OUTCOME
A $7.4 million settlement was reached. Dr A. and his facility were responsible for $4.5 million; one of the radiologists and her employer, $475,000; the other radiologist and his employer, $750,000; Dr K. and his employer, $1.19 million; and the second medical center and several of its nurses, $560,000.
COMMENT
In this horrible case, there was no failure to diagnose. Dr A. diagnosed “suspected child abuse” during the May 2009 visit. The issue was the management of the case after abuse was suspected.
Suspected child abuse is a “hot potato,” and the cases are difficult to manage. Clinicians are trained to spot and treat illness. We are not well equipped to identify short-term safe housing, file court papers to terminate parental rights, conduct home visits, or interview family, friends, and neighbors to determine the best living arrangement for an at-risk patient.
Many clinicians feel that issues of abuse are outside medicine and are more appropriately dealt with by social workers, the courts, and law enforcement. Candidly, managing these cases is taxing. But manage them we must to adequately protect those who cannot protect themselves.
This case proves clinicians will be held accountable for child abuse. The defense attorneys realized the enormous malpractice exposure and consented to the substantial $7.4 million settlement. (This, it should be noted, is in addition to the largest verdict against the State of New Jersey in history: $166 million awarded against the Division of Youth and Family Services. As for the abusive father in this case, he received a paltry jail term of six years.)
So what do we do when evidence of abuse is discovered? How do we proceed? First, in cases when abuse is suspected, it is a bedrock principle that a child can’t be returned to the hands of the abuser. But how do we secure the patient’s safety after making a diagnosis of “likely child abuse”? As clinicians, we are duty bound to report abuse. Yet, under most circumstances, we do not have an automatic mechanism to emergently remove a child from a dangerous situation under our own authority: With great responsibility comes limited power. Sarcasm aside, there are steps we can take to safeguard children at risk.
Continue to learn how to safeguard children at risk >>
