Objective 3: Explain legal issues and legal terminology. Risk Management Injury is damage to the body that restricts activity and/or causes disability. Those who participate in sports and other physical activities, risk sustaining an injury. Sports Medicine professionals should try to minimize the risk of injury as much as possible.

Risk Management: Types of Sports Athletes use their body to deter or punish opponents. (Intent of the sport.) Risk of injury relatively high. COLLISION Football Rugby Ice Hockey

Risk Management: Types of Sports Contact occurs, but is not the intent of the sport and discouraged by rules. Traumatic and overuse injuries are common. CONTACT Basketball Baseball Field Hockey Lacrosse Rodeo Soccer Softball Water Polo Wrestling

Risk Management: Types of Sports Sports where players are separated such that contact is unlikely without violation. Acute, traumatic injuries still occur, but the incidence of chronic, overuse related injury is greater. NON-CONTACT Archery Badmiton Bowling Crew/rowing Cross country running Curling Fencing Golf Gymnastics Skiing/Snowboarding Squash Swimming Diving Tennis Track & Field Volleyball

Legal Terminology It is assumed that an individual who participates in an activity and is injured as a result of the ordinary risk associated at the activity will not have grounds for negligence. Assumption of Risk

Legal Terminology Touching someone without their permission. Battery

Legal Terminology Doing something (commission) or failing to do something (omission) that a reasonable person would or would not do under similar circumstances. Commission & Omission

Legal Terminology Failing to inform a participant of potential risks and dangers. When dealing with minors, failing to warn parents or obtaining consent. Failure to Warn

Legal Terminology Health Insurance Portability and Accountability Act HIPAA Law that mandated four main areas of change for business in the health care industry. Privacy of health information Standards for electronic transactions of health information and claims. Security of electronic health information. National identifiers for providers.

Legal Terminology Being informed of all procedures and the potential risks and benefits of each. Informed Consent

Legal Terminology The legal responsibility to act in a reasonable and prudent manner. Failure to perform in such a manner makes you legally liable. Liability

Legal Terminology When an individual commits a negligent act while providing care. Malpractice

Legal Terminology Failure to use ordinary or reasonable care. In order to prove, four basic elements must be shown: Duty of care – an individual has the responsibility to provide care. Breach of duty – conduct of provider falls short of that duty. Usually commission or omission. Injury or damage – results of the breach of duty. Proximate cause – the injury or damage directly related to the breach of duty. Negligence

Legal Terminology Provides reasonable and prudent care expected as compared to someone with similar education and experience. Standard of Care

Ethical Conduct and Associated Issues Sports medicine professionals must act at all times with the highest standards of conduct and integrity. Ethics can be defined as a system of moral principles or standards governing conduct and knowledge of right and wrong.

Ethical Conduct and Associated Issues Federal legislation that opens up services, facilities, and employment opportunities to Americans with disabilities. Americans with Disabilities Act (ADA)

Ethical Conduct and Associated Issues Many people believe fair play and sportsmanship to be the “golden rule” of the sports world. Fair Play and Sportsmanship Some ethical issues related to fair play/sportsmanship include: Cheating Performance Enhancing Drugs Drug Testing

Ethical Conduct and Associated Issues: Fair Play and Sportsmanship Manifests itself in several ways in the world of athletics. Is victory due to training and talent, or cheating? Cheating The pressure of failing is too much to deal with. No one wants to be a failure.

Ethical Conduct and Associated Issues: Fair Play and Sportsmanship Substances used for the express purpose to perform better athletically. Performance Enhancing Drugs

Ethical Conduct and Associated Issues: Fair Play and Sportsmanship A common tool used to try to deter the use of performance enhancing drugs. Drug Testing

Ethical Conduct and Associated Issues Each career area has guidelines regarding what you can and cannot do. Make sure you are staying within the boundaries of your training and complying with local and federal laws. Scope of Practice

Ethical Conduct and Associated Issues An addition to the 14 th Amendment in No person shall be excluded on the basis of gender or be denied the benefit of any education program or activity receiving Federal financial assistance. Title IX - Gender Equity

Ethical Conduct and Associated Issues Our cultural traditions value winning, and why not, since it is part of the reason sports exist. What we fail to teach our children, students, athletes, and society in general is that the honest pursuit of anything carries with it the responsibility to do it right! Winning At All Costs

Reduce Potential Risk of Litigation Be familiar with medical histories of athletes, clients, or patients. Carry liability insurance. Be informed and current in changes in the standard of care through continuing education. Clinician Risk Reduction

Ethical Conduct and Associated Issues Clinician Risk Reduction (con’t) Demonstrate appropriate documentation. Implement a comprehensive record-keeping system. Critical in litigation, as well as with communication between members of sports medicine team. Pre-participation exams, insurance forms, personal data, rehab programs, progress charts, and clearance for participation are essential. In a legal situation, “if it wasn’t written down, it didn’t happen”! Injury reporting forms and injury tracking software are available online.

Reduce Potential Risk of Litigation SOAP Format – a medical documentation method S = Subjective: Information that the patient reports. Can also be answers to questions you ask. O= Objective: Information that can be measured and expressed in a standard format. Anything that you observe visually or palpate manually. A= Assessment: What decisions are made with the sunjective and objective information gathered. What is the injury based on the facts? P = Plan: Course of treatment to be carried out.

Reduce Potential Risk of Litigation Clinician Risk Reduction (con’t) Sara is a 17 year-old female. She was at volleyball practice when she jumped to block a ball; when she came down she landed on another girls foot. She felt a pop in her ankle and shooting pain up her leg. After a few minutes she was able to put a small amount of weight on it and limp off the court. When she took off her shoe she noticed that her ankle was swollen and starting to bruise. During the remainder of practice her coach had her ice and elevate her foot on a chair until her mom picked her up. Her mom took her to the doctor since Sara was unable to walk without pain 6 out of 10 on pain scale. The doctor took x-rays of Sara's ankle, which were negative for a fracture. The doctor diagnosed Sara as having a grade II ankle sprain. Sara was given an immobilization boot and crutches, and told to ice and elevate her foot for 20 minutes every couple of hours.

Reduce Potential Risk of Litigation Follow physician’s orders and recommendations. Clinician Risk Reduction (con’t) Have an Emergency Action Plan: Develop separate EAP for each field, gym, or court. Include procedures and policies for removal of protective equipment. Emergency communication needed. Have keys to doors, gates or padlocks easily accessible. Hold an annual meeting with all involved to review EAP. Carry contact information for athletes and coaches at all times.

Reduce Potential Risk of Litigation Clinician Risk Reduction (con’t) Always stay within your scope of practice. Maintain qualified and adequate supervision of facilities, employees, and equipment. Maintain good rapport with athletes, parents, coaches, physicians, clients and colleagues. (Sports Medicine Team)