What Are the Four D’s?

When it comes to medical malpractice, four aspects must be present in any and all cases. The four D’s – duty, dereliction, direct causation, and damages – remind the public of what constitutes an act of medical malpractice. Medical malpractice is not always intentional; it is commonly attributed to acts of negligence that still possess overarching consequences. Severe cases of malpractice result in injury or death to the patient. Other cases pose more of a financial burden because the medical professional orders needless exams, surgeries, or unnecessary equipment use. The four D’s guide us in assessing medical malpractice. So, what exactly constitutes each aspect?

Duty refers to a medical professional’s obligation to uphold the rules and guidelines set forth to ensure smooth and safe practice. One clear indicator that a professional is breaching this tenet is an aversion toward referrals. A doctor that is not qualified to treat certain conditions should not give medical advice – they should refer a patient to a qualified practitioner. An unqualified medical professional provides inadequate treatment and counsel, putting the patient at risk,

This category of malpractice also involves retaining patient confidentiality and treatment. Even if the doctor does not inflict bodily harm to the patient, they can still file a claim against a practitioner that breaches their confidentiality agreement or provides biased and/or prejudiced treatment.

Dereliction occurs when a medical professional has breached terms of their practice or overstepped patient boundaries.

A court will charge a medical practitioner with breaching their terms of practice simply by not meeting the expectations of the patient. For example, if the professional works in an unsanitary environment, while the patient is under the impression that the workroom is safe, they can be charged with dereliction. Unfounded diagnoses are another example of dereliction because they can result in unnecessary treatment, costs, and emotional distress.

A professional is also charged with dereliction if they perform any medical procedure not specified with, or approved by, the patient. In severe cases, this can involve the removal of unapproved body parts or altering a patient’s preapproved cosmetic surgery.

Direct causation is an assessment that determines whether dereliction resulted in negative consequences. Dereliction in which a medical professional operates on or removes an unapproved body part is straightforward. Record will show that the practitioner did not previously obtain patient approval, and they will be charged. Some situations, like claiming a lack of workplace sanitation caused patient illness, require more evidence to count as dereliction. In both scenarios, medical records, and other written evidence of workplace maintenance, are essential in determining direct causation.

Damages refer to any class of suffering directly caused by medical malpractice as determined by the previous three D’s. You can define suffering as any financial, emotional, mental, or bodily harm incurred by the medical practitioner. For example, infection caused by dereliction can result in both emotional and bodily suffering of the patient. Courts award financial compensation to address damages that result from remedying the issues caused by malpractice. Medical bills, lost wages, and even emotional distress are all compensable as forms of damage.

Using the four D’s, patients can act against medical malpractice. Talk to a lawyer about filing a claim against a practitioner that has directly incurred damage during any portion of the diagnosis and treatment process.

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