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"Unfortunately, while health care access continues to decline, the episodes of bad outcomes in waiting rooms can only rise.
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When an ED physician was sued for allegedly missing signs and symptoms of a subarachnoid hemorrhage, the emergency medical record (EMR) documentation that was brought into evidence didn't help matters.
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A rural hospital contacts an air medical service (AMS) provider to transfer by helicopter a patient with blunt trauma. The distance between the sending and receiving facility is 75 miles. The "Life Flight" helicopter crew receives the request at 00:00, and departs their base at 00:20. They abort the flight at 00:40 hours, 10 miles from the sending facility, because the cloud ceiling drops to 700 feet, 300 feet below the Federal Aviation Administration (FAA) minimum for night flight by helicopters. The sending facility then calls another AMS provider and requests that the patient be transported to the same receiving facility.
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The case of Moses v. Providence Hospital and Medical Centers, Inc. could be the tipping point that finally puts to rest the oft-repeated mantra of the civil courts that "EMTALA is not a federal malpractice law."
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In a testicular torsion case, consistent and clear documentation by both ED nurses and physicians of the complaint, the onset of the problem and the examination of the patient placed the patient outside the timeframe where any medical intervention would have lead to a different result.
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If it ever happens to you, it's a moment you'll never forgetbeing served with papers from a patient's attorney. What do you do first?
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Your own personal notes about a patient's care. Incident reports if a patient is harmed. Information given verbally or in writing to the hospital's risk managers. Conversations or e-mails with other ED physicians about the patient's care. E-mails or conversation with physicians who don't work in your ED. Personal correspondence with non-involved parties.
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Four blood cultures come back positive, but when an ED nurse contacts the woman's husband, he says she's doing much better. Neither the ED nurse nor the physician asks the patient to return to the ED, and she returns two days later with altered mental status and partially treated meningitis. An adverse outcome results. Could your ED be sued?
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In light of the existing health care crisis, patients who leave the emergency department (ED) against medical advice (AMA) will foreseeably represent an increasing population of emergency patients. Despite this, these patients have attracted little academic interest within the emergency medicine literature.
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A recently arbitrated case presents a starting off point for a discussion regarding a commonly applied dressing and a frequently used but often misunderstood method of resolving medial malpractice disputes.
