05/01/2012

Understand legal issues when using CBCT scans

by Stuart J. Oberman, USA

Dentists are legally and ethically obligated to do no harm to their patients. Improper diagnosis after using a CBCT (cone-beam computed tomography) does not align with this standard because delay of diagnosis leads to delay of treatment. This is not in the best interest of the patient because it can lead to an inferior prognosis. Also, not every patient requires a CBCT scan; therefore, it is the dentist’s responsibility to determine whether a CBCT scan is necessary by using reasonable, careful judgment in light of the patient’s medical and dental history and thorough examination. The dentist should do a cost-benefit analysis before requesting a CBCT scan. When doing so, the dentist should consider whether the likely benefit to the patient exceeds the ionizing radiation risk and the financial cost.

Dentists’ scope of legal responsibility to diagnose

When using CBCT, as with other diagnostic tools, the dentist’s responsibility is not limited to the area of interest being diagnosed or treated. The treating dentist is legally responsible for diagnosing any disease that falls within the scope of the dentist’s license, which is normally broad in scope, encompassing all diseases and lesions of the jaw and related structures. As for a dentist’s responsibility for diagnosing a disease that falls outside the scope of the dentist’s license, the answer is not clear. Thus, it is always a good idea to be cautious and assume the responsibility to recognize any abnormality that appears anywhere on the CBCT scan. If ... ART 1 ... dentist is unsure of ...ART 2... scan results, he or she should consult with ...ART 3... specialists in the field or refer ...ART 4... patient to ...ART 5... specialist.

Neglect contributed to death of patient at community hospital

16 August 2012 | By Sarah Calkin

A patient who choked to death at a hospital run by Somerset Partnership Foundation Trust had been neglected by staff, a coroner has ruled.

Parkinson’s sufferer Diana Mansfield, 78, was struggling to swallow during her stay at Frome Community Hospital in September 2011. On 3 September she choked and died. East Somerset coroner Tony Williams found ..ART1... primary cause of death was ....ART2... acute upper airway obstruction and dysphagia, ...ART3... common side effect of Parkinson’s.

Following the inquest in July he identified failings made in the nursing care received by Ms Mansfield and recorded a verdict of accidental death aggravated by neglect.

The Care Quality Commission visited the 28-bed hospital earlier this year in response to concerns about care and welfare of patients and staffing levels arising from Ms Mansfield’s death.

Inspectors judged the hospital was meeting standards overall. .....CONECTIVO.... it raised minor concerns about staffing levels, noting the ward had a sickness absence rate of nearly 10 per cent and cover was not always available for absent staff for a whole shift.

The full staffing establishment on the 12-bed ward where Ms Mansfield stayed was three registered nurses and four healthcare assistants on the early shift and five staff - usually two nurses and three HCAs - on the late shift. Some nurses complained this was not always adequate to meet the needs of patients and said it was sometimes a struggle to complete all their tasks.

Patient Confidentiality and Recordkeeping

Privacy is a patient right. Dentists have an ethical and legal responsibility to safeguard patient information. Patient information includes such information as personal data, medical history, diagnosis, treatment, and financial situation.

Patient information should be shared only on a need-to-know basis with those who participate in the care of the patient. ....CONECTIVO... disclosure is required or permitted by law, patient information should not be shared with anyone without the patient's written permission. Court orders, subpoenas and investigations by the Office of Professional Discipline are examples of disclosures that may be required even in the absence of the patient's consent.

Health professionals are required to maintain records for each patient that accurately reflect the evaluation and treatment of the patient according to section 29.2(a)(3) of the Rules of the Board of Regents. All patient records must be retained for at least six years, with the exception of records for minor patients, which must be maintained for at least six years and for one year after the minor patient reaches the age of 21.

(Adapted from NY State Education Department − Office of the Professions: http://www.op.nysed.gov/prof/dent/ dentpracticeguide.htm)

Neglect contributed to death of patient at community hospital

16 August 2012 | By Sarah Calkin

A patient who choked to death at a hospital run by Somerset Partnership Foundation Trust had been neglected by staff, a coroner has ruled.

Parkinson’s sufferer Diana Mansfield, 78, was struggling to swallow during her stay at Frome Community Hospital in September 2011. On 3 September she choked and died. East Somerset coroner Tony Williams found ..ART1... primary cause of death was ....ART2... acute upper airway obstruction and dysphagia, ...ART3... common side effect of Parkinson’s.

Following the inquest in July he identified failings made in the nursing care received by Ms Mansfield and recorded a verdict of accidental death aggravated by neglect.

The Care Quality Commission visited the 28-bed hospital earlier this year in response to concerns about care and welfare of patients and staffing levels arising from Ms Mansfield’s death.

Inspectors judged the hospital was meeting standards overall. .....CONECTIVO.... it raised minor concerns about staffing levels, noting the ward had a sickness absence rate of nearly 10 per cent and cover was not always available for absent staff for a whole shift.

The full staffing establishment on the 12-bed ward where Ms Mansfield stayed was three registered nurses and four healthcare assistants on the early shift and five staff - usually two nurses and three HCAs - on the late shift. Some nurses complained this was not always adequate to meet the needs of patients and said it was sometimes a struggle to complete all their tasks.

Neglect contributed to death of patient at community hospital

16 August 2012 | By Sarah Calkin

A patient who choked to death at a hospital run by Somerset Partnership Foundation Trust had been neglected by staff, a coroner has ruled.

Parkinson’s sufferer Diana Mansfield, 78, was struggling to swallow during her stay at Frome Community Hospital in September 2011. On 3 September she choked and died. East Somerset coroner Tony Williams found ..ART1... primary cause of death was ....ART2... acute upper airway obstruction and dysphagia, ...ART3... common side effect of Parkinson’s.

Following the inquest in July he identified failings made in the nursing care received by Ms Mansfield and recorded a verdict of accidental death aggravated by neglect.

The Care Quality Commission visited the 28-bed hospital earlier this year in response to concerns about care and welfare of patients and staffing levels arising from Ms Mansfield’s death.

Inspectors judged the hospital was meeting standards overall. .....CONECTIVO.... it raised minor concerns about staffing levels, noting the ward had a sickness absence rate of nearly 10 per cent and cover was not always available for absent staff for a whole shift.

The full staffing establishment on the 12-bed ward where Ms Mansfield stayed was three registered nurses and four healthcare assistants on the early shift and five staff - usually two nurses and three HCAs - on the late shift. Some nurses complained this was not always adequate to meet the needs of patients and said it was sometimes a struggle to complete all their tasks.

Patient Confidentiality and Recordkeeping

Privacy is a patient right. Dentists have an ethical and legal responsibility to safeguard patient information. Patient information includes such information as personal data, medical history, diagnosis, treatment, and financial situation.

Patient information should be shared only on a need-to-know basis with those who participate in the care of the patient. ....CONECTIVO... disclosure is required or permitted by law, patient information should not be shared with anyone without the patient's written permission. Court orders, subpoenas and investigations by the Office of Professional Discipline are examples of disclosures that may be required even in the absence of the patient's consent.

Health professionals are required to maintain records for each patient that accurately reflect the evaluation and treatment of the patient according to section 29.2(a)(3) of the Rules of the Board of Regents. All patient records must be retained for at least six years, with the exception of records for minor patients, which must be maintained for at least six years and for one year after the minor patient reaches the age of 21.

(Adapted from NY State Education Department − Office of the Professions: http://www.op.nysed.gov/prof/dent/ dentpracticeguide.htm)

05/01/2012

Understand legal issues when using CBCT scans

by Stuart J. Oberman, USA

Dentists are legally and ethically obligated to do no harm to their patients. Improper diagnosis after using a CBCT (cone-beam computed tomography) does not align with this standard because delay of diagnosis leads to delay of treatment. This is not in the best interest of the patient because it can lead to an inferior prognosis. Also, not every patient requires a CBCT scan; therefore, it is the dentist’s responsibility to determine whether a CBCT scan is necessary by using reasonable, careful judgment in light of the patient’s medical and dental history and thorough examination. The dentist should do a cost-benefit analysis before requesting a CBCT scan. When doing so, the dentist should consider whether the likely benefit to the patient exceeds the ionizing radiation risk and the financial cost.

Dentists’ scope of legal responsibility to diagnose

When using CBCT, as with other diagnostic tools, the dentist’s responsibility is not limited to the area of interest being diagnosed or treated. The treating dentist is legally responsible for diagnosing any disease that falls within the scope of the dentist’s license, which is normally broad in scope, encompassing all diseases and lesions of the jaw and related structures. As for a dentist’s responsibility for diagnosing a disease that falls outside the scope of the dentist’s license, the answer is not clear. Thus, it is always a good idea to be cautious and assume the responsibility to recognize any abnormality that appears anywhere on the CBCT scan. If ...ART 1... dentist is unsure of ...ART 2... scan results, he or she should consult with ...ART 3... specialists in the field or refer ...ART 4... patient to ...ART 5... specialist.

Neglect contributed to death of patient at community hospital

16 August 2012 | By Sarah Calkin

A patient who choked to death at a hospital run by Somerset Partnership Foundation Trust had been neglected by staff, a coroner has ruled.

Parkinson’s sufferer Diana Mansfield, 78, was struggling to swallow during her stay at Frome Community Hospital in September 2011. On 3 September she choked and died. East Somerset coroner Tony Williams found ..ART1... primary cause of death was ....ART2... acute upper airway obstruction and dysphagia, ...ART3... common side effect of Parkinson’s.

Following the inquest in July he identified failings made in the nursing care received by Ms Mansfield and recorded a verdict of accidental death aggravated by neglect.

The Care Quality Commission visited the 28-bed hospital earlier this year in response to concerns about care and welfare of patients and staffing levels arising from Ms Mansfield’s death.

Inspectors judged the hospital was meeting standards overall. .....CONECTIVO.... it raised minor concerns about staffing levels, noting the ward had a sickness absence rate of nearly 10 per cent and cover was not always available for absent staff for a whole shift.

The full staffing establishment on the 12-bed ward where Ms Mansfield stayed was three registered nurses and four healthcare assistants on the early shift and five staff - usually two nurses and three HCAs - on the late shift. Some nurses complained this was not always adequate to meet the needs of patients and said it was sometimes a struggle to complete all their tasks.