Revised September 19, 1989
An incident is any actual or alleged injury to a patient of a University medical facility resulting from the rendering or failure to render professional services by a physician or any person for whose acts or omissions the physician is legally responsible, and which resulted from or was attendant to a therapeutic or diagnostic procedure.
NOTE: To the extent possible, the judgment as to whether an injury resulted from the "rendering or failure to render professional services" will be based on the general standards as commonly practiced by physicians in the same specialty.
An alleged incident is any claim by or for a patient of a University medical facility that there was a failure to obtain an informed consent from the patient.
NOTE: A claim of failure to obtain an informed consent may be based on the failure of the physician to advise the patient of alternate methods of treatment, possible complications, failure to obtain normally expected results, or for other reasons.
All incidents, actual or alleged, must be reported in writing.
Incident reports must be:
NOTE: If not hand carried, incident reports must be mailed in a sealed envelope marked PERSONAL.
All reports of actual or alleged incidents at UMCHC must be made using the UMCHC form "Management Variance Incident Report," and must include:
All reports of actual or alleged incidents must be made on a Patient Incident Report Form (UMUW Form 192).
All reports must be marked CONFIDENTIAL and filed in a separate, confidential file. They are not to be made part of the patient's medical record.
Any summons or petitions served on an employee regarding a claim of alleged medical malpractice must be forwarded immediately to the General Counsel in accordance with provisions of BP 712 Summonses & Petitions.
NOTE: Forwarding a summons and petition does not satisfy the requirement for submitting a detailed letter-report as outlined above.
Except for requests made by the General Counsel and the UM Director of Risk & Insurance Management, all requests for records and information must be made in writing to the physician or the physician's department.
All requests must be reviewed by the administrative head of the medical facility before any record or information is released.
All requests or subpoenas to appear for depositions and all subpoenas to furnish records or for any other data or purpose concerning a claimant, must be referred to the General Counsel for review and advice as to the action to be taken.
All correspondence from a claimant, a claimant's attorney or insurance company regarding an alleged accident or incident; questions on the medical and/or professional bill sent to the claimant; or which requests information regarding University insurance must be forwarded immediately to the UM Director of Risk & Insurance Management before any response is made.
NOTE: The UM Director of Risk & Insurance Management will review the correspondence with the General Counsel. One of these offices will advise the recipient of the correspondence concerning the reply to be made.
Physicians must not discuss the alleged incident or accident with the claimant, the claimant's attorney or insurance company or anyone purporting to represent the claimant except at a meeting approved by the General Counsel.
REFERENCE: BP 803 Commercial Coverages provides summary information about commercial insurance coverages and BP 804 Self-Insured Coverages provides summary information about self-insured programs.