Arizona Psychiatric Associates, PLLC

While conducting a patient's evaluation, diagnosis, treatment, monitoring, and discharge or disposition a physician must exercise that reasonable degree of clinical knowledge, skill, and care, which is ordinarily expected of a member of his profession in similar circumstances. "Errors of Fact" is the term used to decsribe a failure to obtain adequate information such as patient's prior medical records or laboratory tests, and can be grounds for a claim of negligence. On the other hand,  "Errors of Judgment" where after exercising due diligence in obtaining all the needed information, the physician acted in good faith but there was a bad outcome cannot be grounds for negligence.

The alleged negligence of a physician must be proven by preponderance of evidence.  The four elements, sometimes called the "Four Ds", of negligence are as follows:

Duty; it must be established that the physician had a duty

Dereliction of Duty; that the physician breached the duty

Direct Causation; that the dereliction of duty directly caused the alleged damage

Damages; presence of actual damages

In majority of malpractice cases, an expert testimony is needed to establish that a defending physician was negligent by practicing in a manner that fell below the "standard of care", however, at times the professional conduct is so egregious that even a lay person can determine that the professional care was very poor.  For such rare situations, a concept called "Res Ipsa Loquitur" (the thing speaks for itself) can be applied; in this situation, expert testimony is not needed, and the burden of proof shifts to the defending physician to show that there was no negligence.

Negligence on the part of a physician can be claimed to have caused the harm in two ways.  First, there can be a claim of what is called "Cause-in-fact" meaning that if the physician had not carried out a specific action, the harm would not have occurred; an example would be prescribing a contraindicated medication resulting in harm to the patient.  Secondly, there may be a contention that the alleged professional negligence served as the "proximate cause" of the claimed harm; i.e. the effective cause of loss or damage.  It is an unbroken chain of cause and effect between the occurrence of a negligent act and resulting injury or damage.

Statistically, the most common reasons cited for psychiatric malpractice claims are incorrect treatment, specifically negligent use of psychiatric medications including failure to obtain informed consent, attempted and/or completed suicide, incorrect diagnosis, improper supervision and improper commitment