Managing the clinical and medicolegal risks of obesity

Abstract

Obesity is a major public health problem and could soon become a major medicolegal issue as well if appropriate risk management is not undertaken. Apart from the clinical complications of obesity, problems could arise from the use of inappropriate equipment. Insufficiently strong equipment used to move/transport/treat an obese patient could break or fail. Staff who manually handle obese patients without proper equipment and training could suffer back injuries. These types of claims should be preventable with sufficient investment in equipment and training. Unless the problem is addressed now, there could be an increase in claims. These will include clinical negligence claims brought on patients' behalf for injuries due to handling difficulties, equipment failure, problems with calculation of drug doses and failure of diagnosis. There will also be personal injury claims associated with manual handling of obese patients brought by the medical staff responsible for their care.

Risks to Healthcare Organizations and Staff Who Manage Obese (Bariatric) Patients and Use of Obesity Data to Mitigate Risks: A Literature Review

“…Diverse risk management programs should also be implemented to reduce risks to carers, including using bariatric patient handling equipment, providing education and training; use of written procedures, considering environmental design, and bariatric patient risk assessments and individual care plans. 26 , 30 “Lift teams” have also significantly reduced carer injuries and increasing staff job satisfaction and perceptions of organizational commitment to safety.…”

“…Recommendation: Patient-handling controls are required such as lifting/transfer equipment, ergonomic assessments, no-lift policies and staff training. 3 Chappell (2007) 30 Medicolegal risk Claim increases relating to clinical negligence claims and staff injuries may occur if obesity risk management is not implemented. Recommendation: Investment in clinical and patient-handling equipment, and patient-handling training is required.…”

“…5,11 These challenges can result in increased risks of suboptimal care or adverse outcomes for patients, which may result in medical negligence cases. 30 Clinical risks relating to maternal obesity and childbirth outcomes should also be considered by hospitals as they represent a significant portion of overall negligence claims. 31 An organization's inability to care for patients with obesity due to lack of bariatric equipment or facilities may create legal risks that may be increasingly supported by legal arguments advocating for the same standards of care regardless of body size.…”