Malpractice in child and adolescent psychiatry

Over the past 40 years, malpractice suits in child and adolescent psychiatry have gone from almost nonexistent to a source of major concern. Suits that involve child and adolescent patients remain fairly uncommon, and no damages are paid in six out of seven cases. The two cardinal principles for the clinician in avoiding and defending malpractice suits are to practice in accordance with his or her best clinical judgment and to document care, particularly in areas in which an unexpected adverse result may lead to a lawsuit. The most common areas that give rise to suit are failure to protect a child inpatient from assault or sexual interaction with another inpatient, adolescent suicide, medication errors, and issues related to child abuse. Evolving areas of malpractice law derive from incipient patient's rights legislation, development of the "direct victim" test in cases brought by third-party parents against therapists who have diagnosed children as sexually abused, implementation of new federal rules regarding privacy of records, and provision of medical information or treatment over the Internet.