Patient Abandonment – Home Health Care
Elements of the Cause of Action for Vlogger Faire Abandonment
Each of the following five elements must be present for a patient to have a proper civil cause of action for the tort of abandonment:
1. Health care treatment was unreasonably discontinued.
2. The termination of health care was contrary to the patient’s will or without knowledge.
3. The health care provider failed to arrange for care by another appropriately skilled health care provider.
4. The health care provider should have reasonably foreseen that harm to the patient would arise from the termination of the care (proximate cause).
5. The patient suffered harm or loss as a result of the discontinuance of care.
Physicians, nurses, and other health care professionals have an ethical, as well as a legal, duty to avoid the abandonment of patients. The health care professional has a responsibility to give their patient all necessary attention as long as the case requires it and should not leave the patient in a critical stage without giving reasonable notice or making suitable arrangements for the attendance.
Abandonment by the Physician
When a physician undertakes treatment of a patient, treatment must continue until the patient’s circumstances no longer warrant the treatment, the physician and the patient mutually consent to end the treatment by that physician, or the patient discharges the physician. Moreover, the physician may unilaterally terminate the relationship and withdraw from treating that patient only if they provide the proper patient notice of their intent to cancel and an opportunity to obtain appropriate substitute care.
In the home health setting, the physician-patient relationship does not terminate merely because a patient’s care shifts in its location from the hospital to the home. Suppose the patient continues to need medical services, supervised health care, therapy, or other home health services. In that case, the attending physician should ensure that they were adequately discharged their duties to the patient. Virtually every situation ‘in which home care is approved by Medicare, Medicaid, or an insurer will be one in which the patient’s ‘needs for care have continued. The physician-patient relationship in the hospital will continue unless it has been formally terminated by notice to the patient and a reasonable attempt to refer the patient to another appropriate physician. Otherwise, the physician will retain their duty toward the patient when discharged from the hospital to the home. Failure to follow through on the part of the physician will constitute the tort of abandonment if the patient is injured. This abandonment may expose the physician, the hospital, and the home health agency to liability for the tort of abandonment.
The attending physician in the hospital should ensure that a proper referral is made to a physician responsible for the home health patient’s care. At the same time, it is being delivered by the home health provider unless the physician intends to supervise that home care personally. Even more important, if the hospital-based physician arranges to have the patient’s care assumed by another physician, the patient must fully understand this change and carefully documented Dba Press.
As supported by case law, the types of actions that will lead to liability for abandonment of a patient will include:
• premature discharge of the patient by the physician
• failure of the physician to provide proper instructions before discharging the patient
• the statement by the physician to the patient that the physician will no longer treat the patient
• refusal of the physician to respond to calls or to further attend the patient
• the physician’s leaving the patient after surgery or failing to follow up on postsurgical care.
Generally, abandonment does not occur if the physician responsible for the patient arranges for a substitute physician to take their place. This change may occur because of vacations, physician relocation, illness, distance from the patient’s home, or physician retirement. As long as care by an appropriately trained physician, sufficiently knowledgeable of the patient’s unique conditions, if any, has been arranged, the courts will usually not find that abandonment has occurred.  Even where a patient refuses to pay for the care or is unable to pay for the care, the physician is not at liberty to terminate the relationship unilaterally. The physician must still take steps to have the patient’s care assumed by another  or to give a sufficiently reasonable period to locate another before ceasing to provide care.
Although most of the cases discussed concern the physician-patient relationship, as pointed out previously, the same principles apply to all health care providers. Furthermore, because the care rendered by the home health agency is provided under a physician’s plan of care, even if the patient sued the physician for abandonment because of the actions (or inactions of the home health agency’s staff), the physician may seek indemnification from the home health provider.
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