0:01

I understand.

0:02

Um, and I'm fairly informed that the whole idea

0:06

of the Night Nighthawk process is,

0:10

is very prevalent in your business right now,

0:13

and it really does impact the issues of vicarious liability.

0:18

What happens when you're having films read

0:23

at night from wherever,

0:26

who bears the liability for the preliminary reports

0:31

and is liability related

0:32

to speed at which there is a review of cases?

0:36

Well, e each of these involved different issues,

0:41

but we still need to go back to basic principles.

0:44

So let, let me go through a couple scenarios.

0:47

When Nighthawks make a mistake,

0:50

does the Nighthawk company get sued

0:52

or does the company, uh,

0:54

contracting radiology group or both?

0:58

And to what extent do private practice radiology groups have

1:01

to vet the overnight covering Nighthawk service?

1:05

That's a question that I was asked. Okay.

1:09

When Nighthawks make a mistake,

1:11

does the Nighthawk company get sued?

1:13

Yes. Or the contracting radiology group?

1:18

Yes, because the contracting radiology group generally

1:23

has but not always fact driven

1:26

some supervisory control over the night hook group.

1:30

Now, can you, can you eliminate that

1:34

through contract language?

1:36

Can you eliminate that

1:37

through agreements with the institution?

1:40

Yes, you can. But in the scenario, given, yes,

1:45

both groups would be held liable.

1:48

The next question I was asked, to

1:50

what extent do private practice radiology groups have to vet

1:55

the overnight covering Nighthawk service?

1:58

Think of that question from the perspective of the patient.

2:02

I vet the people who mow my lawn outside my office.

2:08

Okay? We all have responsibilities over certain things.

2:12

If you have some group reading film,

2:16

yeah, you better vet them.

2:18

You better know what they're doing

2:19

and you better have policies

2:20

and procedures that, that dictate

2:24

what happens in these scenarios.

2:26

And so, yes, you certainly are

2:28

responsible for vetting, vetting them.

2:30

Another question I'm asked,

2:33

how do you handle mistakes in preliminary reports

2:36

that lead to bad outcomes?

2:38

When they note the error in the morning,

2:40

is there wording they should use?

2:42

Well, if you've got a mistake in a preliminary report

2:48

that is acted on to a bad consequence,

2:53

then everybody who was part of that is going

2:57

to be liable to some extent

2:59

Under vicarious liability.

3:00

Okay, so wait a second. I'm home.

3:03

I come in in the morning, the preliminary report is there

3:07

and somebody did something before I ever got there.

3:11

How am I liable for that?

3:14

Answer to that question is,

3:16

under certain circumstances you're not liable,

3:19

but under others, you are.

3:21

What, what circumstances are you

3:22

liable in that circumstance?

3:25

You are liable if you don't have a appropriate process

3:30

and procedure by which when there is a read

3:34

that requires immediate action has happened overnight here,

3:39

that you don't have some kind

3:42

of double check fail safe on that.

3:44

If you don't, then you could be held liable for a failure

3:48

to properly supervise and

3:49

therefore be vicariously liable in that circumstance.

3:53

If you're, you're getting a nighthawk person

3:55

to report a preliminary report, it better not be acted on

4:00

until somebody can call it not a preliminary report.

4:04

There has to be some process

4:05

and procedure to make that happen.

4:07

It says what happens. Another question.

4:09

What happens when the reverse a preliminary report finding

4:14

and it takes out the contracting group we wrong?

4:18

Can the preliminary nighthawk opinion be used against them?

4:21

The answer is yes. Okay. The answer is yes.

4:24

If there's a preliminary report that states the diagnosis

4:28

and the, if I understand this question correctly

4:31

and the contracting group makes a different conclusion

4:35

and is wrong, can the evidence

4:38

of the first report be used against them?

4:41

Absolutely. It's part of the whole story.

4:44

Just assume everything that's part of the story can be used.