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Some EDs have adopted the practice of documenting overcrowding, either
by flagging patient charts or electronically recording the
information with software, to pinpoint exactly how busy—and
possibly, how understaffed—the department was on a given time
and day. But is this going to help or hurt the ED physician in the
event of a malpractice lawsuit?
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Jason Rinehart presented to the emergency department (ED) of Akron General Medical Center with nausea, vomiting, and back pain.1 No definitive diagnosis was made, and the patient was discharged with medications to control his symptoms. He died hours after discharge, and an autopsy revealed an aortic dissection as the cause of death.
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Being served with papers indicating a patient has sued you is a
shocking and upsetting moment. However, this doesn't necessarily mean
the case is valid—or even that it will go forward at all.
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The medical record is an essential component of the physician-patient relationship. It is used to document the interaction between patients, physicians, and other medical and non-medical personnel. Without the medical record, it would be impossible to coordinate appropriate, timely, and continuous medical care.
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If a man was discharged from your ED after being treated for injuries resulting from a fistfight, the ED record might state that the patient agreed to go into an anger management program and that he was given a referral to outpatient therapy. But most likely, it would neither document whether the patient had access to a gun nor other factors indicating that the potential for violence was assessed by ED staff.
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Many EDs videotape trauma cases for quality improvement and educational purposes, but some have put a stop to this practice due to concern about lawsuits.
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How can a hospital be sued by a plaintiff's attorney when the alleged negligence was committed by the independently contracted emergency physician?
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It is the duty of a physician or other health care provider dealing with a case in the ED to give the patient or, in certain circumstances (where the patient's competence is in question), the patient's family, attendants or caregivers, all necessary and proper instructions as to the care and attention to be given to the patient and the cautions to be observed following discharge from the ED.
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In what context would a court determine that a patient was not on equal footing with a provider or institution and, therefore, in a position of weakness regarding his/her ability to effectively bargain?
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If a patient is physically violent, your ED's process may involve the use of restraints and contacting security. But the appropriate action to take may be less clear if a patient seems flirtatious, exposes him or herself intentionally, or makes sexually provocative remarks.