS |
Centers for Medicare and Medicaid services. Regulatory federal agency. |
Complaint
(Also See CMS)
|
The first or initial pleading on the part of a plaintiff in a civil lawsuit stating the allegations of misconduct |
| Comfort Care |
The level of care needed to keep DNR patients comfortable. Comfort care attends to patients' basic needs for nourishment and relief from pain and provides care appropriate to, and consistent with, patients' needs and wishes. Extraordinary and/or heroic measures to preserve life are beyond comfort care. |
| Consent |
A voluntary statement by one person allowing another to do something |
Conservator |
A person, official, or institution designated by a court to take over and protect the interests of an incompetent person |
Damages |
The fair compensation allowed by the court for injury suffered by the unlawful or negligent act of another |
Defendant |
An individual or entity against whom a civil or criminal action is brought |
Deposition |
A sworn statement, made out of court during the discovery phase of litigation, that may be admitted into evidence at trial
|
Discovery |
The pre-trial process entered into by parties to a lawsuit to obtain facts, documents, and information about the case in preparation for trial.
|
Do Not Resuscitate (DNR) Order |
An order entered by the patient's treating physician in the medical record which directs that cardio-pulmonary resuscitation should not be performed if the patient suffers cardiac or respiratory arrest. The order may contain limiting language allowing only certain types of resuscitation measures, but excluding others. |
| DOH |
Department of Health. See New York State, Department of Health. |
| EMTALA |
The Emergency Medical Treatment and Active Labor Act - Congressional act requiring a hospital to provide a medical screening examination to an individual coming to a hospital and requesting treatment and to stabilize, within the capabilities of the hospital, any emergency medical condition discovered. |
| Excess Insurance |
An insurance policy covering the insured against loss or damage above the limits of primary insurance |
| Expert Witness |
An individual who is qualified, by experience or education, to express an expert opinion at trial about one or more elements of a case. An attending physician or a treating nurse who is a defendant in a medical malpractice lawsuit will be allowed to testify as to the care rendered and to express opinions as an expert witness. Experts who are not parties to the litigation may also serve as expert witnesses. |
| Guardian |
A person, appointed by the court, given the power and charged with the duty to care for another person's physical body, as well as his/her property |
| Guardian Ad Litem |
A person appointed by the court to represent the interests of an infant or an incompetent who is a party to a litigation |
| Hazard |
A condition that creates or increases the probability of loss |
| HIPAA |
Health Insurance Portability and Accountability Act - Legislation passed by Congress in 1996 that addresses health insurance coverage, patient confidentiality, and privacy standards |
| Incident |
An event that either did, or potentially could have, resulted in injury or loss |
| Indemnity |
Denotes a compensation given to make a person whole from a loss already sustained |
| Insurance |
A contractual relationship which exists when one party (the insurer), for a fee (the premium), agrees to reimburse another party (the insured) for loss to a specified subject (the risk) caused by designated contingencies (perils or hazards). Claims made: A type of insurance that will only cover claims reported or filed during the year the policy is in force for any events which occurred that year or any previous period covered by the contract. Occurrence made: A form of insurance which covers events occurring within the contract period, regardless of when a claim is filed. |
| Interrogatories |
Written questions presented before trial, requiring written answers given under oath by one party to the opposing party. The responses may be admitted at trial. |
| JCAHO |
Joint Commission on Accreditation of Healthcare Organizations—Voluntary participation regulatory agency |
| Judgment |
The decision of a court or a jury, or the reason for the decision |
| Liability |
Any legally enforceable obligation or responsibility |
| Limits of Liability |
The maximum amount which an insurance company agrees to pay in the event of a loss |
| Litigation |
A lawsuit |
| Living Will |
A written declaration stating the patient's desires for medical care or non-care, including palliative care, and other related matters, such as organ donation ad body disposal |
| Loss |
The basis for a claim of damages. A loss may include past and present future wages, medical expenses, pain and suffering, loss of companionship, etc. |
| Malfeasance |
The wrongful performance of an act that the individual has no right to perform, or has been expressly forbidden by contract to perform |
| Malpractice |
The acts or omissions of a health care provider that fall below the recognized standard of acceptable professional practice under the circumstances |
| Medical Care |
Includes any procedure or treatment rendered by a physician or health care provider designed to diagnose, assess, or treat a disease, illness, or injury, including surgery; drugs; transfusions; mechanical ventilation; dialysis; cardiopulmonary resuscitation; artificial or forced feeding of nourishment, hydration, and other basic nutrients, regardless of method used; radiation therapy; or any other medical act |
| Morale Hazard |
A careless attitude on the part of an insured which increases the chance of loss or causes losses to be greater than would ordinarily be the case |
| Motion |
A written or oral request that the judge make an order or ruling about some aspect of a lawsuit |
| Negligence |
The failure of an individual to exercise the ordinary degree of care that would be expected from a reasonable and prudent person acting in the same situation, under the same or similar circumstances. This term is generally synonymous with malpractice. |
New York State, Department of Health—
(NYS, DOH) |
Regulatory agency managed by New York State |
| NYPORTS |
New York Patient Occurrence Reporting and Tracking System – Adverse event reporting system managed by New York State, Department of Health |
| Occurrence |
An event that either did, or potentially could have, resulted in injury or loss |
| Occurrence Insurance |
See Insurance |
| Occurrence Report |
The form used to document the details of an incident. The Occurrence Report is the primary communication mechanism used by the Risk Management office to identify events or situations that may represent liability exposure. The report also is an important component of the Medical Center's Quality Assurance Program. |
OMH
|
Office of Mental Health – Regulatory agency managed by New York State |
| Perjury |
Lying under oath |
| Plaintiff
|
The individual who initiates a lawsuit |
| Power of Attorney |
A traditional form of appointing another person (the attorney-in-fact) to act on one's behalf. "Durable" powers of attorney continue beyond one's competency. A durable power of attorney for health care specifically gives the attorney-in-fact the power to make decisions about the patient's medical treatment. |
| Premium |
The payment by a policyholder to purchase an insurance policy |
| Primium Coverage |
The first layer of protection offered by an insurance carrier |
| Prior Acts |
Insurance coverage that can be offered in a claims-made liability policy for claims that occurred, but were not reported for, a specific time before the effective date of that policy |
| Privileged Communication |
A statement made by a person to another that is protected by law from disclosure. A privilege may be absolute or qualified. A statement by a client to his or her lawyer is privileged under the attorney-client privilege. A statement given by a witness to an official of the Office of Risk Management is subject to qualified privilege and may not be disclosed without a showing of good cause. Tennessee law does not recognize a formal doctor-patient privilege, but the ethical principles of the profession require that medical information be retained in a confidential manner. For more details, contact the Office of Risk Management (464-6166) or the University Counsel's Office (464-4700). |
| Proximate Cause |
The actual legal cause of an injury or loss |
| Punitive Damages |
Damages awarded to a plaintiff, separately and in addition to any compensatory damages, to punish the defendant for outrageous conduct |
| Res Ipsa Loquitor
|
"The thing speaks for itself." The presumption that the cause of the injury was under the defendant's exclusive control and the injury itself was of a type that would not normally occur in the absence of negligence (usually involves surgery-related cases where the patient is under anesthesia). |
| Reserves |
Money set aside in anticipation of paying awards, settlements, costs of litigation (attorney fees, expert witness fees, etc.) |
| Respondeat Superior |
"Let the master answer." A legal doctrine under which employers may be liable to injured persons for the actions of their employees taken within the scope of employment |
| Risk |
The possibility of an adverse deviation from a desired outcome, the uncertainty of loss |
| Risk Management |
The practice of identifying and analyzing risk or losses and taking those measures necessary to minimize the real or potential losses to levels acceptable to the organization.
The risk management function can be broken down into four steps:
- Identification and analysis of loss exposures
- Selection of the appropriate mechanism(s) to reduce or, if possible, eliminate the possibility of loss
- Implementation of the chosen technique(s)
- Monitoring and review of the results
|
| Self-Insurance |
A system whereby an organization (such as Upstate Medical University) sets aside money to cover any losses that may occur - losses that would ordinarily be covered by an insurance policy. The money that would normally go to premium payments is, instead, paid into a trust fund set up for this purpose to provide a source of payment for losses and litigation expenses incurred. |
| Sentinal Event |
An unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. Serious injury specifically includes loss of limb or function. The phrase "risk thereof" includes any process variation for which a recurrence would carry a significant chance of a serious adverse outcome. |
| Standard of Care |
The standard by which negligence is determined. The degree of skill associated with the activities of a reasonable, prudent, ordinary practitioner acting under the same, or similar, circumstances. Refers to "reasonable", not necessarily "exemplary", care. |
| Statute of Limitations |
Refers to the legal limit on the time allowed for filing suit in civil matters. It is usually measured from the time the adverse occurrence, or from the time when a reasonable person would have discovered the wrong. |
| Stipulation |
An agreement by both parties in a lawsuit that may alter any case-related matters. A common example is when both parties agree to admit certain facts into evidence during a trial. |
| Subpoena |
The process by which the attendance of a witness is compelled by authority of the court |
Subpoena
Duces Tecum |
A court order that commands a person to come to court and to produce whatever documents are named in the subpoena |
| Summons and Complaint
|
The first notice and initial pleading on the part of a plaintiff in a civil court action. The complaint details the various allegations of misconduct by the defendant, as well as a request for monetary compensation. |
| Surrogate |
A substitute decision maker. In health care, a person who gives informed consent on behalf of an incapacitated patient, or who has the legal authority to ask that life-support systems be withheld or removed from a terminal patient. "Proxy" and/or "health care agent" are terms of similar usage. Under Tennessee regulations for Do Not Resuscitate (DNR), a surrogate is the most likely to know the wishes of the patient with respect to the possible withholding of resuscitative services or withdrawal of resuscitative services. |
| Tail Coverage |
Coverage provided by a claims-made liability insurance policy that extends its protection beyond its expiration date for claims that actually happened within the original policy period but are not reported until after the policy has terminated |
| Term |
The length of time covered by an insurance policy or a premium |
| Terminal Condition |
Any disease, illness, injury, or condition, including, but not limited to, coma or persistent vegetative state, sustained by any patient, from which there is no reasonable medical expectation of recovery, and which will result in the death of such patient, regardless of the use or discontinuance of medical treatment implemented for the purposes of sustaining life or the life processes (see also the definition under LIVING WILL) |
| Tort |
An injury or wrong committed against an individual by another, either intentionally or unintentionally, giving rise to a claim for monetary damages |
| Underwriting |
The process by which an insurance company determines whether or not, and on what basis, it will accept an application for insurance |
| Workers' Compensation |
A means created to protect a worker against injury suffered during his or her employment. Statutorily required insurance which limits an employer's liability to employees. |
| Work Product |
The materials used by the Office of Risk Management or an attorney in preparation for a trial. Such materials are not subject to discovery. |
