Archive February 2019 XX, No. 2

Legal Update: The Ride Home: Uber Complicated or Easy Lyft?

When there's no one there to drive your patient home after surgery.

Jason Krisza

Jason Krisza, Esq.

BIO

STRANGER DANGER
STRANGER DANGER If you let an unaccompanied patient take a taxi, Uber or Lyft home, you must consider the driver a responsible adult.

What do you do when a patient wants to climb into the back of an Uber, Lyft or taxi after surgery instead of riding home in the front seat with a responsible caregiver? And what if a patient tries to drive herself home, like the sly 80-year-old lady who told the nurses that her husband was at home waiting for her, but was unable to drive. She had a taxi take her to her car at the far end of the parking lot. She drove herself home, still under the influence of her auxiliary block and sedation. Her husband? No, he was not home waiting for her. He had died years before.

Some practical advice

What's a surgical facility leader to do when a patient fails to comply with the CMS requirement that all patients must be discharged in the company of a responsible adult?

If you know beforehand that a patient won't have a ride home from a friend or family member, you can reschedule the case — although some suggest you should make a plan for discharge part of pre-op preparation to avoid last-minute cancellations.

But what if the patient's dressed and ready for discharge and there's no one in the waiting room to take her home — and there's no one she can call to come get her? (Even if a loved one is waiting at home, someone still needs to accompany the patient on the ride from the facility.)

The short answer: document, document, document. Have the patient sign an against medical advice (AMA) form, write up an incident report in the patient's medical record and notify the surgeon. While documentation is an essential factor of risk mitigation, there's no guarantee that documenting that the patient failed to comply with your discharge policy will be a successful defense in a lawsuit.

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