I am not sure if it was a normal day, as I'd been working as an occupational therapist contractor for this organization for only a few months. However, my morning did not start great as I spilled a cup of coffee on my uniform. I should have taken that spilled coffee as a hint as to what type of day I would have at work that would have a lasting effect for the next year of my life.
As an occupational therapist, I am responsible for therapeutically working with patients to allow the patient to perform day-to-day tasks and return to their pre-ailment physical status.
This is done by:
- Evaluating the patient's ailment and needs
- Assessing the patient's home environment to ensure it is safe for the patient to perform his day-to-day task and activities of daily living
- Training the patient and caregiver (if available) in the use of special equipment that's needed in the home
- Developing treatment plans that address the needs of the patient
- Establishing specific goals for the patient to reach as part of his rehabilitation
I always aim to help people get better so that they can function independently. Although there are risks with any job, my worst nightmare has always been making a mistake.
Besides the coffee situation that morning, the day progressed normally. However, one of the other occupational therapists had to leave early and asked if I could cover his remaining patients that were scheduled for a discharge assessment. This was close to the end of the day. Since I was a consultant for the organization, I was concerned about procuring non-approved overtime.
This is where things changed. The mere thought of getting in trouble for staying over my time made me rush through the discharge assessment.
Usually, this is my discharge assessment routine:
- Review the patient's medical history
- Review all of the notes leading to the day of the discharge evaluation
- Interview the patient and caregiver regarding any added accommodations that they may need at home and ask whether they are prepared for the patient to return home
In some cases, I would even visit the home to ensure everything was ready for the patient's arrival.
I'm not saying that all occupational therapists do the above, but it was what I was used to doing. But on this day and for this patient, I didn't do my normal process because I was rushing to clock. I was unfamiliar with this patient and didn't follow my routine, so I based my assessment on what I saw in front of me — on the glance that I gave the patient's chart. I know what you're thinking, and I can assure you that at the time, it didn't cross my mind that I was doing something wrong.
As I assessed the patient, I quickly saw that they were able to:
- Open cabinets without difficulty
- Mobilize safely with the proper mobility aids
- Open medication bottles without difficulty
- Communicate, for the most part, correctly
You would think that I assessed everything, right? I did not ensure that the patient had the appropriate equipment at home to shower safely without falling. If I had read the notes thoroughly, I would have realized that this was ordered, but the patient's regular occupational therapist did not inform me before leaving.
I cleared the patient to go home. The family was under the assumption that everything had been set before the discharge, so they didn't worry about getting the home ready. The patient was taken to their home and three days later was found on the bathroom floor unresponsive due to a fall. This fall could have been prevented if:
- The bathroom safety device had been installed
- The patient was able to shower while sitting down on a bath chair
- I had performed a thorough assessment
- I had received a proper report from the patient's regular occupational therapist
As a result of my not doing my job correctly and a series of unfortunate events, this patient's preventable fall ended his life and triggered a negligence suit against me.
Do you know the feeling of doom that occurs when you are almost involved in a car accident? Well, that feeling lasted 12 months for me. As soon as I was served with a lawsuit letter from the attorney representing the patient's family, I knew I would lose everything I had. Why do I say this? Because I did not have medical malpractice insurance at the time of the incident -- and I was not sure if the practice I was working for would help me with my legal fees and settlement costs.
I was being sued for causing this patient's death because I had allowed the patient to go home before the appropriate safety equipment was installed. The patient's regular occupational therapist was also sued for negligence.
I am grateful that the organization did cover the lawyers’ fees for both the other occupational therapist and me, which amounted to over $90,000, but it did not cover anything else.
The case went to trial, and a jury determined that I was at fault and needed to pay the patient’s family $400,000 as compensation for the patient’s death. I had to sell my home, declare bankruptcy, and sell my car. Even after doing all of that, I was able to raise only $300,000.
In a turn of events, the patient's family decided to settle the suit for the amount I raised, and did not pursue the remaining $100,000 of the verdict against me. However, that was not all that they received. The other occupational therapist was found to also be at fault because he didn't finish his assessment or make sure everything was ordered in time for discharge. He had to pay $500,000.
In addition to the enormous financial losses, I also suffered psychological consequences of the lawsuit. I started second - guessing everything I did. It became so hard to concentrate. I continuously looked at everything — 3, 4, 5, 6 — times, which became a big time waster. I decided to take a break from work and focus on my mental health.
Lessons Learned by This Occupational Therapist
I learned so many things from this experience. I learned:
- Have malpractice insurance, especially as a contractor
- Follow my own judgment and regular practice
- Have barriers and limitations when accepting patients I am not familiar with
- Obtain a good report on your patient in the case an emergency happens and a co-worker has to take over
- Nurture spiritual supports that will sustain me during tough times