emphasis on quality assurance and discharge planning.
PRO would review 15% of military medical records.
(3) In 1986, the Health Care Quality Improvement Act was established (Public
Law 99-660). This legislation provides immunity from damages to persons, hospitals, or
other health care entities participating in or providing information for peer review. It
includes creation of a National Data Bank and all health care entities must report all
settlements and adverse peer review determinations to the appropriate state medical
licensing board, the Department of Health and Human Services (HHS), and to the "Bank."
Hospitals must request such information routinely as part of physician credentials review.
BENCHMARK COURT DECISIONS
The legal impact of two court decisions placed emphasis on accountability and
made hospitals and their governing bodies responsible for the actions of the staff providing
services in that hospital.
a. In Darling vs Charleston Community Memorial Hospital, the highest court of the
state of Illinois considered the case of a young man treated in an emergency room for a
fractured leg. Complications which reflected improper care led to amputation of the leg.
The court held that the hospital governing board had a duty to establish mechanisms for the
medical staff to evaluate, advise, and where necessary, take action when an unreasonable
risk of harm to a patient arises from the treatment being provided by a physician.
b. In the case of Gonzales vs Nork and Mercy Hospital, Dr. Nork was found to have
improperly performed spinal fusions on a number of patients for several years, with no
evidence of any hospital intervention. In 1972, the California court found that Mercy
Hospital was liable because it had failed to meet its duty to protect its patients from
malpractice by a member of its medical staff knowing, or it should have known, that
malpractice was likely to be committed upon them. Mercy Hospital had no actual
knowledge of Dr. Nork's propensity to commit malpractice, but it was negligent in not
knowing because it did not have a system for acquiring that knowledge.