(B) Interpreting physicians who fail to meet the continuing education requirements of paragraph (a)(1)(ii)(B) of this section shall obtain a sufficient number of. LCRA: required of all physicians, dentists and nurses in every state a physician fails to meet continuing education requirements. he or she is guilty of. If you are unable to complete the minimum CME requirements due to health, Application for Waiver of Continuing Medical Education During Renewal Cycle There are a number of educational activities that meet the content standards for.
How can I claim hours for which I have no documentation? The organization sponsoring the program must provide documentation that includes the participant's name, course title, dates of attendance and duration, the sponsoring organization and accrediting agency name, and hours received. Additionally, you may be charged with unprofessional conduct for misrepresenting compliance with the CME requirements during the license renewal process.
What if I cannot afford the cost involved in taking CME courses? There are many sources for earning CME credit that are available at low or no cost. Online CME offered by accredited providers is one source. Medical journals often offer CME credits related to one or more articles. Also, local hospitals may offer approved courses for CME credit to all physicians.
I have a California license, but I am currently in the military. Can I be exempt from CME? The law requires that every military physician comply with the CME requirement. However, reasons of war or being aboard a ship for extended periods of time several years which preclude a physician from participating in any CME may be considered.
Requests to waive the CME requirement may be submitted to the Board. How many hours do I need to complete by my next renewal? If a waiver is granted for a renewal period, approved hours must be completed by the renewal period following the waived period. Should I send CME documentation with my license renewal notice?
Continuing Education - Licensees | Medical Board of California
If a physician is not being audited for CME completion, it is only necessary to sign the self-certification statement on the renewal application form and return it with the renewal payment. Documents that are acceptable include: Certificates of completion of CME activities, including in person or self-study programs.
The documentation must show the name of the physician as the participant, the title and date s of the course or completion of the program, the number of approved CME hours or prescribed credit hours granted for completion, or a copy of the medical specialty board certificate good for hours of credit. What happens if I am audited and cannot show proof or evidence of attendance of CME programs? Where a person is guilty of negligence per se, no further proof is needed.
Duty on the part of a hospital and doctor to obtain prior consent of a patient There exists a duty to obtain prior consent with respect to living patients for the purpose of diagnosis, treatment, organ transplant, research purposes, disclosure of medical records, and teaching and medico-legal purposes. With respect to the dead in regard to pathological post mortem, medico-legal post mortem, organ transplant for legal heirsand for disclosure of medical record, it is important that informed consent of the patient is obtained.
Consent can be given in the following ways: It may be oral or in writing. Though both these categories of consents are of equal value, written consent can be considered as superior because of its evidential value. Implied consent may be implied by patient's conduct. Tacit consent means implied consent understood without being stated. This consent is given by family members. Generally, courts have held that consent of family members with the written approval of 2 physicians sufficiently protects a patient's interest.
Advance consent, proxy consent, and presumed consent are also used. While the term advance consent is the consent given by patient in advance, proxy consent indicates consent given by an authorized person. As mentioned earlier, informed consent obtained after explaining all possible risks and side effects is superior to all other forms of consent. The importance of obtaining informed consent In the case of Samira Kohli vs.
Prabha Manchanda and Ors. The appellant was neither a minor nor mentally challenged or incapacitated. As the patient was a competent adult, there was no question of someone else giving consent on her behalf. The appellant was temporarily unconscious under anesthesia, and as there was no emergency. The respondent should have waited until the appellant regained consciousness and gave proper consent. The question of taking the patient's mother's consent does not arise in the absence of emergency.
Consent given by her mother is not a valid or real consent. The question was not about the correctness of the decision to remove reproductive organs but failure to obtain consent for removal of the reproductive organs as performance of surgery without taking consent amounts to an unauthorized invasion and interference with the appellant's body.
Continuing Medical Education
The respondent was denied the entire fee charged for the surgery and was directed to pay Rs. With this epoch making decision, doctors and hospitals became aware of the fact that as long as they have paid patients, all patients are consumers even if treatment is given free of charge. While the above mentioned apex court decision recognizes that a small percentage of patients may not respond to treatment, medical literature speaks of such failures despite all the proper care and proper treatment given by doctors and hospitals.
Failure of family planning operations is a classic example.
The apex court does not favor saddling medical men with ex gratia awards. Similarly, a in a few landmark decisions of the National Commission dealing with hospital death, the National Commission has recognized the possibility of hospital death despite there being no negligence.
Saghir Ahmad and D. Smt Santra underwent a family planning operation related only to the right fallopian tube and the left fallopian tube was not touched, which indicates that complete sterilization operation was not performed.
A poor laborer woman, who already had many children and had opted for sterilization, became pregnant and ultimately gave birth to a female child in spite of a sterilization operation that had obviously failed. Claim for damages was based on the principle that if a person has committed civil wrong, he must pay compensation by way of damages to the person wronged. The apex court held: The obligation to maintain besides being statutory in nature is also personal in the sense that it arises from the very existence of the relationship between a parent and the child.
Claim for damages, on the contrary, is based on the principle that if a person has committed civil wrong, he must pay compensation by way of damages to the person wronged. While elaborating on medical negligence, the apex court observed as follows abridged: Every doctor who enters into the medical profession has a duty to act with a reasonable degree of care and skill.
In the case of Bolam V. A man need not possess the highest expert skill: It is well established law that it is sufficient if he exercises the ordinary skill of an ordinary competent man exercising that particular art.
In the case of a medical man, negligence means failure to act in accordance with the standards of reasonably competent medical men at the time. There may be one or more perfectly proper standards, and if he confirms with one of these proper standards, then he is not negligent. While the amount of Rs. Though the insurance company took a stand since the nurse who administered the adult dose of inj. Lariago to the child was not qualified, the apex court did not go into this issue while adjudicating negligence related proceeding.
Therefore, it is important to keep in mind that doctors and hospitals should not only obtain a Professional Indemnity Insurance Policy, but also take care that nurses and other hospitals staff engaged by it are qualified. The brief facts of the case are as follows: They approached the National Commission for compensation and adequate relief. The case involves the unfortunate death of a young boy, Shri Sumanta Mukherjee, a student of second year B. Sumanta was conscious after the accident and was taken to the hospital about 1 km from the site of the accident.
He was insured for Rs. When he reached the hospital, the deceased was conscious and showed the Mediclaim certificate he was carrying in his wallet. He also assured that charges for treatment would be paid and treatment should be started.
Acting on this promise, the hospital started treatment in its emergency room by giving moist oxygen, starting suction, and by administering injection Driphylline, Injection Lycotinx, and titanous toxoid. The respondents demanded an immediate payment of Rs.
Actually, the crowd collected Rs. As the hospital was adamant and discontinued treatment after giving treatment for 45 minutes, the people from the crowd present were forced to take the patient to National Calcutta Medical College, which is about km from the current hospital. The patient died on the way and was declared dead upon arrival at the National Calcutta Medical College.
The Commission observed as follows: A human touch is necessary; that is their code of conduct; that is their duty and that is what is required to be implemented. However, it remains to be seen whether the above award has brought in any attitudinal change in the medical fraternity. Persons belonging to the poor class who are provided service free of charge are beneficiaries of service which is hired or availed of by the paying class.
The status of an emergency or critically ill patient would be the same as people belonging to the poor class since both are not in a position to pay.Everything you think you know about addiction is wrong - Johann Hari
Free services would also be services and the recipient would be the consumer under the Act. Since doctors started treatment on the deceased due to an emergency, that itself is availing of services, may it be free of cost or promised deferred payment. Expert evidence pointed out that discontinuance of treatment hastened the death of the patient, which itself is deficiency in service.
Serious negligence and laxity on the part of the hospital by refusing admission and treatment facility to the youth who was almost in dying condition, defying all medical ethics and a gross violation of the Clinical Establishment rules and Act of as amended in How was a patient who was advised admission at ITU was allowed to leave the hospital for treatment elsewhere without signing any document or risk bond not shown?
Withdrawal of treatment can not be justified on any ground. Deficiency is writ large. Secondly, while dealing with the contention that there was no consent for treatment, the National Commission observed as follows abridged: Consent is implicit in such cases.
On the contrary, a surgeon who fails to perform an emergency operation must prove that the patient refused to undergo an operation not only at the initial stage but even after he was informed about the dangerous consequences of not undergoing the operation. Waiting for consent of a patient or a passer-by who brought the patient to the hospital is nothing but absurd and is apparent failure of duty on the part of doctor. Deficiency in service was proved and compensation was granted.
While the cause of action before MACT was rash and negligent driving, due to which the accident was caused, the cause of action against doctors and hospitals is for deficiency in rendering service — emergency treatment by the doctors or the hospital.
Since both causes are separate and distinct, complaint is maintainable. One of the important characteristics of a good law is that the law should be definite, lucid, and unambiguous with the flexibility to relate to different situations, facts, and circumstances and that justice is done in accordance with law. The objective is to avoid confusion in the minds of the citizens as to what the law of the land is. As laid down in u.
So far as the case law laid down by the National Commission and State Commission is concerned, they are followed by lower fora as a binding precedent though no specific provision has been made in the Consumer Protection Act, It is generally accepted that when a point of law is settled by a decision of a superior authority, it is not to be departed from.
Change of a judge shall not affect the settled legal position. A new judge is not supposed to pronounce a new law but is expected to maintain and expound the old one. While this appears to restrict the elbow room of new judges to interpret the law when there is a settled legal position laid down by his predecessor, this restriction is substantially lifted when the law undergoes amendment.
There is considerable criticism that Consumer Fora have not scrupulously followed the principle laid down by superior fora, that is State Commissions of the state and the National Commission and also that even superior fora have often not maintained settled positions laid down by their predecessors.
The decisions of the National Commission and State Commissions are reported. However, there may not be uniformity with all such decisions. Furthermore, there may be conflicting decisions of various State Commissions and National Commissions.
Consequently, while some legal experts have called for express provision to that effect, others feel that the principle being followed in respect of the Supreme Court and High Courts since an appeal to Supreme Court is provided, High Courts are generally not expected to entertain consumer related writs though there is no such bar in the Act may be generally followed even in respect of the decisions of State and National Commission subject to the interpretations if any of High Courts and the final legal position as laid down by Supreme Court.
Clear case of medical negligence similar to res ipsa loquitor? An appellant doctor was found by the State Commission to be responsible for leaving ribbon gauze in the right side of the nose after a septoplasty resulting in several complications. The complainant suffered and had to be under treatment all the while the National Commission confirmed the order and observed that it has no option but to deduce that it was a clear case of medical negligence on the part of the appellant.
The National Commission in the case of Dr.
Thomas and Anr, II CPJ NC held that based on the facts and circumstances, the obvious deduction is that the appellant doctor is responsible for leaving behind ribbon gauze resulting in complications. Medical negligence was proved. The brief facts of the case are as follows.
The complainant was having some nasal and breathing problems. He approached the appellant doctor who upon examination advised a septoplasty, which was carried out on August 18, in second Respondent's hospital. It is the case of the complainant that after the operation, the pain aggravated and the breathing problem persisted.
After examination, the complainant was advised to take some antibiotics for major nasal infection. Despite taking these medicines, the complainant was not getting any relief so he was taken to St.
A computed tomography CT scan showed that there was a deposit inside the nasal cavity for which an endoscopy was performed at St. Cotton gauze was removed from the nasal section on November 28, It was in these circumstances alleging medical negligence on the part of appellant and second respondent a complaint was filed before the State Commission.
After hearing perusal of evidence and other material on record, the State Commission held the second respondent guilty of medical negligence and directed him to pay a compensation of Rs. Aggrieved by this order, the Appellant doctor filed this appeal. As held by the State Commission, it is neither the surgery nor the procedure adopted that is under challenge. What is being challenged is the leaving behind of cotton gauze after surgery and the non removal of it by the appellant doctor.