Your Best Malpractice Protection: Indisputable, Court-Proven Objective Data
FEATURE
David Marcarian
John Maltby
Every DC should be alert to his or her malpractice risks, especially in today’s litigious business and health care environments. This is a genuine case that will make you think twice about each new patient who enters your door.
Recently, a gentleman walked into the office of Dr. Joanna Smith (a real DC, but not her real name) hoping to become a new patient. He was enthusiastic about starting care because his friends had told him of the benefits of chiropractic and its positive impact on health. His eagerness to begin care led him to Dr. Smith’s office, where he hoped to get started immediately for wellness care.
When embarking on care with a new patient, there ai e generally two approaches DCs can take: Method A, which utilizes traditional intake procedures such as history, X-ray imaging, and orthopedic tests, with treatment commencing thereafter if care is appropriate and no contraindications appear.
With Method B, the new patient would also undergo a baseline Electronic Digital Palpation and DynaROM Motion
^Wherever patient care and liability are concerned, the more you know, the better. J J
sEMG evaluation, utilizing FDA-certified technology that has been approved by the courts as providing “indisputable evidence of injury” (Case #04-1149RX, Florida DOH). Such information is invaluable for both new and ongoing cases and for avoiding malpractice claims. Wherever patient care and liability are concerned, the more you know, the better.
Proactive DCs are always aware that a malpractice claim can arise at any time and for a variety of reasons. Among a plethora of possibilities, claims can originate from the practitioner’s failure to properly interview a patient regarding pertinent facts or other information, or the doctor’s failure to make proper clinical discovery of factors that could influence treatment and potentially induce harm.
DynaROM Motion sEMG testing establishes baseline findings for every patient, regardless of the accuracy of disclosure
■ " Among a plethora of possibilities, claims can originate from the practitioner’s failure to properly interview a patient
or evidence of prior injury. This is especially important when considering the potential risks of malpractice, which may not be evident but must always be considered. Thorough intake and re-exam processes help ensure appropriate care for patients while supporting the DC’s diagnoses, objectives, and patient care plans.
Fortunately, Dr. Smith was an advocate of Method B and using DynaROM testing as part of her baseline intake procedures for new patients. After a month of treating this patient, and eleven adjustments later,
Dr. Smith received a letter from an attorney filing suit against her for causing harm to this patient. She was ac-
cused of injuring a healthy patient by the use of chiropractic adjustments. The suit claimed the patient was in perfect health prior to being adjusted by Dr. Smith.
Because Dr. Smith had performed baseline intake DynaROM testing on this patient, she possessed indisputable evidence that this patient had entered her care with preexisting injuries. Dr. Smith then had the patient’s test data reviewed by a well-known expert witness (there are now ten chiropractic experts specializing in DynaROM data review.) She was then able to send to the patient’s attorney a detailed report showing the patient’s status upon intake, and before performing any chiropractic adjustments. This documentation clearly indicated that the patient had pre-existing injuries prior to being adjusted by Dr. Smith.
Upon further investigation, it was discovered that this patient had previously been denied benefits for a worker’s compensation claim. He then sought out Dr. Smith as an easy target for pursuing a malpractice lawsuit for the same injuries. He also considered chiropractors to be vulnerable targets due to the “low-tech” nature of chiropractic care and what he perceived to be an inability to disprove his claim against Dr. Smith. He did not foresee the significance of DynaROM technology or its impact on the veracity of his claim.
The accompanying graph is what Dr. Smith sent to the patient’s attorney, along with the DynaROM expert’s report. The upper half of the graph shows muscle guarding measured
over time as determined by the use of surface electromyography during active ROM testing. The left lumbar is illustrated in blue, the right lumbar is illustrated in red. The lower half of each image displays the electronically graphed ranges of motion - much more precisely and accurately than visual measurements and capable of capturing more information. By simultaneously measuring range of motion and muscle guarding, the dysfunctional muscle guarding patterns associated with prior injuries are clearly evident, even when a patient’s range of motion is normal. The DynaROM technology was responsible for winning several landmark soft tissue personal injury cases where this data was essential in proving a claimant’s injuries.
Dr. Smith’s story could have ended badly without her use of baseline DynaROM testing on all new patients. Instead, her use of this simple procedure, which takes the same time as visual range of motion testing, with the placement
of electrodes, pro-
tected her from a bogus malpractice claim that would likely have been settled in favor of the patient. After sending the DynaROM test results and the expert’s report to the patient’s
attorney, she was never contacted again.
“Care with caution” is an inescapable truth in health care today. The technology is here for making better decisions about patient care and for avoiding the associated pitfalls of practice. Objective data is the norm in health care today. Why practice without it? Cardiologists use the EKG. Chiropractors make better - and safer - decisions using DynaROM technology.
HMr. Marcarían is a NASA-Trained Researcher and inventor of high-tech biometric instrumentation, including the patented Wireless DynaROM Motion sEMG System which graphs muscle guarding and ROM simultaneously. This technology has established chiropractors as the leading experts in soft tissue injury. Upcoming CE Seminars can be viewed at www. myovision. com or by emailing davidapnyovision. com.
Dr. Maltby is a respected expert witness and twoterm past-President of the International Chiropractors Association (ICA). He also served as ICA Chairman of the Board, and was ICA ’s Chiropractor of the Year in 2007. Dr. Maltby has represented the ICA on the Board of Directors of the World Federation of Chiropractic, jmaltbyiafrontier. com 760-9227353
