Protecting Providers: Mitigating Lawsuit Risks from Noncompliant Patient Care 

At times, healthcare providers may come across patients who don’t follow medical advice, and that is a risky challenge. If this results in something going wrong, providers are likely to face a lawsuit, even if the patient is the one who did not follow the instructions. Which is why it’s crucial to communicate early and effectively, document everything, and follow up. In this blog, we will discuss two real cases from New York to show how this works in practice. 

Perez v. Baez 

In July 2013, Mr. Perez was facing low sodium levels and was confused. He went to Forest Hills Hospital, where a pulmonologist had ordered tests, including an endoscopic biopsy. 

Mr. Perez was discharged from the hospital on August 2, and the doctor had given him oral and written instructions to return for a follow-up within a week. The final biopsy results came out after Mr. Perez had left. The reports did not show cancer; however, more tests were needed to be certain. Despite believing that this was a possible case of cancer, the doctor did not call the patient, nor made a follow-up or urge him to return. Mr. Perez, too, did not return.  

About two years later, the patient was diagnosed with stage 4 lung cancer that had already spread in his body, and he passed away just a month later.  

The doctor and the hospital were both sued by his wife. In his defense, the doctor argued that Mr. Perez had ignored the discharge instructions and requested the court to dismiss the case before trial, but the court disagreed. As per the court, the doctor should have followed up with the patient himself, especially since the test results were unclear. The case went straight to trial.  

Pierre-Canel v. Eye Surgery Aesthetics, P.C. 

This case involves a patient who saw an eye doctor in September 2013. She had complaints of tearing and discharge in her left eye. The doctor discovered an adhesion (symblepharon) and also had suspicions of cancer. As per observation, the doctor recommended surgery with a biopsy.  

The patient not only skipped her pre-op checkup but also skipped her next appointment. Nine months later, she returned to the doctor. He again recommended her surgery, for which she got clearance and scheduled the operation. However, she canceled her appointment again. 

She then returned in October 2014 with worse symptoms, and the doctor diagnosed her with an infection and prescribed antibiotics. She was also advised to go to the emergency room urgently. The doctor then called her twice after that for a follow-up. The patient consistently delayed care and failed to follow up. A few months later, she lost her eye to cancer.  

This led to the patient suing the doctor, claiming that he had delayed the diagnosis. Fortunately, the doctor had clear notes; he had explained the risk of cancer, made multiple calls, and offered treatment as well. Therefore, the court decided in favor of the doctor and held the patient responsible for delaying care. The doctor won the case. 

Key Takeaways 

What can be learnt from these cases is that when it comes to patients who don’t listen, it is not always the provider’s fault. However, it is crucial to take a few steps for the provider to protect themselves.  

• Clear Communication: Be honest with your patients and tell them clearly what they need to do, why it’s crucial and what could happen if they don’t follow through. Use a language that is easy for your patients to understand, write it down, and if possible, speak to a close family member. 
• Documentation: Don’t keep faith in just a word of mouth, write all your notes down. These notes must include what you told the patient and how they responded. In case you follow up by phone or email, ensure to note it down too. 
• Follow Up: Set up a system that can help you track missed or canceled appointments. Ensure that you either call or drop a message to your patients who skip visits. If they still seem to be out of reach, send a certified letter and explain the risks of not getting appropriate care on time.  

While you cannot control your patient’s actions, you can still control how efficiently you communicate, document, and follow up. Small steps can make the biggest difference in court and can also help save lives.