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Whenever an individual enters an ambulance (or medical helicopter) owned and operated by a hospital, the federal government deems the person to have come to the hospitals emergency department for purposes of triggering the hospitals obligations under the Emergency Medical Treatment and Labor Act (EMTALA).1
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Not surprisingly, if a consultant is unavailable and a bad outcome occurs, the emergency physician (EP) is potentially a defendant in any subsequent medical malpractice lawsuit, says Damian D. Capozzola, JD, an attorney with Crowell & Moring, LLP, in Los Angeles, CA.
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Forty percent of hospital readmissions within 30 days come through the ED, according to an analysis of data from the Healthcare Cost and Utilization Project state inpatient and ED databases on 4,028,555 patients discharged from acute care hospitals in California, Florida, and Nebraska between July 1, 2008, and September 31, 2009.1
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If an emergency physician (EP) decided not to prescribe opioids for a patient after learning from a prescription drug monitoring database that the patient had just received a two-week prescription for the same medication from another provider, could the EP be successfully sued for failure to treat?
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Lab work was ordered for a patient who presented to an ED after having experienced her first seizure, but it wasnt reviewed until after the patient was discharged.
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If a patient deteriorates because of a transport and later sues, concerns will inevitably arise that the emergency physician (EP) didnt stabilize the patient prior to transport, or that the patient should not have been transferred, says John Tafuri, MD, FAAEM, regional director of TeamHealth Cleveland (OH) Clinic and chief of staff at Fairview Hospital, also in Cleveland.
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Informed refusal is the antithesis of informed consent, a natural extension of the doctrine. Informed consent is discussed in great detail in the medical, legal, and risk-management literature; whereas informed refusal has received less attention.
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Was a patient transferred without being intubated first because the emergency physician (EP) wasnt comfortable managing a difficult airway?
