Registered Dietitians and Liability Issues

Liability Issues Affecting Registered Dietitians:
Measures to Avoid and Prevent Negligence

For this application paper, the allied health care professional I chose as the subject is a Registered Dietitian. According to the Academy of Nutrition and Dietetics, “a Registered Dietitian (RD) is a food and nutrition expert who has met the minimum academic and professional requirements to qualify for the credential RD” (Academy of Nutrition and Dietetics, 2015). The main responsibilities for an RD is to learn about the patient’s health, history, diet, and how often they exercise. Once they know all of this information, they are able to help individuals create and establish goals. The patient then has to make sure they visit their RD to monitor their progress. Patients could visit his or her RD at a hospital, private practice, health care organization or facility. Most of the Registered Dietitian’s have a graduate degree and are certified in fields such as renal, pediatrics, food allergy, or sports (Ansel, 2014). Since they have gone through highly specialized training, they are expected to undertake new challenges by diving into practice areas they are unfamiliar with. One of these challenges is to try and avoid being held liable for professional negligence. A myriad of cases that involve RD is when he or she fails to act in a reasonable manner. In order to prove that negligence it is essential to know the main reason behind it. There could be many reasons such as the Registered Dietitian did not fulfill his or her duty to the patient; neglected the dietitian-patient relationship; or patient suffered extra harm due to receiving wrong information from their RD. It has been said that Registered Dietitian’s have been recent targets for malpractice lawsuits. According to Sharon Palmer, RD, who wrote an article back in 2008 called Dietitians in the Legal Line of Fire, the National Practitioner Data Bank collects data over time on various health care practitioners. This involves loss of malpractice awards and license. In her article, she gathered information on “14 successful malpractice lawsuits against dietitians” that all happened between 1990 and 2007 (Palmer, 2008). It definitely is a dietitian’s worst nightmare to be part of a medical malpractice lawsuit today. Based on a 1988 report in the Journal of the American Dietetic Association, dietitians did not have to worry so much about being sued and could consider themselves lucky (Palmer, 2008). Unfortunately, this profession is catching up to other medical professions when it comes to being in risk for liability. Even if RD’s do not want to accept that it is happening, it still is, especially in long-term care. When there is a malpractice dispute involving a Registered Dietitian, it is the court’s job to look carefully “at the law on scope of practice, asking questions about whether the dietitian had the legal authority to provide care and whether the appropriate standard of care was followed. Negligence is the failure to act in a reasonable and prudent manner” (Palmer, 2008). After much research, I came across a real life case study that talks about a common lawsuit that involved Registered Dietitian’s and how standard of care was violated through negligence.
Case Study: Appolo vs. Gyaami This was a professional liability case that occurred on October 31, 2008 and filed on June 15, 2012 at the Court of Appeals in California. The lawsuit was filed by a prison inmate and stated that the Registered Dietitian did not properly diagnose him from his medical conditions, which consisted of diverticulitis of the colon and hiatus hernia. The RD provided his patient a high-fiber diet to alleviate the pain. Instead of this diet producing accurate results and reducing discomfort, the opposite occurred. The patient suffered from chronic dizziness, fatigue, stomach cramps, and diarrhea. The RD was accused of medical malpractice because he did not produce a diet that was prescribed medically. The plaintiff also added to his defensive that the defendant violated the standard of care that is certified to Registered Dietitian’s by disregarding his patient’s orders (California First Appellate District, 2009). As mentioned before, the level of risk that an RD is faced with in negligence is determined by the scope of practice. In this particular case, the RD was working with a very sick patient so his level of risk had a higher degree than if he was working with a healthier patient. It is necessary for all types of medical professions to know steps to avoid or prevent negligence. Registered Dietitian’s are advised to take extra precaution and carry a certain amount of money for personal malpractice liability coverage in case something like the above case occurred. The following is a list of a few precautions advisors could take to reduce risk and deliver quality care:
1) Stay Confidence: This is a major factor in avoiding potential liability. All types of practitioners need to regularly audit all areas of their practice, which includes legal standards of care. As we have learned in past classes about medical malpractice and HIPAA, it is also important to communicate.
2) Stay Updated: By attending conferences and reading publications about the latest industry trends, medical practitioners can stay informed. Medical laws are persistently changing as well.
3) Good documentation: This can easily decrease the risk of being held liable. Patient’s documentations need to support the treatment accurately; this includes their history, weight, height, and a chronological order of suggested course of action. It can also include comments from the patients to help any type of practitioner improve in areas that they need assistance in. In a nutshell, medical professionals need to ensure that they provide the best service possible to each of their patients.

References
Academy of Nutrition and Dietetics. (2015). What is a registered dietitian. Retrieved from http://www.eatrightpro.org/resources/about-us/what-is-an-rdn-and-dtr/what-is-a-registered-dietitian-nutritionist Ansel, K. (2015, May). What a registered dietitian can do for you. Retrieved from http://www.eatright.org/resource/food/resources/learn-more-about-rdns/what-an-rdn-can-do-for-you California First Appellate District (2008, October 31)
Appollo V. Gyaami CA 1/1 A118431
Retrieved from http://www.leagle.com/decision/In%20CACO%2020120615013 Palmer, S. (2008, Feb). Dietitians in the Legal Line of Fire. Today’s Dietitian 10(2), 52.
Retrieved from
http://www.todaysdietitian.com/newarchives/tdfeb2008pg52.shtml