Part 2:Strategic Compliance with the Law

You are an administrator for Big City Hospital Inc., a large medical center. Your medical center has just received a Summons indicating that a Complaint has been filed in the state district court in your city claiming that Dr. Quick, Nurse Sleep, and your medical center were negligent during a recent surgery.

The claim is that the doctor left before the surgical count, the nurse didn't notice a missing sponge during the count, and the patient now has an x-ray showing that there is a sponge in the abdomen. The medical records do not reflect that a sponge count was even completed. Your state of Maryland has an arbitration process that has been completed and the lawsuit has started.

1. As part of the lawsuit, you receive a litigation hold letter requesting that all documents related to the lawsuit be preserved including electronically stored information (ESI).

• Why is it important to preserve documents for litigation?
• How would IT BE DONE? Describe three actions you would take to preserve documents (prevent destruction) for this lawsuit.
• What key documents would need to preserve because they relate to what happened?

1. When a case goes to court, good medical record documentation can make the difference in winning or losing a lawsuit.

• How can medical record documentation limit or increase legal liability?
• As a result of this lawsuit, what three actions would you take to improve medical record surgical care documentation including adequate documentation of the sponge count?