The University of Kentucky (UK) Healthcare Risk Management Committee (UKHC RMC) administers a self- insurance program to protect its physicians from medical malpractice claims, which could result from their participation in the conduct of clinical studies. 

UKHC RMC review is required for all clinical studies that are investigator initiated, studies where the sponsor does not provide indemnification or limits time or dollar amount of indemnification for medical malpractice liability, with the exception of studies that meet the exclusion criteria detailed below. UKHC RMC review assesses the medical malpractice liability for conducting a clinical study. UKHC RMC review also determines whether the protection of this program will be given to a clinical researcher for medical malpractice claims that may arise from participation in a particular clinical study. Medical malpractice liability protection is contingent on UKHC RMC review and approval of proposed clinical studies.  

It is the responsibility of the principal investigator to initiate the non-indemnification review process for all eligible clinical trials, as defined below.

If an investigator does not forward a study for review that qualifies for Inclusion in the Indemnification Process and a problem occurs and a claim is made, the University is not obligated to defend the investigator. 

NOTE: Contact Ellen Hartman (ellen.hartman@uky.edu or 859-218-6610) for any questions regarding protocol eligibility or the non-indemnification submission/review process. 

I. Features of Clinical Studies requiring UKHC RMC Review 

Inclusion criteria for UKHC RMC Review:

1. All non-indemnified human clinical research that is not IRB exempt or expedited regardless of the funding source. Type of IRB review should be determined by the reviewing IRB rather than the relying IRB. This means that if UK IRB is ceding reliance to an external/ central IRB, then the external/ central IRB type of review is what determines if non-indemnification review is needed. 
2. Surveys and medical record chart reviews are included if they require Full IRB review.
3. All human clinical research for which a drug, device, investigative procedure or financial support are provided by an external sponsor, but full indemnification is not provided (i.e. limitation on time or dollar amount). This will require a review of the CTA (Clinical Trial Agreement).  
4. All VA cooperative studies utilizing UK services (i.e. VA Merit Awards).
5. Any study utilizing AI (Artificial Intelligence).
6. Studies in which there is no physical risk to the subject but there could be risk to the institution based on social, political or ethical issues. 

Exclusion criteria:

The following studies do not require review by UKHC RMC:

1.  Industry supported clinical studies that provide full indemnification. 
2. IRB review was Expedited 
3. IRB review was Exempt

Expedited Review:

Low risk studies may qualify for expedited review by RMC.

II. Instructions for submission: 

The Principal Investigator (PI) is responsible for reviewing the inclusion/exclusion criteria for the review process. The PI can ask for legal advice on the requirements by contacting Ella Dunbar at ella.dunbar@uky.edu

If a study qualifies for review then the PI should initiate the process described below: 

To submit an application for review, send the following items to nonindemnification@uky.edu:

1. Completed Clinical Project Risk Assessment Evaluation Form (sections I, II and III)
2. Research Description (Form B) or study protocol 
3. IRB Approval letter(s) from all reviewing IRBs. This includes UK eIRB, Central IRBs (i.e., CIRB, Advarra, Western, etc.) as applicable 
4. IRB Approved Consent document(s) 
5. Clinical Trial Agreement (CTA) or study contract for sponsored/ externally funded studies if no indemnification is provided or if indemnification is limited.  

After the UKHC RMC review, the PI will receive notification of approval. Upon receipt of this approval, the PI may proceed with the steps necessary to initiate the protocol.  

Even though IRB approval has been obtained, if the Risk Management Committee has not given approval, THE STUDY MUST NOT BE STARTED.