ED Legal Letter
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Procedure-related Complication? Expect Supervising EP to Be Named
Lack of adequate supervision and procedure proficiency are the two most common allegations plaintiffs level in such cases.
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ED Protocols Might Add to Liability Exposure of Low-risk Chest Pain
Researchers set out to understand how EPs determine risk and decide to admit patients with low-risk chest pain. They surveyed dozens of emergency medicine residents and faculty about their perceived risk of various scenarios and an admission decision. Physicians used qualitative terms in ways that are different from how those terms are used in typical conversation. This can lead to miscommunication during shared decision-making processes. Investigators discovered that EPs considered any probability greater than 1% for acute coronary syndrome enough of a risk to warrant admission.
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In Missed Appendicitis Cases, Presentations Are Early, Atypical
The authors of a recent study discovered that a triage chief complaint that was less indicative of appendicitis correlated with a higher rate of missed appendicitis in one pediatric ED. The researchers concluded that their findings suggest the potential impact of anchoring bias by a triage chief complaint when trying to diagnose appendicitis. However, one analyst advises that the results should be interpreted with caution because the study authors did not look for the denominator of chief complaints.
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Analysis of Closed Malpractice Cases Reveals Lost Chances to Avoid Problems
A recent analysis of several dozen closed ED malpractice claims revealed failed opportunities to avert diagnostic errors and bad outcomes. Investigators analyzed 62 claims that closed between 2008 and 2015 at a large malpractice insurer, discovering some common final diagnoses in the cases in which errors were made.
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Multiple Theories of Liability Regarding ED Violence
An expert shares insights on third-party violence and hospital liability.
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Hospitals Sued for False Imprisonment Due to Involuntary Holds
Recent lawsuits allege that patients who sought help at an ED for clinical reasons were held involuntarily because they were at homicidal/suicidal risk.
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No One Saw ED Nursing Notes? Jury May Not Like It
An ED patient was very specific during the nursing evaluation of his chest pain: It worsened during exertion. He also reported an extensive family history of cardiac problems. Both worrisome pieces of information were carefully documented in the ED nursing notes. However, they were mentioned nowhere in the EP’s documentation. This became a key issue during malpractice litigation.
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ED Misdiagnosis Case Alleged Failure to Use Decision Tool
Failure to obtain an ordered ECG, failure to use a decision tool, and anchoring bias were factors in a recent ED malpractice claim alleging missed pulmonary embolism.
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Is ED Patient’s Conduct a Viable Defense Strategy?
The plaintiff in one malpractice claim had been seen in the ED for injuries he sustained while fleeing the scene of a crime. However, it was unclear whether a jury would ever get to hear about the patient’s criminal conduct.
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Study: Electronic Medical Record Design Flaws Can Hurt Patients
Patients can be harmed when there are problems in electronic medical records related to how information is conveyed to other providers and how test results get displayed, according to a recent study.