Legal Aspects of Sport

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1 Legal Aspects of Sport Asked by the school to be the team physician Are you an employee or an independent contractor? What is your liability for coverage. Duty to defend vs. Duty to indemnify Is their a written plan of reporting scenario? Knowledge of volunteer activity by Risk Management

2 Legal Aspects of Sport Waivers: the legal validity of waivers for a medical condition (exonerating the school of liability) (ie) single organ (kidney, testicle) hearing impaired, seeing impaired Assumption of risk Can t waive a person s right to sue Waivers won t protect you from gross negligence Can one claim protection under ADA One must make reasonable accommodation Does one have a constitutional right to play a sport Is there an adaptive sport team availablt to the athlete

3 Legal Aspects of Sport IM injections before play to reduce pain

4 Informed Consent ATPC DECEMBER 2016

5 Toradol Injections prior to 2012 Player reports to training room Signs informed consent agreement or nothing at all Receives IM injection of 60 mg Toradol

6 NFL Controversy and Recommendations Ex-Players Suing N.F.L Over Use of Painkiller /football/nfl-sued-by-ex-players-overpainkiller-toradol.html?_r=0 Recommendations of the National Football League Physician Society Task Force on the Use of Toradol Ketorolac in the National Football League- SportsHealth 2012, vol 4, no. 5

7 Current Form and Process CONSENT TO TREATMENT WITH KETOROLAC TROMETHAMINE (TORADOL) I, have (Name of Student-Athlete) been asked to carefully read all of the information contained in this consent form, and to consent to the treatment described below. I have been told that I should ask questions about anything that I do not understand. I understand that the information about the treatment described in this consent form, in addition to discussions with my physicians and any other written materials they may provide, is intended to help me make an informed decision whether to voluntarily undergo treatment with Ketorolac Tromethamine. Recommended Procedure: I understand that my physician(s) have recommended that I undergo treatment with intramuscular injection(s) of Ketorolac Tromethamine (TORADOL). Desired Benefit: I understand that my physician(s) hope to achieve the following benefit(s) from the injection(s) of Ketorolac Tromethamine which include the management of pain and inflammation, although I acknowledge that the desired benefit(s) may not be achieved. Alternatives: I understand that I have the choice NOT to undergo the recommended treatment with Ketorolac Tromethamine. If I do not undergo the treatment, the condition for which I am being treated may get worse. I acknowledge that my physician(s) have discussed other alternative procedures or treatment(s) for my particular condition, if any. These alternatives may include: oral medications, corticosteroid injection(s) into the affected joint(s), surgery, and/or activity modification(s).

8 Risks: I understand that there are inherent risks/consequences in the performance of the recommended treatment. Most of these potential risks/consequences are minor or temporary, but some can be serious and, in rare cases, can cause significant harm or even death. These Risks/Consequences Include: Serious Side Effects: Other Side Effects: Heart Attack Stomach Pain Stroke Constipation High Blood Pressure Diarrhea Heart Failure from Fluid Retention Gas Kidney Problems, Including Kidney Failure Bleeding and Ulcers in the Stomach/Intestines Low Red Blood Cells (Anemia) Life-Threatening Skin Reactions Life-Threatening Allergic Reactions Liver Problems, Including Liver Failure Asthma Attacks in People Who Have Asthma Heartburn Nausea Vomiting Dizziness Get Emergency Help Right Away If You Experience Any of the Following Symptoms: Shortness of Breath or Trouble Breathing Chest Pain Weakness in One Part or Side of Your Body Slurred Speech Swelling of the Face or Throat

9 MY SIGNATURE BELOW ACKNOWLEDGES THAT: 1. I have read (or had read to me), understand and agree to the statements set forth in this consent form. 2. A physician or physician s representative has explained to me all information referred to in this consent form. I have had an opportunity to ask questions and my questions have been answered to my satisfaction. 3. All blanks or statements requiring insertion or completion were filled in before I signed. 4. No guarantees or assurances concerning the results of the treatment(s) have been made. 5. I am signing this consent voluntarily. I am not signing due to any coercion or other influence. 6. I understand that I can withdraw my consent at any time prior to the treatment. 7. I hereby consent and authorize my physician(s)) and/or those associates, assistants and other health care providers designated by my physician(s) to perform the recommended treatment described above. Date Time Signature of Student-Athlete Witness I have explained to the patient signing above all of the information contained in this consent form. I have given no guarantee or assurance as to the results that may be obtained. Date Time Signature of Physician or Physician s Representative

10 Required components of informed consent The Basic Features of Everyday Informed Consent The physician (not a delegated representative) should disclose and discuss: The diagnosis, if known The nature and purpose of a proposed treatment or procedure The risks and benefits of proposed treatment or procedures Alternatives (regardless of costs or extent covered by insurance) The risks and benefits of alternatives The risks and benefits of not receiving treatments or undergoing procedures Source: AMA 1998

11 Legal Aspects of Sport Joint injections before competitive play (fingers/ clavicle/ AC joint) Documented informed consent Short and long term benefits (who benefits?) Reasonable alternative treatment Assumption of risk

12 Legal Aspects of Sport Informed Consent Athletes under age 18 Do athletes give you consent in Emergency situations?

13 POLICY: Intramuscular (IM) or Oral TORADOL (Ketoprofen) Administration University of Minnesota

14 Purpose The indications : to help reduce pain from musculoskeletal injuries to help reduce pain from medical conditions (such as migraine headache, kidney stone, etc.).

15 Policy Toradol is contraindicated : a history of gastrointestinal bleeding and/or ulcers, inflammatory bowel disease renal impairment bleeding disorders liver disease hypertension intolerance to oral NSAIDs

16 Policy Toradol may be administered only after informed consent (including education about the risks and benefits of the treatment) consent should be documented in EMR Repeat administration of Toradol: SA must be actively engaged / compliant with all recommended rehabilitation and treatments.

17 Policy IM Toradol will only be considered for use during competition if the SA is unable to take Oral Toradol.

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