I made a medical error (or am being accused of one). Now what?

The AVMA Trust’s PLIT program receives claims stemming from allegations of malpractice, state licensing board complaints, and animal bailee claims (incidents occurring while the patient is in your care, custody, or control, but unrelated to treatment). While this article will specifically focus on what to do in the wake of a medical error, keep in mind that the same steps should be followed if a board complaint is filed against your veterinary license or if an animal is injured or dies in your care, outside the scope of treatment.

Before exploring the ins and outs of handling medical errors, an important distinction must be noted: Medical errors can be separated into two categoriestrue (or actual) errors versus those alleged by clients.

  • True medical errors: The DVM (or a vet tech or assistant under them) makes a treatment or surgical error. This mistake may be realized at the moment of error or later, upon reexamining the patient.
  • Alleged medical errors: An unsatisfied client is displeased with the care their animal has received and alleges that the DVM (or a vet tech or assistant under them) made a mistake or has not met the standard of care.

I (or my team) made a true medical error.

As a veterinarian, your goal is to provide help and healing to your patients. Realizing that a mistake may have resulted in an injury to a patient can be extremely upsetting, potentially clouding your ability to figure out the next course of treatment for your patient. It’s important to stay calm, think rationally, and always do what’s in the best interest of the patient.

If the mistake is realized at the moment of error (such as transecting a ureter during a spay, fracturing a mandible during tooth extraction, or administering an injection of the incorrect medication), do the following:

  1. Tend to the patient first. If correcting the error or minimizing damage is in your power, do so immediately. If that is not possible, stabilize the patient to the best of your ability and contact an emergency/specialty hospital that can accept the patient as an emergency referral.
  2. Collect yourself before communicating with the client. While time is of the essence, taking a moment to calm yourself prior to interacting with the client is essential.
  3. Explain what happened in layman’s terms and be honest. Discuss the error with the client as soon as possible and be sure to do so in language the client can understand. Speak plainly and assure the client that steps are being taken to remedy the error. If the client becomes agitated or emotional, remain as calm as possible and stick with the facts.
  4. Never, ever offer a client financial compensation. Though your first reaction might be to compensate the client for the error or to cover the cost of referral care, paying for anything will only complicate matters for the insurance carrier and may affect potential reimbursement to the client.
  5. Never assure the client that your malpractice coverage will compensate them or cover the incident. While financial coverage of the incident is likely, never make assurances or promises to the client. Instead, assure them that you have reported the error to your insurance carrier and explain that you will provide them with contact information for the representative handling the claim ASAP.
  6. Report the error to the AVMA Trust team ASAP. As soon as you’re able to do so, contact the AVMA Trust to alert us that a medical error has occurred and that a potential claim might follow. Even if the client seems calm and reasonable when you explain the mistake to them, or if the error appears to have been remedied without a referral, be sure to report the incident. This step allows the insurance carrier to explore the potential claim and ensure that insurance coverage – if needed – occurs in a timely fashion. However, do not include contacting the AVMA Trust or insurance carrier in the patient’s official file.
  7. If the client files or threatens to file a board complaint, contact the AVMA Trust team immediately. Complaints against veterinarians’ licenses have risen dramatically in recent years. If the client so much as mentions a board complaint or threatens your veterinary license, put the AVMA Trust on notice. If you receive an actual board complaint, submit a copy of the complaint to PLIT immediately in order to be assigned legal representation.

If the mistake is realized upon reexamination (such as a thermal burn from heat support during surgery, a foreign object left in the abdominal cavity, or an incorrect dose of medication):

  1. Hear out the client and take careful note of what they’re noticing in their animal. While this step might sound obvious, doing so without coming off as defensive or skeptical can be challenging if you aren’t in the right headspace. Understand that if the client sounds accusatory or angry, they’re coming from a place of concern. Assure them that you will do a thorough examination of the patient and get to the bottom of things.
  2. Upon discovering the error, follow steps 1-7 listed in the above section. When contacting the AVMA Trust and the insurance carrier, be sure to include anything that occurred between the treatment or procedure and the patient presenting at the clinic once again. This information includes how the patient seemed at discharge, any take-home instructions given to the client, and any emails, phone calls, or other contact between the clinic and the client before the patient’s return to the clinic.

I (or my team) are being accused of making a medical error.

Being accused of a medical mistake that you didn’t commit can be just as frustrating and upsetting as actually making an error. In the event that a client or a client’s legal representative accuses you of malpractice, take the following steps:

  1. Get in touch with the AVMA Trust immediately. Even if it appears that the client is making an empty threat, contact the Trust and the insurance carrier as soon as possible. Provide full notes on the patient as well as any letters or emails received from the client and/or their attorneys.
  2. Cut contact with the client. If the client is aggressive or won’t stop contacting you and making demands, calmly and professionally provide the client with the contact information for the insurance claims representative handling the case. Do not engage with the client further or attempt to negotiate. Let the insurance carrier take things from there.

Making a medical error or being accused of one is upsetting and stressful. By following the recommendations above, you can take steps to ensure the most positive outcome possible for you, your clinic, the patient, and the client. If you have any questions about the claims process, please don’t hesitate to contact an AVMA Trust representative at info@avmaplit.com or call us at 1-800-228-7548.