ED Legal Letter
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‘Total Breakdown in Communication’ Led to Settlement of Advance Directive Case
EDs can learn a lot from this particular case about how to avoid litigation for disregarding advance directives.
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EDs Face Legal Trouble if Patient’s Advance Directive Not Followed
Emergency physicians worry about litigation because they did not save a patient’s life. However, few realize there are considerable legal risks if aggressive end-of-life care is provided against the patient’s wishes. Several recent million-dollar settlements have involved ED patients who were resuscitated or intubated against the documented wishes in their advance directives.
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Analysis: Few EMTALA Violations for Vascular-Related Issues
The most frequent vascular-related violations specifically involved lack of vascular specialist availability. Developing specialist networks and maintaining adequate call coverage can help improve patient access to emergency services.
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Lawsuits May Allege Failure to Obtain Dermatology Consults
Shutting out dermatologists can leave a gap in specialty care. This might lead to other specialists consulting and managing conditions outside their scope, or they might transfer patients to a different, distant center.
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Emergency Medicine Trainees More Likely Sued Than Radiology Trainees
Expanding the frequency and improving the quality of communication between radiologists and emergency physicians about imaging studies is always a good practice to facilitate patient care and mitigate mutual risk.
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New Data on Opioid Prescribing Guidelines and ED Practice
Opioid prescribing guidelines were linked to small changes in morphine equivalent units ordered in the ED, according to the authors of a study.
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Legal Standard of Care Is Evolving for ED Patients with Opioid Use Disorder
An ED visit from someone with opioid use disorder is an opportunity to put that person in treatment. People do not present to the ED when things are going well; they present at times of crisis. Sometimes, in that crisis, there is a wakeup. If the system offers some approaches and a treatment pathway, then everybody benefits.
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Considerable Legal Risks for EDs if Discharged Patients ‘Bounce Back’
Patients with a history of substance abuse or chronic pain were most likely to “bounce back” to the ED, according to the authors of a study.
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Discrepancies in Overread of Radiology Studies Pose Legal Risks for EDs
Some argue the costs outweigh the benefits of in-house, overnight attending radiologists. A recent paper provides new evidence of benefit to providing this service.
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Shortness of Breath in Older Adults Is Challenging Diagnosis in ED
Older adults might present with atypical symptoms, such as “just not feeling right.” Some experience a decreased sensation of dyspnea itself, so they do not even report feeling short of breath. Older patients also may present with various comorbid conditions that are causing shortness of breath, such as congestive heart failure or COPD. This can lead to misdiagnosis.