Texas Jurisprudence Exam Guide

If there is no prior physician-patient No relationship, are you legally obliged to respond to a call from a patient for treatment? Does being on call give rise to a No physician-patient relationship? How can one terminate a physician- 30 days written notice; must provide for emergency patient relationship, without abandonment if there is ongoing treatment? Does a physician's duty extend to the Yes unborn child or potential victims of an ill patient? What is "proximate cause"? What are the two components of Prove that negligence caused harm and that the cause was not too remote; what is required to hold a defendant liable in a civil lawsuit Cause-in-fact (but-for test) and foreseeability proximate cause? Does an expert witness have to be Yes actively practicing medicine? Does an expert witness have to know Yes standards of care? Does an expert witness have to have Yes enough training to express an opinion on whether standard of care was provided? Does an expert witness have to be board No, board certified or eqivalent certified? In a medical malpractice case, are expert Yes, with two exceptions witnesses required? In a medical malpractice setting, what 2 Res ipsa loquitur (e.g., amputation of wrong leg) and negligence per se (a law was instances do not need expert testimony? broken) What are "exemplary damages"? Is there a cap to noneconomic damages? Damages above compensatory designed to punish the defendant and deter the behavior $250,000 for physicians, $500,000 for hospitals How much? Does the cap on noneconomic damage No depend on the number of defendants or claimants? What is "proportional responsibility"? Percentage of liability apportioned according to percentage of fault Can the claimant have part of the Yes proportional responsibility? If the claimant's proportionate If > 50%, no damages awarded responsibility is more than what %, he/she may not recover damages? How long is the statute of limitations for 2 years; for minors 2 years after becoming 18 years of age adults? For minors? By how much can the statute of limitations be extended and how? File complaint—extra 60-day, notice letter extends statute by 75 days What is the statute of limitations for 2 years wrongful death? What is the discovery rule? Give Statute does not begin until damage is discovered. For example, a retained examples. sponge that is found 3 years post-op Is there immunity from civil action in Yes, except gross negligence emergency cases? Is there immunity from civil action in Yes, except gross negligence volunteer care? When can a physician be charged with Un-consented surgery or examination or when exceeding the scope of the "assault and battery"? consent When can a physician be charged with Unilateral cessation of treatment when continued treatment is necessary patient abandonment? What is "strict liability"? Are hospitals liable for the actions of a Liability that does not depend on actual negligence, but that is based on a breach of a duty to make something safe. This often applies to product liability No, unless the hospital employs the physician physician? Who determines in a criminal case if the Judge by inspection medical records of a patient should be released? How many days do you have to release 45 days medical records to an attorney? Can medical records be admitted as Yes, but only with affidavit evidence in court? What are the requirements? What are schedule 1, 2, 3, 4, 5 drugs? Schedule 1—no known use (e.g., heroin); schedule 2—very addictive (morphine, cocaine); schedule 3-5—less addictive What are dangerous drugs? Prescription drugs other than schedule 1-5 How many DEA registrations do you need One to prescribe; a separate registration for each location where you dispense if you prescribe drugs? dispense drugs? How often do you renew your DEA Every 3 years license? Can you move your office location and No, need to change BEFORE move then change your DEA? Is a DEA registration sufficient to No, also need Department of Public Safety Bureau of Narcotics and Dangerous prescribe drugs in Texas? Drug registration How often do you renew a DPS license? Yearly Do you have to display the DEA and DPS Not required by any statute. licenses? How many days do you have to notify the 7 days DPS of any change in your information (name, address, tel., etc.)? Can you have your DPS suspended and No, they are interconnected keep your DEA or vice versa? For schedules 2-5 drugs, can you just put No, number and number spelled out the number of pills on prescription? Do you have to put intended use on prescription? Yes With how many days of a schedule 2-5 7 days; only if the drug was already rx in the hospital drug can a patient be discharged from the hospital? What kind of prescription pad do you Official DPS form; no stickers need for schedule 2 drugs? Can you use stickers? Can a physician prescribe schedule 2 Yes, for emergencies, and only for the duration of emergency over the phone? How many days does the physician have 7 days to mail the schedule's emergency prescription to the pharmacy? How many days does the patient have to 7 days fill schedule 2 prescriptions? Can you refill a schedule 2 prescription? No for schedule 2. Max 5 refills for schedules 3-5. How about schedule 3-5? Who can call in prescription from a Any qualified DESIGNATED person physician's office? Can they call in schedule 2? Only physician in emergencies Can a physician prohibit substitutions for Yes generics? From whom and how do you order Schedule 2 on triplicate order form from distributor; schedules 3-5 regular form schedule 2? Schedules 3-5? from wholesaler What drugs do you need to keep records If dispensed in office, then all dangerous drugs, schedule drugs and samples; on? How are the records kept? How separate records for schedule 1+2; inventory every 2 years; records are not often do you need to do inventory? Do submitted; keep records for 2 years you need to submit the records? How long do you have to keep the last inventory list? Who can inspect your drugs? TMB, DPS, attorney general for the DEA What is the method of ordering and Written and signed request by physician; must keep inventory and drug logs accounting for drug samples? Can you repackage samples? No Do you need to keep records on Yes, just like other meds samples? Can a physician buy and rebottle? Any No, except for rural areas (less than 5000 population of town or 2500 of exceptions? municipality, closest pharmacy > 15 miles) To give anesthesia, how often do you Every 2 years have to register with the board? What life support competency do ACLS, PALS, or board-approved course surgeons and anesthesiologists need? How many and what competency levels At least 2 physicians with advanced competency of healthcare providers do you need in all settings? How many days do you have to report 15 days office-based anesthesia-related complications? What is considered an anesthesia-related complication? Admission to hospital within 24 hours or death within 72 hours What is considered intractable pain? Can a hospital forbid a physician to give Pain where cause of pain cannot be removed and where relief or cure has not been found No dangerous drugs or controlled substances for treatment of intractable pain? Can the board take disciplinary action No against a physician for giving dangerous or controlled substances to a patient with intractable pain? What must the physician document prior to treatment of intractable pain? Understanding between physician and patient about treatment; dose, type, frequency of medication; consultation with psychologist, psychiatrist, addictions expert Can you guarantee that a drug will work? No Who can be part of a confidential Persons involved, furthering interest of the patient, and those participating in communication? diagnosis or treatment, e.g., patients, doctors, translators, nurses, etc Is the billing record confidential? No, billing record is NOT part of medical record In a criminal proceeding, is the physician- NO (except for mental health records); judicial ruling should be obtained patient privilege communication confidential? In a criminal proceeding, are records of Yes alcohol and drug abuse confidential? Does the physician confidentiality apply No to court or administrative proceedings brought by the patient against a physician? Can the physician violate confidentiality if Yes, must report that to law enforcement agency (NOT for mental health) he/she thinks he or someone else is in danger? What information must a release of Type of records, reason, and person to whom to release medical records include? How many days (hospital) or business Physician has 15 business days, hospital has 15 days days (physician) does a hospital/physician have to provide medical records when they are requested? What is "therapeutic privilege," when can If physician thinks that information would be harmful to the patient, it can be it be used, who has access to the withheld; in writing, copy in the chart; films or tests must be released to patient information, and what is the protocol the representative physician must follow? Can the physician charge for medical Yes, can charge $25 for first 20 pages, then 15¢ per page plus postage; records and films? For an affidavit? Does notarization $15, films $8; patient MUST pay to get records, 10-day notice he have to give the information if the patient does not pay? What does he do if the patient does not pay? Can you charge a patient requesting records in order to apply for disability or public aid? How many copies are patients entitled to? Can you charge if federal agency is requesting records? No; one copy; no How many years does a physician MD 7 years for adults, 7 years or until age 21; hospital 10 years have to keep records for adults? for minors? How many years do hospitals have to keep records for adults? For minors? Can a physician or hospital get rid of No records after the required years if these records might be part of a litigation? Can you relate information without Yes, all of the above patient consent for treatment? Billing? To report abuse? To law enforcement? For funeral directions? For worker's comp? What is the "minimum necessary standard" for a medical release? Does a patient have the right to see It protects health care information unless it is required to be released (investigation, law enforcement, authorized release, participating care providers, HIPAA compliant release) Yes; yes, they can request amendments his/her own record? Can he/she ask for amendments to the records? What is the Texas medical record privacy It is the state equivalent of HIPAA act? Is it like HIPAA? Within how many days must a hospital Upon request, within 30 business days; hospital must inform patient of availability send an itemized bill to patients? Is this of itemized bill mandatory? Or done by request? When must the hospital inform patients of this option? Can medical records be obtained with a Yes; no subpoena? Does this include substanceabuse records? Are substance abuse records admissible No, unless the crime is EXTREMELY serious during criminal proceedings? Is HIV information confidential? Yes Can you "break" confidentiality in order to Yes tell a spouse that his/her spouse is HIV positive? Can you break confidentiality to tell a Yes partner about notification program?. Are blood bank records confidential? Yes If a blood bank finds a donor with an They can tell name of donor, NOT disease infectious disease, can they call other blood banks and tell them the name of donor and the disease?Edition. If a blood bank finds that blood They can tell name of disease, NOT donor outbound to hospitals is HIV positive, can they call the hospitals and give name of donor? Type of disease? For statistical purposes, can a blood bank Yes, but not names or other identifying information give out medical records? Names? Is genetic information confidential? Yes Can patients have access to the results of Yes their genetic testing? What kind of crime is the unauthorized release of records? Misdemeanor