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Trouble in the Office: Liability Issues in Ambulatory Care


  • Jan M. Kriebs CNM, MSN

    Corresponding authorSearch for more papers by this author
    • Jan M. Kriebs, CNM, MSN, FACNM, is Assistant Professor and director of the midwifery practice at the University of Maryland. She is the coauthor of Varney's Midwifery and the Pocket Midwife. She currently serves as the Region IV representative on the ACNM Fellowship Board of Governors.

Jan M. Kriebs, CNM, MSN, 4th Floor, 405 W. Redwood Street, Baltimore MD 21201. E-mail:


Most clinicians are keenly aware of the liability risks associated with adverse birth outcomes for mother and/or infant. This level of awareness and concern also needs to extend to the day-to-day management of office practice. Clinicians who care for healthy women and their families may see abnormalities infrequently. The low yield of abnormal results means that close monitoring is essential to prevent overlooking the rare abnormal finding. This article focuses on three areas of liability risk for midwives and others who practice in the ambulatory setting: 1) inadequate tracking of test and referral results, 2) failure to diagnose, and 3) poor communication. Although none of these issues are limited to the ambulatory setting, only office practice is addressed in this article.