Claims Corner: Claim Trends and Potential Pitfalls Facing Health Care Facilities and Employees

By: Angela Pacheco Gette


Consistent with insurance carriers industry-wide, health care professional liability claims among THIE’s subscribers have remained relatively flat over the last several years. Claim counts across all lines of THIE’s business were lower in the first quarter of 2022 than they have been in the first quarter of the preceding four years. However, the industry remains guarded in light of new and increasing challenges facing our health care facilities and providers.


Staffing shortages continue to represent the most clear and present danger, leaving insureds exposed in a variety of ways. The most direct exposure comes from inadequate staffing, which forces health care professionals to take on additional duties, responsibilities, and hours. These additional duties or responsibilities may include caring for more patients than usual or working in different units than usual. Deviations from one’s normal workload and set of responsibilities creates an increased risk of error by the health care employee.


Staffing shortages, and the resulting change in duties or responsibilities, also increase the risk of a corporate negligence claim against a hospital or health care facility based on allegations of negligent hiring, training, supervision, or retention of staff. Such claims may result in direct liability against the facility, in addition to any vicarious liability arising from injury caused by an employee. For facilities with one business entity owning the facility and a separate entity operating the facility, these direct liability claims pose an even greater risk if the owner facility handles any of the hiring, credentialing, training, or policy-making duties on behalf of the operating facility. It is critical that these entities carefully examine what roles they are undertaking and what attendant risks are associated with those roles to ensure they are maintaining proper insurance coverage, so no entity is exposed to unintended extra-contractual liability.


Supply chain issues are also creating an increased risk of exposure for health care facilities. No industry is immune to the disruptions occurring in the global supply chain. For health care facilities, these disruptions could impact availability of medications, personal protective equipment, or medical devices, thereby increasing potential exposure for the facility. Attention must be given to supply chain preparedness and response to reduce risk associated with supply chain disruptions.


Finally, social inflation continues to be a concern for carriers and health care facilities. The increasing frequency of criminal charges being brought for acts of medical negligence has potential to drive social inflation in health care professional liability claims upward because it normalizes punishing a health care worker for an unintentional error. While the Texas caps on non-economic damages in health care professional liability cases help blunt the impact, savvy plaintiffs’ attorneys can use social inflation drivers to increase the economic damage components in high severity medical malpractice claims.


Now, more than ever, health care facilities and employees, must evaluate these potential risks with a critical eye, undertake mitigation efforts where possible, and ensure that they are adequately covered in the event a claim is made.


July is UV Safety Month

Summer is here! Summer is here and it’s time to get serious about UV protection!

Sun safety should be considered during any season and amidst any weather because during these times we are still vulnerable to the sun’s rays. Without proper protection, there is an increased risk of eye damage, skin cancers, and premature aging.

THIE is here to share some tips to protect your skin!

Wear Sunscreen

Choosing a good sunscreen and wearing it outside is a very important factor in protecting against both UVB and UVA rays. Effective sunscreens should be labeled as broad-spectrum and have an SPF of 30 or more. At application use the “Teaspoon and Shot Glass Rule” to apply to the correct amount of sunscreen to the exposed areas of skin. Measure out about a teaspoon for your neck and face, and a shot glass amount to apply to the rest of your body.

Sunscreen is only effective so long before it requires another application, so be mindful of the time recommendations on the labels.

This tip is crucial for all, but especially our EMTs out in the field. Did you know that driving can cause skin damage! The rays both through the windshield and the driver’s door can have a huge effect on your skin.

Wear Sunglasses

It’s easy to tell when our skin becomes affected by the sun’s rays, but less obvious is the effect it has on the eyes. In order to properly protect the retina from UV rays, you should purchase and wear glasses that are labeled as 100% UV protection.

The FDA says to “consider large, wraparound-style frames, which may provide more UV protection because they cover the entire eye socket.” While unique lens shapes and colors are fashionable, they do not protect against UV rays.

Monitor Time Spent in the Sun

Spending time out in the sun benefits the Vitamin D levels in a person’s body, however, this only requires 15-20 minutes of sun exposure per day. Between the hours of 10 a.m. and 4 p.m. the UV is at its strongest. To avoid sunburn, monitor the amount of time you spend in direct sunlight.

Did you know you can check the UV index based on your location?

Wear Proper Clothing

Aside from sunglasses, wide-brim hats can help to prevent sunburn to your scalp, face, and shoulders. Clothes do a fine job of blocking harmful UV radiation, especially those labeled as having UPF, or ultra-protection factor. Darker clothing with thicker fabrics does a better job at protecting your skin than lighter fabrics such as linen. When you’re outside be sure to wear clothes that are loose-fitting to avoid stretching fabrics too much to where they are no longer protecting from UV rays.

Information and quotes are derived from research from the CDC, EPA, and FDA.

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