PATIENT-SUPPLIED RESPIRATORY EQUIPMENT IN THE HOSPITAL
by Michael L. Smith, J.D., R.R.T.
Hospitals and respiratory therapists regularly receive requests from patients asking to use their own respiratory therapy equipment in the hospital. Chronic pulmonary patients are generally reluctant to change their treatment regimen and may request they be permitted to continue using their home ventilators or positive airway pressure units in the hospital. Generally, hospitals should not allow patients to use their own medical equipment.
Patient-supplied medical equipment poses numerous risks for hospitals and their RTs. Patient supplied equipment may be a different model than what the hospital's RTs and other staff routinely use, which can contribute to errors in the equipment and alarm settings. The hospital may not have compatible parts to ensure that the patient-supplied equipment remains functional during the patient's hospital stay.
Another risk for the hospital and its staff exists because the patient may not have properly maintained the medical equipment. The hospital and its staff cannot easily determine whether the patient-supplied medical equipment has been regularly serviced, including any necessary modifications based upon recalls. While a particular piece of equipment may appear well maintained on the surface, it could have numerous deficiencies that are almost impossible to detect by the hospital and its staff.
The hospital and its staff may be assuming significant legal liability by allowing patients to use their own medical equipment. Patient-supplied medical equipment that malfunctions could conceivably cause injury to multiple patients and hospital staff. Consequently, hospitals should avoid allowing patients to use their own medical equipment in the hospital.
Despite the risks, most hospitals still allow the use of at least some patient-supplied medical equipment under certain circumstances. Whenever the hospital elects to allow patient-supplied medical equipment, it should involve the hospital's counsel, risk manager, and all the necessary hospital departments in the process.
Most hospitals that allow patient-supplied medical equipment have some type of policy on the use of that equipment. Those policies should require written approval from the patient's physician stating that the patient-supplied equipment is suitable based upon the patient's current medical condition. Every policy also should require notice to all the clinical and non-clinical departments necessary to ensure the equipment is in good working order and safe to operate. Every piece of electrical equipment must be thoroughly checked for electrical safety, usually by the hospital's biomedical department.
Whenever the hospital agrees to allow patient-supplied medical equipment, the hospital should have the patient sign a waiver that explicitly states that the hospital is not assuming any liability for the equipment. The waiver also should permit the hospital to use substitute equipment in the event the patient-supplied equipment fails or the patient's condition changes. Unfortunately, the hospital probably cannot completely absolve itself of any liability for patient-supplied medical equipment, even when the patient signs a waiver.
In the event the patient-supplied equipment fails, the hospital staff will need to intervene and provide appropriate care to the patient, even if the patient assumed all responsibility for the equipment. The hospital staff also will need to regularly check to confirm that the equipment is functioning properly and that the medical equipment remains appropriate for the patient's condition. Of course, the hospital staff must document their regular assessment of the patient-supplied medical equipment.
Michael L. Smith, JD, RRT is board certified in health law by The Florida Bar and practices at The Health Law Firm in Altamonte Springs, Florida. This article is for general information only and is not a substitute for formal legal advice.
This article was originally published in Advance for Respiratory Care and Sleep Medicine.