Policies And Procedures

Practice Guidelines

Postpartum Evaluation Form

Disclosure and Resolution

QI/RM Statements




Cord Blood



QMA Risk Management LLC
Victoria Grace 1/24/2012


�Wrongful abandonment appears to require two elements:

(1) Unreasonable discontinuance without consent, or with insufficient notice or inadequate excuse; AND
(2) Injury or some other detrimental result.

To avoid charges of inadequate excuse or discrimination, no excuse for withdrawal from the case should be given. It is also important to present other health care options to any discontinued patient. If the patient presents in an emergent situation, the provider has to help until an alternative source of care is available. Until emergency personnel have taken over, the midwife cannot refuse to render requested emergency assistance.�

 �Donna Moniz, Attorney at Law � 1996

Withdrawal from A Case

Example Letters of Withdrawal from a Case (adapted to the midwifery format)
[From the American Medical Association�s Medical Legal Forms with Legal Analysis]

Date: _________

Dear _______________,

I will no longer be able to provide midwifery care to you. If you require midwifery care within the next _____ days I will be available, but in no event longer than _____ days.

To assist you in (continuing to receive midwifery) (obtaining medical) care for you during this pregnancy, I will make your records available to a new (midwife) (physician) as soon as you authorize me to send them to that (midwife) (physician).

___________________, (LM) (CNM)

Date: _________

Dear _______________,

I find it necessary to inform you that I am withdrawing from further professional attendance upon you because you have persisted in refusing to follow my midwifery advice and recommendations. Since your condition during this pregnancy is now outside my midwifery scope of practice and requires medical attention, I suggest that you place yourself under the care of (an obstetrician) (a physician) without delay. If you desire I shall be available to attend you within the scope of my midwifery practice for a reasonable time after you receive this letter, but in no event more than ______ days.

This should give you ample time to select a physician of your choice from the many competent practitioners in this (city) (town) (area). With your authorization, I will make available to this physician your case history and information regarding the diagnosis (and treatment) you have received from me.

Very truly yours,

___________________, (LM) (CNM)